Intergenerational Relations and Well-being Among Older Middle Eastern/Arab American Immigrants During the COVID-19 Pandemic.

This study aimed to examine the consequences of COVID-19 socialization restrictions on familial and social support systems of older Middle Eastern/Arab immigrants in Michigan, home to the largest, most visible concentration of Middle Eastern/Arab Americans in the United States. Six focus group (N = 45) interviews were conducted with Middle Eastern/Arab American immigrants aged 60 and older to assess difficulties faced during the pandemic as it related to familial, social, and medical care. Inductive analysis identified two major themes to advance meanings of intergenerational relations among older immigrants (a) the breakdown of family relations, which describes a shift in both the experience and expectations of intergenerational relations in Middle Eastern/Arab families; and (b) cultural sources of increased stress, illustrating how the pandemic interfered with valued family interactions to affect well-being. These findings indicated social and cultural sources of heightened stress linked to shifts in intergenerational relations among Middle Eastern/Arab American older immigrants.

Mothers' Breastfeeding Self-Efficacy after a High-Risk or Normal Pregnancy: A Greek Longitudinal Cohort Study.

BACKGROUND: the objective of this longitudinal study (from pregnancy to the end of the sixth month postpartum) is to elucidate the association between maternal self-efficacy, defined as a mother's confidence in her ability to breastfeed, and breastfeeding outcomes. METHODS: This prospective cohort study was conducted among high-risk pregnant women (including those with conditions such as gestational diabetes, hypertension, pre-eclampsia, and other pathological medical conditions) and normal-risk pregnant women in Greece. The high-risk group included 164 women, while the normal-risk group comprised 154 women. Data were collected using validated psychometric scales, including the Breastfeeding Self-Efficacy Scale-Short Form, State-Trait Anxiety Inventory, Edinburgh Postnatal Depression Scale, Maternal Antenatal Attachment Scale, and Iowa Infant Feeding Attitude Scale. RESULTS: Higher maternal self-efficacy was significantly associated with a longer duration and greater exclusivity of breastfeeding. A statistically significant relationship between the type of breastfeeding and the degree of breastfeeding self-efficacy was observed at multiple postpartum milestones: in the first and third 24 h postpartum, and at the end of the sixth week, third month, and sixth month postpartum. CONCLUSION: The findings underscore the critical role of maternal self-efficacy in breastfeeding success, influenced by individual psychological factors and broader socio-cultural contexts. Strengthening maternal self-efficacy is essential for improving breastfeeding outcomes.

Factors influencing breast cancer screening practices among women worldwide: a systematic review of observational and qualitative studies.

BACKGROUND: The variation in breast cancer incidence rates across different regions may reflect disparities in breast cancer screening (BCS) practices. Understanding the factors associated with these screening behaviors is crucial for identifying modifiable elements amenable to intervention. This systematic review aims to identify common factors influencing BCS behaviors among women globally. METHODS: Relevant papers were sourced from PubMed, Scopus, Embase, and Google Scholar. The included studies were published in English in peer-reviewed journals from January 2000 to March 2023 and investigated factors associated with BCS behaviors. RESULTS: From an initial pool of 625 articles, 34 studies (comprising 29 observational and 5 qualitative studies) with 36,043 participants were included. Factors influencing BCS behaviors were categorized into nine groups: socio-demographic factors, health status history, knowledge, perceptions, cultural factors, cues to action, motivation, self-efficacy, and social support. The quality appraisal scores of the studies ranged from average to high. CONCLUSIONS: This systematic review highlights factors pivotal for policy-making at various levels of breast cancer prevention and assists health promotion professionals in designing more effective interventions to enhance BCS practices among women.

Invesigate How Cultural and Socioeconomic Factors Influence Oral Cancer Prevention Behaviors, Screening Uptake, and Treatment Outcomes.

Background: Oral cancer is a significant global health issue, with prevention and early detection being pivotal for improved outcomes. This study investigates the impact of cultural and socioeconomic factors on oral cancer prevention behaviors, screening participation, and treatment outcomes. Materials and Methods: A cross-sectional study design was employed, involving a sample size of 1,000 participants. Participants were recruited through stratified sampling to ensure cultural and socioeconomic diversity. Statistical analyses, including logistic regression, were used to explore associations between factors and outcomes. Results: The study revealed multifaceted influences of cultural and socioeconomic factors on oral cancer-related aspects. Cultural factors significantly influenced prevention behaviors, with participants from certain cultural backgrounds exhibiting higher rates of tobacco use and lower rates of dietary adherence). Socioeconomic status played a role in screening uptake, with individuals from lower income brackets less likely to undergo regular screenings. Conclusion: Cultural and socioeconomic factors have a substantial influence on oral cancer prevention behaviors, screening participation, and treatment outcomes.

Investigating the Prevalence of Menopausal Symptoms and Medico-Social Dimensions of Menopause in Rural Puducherry, India: A Cross-Sectional Analytical Study.

Introduction Globally, the health of women has been of great concern for healthcare providers for the past many years. However, the concern is limited to maternal and adolescent health and the life course approach is lagging. Thus, a need was felt to study the changes after menopause and its influential factors by determining the prevalence of menopausal symptoms and medico-socio-cultural dimensions of menopause among perimenopausal and early postmenopausal women. Methodology A cross-sectional analytical study was conducted from February 2014 to April 2015 in a rural area of Puducherry among 148 women in perimenopausal and early postmenopausal stages by complete enumeration using a pre-tested semi-structured questionnaire. Prevalence was expressed as frequency with percentage and the chi-square test was used to find the association among the study variables. Results The prevalence of menopausal symptoms was in 143 (96.6%) women. Backache (62.3%) was found to have a higher prevalence. Physical symptoms (93.2%) were most prevalent. Of the women, 95% were affected by mild symptoms. Regarding medical and social dimensions of menopausal symptoms, socioeconomic status to vasomotor, age of menarche to physical, marital status, and abortion status to sexual symptoms were significant. A positive correlation was seen among the four menopausal symptom domains, except for vasomotor to sexual symptoms. Conclusion Increased prevalence of menopausal symptoms is seen among menopausal women who are unaware of seeking medical advice. Additional emphasis should be placed on implementing programmes that will critically help to sensitize and intensify the awareness of menopause among women in India.

Creating culturally-informed protocols for a stunting intervention using a situated values-based approach (WeValue InSitu): a double case study in Indonesia and Senegal.

International development work involves external partners bringing expertise, resources, and management for local interventions in LMICs, but there is often a gap in understandings of relevant local shared values. There is a widespread need to better design interventions which accommodate relevant elements of local culture, as emphasised by recent discussions in global health research regarding neo-colonialism. One recent innovation is the concept of producing 'cultural protocols' to precede and guide community engagement or intervention design, but without suggestions for generating them. This study explores and demonstrates the potential of an approach taken from another field, named WeValue InSitu, to generate local culturally-informed protocols. WeValue InSitu engages stakeholder groups in meaning-making processes which 'crystallize' their envelope of local shared values, making them communicable to outsiders.Our research context is understanding and reducing child stunting, including developing interventions, carried out at the Senegal and Indonesia sites of the UKRI GCRF Action Against Stunting Hub. Each national research team involves eight health disciplines from micro-nutrition to epigenetics, and extensive collection of samples and questionnaires. Local culturally-informed protocols would be generally valuable to pre-inform engagement and intervention designs. Here we explore generating them by immediately following the group WeValue InSitu crystallization process with specialised focus group discussions exploring: what local life practices potentially have significant influence on the environments affecting child stunting, and which cultural elements do they highlight as relevant. The discussions will be framed by the shared values, and reveal linkages to them. In this study, stakeholder groups like fathers, mothers, teachers, market traders, administrators, farmers and health workers were recruited, totalling 83 participants across 20 groups. Themes found relevant for a culturally-informed protocol for locally-acceptable food interventions included: specific gender roles; social hierarchies; health service access challenges; traditional beliefs around malnutrition; and attitudes to accepting outside help. The concept of a grounded culturally-informed protocol, and the use of WeValue InSitu to generate it, has thus been demonstrated here. Future work to scope out the advantages and limitations compared to deductive culture studies, and to using other formative research methods would now be useful.

Marital Quality and Depressive Symptoms Among Older Hispanic Adults in the United States.

OBJECTIVES: Despite the cultural importance of marriage as a social support system and its well-established link to mental health, older Hispanic adult populations, which are the largest racial and ethnic minoritized groups, remain understudied. The current study examined how positive and negative dimensions of marital quality are associated with depressive symptoms. METHODS: Data from Hispanic adults aged 51 years and older (n = 1,012) were obtained from the 2016 and 2018 Health and Retirement Study waves. The Center for Epidemiological Studies-Depression scale (0-8 symptoms) was modeled as a function of positive and negative marital quality measures (1-4), as well as the relevant covariates. RESULTS: Results from a negative binomial regression model showed that a 1-unit change in positive and negative marital quality was associated with a 23.61% reduction and a 23.74% increase, respectively, in depressive symptoms. The interaction terms with marital quality and gender, as well as marital quality and religion, were not statistically significant. DISCUSSION: In the United States, a large percentage of older Hispanic adults are immigrants, and their extended family tends to reside in their countries of origin. As such, older Hispanic adults may have smaller social networks, and marital quality most likely represents a culturally important social support network in later life. Significant associations between depressive symptoms and marital quality among older Hispanic adults should receive more attention in family and public health policy discussions, particularly given the increasing diversity in U.S. society.

The Socio-Cultural Factors Influencing the Level of Public Compliance with Infection Control Measures during the 1918 Influenza Pandemic in Italy: A Historical Approach.

During health emergencies, non-pharmaceutical interventions (NPIs) are adopted in various combinations until a vaccine can be produced and widely administered. Containment strategies, including the closure of schools, churches, and dance halls; banning of mass gatherings; mandatory mask wearing; isolation; and disinfection/hygiene measures, require reasonable compliance to be successfully implemented. But what are the most effective measures? To date, few systematic studies have been conducted on the effects of various interventions used in past epidemics/pandemics. Important contributions to our understanding of these questions can be obtained by investigating the historical data from the great influenza pandemic of 1918, an event widely considered one of the greatest natural disasters in human history. Taking on particular importance is the study of the possible role played by the behaviour of the population and the lack of public obedience to the non-pharmaceutical interventions in a Mediterranean country like Italy-one of the most affected countries in Europe-during that pandemic, with special attention paid to the weight of the socio-cultural factors which hindered the ultimate goal of containing the spread of the virus and preventing excess deaths in the country.

Transforming Dental Care in Saudi Arabia: Challenges and Opportunities.

This comprehensive review examines the dental healthcare system in Saudi Arabia, tracing its evolution, current status, and persisting challenges. The system has evolved significantly due to government initiatives and technological integration, yet it grapples with issues like professional shortages, financial constraints, and disparities in access. Despite improvements in accessibility, geographic and socio-economic disparities persist, and oral health promotion remains limited. The integration of technology faces resistance, and specialized care for people with disabilities requires targeted strategies. Cultural and social factors influence oral health, and the system's response to the COVID-19 pandemic showcases adaptability and patient-centered approaches. Addressing these challenges is crucial for ensuring equitable and effective oral health service delivery in Saudi Arabia.

Knowledge, attitude, and practice of breast self-examination is associated with general self-care and cultural factors: a study from Tamil Nadu, India.

AIM: Breast cancer is the most prevalent type of cancer among women. One form of care related to early detection of breast cancer is breast self-examination (BSE). However, evidence on knowledge, attitude, and practice (KAP) of BSE and its determining factors are minuscule in an Indian context. Therefore, the present study primarily examined the prevalence of KAP of BSE. Further, its association with general self-care and cultural factors was determined. METHODS: This cross-sectional study obtained data from 412 women (Mn age = 26.63) from two rural localities of Vellore district, Tamil Nadu, India. Self-reported questionnaires of KAP of BSE, self-care, and cultural factors were applied. Statistical analyses include independent sample t-test and binomial logistic regression. RESULTS: The majority of the sample had inadequate knowledge (58%), unfavourable attitudes (73.8%), and poor practice (89.6%) of BSE. The general self-care among the sample was moderate. Self-care was found to be a significant predictor of knowledge (b = 0.07, p < .05) and attitude (b = 0.092, p < .05) toward BSE. Shyness was identified as a negative predictor of KAP. Discouraged breast health discussions predicted inadequate knowledge, and not being educated by family/friends had a negative impact on knowledge and practice. A preference for same-gender physicians led to an unfavourable attitude toward BSE. CONCLUSION: The observed negative trends in KAP of BSE are concerning. The results imply that girls and women should be educated and encouraged to practice BSE and promote self-care behaviours. At the same time, efforts to reduce cultural barriers may be helpful to promote the KAP of BSE.

Examining the Role of Cultural and Family Factors in Substance Use Risk Among Indian American Youth.

INTRODUCTION: Although Indian Americans constitute the second-largest immigrant group in the United States, there is a paucity of information about Indian American youth, particularly with respect to substance use risk. We examined the relationship of social factors to permissive substance use beliefs (a proxy for substance use risk since they can lead to adulthood substance use and misuse) and family functioning. METHODS: The study used structural equation modeling to examine the prevalence of permissive substance use beliefs in a sample of Indian American youth ages 12-17 (N = 223) and examined the degree to which discrimination, bicultural identity integration, and endorsement of the model minority stereotype were associated with permissive substance use beliefs. RESULTS: Findings suggest that bicultural identity integration (B = 0.267 [SE = 0.112], p = 0.01) and discrimination (B = 0.294 [SE = 0.087], p = 0.001) are positively associated with permissive substance use beliefs. Bicultural identity integration (B = 0.415 [SE = 0.090], p = 0.0001) was positively associated with family support (B= -0.329 [SE = 0.108], p = 0.002) which, in turn, was associated with less permissive substance use beliefs. In contrast, endorsement of the model minority stereotype (B = 0.351 [SE = 0.090], p = 0.001) was positively associated with family closeness (B = 0.232 [SE = 0.927], p = 0.01) which, in turn, was associated with family support and then with less permissive substance use beliefs. CONCLUSIONS: Discrimination and bicultural identity integration emerged as key constructs related to substance use risk among Indian American youth. These youth could benefit from culturally appropriate prevention programming that addresses the negative impact of discrimination and its effect on permissive substance use beliefs and highlights protective factors.

Salt Intake of Children and Adolescents: Influence of Socio-Environmental Factors and School Education.

(1) Background: The aim of this study was to investigate the salt consumption by children and adolescents from the Silesian Province (Poland), taking into account the region's dietary traditions and the age of the students+. (2) Methods: 300 students aged 10-18 from different types of schools were enrolled in the study and divided into groups in terms of school, sex, and the state of their nutrition. A survey questionnaire about dietary habits, including the frequency and serving size with respect to 12 salty products, was used. On the basis of the frequency and the amount of consumed products, as well as the data on salt content, the amount of total daily intake of salt was estimated. (3) Results: The mean daily intake of salt by children and adolescents was 1.083 g (0.433 g of sodium); children aged 10-12 consumed the highest amount of salt (1.296 g/day) compared to pupils aged 13-15 (1.131 g of sodium) and adolescents aged 16-18 (0.863 g/day). (4) Conclusions: With age, as a result of various factors, the consumption of salt declines. The parents' impact and the familial socio-environmental factors begin to wane, and other factors start to have influence, e.g., school education of a healthy lifestyle and health behavior of peers.

Do pre-transplant cultural factors predict health-related quality of life after kidney transplantation?

BACKGROUND: Post-transplant health-related quality of life (HRQOL) is associated with health outcomes for kidney transplant (KT) recipients. However, pretransplant predictors of improvements in post-transplant HRQOL remain incompletely understood. Namely, important pretransplant cultural factors, such as experience of discrimination, perceived racism in healthcare, or mistrust of the healthcare system, have not been examined as potential HRQOL predictors. Also, few have examined predictors of decline in HRQOL post-transplant. METHODS: Using data from a prospective cohort study, we examined HRQOL change pre- to post-transplant, and novel cultural predictors of the change. We measured physical, mental, and kidney-specific HRQOL as outcomes, and used cultural factors as predictors, controlling for demographic, clinical, psychosocial, and transplant knowledge covariates. RESULTS: Among 166 KT recipients (57% male; mean age 50.6 years; 61.4% > high school graduates; 80% non-Hispanic White), we found mental and physical, but not kidney-specific, HRQOL significantly improved post-transplant. No culturally related factors outside of medical mistrust significantly predicted change in any HRQOL outcome. Instead, demographic, knowledge, and clinical factors significantly predicted decline in each HRQOL domain: physical HRQOL-older age, more post-KT complications, higher pre-KT physical HRQOL; mental HRQOL-having less information pre-KT, greater pre-KT mental HRQOL; and, kidney-specific HRQOL-poorer kidney functioning post-KT, lower expectations for physical condition to improve, and higher pre-KT kidney-specific HRQOL. CONCLUSIONS: Instead of cultural factors, predictors of HRQOL decline included demographic, knowledge, and clinical factors. These findings are useful for identifying patient groups that may be at greater risk of poorer post-transplant outcomes, in order to target individualized support to patients.

Neurodevelopmental assessments used to measure preschoolers' cognitive development in Latin America: a systematic review.

OBJECTIVE: The objective of this study was to systematically review the standardized neurodevelopmental assessments used to study preschool-aged children's cognitive development in Spanish-speaking Latin America. METHODS: The authors systematically searched PubMed, PsycINFO, and ERIC databases for peer-reviewed articles from Spanish-speaking Latin American countries. Articles were included if they measured cognitive development among children aged 2-6 years using at least one standardized assessment tool; 97 articles were included and reviewed in accordance with PRISMA guidelines to assess their use of these tools. RESULTS: Ninety-seven studies across 13 countries used a total of 41 assessments to measure cognitive development; most widely used were the Wechsler intelligence scales (n = 46/97), particularly the Wechsler Preschool and Primary Scale of Intelligence and Wechsler Intelligence Scale for Children (n = 23 and 29, respectively). Other common assessments included the McCarthy Scales of Children's Abilities (n = 9), Raven's Progressive Matrices (n = 9), Child Neuropsychological Assessment (n = 8), and Peabody Picture Vocabulary Test (n = 7). In regions where normative data for a given assessment were unpublished, authors commonly used norms from the United States, Mexico, or Spain or did not report standard scores in their analyses. CONCLUSIONS: The wide range of tools used in these studies presents a challenge for generalizing results when measuring the neurodevelopment of Latin American preschool-aged children. The low availability of normative data for specific regions reveals concerns if some tools are culturally and linguistically appropriate even when Spanish is a common language, particularly in low-resource settings. Future work to forge greater consistency in the use of validated measures, clarity in reporting research methods, and publication of regional normative data would benefit the field.

Is White Evangelical Antistructural Theology Related to Poor Health Outcomes?

Policy Points White evangelical theology has an "antistructural" component. Counties with a high percentage of White evangelicals have higher mortality rates and more persons with fair/poor health. The potential influence of antistructural components in evangelical theology on decision making and resource allocation and, ultimately, the length and quality of life of community members presents a point of intervention for religious leaders and policymakers to improve population health. CONTEXT: Structural factors are important determinants of health. Because antistructuralism has been identified as a tenet of White evangelical theology, we explored if there is an association of the percentage of White evangelicals in a US county with two county health outcomes: premature mortality and percentage of fair/poor health. METHODS: Regression analysis was performed with data from 2022 County Health Rankings and the American Value Atlas from the Public Religion Research Institute. FINDINGS: Every percent of evangelicals in a county is associated with 4.01 more premature deaths per 100,000 population and 0.13% fair/poor health. After controlling for income, education, political ideology, and county school funding adequacy (a proxy for antistructuralism), the associations remain positive and significant. CONCLUSIONS: We hope these findings could inform dialogue and critical analysis among individuals of evangelical faith, particularly fundamental and Pentecostal subsets, regarding a belief system that is inclusive of individual dimensions and health-promoting structural policies like school funding, Medicaid expansion, and antipoverty programs. These findings also demonstrate the importance of considering cultural factors like religion and political ideology in population health outcomes research.

Why Gerontology Needs Anthropology: Toward an Applied Anthropological Gerontology.

In this essay, we argue that gerontologists should increase their engagement with anthropologists to increase transdisciplinary collaboration, fulfill the interdisciplinary promise of gerontology as a field, and to ensure the work of anthropologists is formed by, and employed in, situations where meaningful engagement with practitioners and policymakers can lead to social change. Anthropology is the study of human societies in historical, biological, and sociocultural context, comprising a holistic field of study that can contribute unique methods, approaches, and theories to the field of gerontology. Although increasing amounts of anthropological scholarship have focused on older adulthood, this critical work of anthropologists still needs to be utilized by those in positions of power to enact change. Furthermore, the work conducted by anthropologists of aging has not consistently been recognized as anthropological scholarship. Therefore, a notable gap exists between the promise of the anthropology of aging and the utilization of the field, its findings, and engagement with the broader gerontological academy. As such, the contributions of anthropology to aging scholarship and the resulting reduction in inequities in the aging experience are not always adequately recognized. By examining the history of anthropology's engagement with aging and the lifecourse, we argue for a more applied anthropological gerontology. We conclude with a call to action to ensure that anthropological gerontology is seen as a fundamental branch of scholarship, both within anthropology and gerontology, which can be used to improve the lived experiences of older adults globally.

The primacy of ocular perception: a narrative review on the role of gender identity in eating disorders.

BACKGROUND: Phenomenological research has enriched the scientific and clinical understanding of Eating Disorders (ED), describing the significant role played by disorders of embodiment in shaping the lived experience of patients with ED. According to the phenomenological perspective, disorders of embodiment in ED are associated with feelings of alienation from one's own body, determining an excessive concern for external appearance as a form of dysfunctional coping. The purpose of the present narrative review is to address the role of gender identity as a risk factor for EDs in the light of phenomenological approaches. METHODS: Narrative review. RESULTS: The current study discusses the interplay between perception, gender identity, and embodiment, all posited to influence eating psychopathology. Internalized concerns for body appearance are described as potentially associated with self-objectification. Furthermore, concerns on body appearance are discussed in relation to gendered social expectations. The current review also explores how societal norms and gender stereotypes can contribute to dysfunctional self-identification with external appearances, particularly through an excessive focus on the optical dimension. The socio-cultural perspective on gender identity was considered as a further explanation of the lived experience of individuals with ED. CONCLUSIONS: By acknowledging the interplay between these factors, clinicians and researchers can gain a deeper understanding of these disorders and develop more effective interventions for affected individuals. LEVEL OF EVIDENCE: Level V narrative review.

Examining Utilization of Formal Supports and Related Impacts on Overall Well-Being Among East Asian American Family Caregivers of Persons With Dementia: A Mixed-Methods Study.

BACKGROUND AND OBJECTIVES: Although East Asian American family caregivers are known to underutilize formal support services, there is a lack of evidence regarding the associations of formal service utilization with caregivers' well-being. This study examined the prevalence of different types of home-and community-based formal service utilization among Korean and Chinese American family caregivers of persons with dementia and how utilization of such services was associated with their well-being. We also explored their overall experience in accessing and utilizing formal dementia support services and programs. RESEARCH DESIGN AND METHODS: We employed a convergent mixed-methods study design. In a convenience sampling method, we recruited 62 family caregivers. Logistic regression and thematic analysis were utilized to analyze data. RESULTS: The results showed in-home services were mostly utilized among family caregivers of these ethnic groups. Out of 9 different support services, those who utilized nutrition programs and case management were more likely to report higher overall well-being. Four themes were developed: (1) awareness of formal support services but uncertainty on how to access them, (2) language barriers imposing additional challenges in accessing formal support services, (3) traveling to access culturally appropriate services, and (4) desire for culturally tailored medical and long-term care services. DISCUSSION AND IMPLICATIONS: Findings from this study suggest the importance of case management services to overcome barriers to accessing and utilizing a wide range of formal support services and provision of culturally appropriate food in formal support services to increase East Asian American family caregivers' utilization of long-term care services.