Breaking the Silence on Food Risks for Elderly People Living Alone.

(1) Background: Currently, numerous qualitative research studies on food and its influence on health are being conducted. In qualitative research, data are obtained by analyzing participants' responses. However, silence during conversation has been little studied. The aim of this study was to interpret the silences in the narratives of elderly people living alone about the potential risks of not keeping a healthy diet. (2) Methods: This is a descriptive and interpretative observational study under the qualitative research paradigm following a phenomenological and ethnographic perspective. The study was developed in two phases with people over 65 years old. In the first phase, from June 2021 to January 2022, 90 interviews, 12 life history analyses, 58 food diaries and 51 free listings (cultural domain technique) were conducted. In the second phase, from March to June 2022, 3 participatory workshops and 24 pile sorts (cultural domain technique) were conducted, as well as 3 focus groups. Only data from participants over 65 years old living alone are analyzed in this paper. The ATLAS-ti (Version 22) qualitative analysis software was used for coding and data analysis. (3) Results: The results show that elderly people living alone would sometimes remain silent during the various conversations conducted within the research. This silence reflects their desire to downplay the risks to their health from not eating well due to their unwanted loneliness. The people participating in our research had chronic health problems, financial insecurity and emotional problems. (4) Conclusions: We concluded that elderly people living alone are unable to maintain a healthy diet because they downplay their risk of malnutrition. This mindset is caused by their loneliness and bolstered by a situation of learned helplessness and social injustice.

Categorizations of Trust and Distrust in the Classifications and Social Representations of Food among Pregnant and Breastfeeding Women in Spain-Applying the Cultural Domains' Pile Sort Technique.

Food is fundamental in the decision making of pregnant and breastfeeding women to care for their own health and that of their child. In this paper, we explore some common food classification systems and certain attributes assigned to these categories, represented by values of trust and distrust. This study is based on an interdisciplinary research project in which we analysed discourses and practices regarding the dietary intake of pregnant and breastfeeding women in relation to the presence of chemical substances in foods. The results presented are part of the second phase of this research where we explored the results of our analysis of the pile sort technique based on an analysis of cultural domains in order to explore the categories and semantic relations among terms regarding trust and distrust in food. This technique was applied to the 62 pregnant and breastfeeding women of Catalonia and Andalusia. These women also participated in eight focus groups that provided information and narratives enabling us to analyse the meanings of the associative subdomains obtained in the pile sorts. They classified different foods and assigned certain attributes to them according to the level of trust and mistrust, providing a social representation of food risks. The mothers expressed great concern about the quality of the food they consume and about its possible effects on their own health and on that of their child. They perceive that an adequate diet is one based on the consumption of fruits and vegetables, preferably fresh. Fish and meat generate serious concern, as their properties are considered ambivalent depending on the food's origin and mode of production. These criteria are perceived by women as relevant to their food decisions and, therefore, emic knowledge should be taken into account when developing food safety programmes and planning actions aimed at pregnant and breastfeeding women.

Facilitators and Barriers of Medication Adherence Based on Beliefs of Persons with Bipolar Disorder: A Qualitative Study.

One of the big challenges in treating individuals with bipolar disorder (BD) is nonadherence to medication. This is the principal factor associated with a worse prognosis or outcome of the disease. This study aimed to explore and analyze the individual perceptions that people with BD have about the positive and negative aspects when taking medication. A descriptive and interpretative study was carried out using the qualitative research paradigm with the use of the analytical technique of discourse analysis, extracting the data through the completion of focus groups. Participants' speech was digitally audio-recorded in digital format. In order to complete the codification of the participants' speech content, we relied on the qualitative data analysis (using the QRS NVivo 10 computer software). Thirty-six participants diagnosed with bipolar disorder took part in our study. In the participants' speech concerning the main barriers to pharmacological treatment, three key topics were identified. Perceived facilitators were summarized in four factors. The main facilitators regarding the use of pharmacological treatment in individuals with BD were the ones related with the perceived need for treatment in the acute phase, the recognition of the illness, the shared clinical decision, and the causal biological attribution in the chronic phase. In terms of perceived barriers, social control was identified in both phases, adverse effects in the acute phase, and the absence of effective treatment in the chronic state.

The Sound of Silence: Unspoken Meaning in the Discourse of Pregnant and Breastfeeding Women on Environmental Risks and Food Safety in Spain.

(1) Background: In recent years, a growing number of qualitative health research studies have performed discourse analysis of data from participants' narratives. However, little attention has been paid to the gaps and silences within these narratives. The aim of the present study is to interpret the silences detected in the discourse of pregnant and breastfeeding women concerning environmental risks and food safety. (2) Methods: This descriptive, interpretive, observational study was conducted according to a qualitative research paradigm and from a phenomenological and ethnographic perspective. The study sample was composed of 88 intentionally selected women, among whom fifty interviews, three ethnographies and five focus groups were conducted. Data coding and analysis were performed using N-Vivo 12 software. (3) Results: The results obtained show that the women's discourse presented silences that reflected their minimisation of perceived environmental and food risks. However, these women were wary of food produced in the proximity of contaminated areas. Nevertheless, the participants believed they were powerless to overcome environmental pollution and the potential contamination of their own bodies. (4) Conclusions: The participants' minimisation of the environmental risks faced and their inaction in this respect are sustained by the biopolitical practices of public institutions, which have propelled these women into a situation of learned helplessness and social injustice.

Perception and Demands of Pregnant and Breastfeeding Women Regarding Their Role as Participants in Environmental Research Studies.

A significant proportion of scientific studies consider pregnant and breastfeeding women as vulnerable subjects. The objective of this study was to analyse the perception of pregnant and breastfeeding women regarding their participation in environmental research studies. Our work is a descriptive and interpretative observational study that has been developed under the qualitative research paradigm following a phenomenological and ethnographic perspective. The study involved 173 women selected intentionally in two Spanish autonomous communities. To obtain the primary data, we relied upon 111 interviews, four focused ethnographies and eight focus groups. The data encoding and analysis was carried out with the help of NVivo 12 software (QSR International, Boston, MA, USA). We evidenced the need of pregnant and breastfeeding women for more detailed and accurate information on the risk of environmental pollutant exposure during their crucial life stage. In addition, these women claimed for a more participatory role in research studies. Pregnant and breastfeeding women in Spain ask for greater interaction with researchers and propose a dialogical relationship between valid partners. We conclude that our pregnant and breastfeeding women claim more research focused on their collective, as well as clearer, more accessible and structured information on the risks of exposure to environmental contaminants. In addition, they do not want to simply be informants; rather, they ask to be active and empowered members by providing their opinions and arguments throughout the research process.

Motivating Pregnant and Breastfeeding Women in Spain to Avoid Persistent Toxic Substances in Their Diet.

The objective of this study was to explore what motivates pregnant and breastfeeding women to make changes in their diet, specifically to examine how their perceptions regarding diet facilitate or act as obstacles to introducing healthy eating habits. For the optimal development of the mother, the fetus, or breastfeeding baby, it is important to avoid foods containing substances, such as persistent toxic substances (PTSs), that are harmful to health during pregnancy and after the baby's birth. This study used a qualitative research methodology, based on semi-structured individual interviews, food diaries, free lists, and focus groups with 111 pregnant and breastfeeding women in Spain. This approach was followed by a systematic and exhaustive exploitation of the qualitative data obtained, following the methodological principles of grounded theory. From the study results, we conclude that the motivation for a change in diet to avoid PTSs is based on the desire to promote good health, beliefs about the importance of having a varied diet, and the avoidance of potential risks. The main obstacles to change can be attributed to inadequate information, contradictory discourses, and socioeconomic difficulties.

La epidemia de la obesidad en España: la retórica de su discurso y riesgos potenciales / A epidemia de obesidade na Espanha: a retórica do seu discurso e riscos potenciais / The obesity epidemic in spain: the rhetoric of its discourse and potential risks

Resumen: La obesidad se ha convertido en una prioridad para las políticas de salud pública en España. Basándose en el aumento de su prevalencia ha sido catalogada como una epidemia. A pesar de estas afirmaciones, las investigaciones no parecen siempre tan concluyentes. El objetivo de este artículo es revisar algunas de las 'verdades' en torno a la obesidad: a) que la obesidad va en aumento y es una epidemia en España; b) que existe una relación directa entre peso y salud; y c) que la obesidad tenga su consecuencia única en el desequilibrio entre gasto y consumo energético. Además, dado que las ideas vertidas en torno a la epidemia de la obesidad, y el modo exagerado y alarmista en que se produce, pueden tener consecuencias dañinas e impredecibles sobre la salud de las personas, un segundo objetivo es delinear algunos de los posibles riesgos de estas prácticas de comunicación. (AU)

Resumo: A obesidade tornou-se uma prioridade para as políticas de saúde pública na Espanha. Com base no aumento da prevalência foi classificada como uma epidemia. Apesar dessas afirmações, as investigações nem sempre parecem tão conclusivas. O objetivo deste artigo é analisar algumas das 'verdades' sobre a obesidade: a) que a obesidade está aumentando e é uma epidemia em Espanha; b) existe uma relação direta entre peso e saúde; e c) que a obesidade tenha uma consequência única em um desequilíbrio entre gasto e consumo de energia. Além disso, uma vez expressas as ideias sobre a epidemia da obesidade, a maneira exagerada e alarmista que ocorre pode ter consequências imprevisíveis sobre a saúde das pessoas; um segundo objetivo é delinear alguns dos possíveis riscos dessas práticas de comunicação. (AU)

Abstract: Obesity has become a top priority for public health policies in Spain. Based on increasing prevalence, it has been classified as an epidemic. Despite these claims, research does not always seem so conclusive. The purpose of this article is to review some of the 'truths' about obesity: a) that it is on the rise and is an epidemic in Spain; b) that there is a direct relationship between weight and health; c) that its sole effect is the imbalance between energy expenditure and intake. In addition, since the ideas expressed about the obesity epidemic and the exaggerated and alarmist way they are produced might have harmful and unpredictable consequences on people's health, a second aim is to point out some of the possible risks inherent in those communication practices. (AU)