Ageism Linked to Culture, Not Demographics: Evidence From an 8-Billion-Word Corpus Across 20 Countries.

OBJECTIVES: Ageism has increased over 200 years and costs the U.S. health care system $63 billion a year. While scholars agree on the consequences of ageism, there are disagreements on whether it is related to the demographics of aging, or society's cultural values. We test both hypotheses across 20 countries. METHOD: To circumvent the sampling limitations of survey studies, we used an 8-billion-word corpus, identified 3 synonyms with the highest prevalence-aged, elderly, old people-and compiled the top 300 words (collocates) that were used most frequently with these synonyms for each of the 20 countries. The resulting 6,000 collocates were rated on an ageism scale by 2 raters to create an ageism score per country. Cultural dimension scores-Power Distance, Individualism, Masculinity, Uncertainty Avoidance, and Long-term Orientation-were taken from Hofstede, and demographics-size and speed of population aging-came from the World Development Indicators. RESULTS: Of the 20 countries, UK topped the ageism table, while Sri Lanka had the lowest ageism score. Multiple regression models showed that higher levels of masculinity and long-term orientation are associated with ageism, controlling for other cultural dimensions, demographics (size and speed of aging), and economics (GDP-per-capita). DISCUSSION: Our findings blunt the deterministic nature of ageism at the societal level. Demographics is only one side of the ageism coin, and the cultural side is equally, if not more important. This study lays the groundwork to tackle societal ageism-one of our generation's most pernicious threats.

Do experiences with pregnancy, birth and postnatal care in Norway vary by the women's geographic origin? a comparison of cross-sectional survey results.

BACKGROUND: A national survey was conducted to measure and benchmark women's experiences with pregnancy, birth and postnatal care in Norway. The purpose of this secondary analysis is to explore potential variation in these experiences with regard to the survey respondents' geographic origin. METHODS: Data were collected in a national observational cross-sectional study, by a self-administered questionnaire and from registries. The questionnaire collects patient reported experience measures (PREMS) of mainly nontechnical aspects of the health-care services. While taking the clustered characteristics of the respondents into consideration, we compared the mean scores on 16 indexes between women of four different geographic origins using linear regression models. RESULTS: The origin of the 4904 respondents were classified as Norway (n = 4028, 82%), Western Europe, North-America, Oceania (n = 233, 5%), Eastern Europe (n = 290, 6%), and Asia, Turkey, Africa, and South-America) (n = 353, 7%). The observed differences were moderate, and no consistency was present in the results in respect of direction or magnitude of the differences between the groups. CONCLUSIONS: With some important cautions, we conclude that this study did not detect systematic differences between groups of different geographic origin, in their experiences with pregnancy and maternity care in Norway.

The Hispanic Americans Baseline Alcohol Survey (HABLAS): the association between acculturation, birthplace and alcohol consumption across Hispanic national groups.

Acculturation to U.S. society has been associated with an increase in drinking and binge drinking among Hispanics. This paper examines the association between acculturation and three drinking-related outcomes: average number of drinks consumed, binge drinking, and drinking 12 drinks or more in a single day in four major Hispanic national groups. The 2006 Hispanic Americans Baseline Alcohol Survey used a multistage cluster sample design to interview 5224 adult Hispanics (18+ years) in five selected U.S. metropolitan areas: Miami, New York, Philadelphia, Houston, and Los Angeles. The four national groups interviewed were: Puerto Ricans, Cuban Americans, Mexican Americans, and South/Central Americans. The survey response rate was 76%. Data on drinking behavior were collected and the analyses include bivariate and multivariate regression techniques. Multivariate analysis did not show an association between acculturation and volume of drinking, binge drinking, or drinking 12 or more drinks in a single day among men. Acculturation stress, however, was associated with drinking 12 or more in a day among men. Among women, high acculturation was associated with a higher volume of drinking, and it also interacted with national group to increase the likelihood of binge drinking. Acculturation does not have a homogeneous effect on drinking across gender and Hispanic national groups. The results confirm that acculturation has a more consistent association with increased drinking and binge drinking among women than among men. The effect of acculturation is therefore gender-specific. This heterogeneity across Hispanic national groups must be considered in future research, treatment, and prevention efforts.

Genetic variants in sporadic Parkinson's disease: East vs West.

A number of gene variants or single nucleotide polymorphisms (SNPs) have been shown to modulate the risk of Parkinson's disease (PD). These variants are identified from genetic association studies of familial PD and candidate genes, and from genome wide association studies (GWAS). These include REP1 dinucleotide repeat polymorphism within the promoter region of the SNCA gene, and SNPs within the vicinity of SNCA and LRRK2 genes. A number of exonic variants of LRRK2 (G2385R, R1628P, S1647T, M1646T, A419V, R1398H, N551K, Y2189C) have been shown to influence PD risk in various ethnic populations. Numerous GWAS linked loci including BST1 (bone marrow stromal cell antigen 1), PARK16 (parkinson disease 16 susceptibility), GAK (cyclin G associated kinase), and HLA (human leukocyte antigen) have also been identified. The genetic variants have differential effect on PD risk in Eastern and Western populations. Knowing the basis behind ethnic-specific variances would further our understanding of the pathophysiologic mechanisms and help planning of genetic testing programmes.

The effect of culture on the curvilinear relationship between performance and turnover.

Although researchers have theorized that there exists a curvilinear relationship between job performance and voluntary turnover, their research has been tested in the United States or culturally similar Switzerland. Through a study of the performance-turnover relationship from a multinational service-oriented organization in 24 countries, we demonstrate that the general relationship between performance and turnover is similar across countries but the details of that relationship change across countries. Using 4 cultural dimensions--in-group collectivism, power distance, uncertainty avoidance, and performance orientation--we find that cultural factors alter the overall probability of voluntary turnover and influence the degree of curvilinearity in the performance-turnover relationship. Our findings have implications for research on the performance-turnover relationship, turnover research, and practice.

Prevalence of chronic hepatitis B among foreign-born persons living in the United States by country of origin.

Estimates of the prevalence of chronic hepatitis B (CHB) in the United States differ significantly, and the contribution of foreign-born (FB) persons has not been adequately described. The aim of this study was to estimate the number of FB persons in the United States living with CHB by their country of origin. We performed a systematic review for reports of HBsAg seroprevalence rates in 102 countries (covering PubMed from 1980 to July 2010). Data from 1,373 articles meeting inclusion criteria were extracted into country-specific databases. We identified 256 seroprevalence surveys in emigrants from 52 countries (including 689,078 persons) and 1,797 surveys in the general populations of 98 countries (including 17,861,035 persons). Surveys including individuals with lower or higher risk of CHB than the general population were excluded. Data were combined using meta-analytic methods to determine country-specific pooled CHB prevalence rates. Rates were multiplied by the number of FB living in the United States in 2009 by country of birth from the U.S. Census Bureau to yield the number of FB with CHB from each country. We estimate a total of 1.32 million (95% confidence interval: 1.04-1.61) FB in the United States living with CHB in 2009; 58% migrated from Asia and 11% migrated from Africa, where hepatitis B is highly endemic. Approximately 7% migrated from Central America, a region with lower CHB rates, but many more emigrants to the United States. This analysis suggests that the number of FB persons living with CHB in the United States may be significantly greater than previously reported. Assuming 300,000-600,000 U.S.-born persons with CHB, the total prevalence of CHB in the United States may be as high as 2.2 million.

The potato's contribution to population and urbanization: evidence from a historical experiment.

We exploit regional variation in suitability for cultivating potatoes, together with time variation arising from their introduction to the Old World from the Americas, to estimate the impact of potatoes on Old World population and urbanization. Our results show that the introduction of the potato was responsible for a significant portion of the increase in population and urbanization observed during the eighteenth and nineteenth centuries. According to our most conservative estimates, the introduction of the potato accounts for approximately one-quarter of the growth in Old World population and urbanization between 1700 and 1900. Additional evidence from within-country comparisons of city populations and adult heights also confirms the cross-country findings.

Foreign children with cancer in Italy.

BACKGROUND: There has been a noticeable annual increase in the number of children coming to Italy for medical treatment, just like it has happened in the rest of the European Union. In Italy, the assistance to children suffering from cancer is assured by the current network of 54 centres members of the Italian Association of Paediatric Haematology and Oncology (AIEOP), which has kept records of all demographic and clinical data in the database of Mod.1.01 Registry since 1989. METHODS: We used the information stored in the already mentioned database to assess the impact of immigration of foreign children with cancer on centres' activity, with the scope of drawing a map of the assistance to these cases. RESULTS: Out of 14,738 cases recorded by all centres in the period from 1999 to 2008, 92.2% were born and resident in Italy, 4.1% (608) were born abroad and living abroad and 3.7% (538) were born abroad and living in Italy. Foreign children cases have increased over the years from 2.5% in 1999 to. 8.1% in 2008.Most immigrant children came from Europe (65.7%), whereas patients who came from America, Asia and Oceania amounted to 13.2%, 10.1%, 0.2%, respectively. The immigrant survival rate was lower compared to that of children who were born in Italy. This is especially true for acute lymphoblastic leukaemia patients entered an AIEOP protocol, who showed a 10-years survival rate of 71.0% vs. 80.7% (p < 0.001) for immigrants and patients born in Italy, respectively. CONCLUSIONS: Children and adolescents are an increasingly important part of the immigration phenomenon, which occurs in many parts of the world. In Italy the vast majority of children affected by malignancies are treated in AIEOP centres. Since immigrant children are predominantly treated in northern Italy, these centres have developed a special expertise in treating immigrant patients, which is certainly very useful for the entire AIEOP network.

The demise of the American Indios.

This symposium takes as its point of departure two books by Massimo Livi Bacci, Conquest and El Dorado in the Marshes, published in English in 2008 and 2010. Livi Bacci assesses widely varying estimates of the demographic dimensions of the collapse of the Native populations following their contact with Europeans and elucidates the proximate causes of that catastrophe. Drawing on models that combine production potential with demography, environment, and technology, Shripad Tuljapurkar discusses analogous historical experiences of the populations of Polynesia and the social transformation they entailed. David S. Reher argues that explanations of the estimated demographic dynamics need to take into account the negative fertility responses of the Indigenous population to the disruption of their traditional way of life. Focusing on the biological aspects of immunity to diseases such as smallpox, Andrew Noymer demonstrates that infectious diseases alone could not account for the Indios' population collapse. The contributions to this symposium are based on presentations at a session at the 2010 annual meeting of the Population Association of America, held in Dallas, Texas, that examined the demographic consequences of the Spanish conquest of the Caribbean region and of South America in light of the two books.

Do family policy regimes matter for children's well-being?

Researchers have studied the impact of different welfare state regimes, and particularly family policy regimes, on gender equality. Very little research has been conducted, however, on the association between different family policy regimes and children's well-being. This article explores how the different family policy regimes of twenty OECD countries relate to children's well-being in the areas of child poverty, child mortality, and educational attainment and achievement. We focus specifically on three family policies: family cash and tax benefits, paid parenting leaves, and public child care support. Using panel data for the years 1995, 2000, and 2005, we test the association between these policies and child well-being while holding constant for a number of structural and policy variables. Our analysis shows that the dual-earner regimes, combining high levels of support for paid parenting leaves and public child care, are strongly associated with low levels of child poverty and child mortality. We find little long-term effect of family policies on educational achievement, but a significant positive correlation between high family policy support and higher educational attainment. We conclude that family policies have a significant impact on improving children's well-being, and that dual-earner regimes represent the best practice for promoting children's health and development.

Incidence of celiac disease among second-generation immigrants and adoptees from abroad in Sweden: evidence for ethnic differences in susceptibility.

BACKGROUND AND AIMS: The incidence of celiac disease (CD) shows large, worldwide variation. However, whether its causes are environmental (gluten-containing diet) or genetic (specific haplotype) have not been established. The aim of the present study is to examine the incidence of CD among second-generation immigrants and adoptees from abroad to disentangle genetic/ethnic versus environmental influences (assuming that immigrants have similar gluten exposures to native Swedes, and thus differ from them only in terms of their genetic background). METHODS: Second-generation immigrants and adoptees from abroad were identified in the MigMed 2 Database and were followed until diagnosis of CD, death, or the end of study. Standardized incidence ratios (SIRs) were calculated among these immigrants with native Swedes as the reference group. RESULTS: A total of 1,050,569 children were defined as second-generation immigrants and the overall SIR of CD (SIR = 0.89, 95% confidence interval 0.84-0.94) was significantly lower than that of native Swedes. The incidence of CD among children with parents from Western, Eastern, and Northern European countries was similar to that in native Swedes, but was lower for those with parents from low-prevalence countries, especially Eastern and Southeast Asian countries. A total of 51,557 children born in foreign countries were adopted by Swedes. Adoptees from Eastern Asia had a significantly decreased SIR of CD. CONCLUSIONS: The decreased incidence of CD in second-generation immigrants and some groups of adoptees from abroad strongly suggests that ethnic genetic heterogeneity may contribute to the worldwide variation in CD incidence.

Analysis of the soft tissue profile in Croatians with normal occlusions and well-balanced faces.

The aim of the study was to test the hypothesis that there is no difference between the soft tissue profile of Croatian and white North American adults. Facial profile photographs were taken of 110 Croatians (52 males and 58 females) with normal occlusions and well-balanced faces (age 22-29 years). The findings were also compared with a white Brazilian group. An independent Student's t-test (P < 0.05) was used to compare the soft tissue parameters of Croatians with those of North Americans and to assess gender differences. The soft tissue profile measurements that showed significant gender dimorphism (P < 0.001) were the true vertical line [(TVL)-nasal tip (NT)] and TVL-point B, indicating that the males had slightly greater nasal prominence (mean difference: 1.32 mm) and deeper labial sulci (mean difference: 2.04 mm) compared with the females. The upper lip was the same for both genders (1.25 mm), while the lower lip was 0.97 mm more prominent in females than in males. All soft tissue variables, except TVL-NT showed significant differences between Croatian and white American female subjects (P = 0.096). For male subjects, nasolabial angle was the only variable that showed no statistically significant difference between the two populations. A universal standard of facial aesthetic is not applicable to diverse white populations. These differences should be considered in diagnosis and treatment planning for Croatians, together with their individual characteristics.

Pre-travel preparation for Cusco, Peru: a comparison between European and North American travelers.

BACKGROUND: Demographics, preferences on health care, and regional differences in pre-travel advice guidelines may influence the preparation of travelers to developing countries. METHODS: A secondary data analysis of the database of a travelers' health survey conducted in Cusco in 2002 was performed. Data from those whose place of residence was North America or Western Europe were selected. Illness rates, vaccinations, prophylactic medication use, and general recommendations on disease prevention were compared between the two groups. RESULTS: Data from 1,612 North Americans (NAM) and 3,590 Western Europeans (EUR) were analyzed. NAM were older, stayed longer in Cusco, and had less experience traveling to developing countries (p < 0.01). They reported being ill more often than EUR (58% vs 42%, p < 0.01). Diarrhea was more frequent among EUR (55.6% vs 46.7%, p < 0.01), and acute mountain sickness (AMS) was more frequent among NAM (52.8% vs 35.2%, p < 0.01). EUR sought advice from health care professionals (67.1% vs 52.0%, p < 0.01) and travel medicine practitioners (45.8% vs 37%, p < 0.01) more often. NAM used prophylactic medications more often (53% vs 48.6%, p = 0.00) and received a lower mean number of vaccines (1.97 ± 1.68 vs 2.63 ± 1.49; t-test 14.02, p < 0.01). Advice on safe sex and alcohol consumption was low in both groups, especially among NAM. CONCLUSIONS: Pre-travel preparation and travel-related illnesses varied between NAM and EUR. Improving consistency of pre-travel preparation based on the best evidence should become a priority among different national bodies providing travel medicine recommendations.

Factors associated with utilization of traditional Chinese medicine by white collar foreign workers living in Taiwan.

BACKGROUND: Traditional Chinese medicine (TCM) has remained an integral part of Chinese culture and society for thousands of years. In Taiwan TCM is a recognized element of its National Health Insurance Scheme. However, there is no knowledge about how TCM is accessed by foreign workers from a non-Asian cultural background. The objectives of this study were to investigate the prevalence and patterns of TCM use among non-Asian white-collar workers living in Taiwan, and examine factors likely to influence their use of TCM. METHODS: This study applied a cross-sectional survey design. A total of 207 white-collar foreign workers of a non-Asian background currently holding National Health Insurance cards who had lived in Taiwan for 4 months or more participated in this study. RESULTS: The prevalence of TCM use was 45%. The most frequently used therapies were traditional Chinese herbs/medicine and acupuncture. Factors indicating the likelihood of TCM usage were age 31-40 years, visit to an allopathic medical doctor in the last year, ability to read Chinese, having a friend or family member available to assist in the use of TCM, and access to information about TCM services available in Taiwan. CONCLUSION: Utilization of TCM by people of a non-Asian background living in Taiwan appears to be most influenced by enabling factors including language ability, access to information, and informal reference persons.

Birthplace differences in stroke rates among coronary heart disease patients: is variation explained by recognized risk factors?

BACKGROUND: The incidence of stroke varies among ethnically and culturally diverse groups. OBJECTIVES: To examine the ethnic-geographic patterns of stroke incidence in men and women with coronary heart disease in Israel, focusing on the extent to which this variability can be explained by known differences in risk factors for stroke. METHODS: Patients with documented coronary heart disease were followed for 6-8 years for incident cerebrovascular events. Baseline medical evaluation included assessment of vascular risk factors and measurements of blood lipids. Among 15,052 patients, 1110 were identified with any incident ischemic cerebrovascular event by ICD-9 codes, of whom 613 had confirmed ischemic stroke or transient ischemic attack. RESULTS: A major excess of ischemic cerebrovascular events among Israeli Arab women as compared to males, and an inverse finding among Israeli born Jews, were noted. The high risk in the Arab population in Israel reflected an unfavorable risk profile, since predicted rates by multivariate analysis and observed rates were 69 and 68 per 1000, respectively. High ischemic cerebrovascular event rates were identified among patients born in the Balkan countries and North Africa (89 and 90 per 1000), but unfavorable risk factor levels of these individuals did not explain them. Most trends appeared similar in male and female patients. A comparison of observed and accepted-according-to-risk-profile rates of ischemic cerebrovascular events yielded significant differences (P = 0.04), consistent with an additional role of geographic/ethnic origin resulting from factors that remain unrecognized, or with variables unassessed in this study. CONCLUSIONS: We identified an ethnic diversity in stroke risk among the Israeli born in different parts of the world beyond what could be expected on the basis of differences in known risk factors. These findings call for detailed research aimed at identifying additional differences in the risk profile of patients with atherothrombotic disease exposed to an increased risk of stroke.

Cancer risks in first-generation immigrants to Sweden.

We used the nationwide Swedish Family-Cancer Database to analyse cancer risks in 613,000 adult immigrants to Sweden. All the immigrants had become parents in Sweden and their median age at immigration was 24 years for men and 22 years for women. We calculated standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) for 18 cancer sites using native Swedes as a reference. Data were also available from compatriot marriages. All cancer was decreased by 5% and 8% for immigrant men and women, respectively. However, most of the male increase was due to lung cancer for which male immigrants showed a 41% excess. Among individual cancer sites and immigrant countries, 110 comparisons were significant, 62 showing protection and 48 an increased risk. Most of the differences between the rates in immigrants and Swedes could be ascribed to the variation of cancer incidence in the indigenous populations. Some high immigrant SIRs were 5.05 (n = 6, 95% CI 1.82-11.06) for stomach cancer in Rumanian women and 2.41 (41, 1.73-3.27) for lung cancer in Dutch men. At some sites, such as testis, prostate, skin (melanoma), kidney, cervix and nervous system, the SIRs for immigrants were decreased; in some groups of immigrants SIRs were about 0.20. The highest rates for testicular cancer were noted for Danes and Chileans. Women from Yugoslavia and Turkey had an excess of thyroid tumours. All immigrant groups showed breast, endometrial and ovarian cancers at or below the Swedish level but the differences were no more than 2-fold.