Increasing risk of hepatocellular carcinoma with successive generations in the United States among Mexican American adults: The Multiethnic Cohort.

BACKGROUND: US-born Latinos have a higher incidence of hepatocellular carcinoma (HCC) than foreign-born Latinos. Acculturation to unhealthy lifestyle behaviors and an immigrant self-selection effect may play a role. In this study, the authors examined the influence of generational status on HCC risk among Mexican American adults. METHODS: The analytic cohort included 31,377 self-reported Mexican Americans from the Multiethnic Cohort Study (MEC). Generational status was categorized as: first-generation (Mexico-born; n = 13,382), second-generation (US-born with one or two parents born in Mexico; n = 13,081), or third-generation (US-born with both parents born in the United States; n = 4914). Multivariable Cox proportional hazards regression was performed to examine the association between generational status and HCC incidence. RESULTS: In total, 213 incident HCC cases were identified during an average follow-up of 19.5 years. After adjusting for lifestyle and neighborhood-level risk factors, second-generation and third-generation Mexican Americans had a 37% (hazard ratio [HR], 1.37; 95% confidence interval [CI], 0.98-1.92) and 66% (HR, 1.66; 95% CI, 1.11-2.49) increased risk of HCC, respectively, compared with first-generation Mexican Americans (p for trend = 0.012). The increased risk associated with generational status was mainly observed in males (second-generation vs. first-generation: HR, 1.60 [95% CI, 1.05-2.44]; third-generation vs. first-generation: HR, 2.08 [95% CI, 1.29-3.37]). CONCLUSIONS: Increasing generational status of Mexican Americans is associated with a higher risk of HCC. Further studies are needed to identify factors that contribute to this increased risk.

US and Chinese preschoolers normalize household labor inequality.

Across many cultural contexts, the majority of women conduct the majority of their household labor. This gendered distribution of labor is often unequal, and thus represents one of the most frequently experienced forms of daily inequality because it occurs within one's own home. Young children are often passive observers of their family's distribution of labor, and yet little is known about the developmental onset of their perceptions of it. By the preschool age, children also show strong normative feelings about both equal resource distribution and gender stereotypes. To investigate the developmental onset of children's recognition of the (in)equality of household labor, we interviewed 3 to 10-y-old children in two distinct cultural contexts (US and China) and surveyed their caregivers about who does more household labor across a variety of tasks. Even at the youngest ages and in both cultural contexts, children's reports largely matched their parents', with both populations reporting that mothers do the majority of household labor. Both children and parents judged this to be generally fair, suggesting that children are observant of the gendered distribution of labor within their households, and show normalization of inequality from a young age. Our results point to preschool age as a critical developmental time period during which it is important to have parent-child discussions about structural constraints surrounding gender norms and household labor.

Couple communication quality and family resilience among Chinese gynecologic cancer patients and their spouses: a dyadic study.

PURPOSE: The purpose of this study was to explore the couple communication process for gynecologic cancer (GC) patients and their spouses. Particular attention was given to examining the relationship between couple communication quality and family resilience for GC dyads. METHODS: In this cross-sectional study, 354 dyads were recruited from a gynecology ward of a public hospital in China. The patients and their spouses completed the Couples' Communication Quality Scale and the Family Hardiness Index. This study used the actor-partner interdependence model (APIM) to examine the effect of couple communication quality on family resilience in distinguishable GC dyads. RESULTS: Both GC patients and their spouses reported a moderate level of couple communication quality and family resilience, but spouses reported better couple communication and family resilience than patients. With the exception of perceived response, for which only a patient actor effect was observed, the factors of couple communication quality had significant actor effects on family resilience for both patients and spouses. Additionally, four significant partner effects were found: spouse self-disclosure, stress coping, and productive action positively predicted patients' family resilience, while patient normalcy crafting positively predicted spouses' family resilience. CONCLUSION: This study not only highlights the need for couple-based communication strategies for developing family resilience but also identifies differences in the experiences of patients and their partners, which provides a direction for future intervention research. Through the development of interventions at a dyadic level, spouses can be encouraged to actively engage in communication, which may promote mutual family resilience in a larger sense.

Using household economic survey data to assess food expenditure patterns and trends in a high-income country with notable health inequities.

This study aimed to identify dietary trends in Aotearoa New Zealand (NZ) and whether inequities in dietary patterns are changing. We extracted data from the Household Economic Survey (HES), which was designed to provide information on impacts of policy-making in NZ, and performed descriptive analyses on food expenditures. Overall, total household food expenditure per capita increased by 0.38% annually over this period. Low-income households spent around three quarters of what high-income households spent on food per capita. High-income households experienced a greater increase in expenditure on nuts and seeds and a greater reduction in expenditure on processed meat. There was increased expenditure over time on fruit and vegetables nuts and seeds, and healthy foods in Maori (Indigenous) households with little variations in non-Maori households. But there was little change in processed meat expenditure for Maori households and expenditure on less healthy foods also increased over time. Routinely collected HES data were useful and cost-effective for understanding trends in food expenditure patterns to inform public health interventions, in the absence of nutrition survey data. Potentially positive expenditure trends for Maori were identified, however, food expenditure inequities in processed meat and less healthy foods by ethnicity and income continue to be substantial.

"Come with us for a week, for a month, and see how much food lasts for you:" A Qualitative Exploration of Food Insecurity in East Harlem, New York City.

BACKGROUND: Food insecurity refers to uncertain access to food on a consistent basis and the stress experienced by families who worry about having sufficient resources to provide balanced meals in their households. Food insecurity has a disproportionate influence on people of color. A robust body of evidence links food insecurity to poor health outcomes. OBJECTIVE: To document experiences of food insecurity among linguistically and ethnically diverse residents of the East Harlem neighborhood of New York City by exploring the ways in which food availability and cost intersect with household budgets, personal preferences, and shopping strategies. DESIGN: In-depth qualitative interviews were conducted with adult residents of New York City's East Harlem neighborhood to provide insights about the links between food insecurity, well-being, and quality of life. PARTICIPANTS/SETTING: Thirty-seven adult residents of East Harlem were recruited through purposive sampling. Eligibility requirements included living in an East Harlem zip code (10029 or 10035); being aged 18 years or older; being the main food shopper and food decision-maker in the household; and speaking English, Spanish, or Mandarin Chinese. The study was conducted from February to May 2018. STATISTICAL ANALYSES PERFORMED: Interviews were analyzed using a grounded theory approach. Codes were organized into broad thematic topics and cross-case analyses were conducted. RESULTS: Participants discussed overall perceptions of food insecurity and seven themes related to the challenges of and strategies for coping with food insecurity: intermittent vs chronic food insecurity, shopping and budgeting strategies, pantries as a vital community resource, social support systems, food insecurity and health, frustration with an unjust system, and pride in "making it work." CONCLUSIONS: To manage food insecurity, many study participants carefully managed food spending, dedicated substantial time to visiting stores and accessing food pantries, and relied on a public benefits cycle that left many without sufficient financial resources at the end of each month.

Pregnant women's decision-making capacity and adherence to iron supplementation in sub-Saharan Africa: a multi-country analysis of 25 countries.

BACKGROUND: Anaemia and related complications during pregnancy is a global problem but more prevalent in sub-Sahara Africa (SSA). Women's decision-making power has significantly been linked with maternal health service utilization but there is inadequate evidence about adherence to iron supplementation. This study therefore assessed the association between household decision-making power and iron supplementation adherence among pregnant married women in 25 sub-Saharan African countries. METHODS: We used data from the Demographic and Health Surveys (DHS) of 25 sub-Saharan African countries conducted between 2010 and 2019. Women's decision-making power was measured by three parameters; own health care, making large household purchases and visits to her family or relatives. The association between women's decision-making power and iron supplementation adherence was assessed using logistic regressions, adjusting for confounders. The results were presented as adjusted odds ratio (AOR) with 95% confidence intervals (CIs). RESULTS: Approximately 65.4% of pregnant married women had made decisions either alone or with husband in all three decisions making parameters (i.e., own health care, making large household purchases, visits to her family or relatives). The rate of adherence to iron medication during pregnancy was 51.7% (95% CI; 48.5-54.9%). Adherence to iron supplementation was found to be higher among pregnant married women who had decision-making power (AOR = 1.46, 95% CI; 1.16-1.83), secondary education (AOR = 1.45, 95% CI; 1.05-2.00) and antenatal care visit (AOR = 2.77, 95% CI; 2.19-3.51). Wealth quintiles and religion were significantly associated with adherence to iron supplementation. CONCLUSIONS: Adherence to iron supplementation is high among pregnant women in SSA. Decision making power, educational status and antenatal care visit were found to be significantly associated with adherence to these supplements. These findings highlight that there is a need to design interventions that enhance women's decision-making capacities, and empowering them through education to improve the coverage of antenatal iron supplementation.

Trends and factors related to adolescent pregnancies: an incidence trend and conditional inference trees analysis of northern Nicaragua demographic surveillance data.

BACKGROUND: We aimed to identify the 2001-2013 incidence trend, and characteristics associated with adolescent pregnancies reported by 20-24-year-old women. METHODS: A retrospective analysis of the Cuatro Santos Northern Nicaragua Health and Demographic Surveillance 2004-2014 data on women aged 15-19 and 20-24. To calculate adolescent birth and pregnancy rates, we used the first live birth at ages 10-14 and 15-19 years reported by women aged 15-19 and 20-24 years, respectively, along with estimates of annual incidence rates reported by women aged 20-24 years. We conducted conditional inference tree analyses using 52 variables to identify characteristics associated with adolescent pregnancies. RESULTS: The number of first live births reported by women aged 20-24 years was 361 during the study period. Adolescent pregnancies and live births decreased from 2004 to 2009 and thereafter increased up to 2014. The adolescent pregnancy incidence (persons-years) trend dropped from 2001 (75.1 per 1000) to 2007 (27.2 per 1000), followed by a steep upward trend from 2007 to 2008 (19.1 per 1000) that increased in 2013 (26.5 per 1000). Associated factors with adolescent pregnancy were living in low-education households, where most adults in the household were working, and high proportion of adolescent pregnancies in the local community. Wealth was not linked to teenage pregnancies. CONCLUSIONS: Interventions to prevent adolescent pregnancy are imperative and must bear into account the context that influences the culture of early motherhood and lead to socioeconomic and health gains in resource-poor settings.

Tanzanian men's engagement in household chores is associated with improved antenatal care seeking and maternal health.

BACKGROUND: Male support for partners' antenatal care (ANC) has the potential to improve women's care-seeking and maternal health outcomes. This study describes factors that are associated with men's involvement in household tasks and explores the relationship between men's help with tasks and women's ANC-seeking, diet and workload during pregnancy as well as other health behaviors. METHODS: This study was conducted in five Lake Zone regions of Tanzania. Cross-sectional surveys were carried out among approximately 10,000 households that had children under the age of 2 years. Surveys were administered to mothers of children less than 2 years and where available, their male partners. Data were collected between December 2015 and May 2020, in conjunction with a large-scale campaign aimed at reducing childhood stunting by changing the behavior of mothers, caregivers, and decision makers. Data analysis included bivariate analysis and logistic regression modeling. RESULTS: Men's engagement in household activities was significantly associated with living in an urban setting, being younger, having at least some formal schooling, early verbal interactions with their children, and male involvement in healthcare decisions. Additionally, mothers of male partners that were engaged in household activities were significantly older and more likely to have at least some secondary school education. Relative to households where men only infrequently helped out with chores or not at all, women from households where men frequently helped were significantly more likely to have taken iron tablets during pregnancy, report having eaten more than usual, lessening their household workload during their most recent pregnancy, and more likely to have played with their child in the week prior to the survey. CONCLUSION: Male's participation in household tasks is associated with a general improvement in mother's ANC behaviors. Implicit in these findings is that general primary education for both men and women has health benefits that transcend socioeconomic class and that future interventions aimed to engage males in household tasks may target older males with less education living in rural areas.

Black-white racial disparities in household food insecurity from 2005 to 2014, Canada.

OBJECTIVES: To understand the differential vulnerability to household food insecurity of the Black population as compared with white counterparts in Canada. METHODS: Using data for households with Black and white respondents in pooled Canadian Community Health Survey cycles from 2005 to 2014, the 18-question Household Food Security Survey Module was analyzed (N = 491,400). Bivariate and multivariate logistic and multinomial regression models were run using respondent's race, immigration status, and six well-established predictors of household food insecurity in the general population. Additional multivariable logistic regression models were run, with race interacted with each predictor individually to yield predicted probabilities. RESULTS: The weighted prevalence of household food insecurity was 10.0% for white respondents and 28.4% for Black respondents. The odds of Black households being food-insecure as compared with white households fell from 3.56 (95% CI: 3.30-3.85) to 1.88 (95% CI: 1.70-2.08) with adjustment for household socio-demographic characteristics. In contrast with white households, there was relative homogeneity of risk of food insecurity among Black subgroups defined by immigration status, household composition, education, and province of residence. Homeownership was associated with lower probabilities of food insecurity for Black and white households, but the probability among Black owners was similar to that for white renters (14.7% vs. 14.3%). Black households had significantly higher predicted probabilities of food insecurity than their white counterparts across all main sources of household income except child benefits and social assistance. CONCLUSION: Being racialized as Black appears to be an overriding factor shaping vulnerability to food insecurity for the Black population in Canada. Future research and public policy on food insecurity should seriously consider the role of racism at the systemic and institutional levels.

RéSUMé: OBJECTIFS: Comprendre la vulnérabilité différentielle de la population noire à l'insécurité alimentaire des ménages par rapport à la population blanche au Canada. MéTHODE: À l'aide des données sur les ménages comptant des répondants noirs et blancs dans les cycles combinés de l'Enquête sur la santé dans les collectivités canadiennes de 2005 à 2014, nous avons analysé les 18 questions du Module d'enquête sur la sécurité alimentaire des ménages (N = 491 400). Nous avons exécuté des modèles de régression logistique et multinomiale bivariés et multivariés en utilisant la race des répondants, leur statut d'immigration et six variables prédictives bien établies de l'insécurité alimentaire des ménages dans la population générale. D'autres modèles de régression logistique multivariés ont aussi été exécutés, avec des interactions entre la race et chaque variable prédictive afin de produire des probabilités prédites. RéSULTATS: La prévalence pondérée de l'insécurité alimentaire des ménages était de 10 % pour les répondants blancs et de 28,4 % pour les répondants noirs. Après la prise en compte du profil sociodémographique des ménages, la probabilité d'insécurité alimentaire chez les ménages noirs comparativement aux ménages blancs est passée de 3,56 (IC de 95 % : 3,30-3,85) à 1,88 (IC de 95 % : 1,70-2,08). Contrairement aux ménages blancs, le risque d'insécurité alimentaire était relativement homogène dans les sous-groupes noirs définis selon le statut d'immigration, la composition du ménage, l'instruction et la province de résidence. L'accession à la propriété était associée à une plus faible probabilité d'insécurité alimentaire tant dans les ménages noirs que dans les ménages blancs, mais la probabilité chez les propriétaires noirs était semblable à celle des locataires blancs (14,7 % c. 14,3 %). Les probabilités prédites d'insécurité alimentaire étaient sensiblement plus élevées dans les ménages noirs que dans les ménages blancs pour toutes les sources de revenu des ménages sauf les prestations pour enfants et l'aide sociale. CONCLUSION: Le fait d'être racisé comme une personne noire semble être un facteur déterminant de la vulnérabilité à l'insécurité alimentaire dans la population noire au Canada. Les études et les politiques publiques futures sur l'insécurité alimentaire devraient envisager sérieusement le rôle du racisme à l'échelle systémique et institutionnelle.

Housing conditions and adverse birth outcomes among Indigenous people in Canada.

OBJECTIVES: Poor housing conditions and household crowding have been identified as important health concerns for Indigenous populations in many countries but have not been explored in relation to adverse birth outcomes in these populations. We investigated housing conditions and adverse birth outcomes in a nationally representative sample of Indigenous people in Canada. METHODS: Data were from a cohort of births between May 2004 and May 2006 created by linking birth and infant death registration data with the 2006 Canadian census. Log-binomial regression was used to examine associations between housing variables (persons per room and needed household repairs) and three adverse birth outcomes: preterm birth (PTB), small-for-gestational-age (SGA) birth, and infant mortality. Separate regression models were run for First Nations, Métis and Inuit mothers, with adjustment for parity and parental socio-economic variables. RESULTS: Need for major household repairs was associated with a slightly increased risk of PTB among First Nations and Métis mothers (adjusted RRs 1.12 and 1.13, respectively; 95% CI 0.94-1.34 and 0.89-1.44, respectively) and a moderately increased risk of infant death in all three groups (aRR = 1.69, 95% CI 1.00-2.85). Household crowding was also associated with a slightly elevated risk of PTB in all three groups (aRR = 1.10, 95% CI 0.95-1.29) and with an increased risk of infant mortality among First Nations (aRR = 1.57, 95% CI 0.97-2.53). CONCLUSION: This study highlights the need to improve understanding of links between housing conditions and perinatal health outcomes in Indigenous populations, including examining cause-specific infant mortality in relation to housing characteristics.

RéSUMé: OBJECTIF: Les mauvaises conditions de logement et le surpeuplement ont été identifiés dans plusieurs pays comme étant des enjeux importants de santé chez les populations autochtones. Cependant, aucune étude n'a exploré les conditions de logement en lien avec les issues défavorables de la grossesse dans ces populations. C'est ce que nous avons examiné dans une cohorte de naissances de mères autochtones au Canada, représentative à l'échelle nationale. MéTHODES: Nous avons analysé une cohorte de naissances survenues entre mai 2004 et mai 2006. Cette cohorte a été créée en couplant les données d'enregistrement des naissances et des décès avec les données du Recensement du Canada de 2006. Nous avons utilisé une régression binomiale logarithmique pour estimer les associations entre les conditions de logement (nombre de personnes par chambre et besoins de réparation du logement) et les taux de trois issues défavorables de la grossesse (naissance prématurée, les nouveau-nés petits pour l'âge gestationnel et la mortalité infantile). Des modèles séparés ont été construits pour les femmes des Premières Nations, inuites et métisses, en ajustant les analyses pour la parité et les variables socioéconomiques parentales. RéSULTATS: Les besoins de réparation du logement ont été associés avec un risque ajusté légèrement augmenté de naissance prématurée parmi les mères des Premières Nations et métisses (RRs ajustés : 1,12 et 1,13, respectivement; IC de 95 % : 0,94, 1,34 et 0,89, 1,44, respectivement) et avec un risque modérément élevé de la mortalité infantile dans les trois groupes (RRa = 1,69, IC de 95 % : 1,00, 2,85). Le surpeuplement du logement a été associé avec un risque légèrement augmenté de la naissance prématurée dans les trois groupes (RRa = 1,10, IC de 95 % : 0,95, 1,29) et avec un risque élevé de la mortalité infantile parmi les Premières Nations (RRa = 1,57, IC de 95 % : 0,97, 2,53). CONCLUSION: Cette étude souligne le besoin d'améliorer notre connaissance des liens entre les conditions du logement et les issues de la santé périnatale au sein des populations autochtones, y compris l'étude de la mortalité infantile par cause en association avec les conditions de logement.

Between a woman and her fetus: Bedouin women mediators advance the health of pregnant women and babies in their society.

INTRODUCTION: Bedouin women in Israel confront a challenging circumstance between their traditional patriarchal society and transition to modernity. In terms of reproductive health, they face grave disparities as women, pregnant women and mothers. In this article we aim to understand the challenges of Bedouin women who work as mediators in the promotion of Bedouin women's perinatal health. We explore their challenges with the dual and often conflictual role as health peer-instructors-mediators in mother-and-child clinics, and also as members of a Bedouin community, embodying a status as women, mothers, and family caretakers. Drawn upon a feminist interpretative framework, the article describes their challenges in matters of perinatal health. Our research question is: how do women who traditionally suffer from blatant gender inequality utilize health-promotion work to navigate and empower themselves and other Bedouin women. METHODS: Based on an interpretive feminist framework, we performed narrative analysis on eleven in-depth interviews with health mediators who worked in a project in the Negev area of Israel. The article qualitatively analyses the ways in which Bedouin women mediators narrate their challenging situations. RESULTS: This article shows how difficult health mediators' task may be for women with restricted education who struggle for autonomy and better social and maternal status. Through their praxis, women mediators develop a critical perspective without risking their commitments as women who are committed to their work as well as their society, communities, and families. These health mediators navigate their ways between the demands of their employer (the Israeli national mother and child health services) and their patriarchal Bedouin society. While avoiding open conflictual confrontations with both hegemonic powers, they also develop self-confidence and a critical and active approach. CONCLUSIONS: The article shows the ways by which the mediator's activity involved in perinatal health-promotion may utilize modern perinatal medical knowledge to increase women's awareness and autonomy over their pregnant bodies and their role as caregivers. We hope our results will be applicable for other women as well, especially for women who belong to other traditional and patriarchal societies.

Ethnicity, household composition and COVID-19 mortality: a national linked data study.

OBJECTIVE: To estimate the proportion of ethnic inequalities explained by living in a multi-generational household. DESIGN: Causal mediation analysis. SETTING: Retrospective data from the 2011 Census linked to Hospital Episode Statistics (2017-2019) and death registration data (up to 30 November 2020). PARTICIPANTS: Adults aged 65 years or over living in private households in England from 2 March 2020 until 30 November 2020 (n=10,078,568). MAIN OUTCOME MEASURES: Hazard ratios were estimated for COVID-19 death for people living in a multi-generational household compared with people living with another older adult, adjusting for geographic factors, socioeconomic characteristics and pre-pandemic health. RESULTS: Living in a multi-generational household was associated with an increased risk of COVID-19 death. After adjusting for confounding factors, the hazard ratios for living in a multi-generational household with dependent children were 1.17 (95% confidence interval [CI] 1.06-1.30) and 1.21 (95% CI 1.06-1.38) for elderly men and women. The hazard ratios for living in a multi-generational household without dependent children were 1.07 (95% CI 1.01-1.13) for elderly men and 1.17 (95% CI 1.07-1.25) for elderly women. Living in a multi-generational household explained about 11% of the elevated risk of COVID-19 death among elderly women from South Asian background, but very little for South Asian men or people in other ethnic minority groups. CONCLUSION: Elderly adults living with younger people are at increased risk of COVID-19 mortality, and this is a contributing factor to the excess risk experienced by older South Asian women compared to White women. Relevant public health interventions should be directed at communities where such multi-generational households are highly prevalent.

A place-based analysis of COVID-19 risk factors in Bangladesh urban slums: a secondary analysis of World Bank microdata.

BACKGROUND: There is a lack of research investigating the confluence of risk factors in urban slums that may make them accelerators for respiratory, droplet infections like COVID-19. Our working hypothesis was that, even within slums, an inverse relationship existed between living density and access to shared or private WASH facilities. METHODS: In an exploratory, secondary analysis of World Bank, cross-sectional microdata from slums in Bangladesh we investigated the relationship between intra-household population density (crowding) and access to private or shared water sources and toilet facilities. RESULTS: The analysis showed that most households were single-room dwellings (80.4%). Median crowding ranged from 0.55 m2 per person up to 67.7 m2 per person. The majority of the dwellings (83.3%), shared both toilet facilities and the source of water, and there was a significant positive relationship between crowding and the use of shared facilities. CONCLUSION: The findings highlight the practical constraints on implementing, in slums, the conventional COVID19 management approaches of social distancing, regular hand washing, and not sharing spaces. It has implications for the management of future respiratory epidemics.

How big is your bubble? Characteristics of self-isolating household units ('bubbles') during the COVID-19 Alert Level 4 period in New Zealand: a cross-sectional survey.

OBJECTIVE: To characterise the self-isolating household units (bubbles) during the COVID-19 Alert Level 4 lockdown in New Zealand. DESIGN, SETTING AND PARTICIPANTS: In this cross-sectional study, an online survey was distributed to a convenience sample via Facebook advertising and the Medical Research Institute of New Zealand's social media platforms and mailing list. Respondents were able to share a link to the survey via their own social media platforms and by email. Results were collected over 6 days during Alert Level 4 from respondents living in New Zealand, aged 16 years and over. MAIN OUTCOMES MEASURES: The primary outcome was the mean size of a self-isolating household unit or bubble. Secondary outcomes included the mean number of households in each bubble, the proportion of bubbles containing essential workers and/or vulnerable people, and the mean number of times the home was left each week. RESULTS: 14 876 surveys were included in the analysis. The mean (SD) bubble size was 3.58 (4.63) people, with mean (SD) number of households 1.26 (0.77). The proportion of bubbles containing one or more essential workers, or one or more vulnerable persons was 45.3% and 42.1%, respectively. The mean number of times individual bubble members left their home in the previous week was 12.9 (12.4). Bubbles that contained at least one vulnerable individual had fewer outings over the previous week compared with bubbles that did not contain a vulnerable person. The bubble sizes were similar by respondent ethnicity. CONCLUSION: In this New Zealand convenience sample, bubble sizes were small, mostly limited to one household, and a high proportion contained essential workers and/or vulnerable people. Understanding these characteristics from a country which achieved a low COVID-19 infection rate may help inform public health interventions during this and future pandemics.

Determinants of severe physical disciplinary practices against children in Egypt.

BACKGROUND: Although nearly 43 % of Egyptian children aged less than 14 years had ever experienced severe physical violent punishment at home, no previous studies identified the predictors of the practice in Egypt. OBJECTIVE: This research aims at identifying the determinants of the use of any severe violent physical practice to discipline children. PARTICIPANTS AND SETTING: The latest national Egyptian Demographic and Health Survey is the main source of data. The caregivers of 13024 children were interviewed. METHODS: A binary logistic regression model is developed to identify the determinants of the use of severe physical disciplinary practices. RESULTS: Results show that children whose parents believe that physical punishment is necessary to discipline children are more likely to experience severe violence (OR = 3.3). Children in the preprimary stage have a high odds ratio of experiencing a severe violent punishment compared to those in preparatory and secondary stages (OR = 3.5). Children whose mothers have experienced domestic physical violence are more likely to be subject to severe physical violence (OR = 1.6 for husband violence, and 1.4 for parents/siblings violence). Children living in Urban Lower Egypt are approximately twice likely as children living in urban governorates to be subject to severe physical violence. Children living in the poorest households are the most likely to experience severe physical violence. CONCLUSION: Severe violent disciplinary practice inside the home is common in Egypt. The findings urge for activating Egyptian Child Law and implementing continuous training programs for parents on positive parenting.

Inflammatory bowel diseases among first-generation and second-generation immigrants in Denmark: a population-based cohort study.

OBJECTIVE: Our objective was to estimate the relative risk of IBD among first-generation and second-generation immigrants in Denmark compared with native Danes. DESIGN: Using national registries, we established a cohort of Danish residents between 1977 and 2018. Cohort members with known country of birth were followed for Crohn's disease (CD) and ulcerative colitis (UC) diagnoses. Incidence rate ratios (IRRs) served as measures of relative risk and were calculated by log-linear Poisson regression, using rates among native Danes as reference, stratified by IBD risk in parental country of birth, and among first-generation immigrants by age at immigration and duration of stay in Denmark. RESULTS: Among 8.7 million Danes, 4156 first-generation and 898 second-generation immigrants were diagnosed with CD or UC. Overall, comparing first-generation immigrants with native Danes, the IRR was 0.80 (95% CI 0.76 to 0.84) for CD and 0.74 (95% CI 0.71 to 0.77) for UC. The IRR of IBD increased with ≥20 years stay in Denmark. The IRR of CD increased with immigration at ≥40 years of age. Comparing second-generation immigrants with native Danes, the IRR of IBD was 0.97 (95% CI 0.91 to 1.04). There was significant interaction with sex, with higher IRR of IBD in male than in female immigrants. CONCLUSION: Relative to native Danish men and women, IBD risk among first-generation immigrants was lower, reflected the risk in their parental country of birth and increased with ≥20 years stay in Denmark. For second-generation immigrants, relative risk of IBD was lower only among women. These complex patterns suggest the role of environmental IBD risk factors.

The elderly living in single-person households in South Korea: a latent profile analysis of self-esteem, life satisfaction, and depression.

OBJECTIVES: Elderly living alone in South Korea report higher rates of psychological distress compared to the population at large. Using a person-centered approach, the aim of the present study was to identify the latent profiles of South Korean elderly living alone based on self-esteem, life satisfaction, and depression. METHOD: Latent profile analysis (LPA) was conducted based on data of 1545 older age individuals living alone. In addition, we examined significant factors that differentiate the observed profiles using multinomial logistic regression analysis. RESULTS: We identified five profiles: "extremely depressed (n = 44, 2.9%)," "severely depressed (n = 169, 10.9%)," "mildly depressed (n = 529, 34.2%)," "low life satisfaction (n = 128, 8.3%)," and "positive adaptation (n = 675, 43.7%)." In addition, results of multinomial logistic regression analysis indicated that males (OR: 1.69; 95% CI: 1.02-2.81), and elderly with lower income (OR: 0.86; 95% CI: 0.81-0.91), lower level of physical health (OR: 0.43; 95% CI: 0.33-0.57), and lower social relationship satisfaction (OR: 0.25; 95% CI: 0.18-0.35) were more likely to fall in the "low life satisfaction" rather than the "positive adaptation" profile. In addition, being female (OR: 0.48; 95% CI: 0.30-0.79), of older age (OR: 1.04; 95% CI: 1.01-.1.07), and higher income (OR: 1.14; 95% CI: 1.08-1.20) were related to classification in the "mildly depressed" rather than the "low life satisfaction" profile. The "severely depressed" group was differentiated by older age (OR: 1.05; 95% CI: 1.01-1.08), lower level of physical health (OR: 0.49; 95% CI: 0.34-0.71), and lower satisfaction with social relationship (OR: 0.54; 95% CI: 0.38-0.76). CONCLUSION: The results highlight the need for welfare policies that secure income and physical health in elderly living alone to enhance their quality of life. Furthermore, interventions that aim to maintain social networks are tantamount in order to prevent isolation in the elderly living alone.

Mujeres, naturaleza y cultura: una lectura ecofeminista de la cultura matrilineal de las tribus khasis, jaintia y garo de Meghalaya / Tribus khasis, jaintia y garo de MeghalayaWomen, Nature and Culture: An Ecofeminist Reading of the Matrilineal Culture of the Khasis, Jaintia and Garo Tribes of Meghalaya / Mulheres, Natureza e Cultura: Uma Leitura Ecofeminista da Cultura Matrilineal das Tribos Khasis, Jaintia e Garo de Meghalaya

El noreste de la India, la tierra de los habitantes originales, sigue una cultura y tradición únicas y fascinantes, ya que sus habitantes están estrechamente vinculados a la naturaleza. El noreste de la India es uno de esos pocos lugares en el mundo donde todavía se practica la cultura matrilineal. En Meghalaya, uno de los estados del noreste, la práctica de la matrilinealidad existe desde hace casi 2000 años entre algunas tribus. Khasi, Jaintia y Garo, las primeras comunidades étnicas de Meghalaya parecen ser homogéneas, ya que la hija menor se convierte en la custodia de las perspectivas ancestrales. Esta práctica en la que las mujeres se convierten en custodias de los artefactos culturales y naturales tiene fuertes paralelos en la teoría del ecofeminismo. Al emplear una perspectiva ecofeminista para leer la cultura matrilineal de las tribus, el documento tiene como objetivo hacer un estudio paralelo sobre la afinidad de las mujeres étnicas con la naturaleza. El ecofeminismo celebra la sólida conexión entre las mujeres y la naturaleza y afirma que las mujeres sirven como defensoras de la naturaleza en lugar de los hombres. Por lo tanto, el documento tiene como objetivo investigar los elementos ecofeministas entre las tribus Khasi, Jaintia y Garo de Meghalaya y trata de expresar una visión ecofeminista sobre la familia, el matrimonio, la religión y la cultura alimentaria de las tribus Meghalaya

Northeast India, the land of original inhabitants, follows a unique and fascinating culture and tradition as its inhabitants are closely attached to nature. Northeast India is one of those few places in the world, where matrilineal culture is still practiced. In Meghalaya, one of the northeastern states, the practice of matrilineality has been in existence for almost 2000 years among a few tribes. Khasi, Jaintia and Garo, the earliest ethnic communities of Meghalaya appear to be homogenous ones, as the youngest daughter becomes the custodian of the ancestral prospects. This practice where the womenfolk become the custodians of the cultural and natural artifacts has strong parallels in the theory of ecofeminism. By employing ecofeministic perspective to read the matrilineal culture of the tribes, the paper aims to make a parallel study on the ethnic women's affinity towards nature. Ecofeminism celebrates the robust connect between women and nature and asserts that women serve as the advocates for nature rather than men. The paper, therefore, aims to investigate ecofeministic elements among the Khasi, Jaintia and Garo tribes of Meghalaya and tries to express an ecofeministic view concerning family, marriage, religion, and food culture of the Meghalaya tribes

O Nordeste da Índia, a terra dos habitantes originais, segue uma cultura e tradição únicas e fascinantes, pois seus habitantes estão intimamente ligados à natureza. O Nordeste da Índia é um dos poucos lugares do mundo onde a cultura matrilinear ainda é praticada. Em Meghalaya, um dos estados do Nordeste, a prática da matrilinearidade já existe há quase 2.000 anos entre algumas tribos. Khasi, Jaintia e Garo, as primeiras comunidades étnicas de Meghalaya, parecem ser homogêneas, pois a filha mais nova se torna a guardiã das perspectivas ancestrais. Essa prática em que as mulheres se tornam guardiãs dos artefatos culturais e naturais tem fortes paralelos na teoria do ecofeminismo. Ao empregar a perspectiva ecofeminista para ler a cultura matrilinear das tribos, o artigo tem como objetivo fazer um estudo paralelo sobre a afinidade das mulheres étnicas com a natureza. O ecofeminismo celebra a conexão robusta entre as mulheres e a natureza e afirma que as mulheres atuam como defensoras da natureza ao invés dos homens. O artigo, portanto, tem como objetivo investigar elementos ecofeminísticos entre as tribos Khasi, Jaintia e Garo de Meghalaya e tenta expressar uma visão ecofeminista sobre família, casamento, religião e cultura alimentar das tribos Meghalaya