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1.
Estud. pesqui. psicol. (Impr.) ; 18(4): 1118-1136, out.-dez. 2019. tab
Artigo em Português | LILACS, Index Psicologia - Periódicos técnico-científicos | ID: biblio-994978

RESUMO

O presente artigo objetivou realizar uma análise sobre como a temática da pobreza tem historicamente comparecido nos estudos e parâmetros de atuação profissional do psicólogo brasileiro. Foi realizada uma revisão bibliográfica acerca do objeto de estudo, o resgate de produções pertinentes sobre a relação da Psicologia brasileira com a pobreza ao longo de seu desenvolvimento, bem como de documentos e parametrizações do Conselho Federal de Psicologia. Observamos um crescimento do envolvimento da Psicologia com a pobreza e demais expressões da "questão social", atrelado com a maior vinculação da profissão com as políticas públicas e sociais. O debate entre "questão social", pobreza e Psicologia, contextualizado em diferentes fases do capitalismo, face às particularidades brasileiras e atual conjuntura, evidencia as contradições: autocrítica acerca do distanciamento com a realidade brasileira e insuficiências teórico-práticas, mas com a hegemonia na Psicologia ainda se fazendo valer por meio de leituras e práticas individualizantes, psicologizantes, perpetradoras da ordem. Dessa forma, uma Psicologia compromissada com a compreensão e superação da pobreza, assim como do sistema que a forja e nela se sustenta, requer a identificação e libertação de sua própria pobreza.(AU)


The present article aims to analyze how the issue of poverty has historically appeared in studies and parameters of the professional work of Brazilian psychologists. A bibliographic review about the object of the study was elaborated, with the retrieval of relevant works about the relationship between Brazilian Psychology and poverty throughout its development, as well as documents and parametrizations of the Federal Council of Psychology. We see an increase in the involvement of Psychology with poverty and other expressions of the "social issue", linked to the greater bondage of the profession with public and social policies. The debate between "social issue", poverty and Psychology, contextualized in different phases of capitalism, in view of the Brazilian characteristics and current situation, shows the following contradictions: self-criticism about distancing from Brazilian reality and theoretical-practical insufficiencies, but with the hegemony in Psychology still being enforced through individualizing, psychologizing readings and practices, perpetrating the order. In this way, a Psychology committed to understanding and overcoming poverty, as well as the system that forges and sustains it, requires the identification and liberation of its own poverty.(AU)


El presente artículo apuntó a realizar un análisis sobre cómo la temática de la pobreza ha formado parte históricamente en los estudios y parámetros de actuación profesional del psicólogo brasileño. Se realizó una revisión bibliográfica acerca del objeto de estudio y un rescate de producciones pertinentes sobre la relación de la Psicología brasileña con la pobreza a lo largo de su desarrollo, así como de documentos del Consejo Federal de Psicología. Observamos un crecimiento de la implicación de la Psicología con la pobreza y demás expresiones de la cuestión social, vinculada con la mayor ligazón de la profesión con las políticas públicas y sociales. El debate entre "cuestión social", pobreza y Psicología, contextualizado en diferentes fases del capitalismo, frente a las particularidades brasileñas y la coyuntura actual, evidencia las siguientes contradicciones: autocrítica acerca del distanciamiento con la realidad brasileña y las insuficiencias teórico-prácticas, empero existe una hegemonía en la Psicología que todavía se hace valer por medio de lecturas y prácticas individualizantes, psicologizantes, perpetradoras del orden. Así, una Psicología comprometida con la comprensión y superación de la pobreza y con el sistema que la forja y en ella se sustenta, requiere de la identificación y liberación de su propia pobreza.(AU)


Assuntos
Humanos , Pobreza/psicologia , Sociologia/história , Capitalismo , Psicologia , Política Pública , Brasil , História
2.
BMC Public Health ; 19(1): 1459, 2019 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-31694592

RESUMO

BACKGROUND: Urbanization and aging are global phenomena that offer unique challenges in different countries. A supportive environment plays an important role in addressing the issues of health behavioral change and health promotion (e.g., prevent chronic illnesses, promote mental health) among older adults. With the development of the socio-ecological theoretical model, studies on the impact of supportive environments on physical activity have become popular in the public health field in the EU and US. Meanwhile, very few Chinese studies have examined the relationship between built environment features and older adults' physical activity at the ecological level. The purpose of the study is to investigate how the factors part of the built environment of Nanjing's communities also influence leisure time physical activity among the elderly. METHODS: Using a socio-ecological model as a theoretical framework, we conducted a cross-sectional study of 399 elderly people from 19 communities in Nanjing, China, using a one-on-one questionnaire to collect data, including participants' perceived built environment and self-reported physical activity. A multivariate linear regression method was used to analyze the factors influencing their recreational physical activity. RESULTS: This study found that compared to older people with low average monthly income, the recreational physical activity of the elderly with average monthly incomes between 1001 and 2000 ¥ (ß = 23.31, p < 0.001) and 2001 ¥ or more (ß = 21.15, p < 0.001) are significantly higher. After controlling for individual covariates, street connectivity (ß = 7.34, p = 0.030) and street pavement slope (ß = - 7.72, p = 0.020), we found that two out of ten built environment factors indicators influence their physical activity. The importance of each influencing factor ranked from highest to lowest are monthly average income, street pavement slope, and street connectivity. Other factors were not significantly related to recreational physical activity by the elderly. CONCLUSIONS: Older adults with a high income were more likely to participate in recreational physical activity than those with a low income. In order to positively impact physical activity in older adults and ultimately improve health, policymakers and urban planners need to ensure that street connectivity and street pavement slope are factored into the design and development of the urban environment.


Assuntos
Ambiente Construído , Exercício/psicologia , Atividades de Lazer/psicologia , Apoio Social , Urbanização , Idoso , Idoso de 80 Anos ou mais , China , Estudos Transversais , Fenômenos Ecológicos e Ambientais , Pesquisa Empírica , Planejamento Ambiental , Feminino , Promoção da Saúde , Humanos , Renda , Masculino , Saúde Mental , Modelos Teóricos , Pobreza/psicologia , Análise de Regressão , Autorrelato
4.
Health Psychol ; 38(12): 1159-1167, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31580130

RESUMO

OBJECTIVE: Using baseline data from a community-based weight-gain prevention intervention study, the authors examined whether coping self-efficacy moderated the associations between chaotic home environment and psychosocial health (perceived psychosocial stress, depressive symptoms, and positive and negative affect) in low-income women who are overweight or obese. METHOD: Participants (N = 740; Mage = 28.06 ± 5.12) completed validated self-report measures of coping self-efficacy, chaotic home environment, perceived psychosocial stress, depressive symptoms, and positive and negative affect. Composite indicator structural equation modeling was used to test the moderation effects. Effect size was calculated using proportion of maximum possible (POMP) scores in the endogenous variables per unit change in the exogenous variable. RESULTS: Coping self-efficacy significantly moderated the associations between chaotic home environment and depressive symptoms (p < .001, POMP = -0.62%) and between chaotic home environment and negative affect (p < .01, POMP = -0.36%). However, coping self-efficacy did not moderate the association between chaotic home environment and perceived psychosocial stress or positive affect. CONCLUSIONS: This study suggests that coping self-efficacy could explain some individual differences in responses to home chaos or to interventions aimed at alleviating depressive symptoms and negative affect in low-income women who are overweight or obese and who experience chaos at home. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Adaptação Psicológica/fisiologia , Obesidade/psicologia , Sobrepeso/psicologia , Pobreza/psicologia , Adulto , Feminino , Humanos , Masculino
5.
J Consult Clin Psychol ; 87(11): 1003-1018, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31556648

RESUMO

OBJECTIVE: The current study examined how severity of disaster exposure and predisaster individual and family characteristics predicted trajectories of disaster-related posttraumatic stress symptoms (PTSS) in children over 4 years following a devastating EF-4 tornado. METHOD: Participants (n = 346; 65% male; 77.5% African American) were 4th-6th-graders and their caregivers, from predominantly low-income households, who were already participating in a longitudinal study of indicated prevention effects for externalizing outcomes when the tornado occurred in 2011. Latent class trajectory analyses were used to identify disaster-related PTSS trajectory groups across the 4-year postdisaster period. RESULTS: Three groups were identified: (1) a group that declined (recovery) in PTSS over time (15.90%); (2) a group that was stable and low in PTSS over time (76.87%); and (3) a group that was stable and high (chronic) in PTSS over time (7.23%). Multinomial logistic regression analyses revealed that greater tornado exposure predicted membership in the declining trajectory group relative to the low-stable group. Positive parenting and pretornado caregiver trauma exposure also moderated how disaster exposure, particularly perceived life threat, predicted PTSS trajectories. CONCLUSIONS: Some youth reported elevated disaster-related PTSS repeatedly for 4 years following a devastating tornado. Consistent with the concept of equifinality, results suggest that there are several pre-exposure risk factors that may increase risk for a chronic PTSS trajectory following disaster exposure. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Família/psicologia , Poder Familiar/psicologia , Pobreza/psicologia , Transtornos de Estresse Pós-Traumáticos/etiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Tornados , Criança , Desastres , Feminino , Humanos , Estudos Longitudinais , Masculino , Fatores de Risco
6.
Malar J ; 18(1): 320, 2019 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-31533727

RESUMO

BACKGROUND: Over the past decade, food insecurity, connected to erratic rains and reduced agricultural outputs, has plagued Malawi. Many households are turning to fishing to seek additional sources of income and food. There is anecdotal evidence that insecticide-treated net (ITN) recipients in Malawi are using their nets for purposes other than sleeping, such as for fishing, protecting crops, and displaying merchandise, among others. The objective of this qualitative study was to explore the factors leading residents of waterside communities in Malawi to use ITNs for fishing. METHODS: This study used qualitative and observational methods. Five waterside communities were identified, two each in the North, Central and Southern regions, representing a mix of lakeside and riverside settings. Fifteen focus group discussions were conducted with a total of 146 participants, including men, women, and community leaders. RESULTS: Respondents stated that they knew that ITNs should be slept under to protect from malaria. Respondents discussed financial hardships their communities were facing due to droughts, poverty, food scarcity, unemployment, and devaluation of the Malawian currency, the kwacha. Many described selling household goods, including clothes and cooking pots, to generate short-term income for their family. Though no respondents admitted to selling an ITN themselves, the practice was commonly known. Participants said that food shortages were forcing them to make difficult choices. Fishing with ITNs was reported to be common in the study sites, as a response to food insecurity, and was widely understood to be harmful over the longer term. Respondents felt that it was everyone's responsibility to cut down on this practice, but that efforts to confiscate or burn nets and boats of those caught fishing with ITNs were counter-productive since boats, especially, were a required resource for a productive livelihood. Respondents feared that if the health workers, government officials and donors continued to see ITNs being misused for fishing, the distribution of free ITNs would end, which would worsen malaria in their communities. CONCLUSIONS: Faced with economic hardships and food security crises, participants reported being forced to look for alternative incomes to feed their families. This sometimes included selling or repurposing their belongings, including ITNs, for income. This issue is complex and will require a community-led multisectoral response to preserve health, fisheries, and livelihoods.


Assuntos
Abastecimento de Alimentos , Mosquiteiros Tratados com Inseticida/estatística & dados numéricos , Controle de Mosquitos/estatística & dados numéricos , Pobreza/psicologia , Feminino , Grupos Focais , Abastecimento de Alimentos/estatística & dados numéricos , Humanos , Malária/prevenção & controle , Malaui , Masculino , Pobreza/estatística & dados numéricos
7.
J Clin Nurs ; 28(23-24): 4412-4423, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31410919

RESUMO

AIMS AND OBJECTIVES: To test the effectiveness of a musical training programme in promoting happiness and quality of life of Hong Kong Chinese underprivileged preschool children. BACKGROUND: The impact of poverty and income disparity on the psychological well-being of children remains a profound global public health concern. There is substantial evidence that poverty and income disparity have many negative impacts on children's psychological well-being, adversely affecting their quality of life. METHODS: A nonequivalent, quasi-experimental, two-group, pretest and post-test, between-subjects design was conducted with 171 Hong Kong Chinese underprivileged preschool children (aged 3-6 years). Participants (n = 100) in the experimental group attended a weekly 1-hr musical training lesson for 12 weeks conducted by the Music Children Foundation. Participants (n = 71) in the wait list control group received the same training after all data had been collected. Data collection for both groups was conducted at baseline and 12-week follow-up. The measured outcomes were happiness level and quality of life. A TREND checklist was completed. RESULTS: Participants in the experimental group reported significantly higher levels of happiness (p = .002) and quality of life (p = .44) than those in the wait list control group. CONCLUSIONS: The present study indicates the effectiveness of a musical training programme in promoting happiness and quality of life of Hong Kong Chinese underprivileged preschool children. It also demonstrated the feasibility of implementing the programme in a community context. RELEVANCE TO CLINICAL PRACTICE: This study aids to inform nurses the beneficial effect of the musical training programme in improving underprivileged children's psychological well-being and quality of life. Indeed, community nurses may act as facilitators to promote the musical training programme to underprivileged children. The involvement of community nurses may greatly enhance the sustainability of the programme, thus making it to be a routine health promotion activity.


Assuntos
Música/psicologia , Pobreza/psicologia , Qualidade de Vida/psicologia , Criança , Pré-Escolar , Enfermagem em Saúde Comunitária/métodos , Feminino , Felicidade , Hong Kong , Humanos , Masculino , Ensaios Clínicos Controlados não Aleatórios como Assunto , Populações Vulneráveis/psicologia
8.
BMC Public Health ; 19(1): 990, 2019 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-31340800

RESUMO

BACKGROUND: Primary care-based behavior change obesity treatment has long featured the Calorie restriction (CC), portion control approach. By contrast, the MyPlate-based obesity treatment approach encourages eating more high-satiety/high-satiation foods and requires no calorie-counting. This report describes study methods of a comparative effectiveness trial of CC versus MyPlate. It also describes baseline findings involving demographic characteristics and their associations with primary outcome measures and covariates, including satiety/satiation, dietary quality and acculturation. METHODS: A comparative effectiveness trial was designed to compare the CC approach (n = 130) versus a MyPlate-based approach (n = 131) to treating patient overweight. Intervenors were trained community health workers. The 11 intervention sessions included two in-home health education sessions, two group education sessions, and seven telephone coaching sessions. Questionnaire and anthropometric assessments occurred at baseline, 6- and 12 months; food frequency questionnaires were administered at baseline and 12 months. Participants were overweight adult primary care patients of a federally qualified health center in Long Beach, California. Two measures of satiety/satiation and one measure of post-meal hunger comprised the primary outcome measures. Secondary outcomes included weight, waist circumference, blood pressure, dietary quality, sugary beverage intake, water intake, fruit and vegetable fiber intake, mental health and health-related quality of life. Covariates included age, gender, nativity status (U.S.-born, not U.S.-born), race/ethnicity, education, and acculturation. ANALYSIS: Baseline characteristics were compared using chi square tests. Associations between covariates and outcome measures were evaluated using multiple regression and logistic regression. RESULTS: Two thousand eighty-six adult patients were screened, yielding 261 enrollees who were 86% Latino, 8% African American, 4% White and 2% Other. Women predominated (95%). Mean age was 42 years. Most (82%) were foreign-born; 74% chose the Spanish language option. Mean BMI was 33.3 kg/m2; mean weight was 82 kg; mean waist circumference was 102 cm. Mean blood pressure was 122/77 mm. Study arms on key baseline measures did not differ except on dietary quality and sugary beverage intake. Nativity status was significantly associated with dietary quality. CONCLUSIONS: The two treatment arms were well-balanced demographically at baseline. Nativity status is inversely related to dietary quality. TRIAL REGISTRATION: NCT02514889 , posted on 8/4/2015.


Assuntos
/psicologia , Promoção da Saúde/métodos , Hispano-Americanos/psicologia , Política Nutricional , Pobreza/psicologia , Adulto , Afro-Americanos/psicologia , California , Centros Comunitários de Saúde , Agentes Comunitários de Saúde , Pesquisa Comparativa da Efetividade , Ingestão de Energia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sobrepeso/dietoterapia , Sobrepeso/psicologia , Atenção Primária à Saúde/métodos , Qualidade de Vida , Projetos de Pesquisa
9.
Artigo em Inglês | MEDLINE | ID: mdl-31330883

RESUMO

No study has been conducted linking Chinese migrants' subjective well-being (SWB) with urban inequality. This paper presents the effects of income and inequality on their SWB using a total of 128,000 answers to a survey question about "happiness". We find evidence for a satiation point above which higher income is no longer associated with greater well-being. Income inequality is detrimental to well-being. Migrants report lower SWB levels where income inequality is higher, even after controlling for personal income, a large set of individual characteristics, and province dummies. We also find striking differences across socio-economic and geographic groups. The positive effect of income is more pronounced for rural and western migrants, and is shown to be significantly correlated with the poor's SWB but not for the well-being of more affluent respondents. Interestingly, high-income earners are more hurt by income inequality than low-income respondents. Moreover, compared with migrants in other regions, those in less developed Western China are found to be more averse to income inequality. Our results are quite robust to different specifications. We provide novel explanations for these findings by delving into psychological channels, including egalitarian preferences, social comparison concerns, expectations, perceived fairness concerns and perceived social mobility.


Assuntos
Felicidade , Disparidades nos Níveis de Saúde , Renda , Migrantes/psicologia , Adolescente , Adulto , China , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Pobreza/psicologia , Saúde da População Rural/economia , Saúde da População Urbana/economia , Adulto Jovem
10.
Nurse Educ Today ; 80: 59-66, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31271940

RESUMO

BACKGROUND: In both the United Kingdom (UK) and the United States (US), health inequities are proving resistant to improvement. Nurses are ideally placed to advocate for social justice. It is therefore important that nurse education encourages awareness of the social determinants of health and equips students to act to address health inequity. However, little is known about student nurses' attitudes to social justice and poverty and the impact of pedagogical strategies used to teach the determinants and patterns of health inequities. OBJECTIVES: To assess and compare UK and US student nurses' attitudes towards social justice and poverty before and after learning about social determinants of health and health inequities. DESIGN: Cross-sectional study with embedded before and after design using validated measures. SETTING: Two universities: one urban UK university and one US university with urban and rural campuses. PARTICIPANTS: 230 student nurses in the UK (n = 143) and US (n = 87) enrolled in courses teaching content including health inequities and social determinants of health. RESULTS: Student nurses generally disagreed with stigmatizing statements about people living in poverty and mostly agreed with statements promoting social justice. However, US students were significantly more likely to have positive attitudes towards both social justice (p = 0.001) and poverty (p < 0.001). In multiple regression analyses, engagement in social justice-promoting activities, activism and higher levels of education were associated with positive attitudes to social justice and poverty. Statistically significant positive changes in attitudes to poverty and social justice after their courses were observed only among US student nurses. CONCLUSION: UK and US student nurses' attitudes to poverty and social justice were generally positive. Education around social determinants of health and health inequity had a different effect in the UK and the US. There is a need to explore further what specific components of educational programmes lead to positive changes in attitudes.


Assuntos
Atitude do Pessoal de Saúde , Pobreza/psicologia , Justiça Social/psicologia , Estudantes de Enfermagem/psicologia , Adulto , Estudos Transversais , Bacharelado em Enfermagem , Feminino , Humanos , Masculino , Psicometria/instrumentação , Psicometria/métodos , Reino Unido , Estados Unidos , População Urbana
11.
Int J Behav Med ; 26(4): 437-442, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31264100

RESUMO

BACKGROUND: Exposure to violence, which is experienced at disproportionally higher levels by black versus white youth, is associated with disruptions in sleep and elevated cardiovascular risk. Further, poor sleep hygiene is associated with insulin resistance. However, research to date examining disruptions in sleep and cardiovascular risk in African-American adolescents has not taken the impact of exposure to violence into account, nor considered how gender might affect patterns of association. The present study addressed this gap by testing a path model linking exposure to community violence, sleep disruption, and insulin resistance in a sample of African-American adolescents and evaluating model fit across gender. METHOD: African-American adolescents (N = 107; 56% female; Mage = 14.29, SD = 1.17) completed structured interviews at home and provided a blood sample after fasting overnight. RESULTS: The model fit connecting exposure to violence with sleep disruption and insulin resistance, adjusting for depressive symptoms and body mass index z score, was excellent. Multiple group analysis indicated gender differences in model fit. Path analysis revealed significant positive associations between exposure to violence and sleep disruption and sleep disruption and insulin resistance for females but not males. CONCLUSION: These data indicate that low-income, urban African-American female adolescents who witness violence and experience sleep disruptions may already be at elevated risk for health problems compared with their male counterparts. Additional research should attempt to replicate and explicate the underlying reasons for the gender differences observed here, with the goal of improving health and disrupting the path leading to health disparities.


Assuntos
Exposição à Violência/psicologia , Resistência à Insulina , Pobreza/psicologia , Distúrbios do Início e da Manutenção do Sono/psicologia , População Urbana/estatística & dados numéricos , Adolescente , Afro-Americanos/psicologia , Feminino , Humanos , Masculino , Fatores Sexuais , Sono
12.
J Fam Psychol ; 33(6): 629-639, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31169392

RESUMO

The present study investigated relations among various aspects of economic adversity and cortisol levels for young children facing economic hardship. Specifically, the study examined relations to cortisol for variables representing family income, material hardship, financial strain, economic instability, and household chaos. Participants were 374 children, ages 3-5 years, who attended a Head Start preschool, as well as their primary caregivers. Nearly all children lived in households classified as poor or low-income, defined as less than two times the federal poverty threshold. Caregivers completed interviews about family demographics and economic adversity at the beginning of the school year. Child salivary cortisol was sampled in duplicate on two weekday mornings at the end of the school year. We hypothesized that economic instability would show direct statistical effects on child cortisol as well as indirect effects via household chaos. A structural equation model that corresponded to this hypothesis showed adequate fit for the sample data and revealed a statistically significant indirect effect of economic adversity on child cortisol via economic instability and household chaos, as well as statistically significant direct effects of economic instability and chaos on child cortisol, and a significant indirect effect of economic instability on cortisol via household chaos. Implications concern understanding mechanisms of poverty risk, including the impact of instability and chaos on stress physiology, and promoting physiological regulation for children facing economic hardship. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Hidrocortisona/metabolismo , Pobreza/psicologia , Meio Social , Adulto , Cuidadores , Pré-Escolar , Família , Características da Família , Feminino , Humanos , Entrevistas como Assunto , Masculino , Philadelphia , Pobreza/estatística & dados numéricos
13.
BMC Public Health ; 19(Suppl 4): 462, 2019 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-31196017

RESUMO

BACKGROUND: Motoric cognitive risk (MCR) syndrome is characterized by slow gait and memory complaints that could be used to predict an increased risk of dementia. This study aims to determine the MCR syndrome and its risk factors among low-income (B40) older adults in Malaysia. METHODS: Data from TUA cohort study involving 1366 older adults (aged 60 years and above) categorized as low-income were analysed, for risk of MCR syndrome based on defined criteria. Chi-square analysis and independent t test were employed to examine differences in socioeconomic, demographic, chronic diseases and lifestyle factors between MCR and non-MCR groups. Risk factors of MCR syndrome were determined using hierarchical logistic regression. RESULTS: A total of 3.4% of participants fulfilled the criteria of MCR syndrome. Majority of them were female (74.5%, p = 0.001), single/widow/widower/divorced (55.3%, p = 0.002), living in rural area (72.3%, p = 0.011), older age (72.74 ± 7.08 year old, p <  0.001) and had lower years of education (3.26 ± 2.91 years, p = 0.001) than non-MCR group. After adjustment for age, gender and years of education, participants living in rural area (Adjusted OR = 2.19, 95% CI = 1.10-4.35, p = 0.026), with obesity (Adjusted OR = 3.82, 95% CI = 1.70-8.57, p = 0.001), diabetes (Adjusted OR = 2.04, 95% CI = 1.01-4.11, p = 0.046), heart disease (Adjusted OR = 2.50, 95% CI = 1.00-6.20, p = 0.049) and cancer (Adjusted OR = 6.57, 95% CI = 1.18-36.65, p = 0.032) were associated with increased risk of MCR syndrome. CONCLUSION: Only 3.4% of older adults from low-income group were identified as having MCR syndrome. Women, those living in rural areas, had obesity, diabetes, heart disease and cancer were more likely to have MCR syndrome. Further investigation on MCR as a predementia syndrome will help in development of preventive strategies and interventions to reduce the growing burden of dementia, especially among individuals with low socioeconomic status.


Assuntos
Transtornos Cognitivos/epidemiologia , Demência/epidemiologia , Pobreza/psicologia , Idoso , Transtornos Cognitivos/psicologia , Estudos de Coortes , Demência/psicologia , Feminino , Humanos , Malásia/epidemiologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Síndrome
14.
BMC Public Health ; 19(Suppl 4): 541, 2019 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-31196019

RESUMO

BACKGROUND: Socioeconomic factors and nutritional status have been associated with childhood cognitive development. However, previous Malaysian studies had been conducted with small populations and had inconsistent results. Thus, this present study aims to determine the association between socioeconomic and nutritional status with cognitive performance in a nationally representative sample of Malaysian children. METHODS: A total of 2406 Malaysian children aged 5 to 12 years, who had participated in the South East Asian Nutrition Surveys (SEANUTS), were included in this study. Cognitive performance [non-verbal intelligence quotient (IQ)] was measured using Raven's Progressive Matrices, while socioeconomic characteristics were determined using parent-report questionnaires. Body mass index (BMI) was calculated using measured weight and height, while BMI-for-age Z-score (BAZ) and height-for-age Z-score (HAZ) were determined using WHO 2007 growth reference. RESULTS: Overall, about a third (35.0%) of the children had above average non-verbal IQ (high average: 110-119; superior: ≥120 and above), while only 12.2% were categorized as having low/borderline IQ (< 80). Children with severe obesity (BAZ > 3SD), children from very low household income families and children whose parents had only up to primary level education had the highest prevalence of low/borderline non-verbal IQ, compared to their non-obese and higher socioeconomic counterparts. Parental lack of education was associated with low/borderline/below average IQ [paternal, OR = 2.38 (95%CI 1.22, 4.62); maternal, OR = 2.64 (95%CI 1.32, 5.30)]. Children from the lowest income group were twice as likely to have low/borderline/below average IQ [OR = 2.01 (95%CI 1.16, 3.49)]. Children with severe obesity were twice as likely to have poor non-verbal IQ than children with normal BMI [OR = 2.28 (95%CI 1.23, 4.24)]. CONCLUSIONS: Children from disadvantaged backgrounds (that is those from very low income families and those whose parents had primary education or lower) and children with severe obesity are more likely to have poor non-verbal IQ. Further studies to investigate the social and environmental factors linked to cognitive performance will provide deeper insights into the measures that can be taken to improve the cognitive performance of Malaysian children.


Assuntos
Transtornos Cognitivos/epidemiologia , Obesidade Mórbida/psicologia , Pobreza/psicologia , Classe Social , Índice de Massa Corporal , Criança , Desenvolvimento Infantil , Pré-Escolar , Cognição , Transtornos Cognitivos/etiologia , Feminino , Humanos , Renda , Testes de Inteligência/estatística & dados numéricos , Malásia/epidemiologia , Masculino , Inquéritos Nutricionais , Estado Nutricional , Obesidade Mórbida/epidemiologia , Pais , Prevalência , Inquéritos e Questionários
15.
BMC Public Health ; 19(Suppl 4): 551, 2019 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-31196024

RESUMO

BACKGROUND: The rapid growth of economy and increasing cost of living in Malaysia have given significant impact especially to the lowest household income population. The main objective of this study was to determine risk factors for low quality of life (QOL) and poor health status of this population. METHODS: This was a cross sectional study design. A total of 347 respondents from low household income groups, including persons with disability and Orang Asli were recruited from E-kasih. A semi-guided self-administered questionnaire was used. QOL measured by EQ. 5D utility value and health status measured by visual analogue score (VAS). Descriptive statistic, bivariate Chi-square analysis and binary logistic regression were conducted to determine factors influencing low QOL and poor health status. RESULTS: Majority of the respondents were Malay, female (61%), 63% were married, 60% were employed and 46% with total household income of less than 1 thousand Ringgit Malaysia. 70% of them were not having any chronic medical problems. Factors that associated with low QOL were male, single, low household income, and present chronic medical illness, while poor health status associated with female, lower education level and present chronic medical illness. Logistic regression analysis has showed that determinants of low QOL was present chronic illness [AOR 4.15 95%CI (2.42, 7.13)], while determinants for poor health status were; female [AOR 1.94 95%CI (1.09,3.44)], lower education [AOR 3.07 95%CI (1.28,7.34)] and present chronic illness [AOR 2.53 95%CI (1.39,4.61)]. CONCLUSION: Low socioeconomic population defined as low total household income in this study. Low QOL of this population determined by present chronic illness, while poor health status determined by gender, education level and chronic medical illness.


Assuntos
Doença Crônica/epidemiologia , Nível de Saúde , Pobreza/psicologia , Qualidade de Vida , Fatores Socioeconômicos , Adulto , Idoso , Distribuição de Qui-Quadrado , Doença Crônica/psicologia , Estudos Transversais , Emprego/estatística & dados numéricos , Feminino , Humanos , Modelos Logísticos , Malásia/epidemiologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco , População Rural/estatística & dados numéricos , Inquéritos e Questionários
16.
BMC Public Health ; 19(Suppl 4): 447, 2019 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-31196141

RESUMO

BACKGROUND: The main aim of this study was to determine the association between Behavioral and Psychological Symptoms of Dementia (BPSD) and caregiver burden, and the mediating role of coping strategy and personality style of caregivers to patients with dementia (PWD). METHODS: This cross-sectional study was conducted among 202 caregivers to PWD in home-based settings. Recruited caregivers were administered questionnaires regarding BPSD which was measured using Neuropsychiatric Inventory-Questionnaire (NPI-Q), caregiver burden using Zarit Burden Interview (ZBI), Brief COPE for coping strategies and Big-Five Inventory which measured personality traits. RESULTS: Majority of the caregivers were female (71.3%), aged 50 and above (55%), single (46%), married (43.6%), working full time (45%) while the rest work part time (22.3%), unemployed (7.4%) and retiree (25.2%), and majority were parents (58.9%) and spouse (18.3%). The duration of caregiving was less than a year (33.7%) while the rest are more than a year. Results demonstrated that the most frequent types of BPSD exhibited by PWD was irritability, followed by apathy and agitation. All of the types of BPSD showed to be significantly correlated to caregiver burden except for anxiety, elation and appetite. Of personality traits, only conscientiousness was found to mediate the relationship between BPSD and caregiver burden (p < .05). Self-distraction, active coping, planning and acceptance were the coping strategies that demonstrated to have mediation effect on the relationship between BPSD and caregiver burden. CONCLUSION: Presentation of BPSD is correlated to caregiver burden which is partially mediated by coping strategies and personality styles.


Assuntos
Adaptação Psicológica , Cuidadores/psicologia , Demência/psicologia , Personalidade , Pobreza/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Efeitos Psicossociais da Doença , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
17.
BMC Public Health ; 19(1): 732, 2019 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-31185954

RESUMO

BACKGROUND: Women in India are often asked to make informal payments for maternal health care services that the government has mandated to be free. This paper is a descriptive case study of a social accountability project undertaken by SAHAYOG, a nongovernmental organization in Uttar Pradesh, India. SAHAYOG worked with community-based organizations and a grassroots forum comprised of low caste, Muslim, and tribal women to decrease the prevalence of health provider demands that women and their families make informal payments. METHODS: The study entailed document review; interviews and focus group discussions with program implementers, governmental stakeholders, and community activists; and participant observation in health facilities. RESULTS: The study found that SAHAYOG adapted their strategy over time to engender greater empowerment and satisfaction among program participants, as well as greater impact on the health system. Participants gained knowledge resources and agency; they learned about their entitlements, had access to mechanisms for complaints, and, despite risk of retaliation, many felt capable of demanding their rights in a variety of fora. However, only program participants seemed successfully able to avoid making informal payments to the health sector; health providers still demanded that other women make payments. Several features of the micro and macro context shaped the trajectory of SAHAYOG's efforts, including deeply rooted caste dynamics, low provider commitment to ending informal payments, the embeddedness of informal payments, human resources scarcity, and the overlapping private interests of pharmaceutical companies and providers. CONCLUSION: Though changes were manifest in certain fora, providers have not necessarily embraced the notion of low caste, tribal, or Muslim women as citizens with entitlements, especially in the context of free government services for childbirth. Grassroots advocates, CBOs, and SAHAYOG assumed a supremely difficult task. Project strategy changes may have made the task somewhat less difficult, but given the population making the rights claims and the rights they were claiming, widespread changes in demands for informal payments may require a much larger and stronger coalition.


Assuntos
Gastos em Saúde/estatística & dados numéricos , Serviços de Saúde Materna/economia , Parto/psicologia , Pobreza/psicologia , Marginalização Social/psicologia , Adulto , Medo , Feminino , Grupos Focais , Gastos em Saúde/legislação & jurisprudência , Humanos , Índia , Islamismo/psicologia , Organizações , Grupos Populacionais/psicologia , Pobreza/economia , Gravidez , Classe Social , Responsabilidade Social
18.
BMC Pregnancy Childbirth ; 19(1): 202, 2019 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-31200665

RESUMO

BACKGROUND: The aim of the study was to identify trajectories of perinatal depressive symptoms and their predictors among women living in a low-resource setting in South Africa, and who present with a risk of depression during pregnancy. METHODS: This is a secondary analysis of a randomised controlled trial among 384 women living in Khayelitsha, a low income setting in South Africa, recruited at their first antenatal visit if they scored 13 or above on the Edinburgh Postnatal Depression Scale, were at least 18 years of age, less than 29 weeks pregnant and spoke isiXhosa. Participants were followed up at 8 months gestation, 3 and 12 months postpartum. Latent trajectories of depressive symptoms were identified using growth mixture modelling, based on the Hamilton Depression Rating Scale (HDRS). There were no differences in HDRS scores between the control and intervention arms, so all participants were assessed together. Health, social and economic predictors of trajectories were investigated to identify high-risk groups with greater or more chronic depressive symptoms, using univariate logistic regression. RESULTS: Two trajectories were identified: antenatal only (91.4%), with moderate to severe symptoms at baseline which later subside; and antenatal and postnatal (8.6%), with severe depressive symptoms during pregnancy and later in the postpartum period, which subside temporarily to moderate levels at 3 months postpartum. Predictors for the antenatal and postnatal trajectory include severe food insecurity, intimate partner violence, lower social support, greater functional impairment, problematic drinking and suicide risk. CONCLUSIONS: A small proportion of women who are at risk for depression antenatally remain at risk throughout the perinatal period, and can be differentiated from those who show a natural remission. Identification and referral strategies should be developed with these findings in mind, especially given the limited mental health resources in low-income settings.


Assuntos
Depressão Pós-Parto , Depressão , Pobreza , Complicações na Gravidez , Adulto , Depressão/diagnóstico , Depressão/epidemiologia , Depressão/psicologia , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/epidemiologia , Depressão Pós-Parto/psicologia , Feminino , Humanos , Pobreza/psicologia , Pobreza/estatística & dados numéricos , Gravidez , Complicações na Gravidez/diagnóstico , Complicações na Gravidez/psicologia , Prognóstico , Escalas de Graduação Psiquiátrica , Medição de Risco/métodos , Fatores de Risco , África do Sul/epidemiologia
19.
J Fam Psychol ; 33(7): 830-840, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31219271

RESUMO

Guided by family systems theory and using 2-wave data from 4,843 low-income, unmarried couples in the Building Strong Families study, we examined paths from paternal and maternal pregnancy intentions to family functioning in personal, relationship, and coparenting domains. Using 3-step Latent Class Analysis, we first identified 3 subgroups of couples based on both parents' pregnancy intentions: Both Wanted/Both On-time (33.8%), Both Wanted/Both Mistimed (56.1%), and Women Wanted/Both Mistimed (10.1%). We then examined how family functioning varied across these 3 classes. We found that fathers and mothers in the Women Wanted/Both Mistimed class experienced the lowest levels of family functioning. Mothers in the Both Wanted/Both On-time class reported higher family functioning than mothers in the Both Wanted/Both Mistimed class, whereas few differences were identified between fathers in the Both Wanted/Both On-time class and the Both Wanted/Both Mistimed class. We discussed implications for families transitioning to parenthood of this nuanced understanding of associations between pregnancy intentions and family functioning. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Relações Familiares/psicologia , Intenção , Pais/psicologia , Pobreza/psicologia , Gravidez não Planejada/psicologia , Pessoa Solteira/psicologia , Adulto , Feminino , Humanos , Masculino , Gravidez , Pessoa Solteira/estatística & dados numéricos , Adulto Jovem
20.
Artigo em Inglês | MEDLINE | ID: mdl-31212868

RESUMO

Rapid urbanization in low- and middle-income countries (LMICs) is transforming dietary patterns from reliance on traditional staples to increased consumption of energy-dense foods high in saturated fats, trans fats, sugars, and salt. A systematic literature review was conducted to determine major food sources of salt in LMICs that could be targeted in strategies to lower population salt intake. Articles were sourced using Medline, Web of Science, Scopus, and grey literature. Inclusion criteria were: reported dietary intake of Na/salt using dietary assessment methods and food composition tables and/or laboratory analysis of salt content of specific foods in populations in countries defined as low or middle income (LMIC) according to World Bank criteria. Of the 3207 records retrieved, 15 studies conducted in 12 LMICs from diverse geographical regions met the eligibility criteria. The major sources of dietary salt were breads, meat and meat products, bakery products, instant noodles, salted preserved foods, milk and dairy products, and condiments. Identification of foods that contribute to salt intake in LMICs allows for development of multi-faceted approaches to salt reduction that include consumer education, accompanied by product reformulation.


Assuntos
Países em Desenvolvimento/estatística & dados numéricos , Ingestão de Alimentos/psicologia , Comportamento Alimentar/psicologia , Pobreza/psicologia , Pobreza/estatística & dados numéricos , Cloreto de Sódio na Dieta , Humanos
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