Measuring Differences in the Effect of Social Resource Factors on the Health of Elderly Canadian Men and Women

It is well-documented that differences in the exposure to social resources play a significant role in influencing gender inequalities in health in old age. It is less clear in the literature if social factors have a differential impact on the health of older men and women. This paper examines gender differences in the patterns of social predictors of health among elderly persons. Using data from the 1998-1999 Canadian National Population Health Survey, the findings show that differences in socio-economic, lifestyle, and psychosocial resources contribute to variation in the health status of elderly persons in terms of self-rated health and functional and chronic health. Many of these predictors of health, however, differ in their effect on health between elderly males and females. The impact of age and exercise on health is larger for older women compared to older men, yet income, smoking, level of social support, and distress have a greater effect on health for older men than they do for older women. These gender differences have important policy implications for health-care promotion and delivery services. Health policy needs to reflect the underlying social determinants of health, and their differential influence on the health of elderly men and women.Gender, Morbidity, Disability, Self-rated Health, Psychosocial, Lifestyle, Old age, Canada, NPHS

Gender Differences in the Influence of Economic, Lifestyle, and Psychosocial Factors on Later-life Health

This paper examines the differential impact of social forces on the health of men and women aged 65+ using data from the 1994-1995 National Population Health Survey. Multiple regression analysis is used to estimate gender differences in the influence of socio-economic, lifestyle, and psychosocial factors on both self-rated health and overall functional health. Some key findings are: 1) the relationship between income and health is significant for older women, but not for older men, while the opposite occurs for education; 2) having an acceptable body weight is positively associated with health for elderly women only; and 3) stress-related factors are generally much stronger determinants of health for older women. These findings shed light on the processes of healthy aging for men and women.health; aging; gender differences; NPHS

Ethnic Inequality in Canada: Economic and Health Dimensions

This study examines ethnic based differences in economic and health status. We combine existing literature with our analysis of data from the Canadian Census and National Population Health Survey. If a given sub-topic is well researched, we summarize the findings; if, on the other hand, less is known, we present data placing them in the context of whatever literature does exist. Our findings are consistent with existing literature on ethnic inequalities in Canada. Recent immigrants with a mother tongue other than English or French are among the most economically disadvantaged in Canadian society, though the results vary depending on gender and ethnic background. In fact economic inequality according to type of occupation can be attributed to gender rather than ethnicity; that is, the Canadian labour force continues to be more gender- than ethnically-differentiated. Yet recent immigrants, especially from Asia, are advantaged in health outcomes compared to Canadian-born persons – the “healthy immigrant” effect. Interestingly they are less likely to report having a physical check-up and, for women (especially Asian-born women), a mammogram within the last year compared to their Canadian-born counterparts. Given the significance of both gender and ethnicity as predictors of well-being, future research should examine the intersection between the two identity markers and their relationship to social inequality.ethnicity, immigration, language, gender, income, occupation, health

Rethinking retirement

Four of the seven chapters in this volume are based on papers originally presented at the 6th Annual John K. Friesen Lecture Series in Gerontology held at Simon Fraser University April 3-4, 1995. The impetus for the symposium and the volume was provided by the profound changes that are taking place in Canada and throughout the developed world in the way retirement is being conceptualized, timed, and reflected in corporate and public policy.\u27 A systematic examination of these changes seemed warranted.TABLE OF CONTENTS: 1. Introduction. 2. Population Aging: A Contested Terrain of Social Policy/ Ellen M. Gee; 3. Rethinking Retirement: Issues for the Twenty-First Century / Victor W. Marshall; 4. The Older Worker in Canadian Society: Is There a Future? / Victor W Marshall; 5. Security for Social Security - Raise the Age of Entitlement? / Robert L. Brown; 6. Work, Retirement and Women in Later Life / Susan A. McDaniel; 7. Women\u27s Retirement: Shifting Ground / Lynne MacFadgen and Lillian Zimmerman

Internet Devices and Desires: A Review of Randomized Controlled Trials of Interactive, Internet-mediated, In-home, Chronic Disease Monitoring Programs

Abstract:Background and Objectives: The advent of the Internet has made in-home monitoring a possibility for patients suffering from chronic disease, although few studies have examined this phenomena across different disease states. The goal of this review is to identify and evaluate studies where randomized control trials were used to evaluate Internet-mediated home monitoring systems designed to manage and support patients with chronic diseases.Methods and Results: We reviewed 454 abstracts of articles describing computerbased health interventions and read forty-three articles in depth. Seventeen articles met inclusion criteria and were selected for this review. Only completed randomized, controlled trials that reported physiological health outcomes of the intervention were included. Other results reviewed included the populations studied, the short and long term effectiveness of the interventions, costs and technology-related issues and health care provider communication. Internet-mediated home monitoring interventions appear to have some benefit for specific chronic diseases in specific circumstances. Few studies documented cost savings; none of those that did used consistent measures. Studies seldom addressed the challenges of introducing sophisticated interactive-monitoring systems into patients’ homes, the reasons for attrition from trials, or the effects of the intervention on the work of care providers or interprofessional practices.Conclusions: The interventions reviewed showed potential to enhance chronic disease management in some cases. However, the short duration of the studies made it difficult to generalize the results to wider home care settings or predict the effectiveness of such systems over the long and complicated courses of chronic diseases. Thus, despite hopes for significant cost and labour savings, Internet-mediated systems for monitoring chronic diseases in patients’ homes will likely complement rather than replace usual care

Women\u27s Health and Health Care Reform: The Economic Burden of Disease in Women

This report estimates the direct and indirect costs of care for women for the major chronic diseases and conditions that women face across the lifespan. It also identifies the key primary care and preventive services that can lead to prevention, early detection or early intervention for these conditions. Health care screening, counseling, early diagnosis, and early intervention health care services are important for women at each stage of their lives. But women typically seek care in primary care settings for family planning services and cancer screening prior to becoming pregnant. As a result, high quality care during the reproductive years offers an important opportunity to identify risk factors and health conditions and to provide appropriate interventions and quality care. Primary and preventive care standards also underscore that screening for cancer, risks for heart disease, family planning services and detection of violence, as well as smoking cessation and nutrition counseling, should begin during the reproductive years. A healthy pregnancy, leading to the best outcome for both mother and child, begins when the woman is in the best possible health prior to conception. Counseling on obesity prevention and smoking cessation are vital prior to pregnancy; delaying counseling until after conception compromises a woman\u27s ability to achieve the best outcomes. Identification of hypertension and/or gestational diabetes in pregnancy provides an opportunity to identify women at higher risk of heart disease and diabetes later in life. Early care is particularly important for women who are members of racial and ethnic minority groups. Approximately one in every three residents of the United States self-identifies as African-American, American Indian/Alaska Native, Asian/Pacific-American, or Latino. Disparities in health status are closely associated with race and ethnicity – in health insurance coverage, psychosocial stress, discrimination and health care access and quality, and in deaths due to breast cancer and pregnancy-related causes

Comparing neural correlates of conditioned inhibition between children with and without anxiety disorders - A preliminary study

Cognitive-behavioral therapy (CBT), a first-line treatment for pediatric anxiety disorders, is based on principles of threat learning and extinction. However, CBT does not work sufficiently for up to 40% of clinically anxious youth. The neural and behavioral correlates of conditioned inhibition might provide promising targets for attempts to improve CBT response. During conditioned inhibition, threat and safety cues appear together, forming a safety compound. Here, we test whether this safety compound elicits a reduced fear response compared to pairing the threat cue with a novel cue (novel compound). The current pilot study compares behavioral, physiological, and neural correlates of conditioned inhibition between children with (n=17, Mage=13.09, SD=3.05) and without (n=18, Mage=14.49, SD=2.38) anxiety disorders. Behavioral and physiological measures did not differ between children with and without anxiety disorders during fear acquisition. During testing, children with anxiety disorders showed overall higher skin conductance response and expected to hear the aversive sound following the novel compound more often than children without anxiety disorders. Children with anxiety disorders showed more activity in the right ventromedial prefrontal cortex (vmPFC) to the safety versus novel compound. Children without anxiety disorders showed the opposite pattern - more right vmPFC activity to the novel versus safety compound (F(1,31)=5.40, p=0.03). No group differences manifested within the amygdala, dorsal anterior cingulate cortex, or hippocampus. These pilot findings suggest a feasible approach for examining conditioned inhibition in pediatric anxiety disorders. If replicated in larger samples, findings may implicate perturbed conditioned inhibition in pediatric anxiety disorders and provide targets for CBT

Zero-DeepSub: Zero-Shot Deep Subspace Reconstruction for Rapid Multiparametric Quantitative MRI Using 3D-QALAS

Purpose: To develop and evaluate methods for 1) reconstructing 3D-quantification using an interleaved Look-Locker acquisition sequence with T2 preparation pulse (3D-QALAS) time-series images using a low-rank subspace method, which enables accurate and rapid T1 and T2 mapping, and 2) improving the fidelity of subspace QALAS by combining scan-specific deep-learning-based reconstruction and subspace modeling. Methods: A low-rank subspace method for 3D-QALAS (i.e., subspace QALAS) and zero-shot deep-learning subspace method (i.e., Zero-DeepSub) were proposed for rapid and high fidelity T1 and T2 mapping and time-resolved imaging using 3D-QALAS. Using an ISMRM/NIST system phantom, the accuracy of the T1 and T2 maps estimated using the proposed methods was evaluated by comparing them with reference techniques. The reconstruction performance of the proposed subspace QALAS using Zero-DeepSub was evaluated in vivo and compared with conventional QALAS at high reduction factors of up to 9-fold. Results: Phantom experiments showed that subspace QALAS had good linearity with respect to the reference methods while reducing biases compared to conventional QALAS, especially for T2 maps. Moreover, in vivo results demonstrated that subspace QALAS had better g-factor maps and could reduce voxel blurring, noise, and artifacts compared to conventional QALAS and showed robust performance at up to 9-fold acceleration with Zero-DeepSub, which enabled whole-brain T1, T2, and PD mapping at 1 mm isotropic resolution within 2 min of scan time. Conclusion: The proposed subspace QALAS along with Zero-DeepSub enabled high fidelity and rapid whole-brain multiparametric quantification and time-resolved imaging.Comment: 17 figures, 3 table

Factors determining ultra-short-term survival and the commencement of active treatment in high-grade serous ovarian cancer: a case comparison study

From Springer Nature via Jisc Publications RouterHistory: received 2020-06-12, accepted 2021-03-10, registration 2021-03-10, pub-electronic 2021-04-08, online 2021-04-08, collection 2021-12Publication status: PublishedFunder: Cancer Research UK; doi: http://dx.doi.org/10.13039/501100000289; Grant(s): 22647Abstract: Background: Despite improvements in median survival some patients with advanced ovarian cancer die within 100 days of diagnosis; the reasons for which remain poorly understood. Here we investigate if ultra short-term survival can be explained by patient characteristics or treatment pathways. Methods: A nested case comparison study was used to examine differences between patients with high grade serous ovarian/fallopian tube cancer who died within 100 days (n = 28) compared to a comparison group of patients matched for histology and including any survival greater than 100 days (n = 134). Results: Cases and comparison patients had similar ages, BMI, ACE-27, deprivation indices, and distribution of disease on CT. There were no significant delays in time to diagnosis or treatment (p = 0.68) between the groups. However, cases had lower serum albumin, haemoglobin and higher platelet counts than matched comparison patients (p < 0.0001) and a worse performance score (P = 0.006). Conclusion: Patients who die rapidly after a diagnosis of ovarian cancer are only slightly older and have similar pre treatment frailty compared to patients whose survival approaches the median. However they do appear to undergo greater physiological compromise as a result of their disease