SOCIAL DETERMINANTS OF OVERWEIGHT AND OBESITY AMONG ELDERLY MEN AND WOMEN IN TAIWAN

Although an obesity epidemic has spread to people of all age groups, empirical knowledge about elderly obesity remains largely scant, particularly in non-Western societies. This dissertation addresses that gap by examining the social determinants of overweight and obesity and weight gain among men and women, using 1999 and 2003 waves of the longitudinal Survey of Health and Living Status of the Near Elderly and Elderly in Taiwan. Existing literature shows that the effect of socioeconomic status (SES) on body weight shifts from positive to negative as the level of development of a society progresses from low to high, and social gradients in obesity appear first among women. A gender-specific pattern of social disparities in overweight and obesity is expected to have emerged in Taiwan. The analysis captures a gendered pattern in the transition of the SES-obesity relationship in Taiwan. Similar to less-developed countries, men and women with more material resources (i.e. income and wealth) have an elevated risk of overweight and obesity, indicating the importance of material resources in getting access to food through most of the lifetime of this elderly population. However, household wealth is inversely associated with short-term weight gain among women, suggesting that wealth may become a protective factor against overweight and obesity. The education effect has shifted to the pattern of Western societies, particularly among women. While education has strong negative impacts on cumulative body weight among women, it is inversely associated with short-term weight gain for both men and women. The protective effect of education emerges earlier among women than among men, probably as a result of educated women adopting the Western ideal of thinness. Also, the negative effect of childhood SES on body weight among women is transmitted through education. Hence, social disparities in overweight and obesity among older women is mainly produced by differential weight gains in adulthood for individuals of different SES. Finally, the relationship between social participation and excess body weight is explored. Men and women with active social participation have a reduced risk for greater weight gain, suggesting that social participation may have some buffering effects on unhealthy weight outcomes of the disadvantaged groups, especially among women

Demographic change and response: social context and the practice of birth control in six countries

This paper expands on Kingsley Davis’s demographic thesis of change and re- sponse. Specifically, we consider the social context that accounts for the primacy of particular birth control methods that bring about fertility change during specific time periods. We examine the relevance of state policy (including national family planning programs), the international population establishment, the medical profession, organized religion, and women’s groups using case studies from Japan, Russia, Puerto Rico, China, India, and Cameroon. Some of these countries are undergoing the second demographic transition, others the first. Despite variations in context, heavy reliance on sterilization and/or abortion as a means of birth control is a major response in most of these countries. The key roles of the medical profession and state policy are discussed, along with the general lack of influence of religion and of women’s groups in these countries

Structural Basis for Specific Binding of Human MPP8 Chromodomain to Histone H3 Methylated at Lysine 9

. MPP8 binding to methylated H3K9 is suggested to recruit the H3K9 methyltransferases GLP and ESET, and DNA methyltransferase 3A to the promoter of the E-cadherin gene, mediating the E-cadherin gene silencing and promote tumor cell motility and invasion. MPP8 contains a chromodomain in its N-terminus, which is used to bind the methylated H3K9. HP1, a chromodomain containing protein that binds to methylated H3K9 as well. The structure also reveals that the human MPP8 chromodomain forms homodimer, which is mediated via an unexpected domain swapping interaction through two β strands from the two protomer subunits.Our findings reveal the molecular mechanism of selective binding of human MPP8 chromodomain to methylated histone H3K9. The observation of human MPP8 chromodomain in both solution and crystal lattice may provide clues to study MPP8-mediated gene regulation furthermore

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

Socioeconomic differentials in smoking duration among adult male smokers in China: result from the 2006 China Health and Nutrition Survey.

A smoker's risk of diseases and death from smoking is closely related to his/her smoking duration. But little is known about the average length of smoking and the association between smoking duration and socio-economic status (SES) among Chinese smokers.A sample of male ever smokers (N = 2,637) aged 18+ years was drawn from the 2006 China Health and Nutrition Survey to examine the average length of smoking and socioeconomic differentials in smoking duration. Kaplan-Meier analysis was used to obtain median smoking duration. Log-logistic regression models were employed to estimate the relative duration of smoking, adjusted for demographic characteristics, smoking history, and health status.Results showed that Chinese male ever smokers aged 18 years and older had a median duration of smoking of 58 years (95% CI: 56-61). Male ever smokers with a lower status job (i.e. farmers, manual and skilled workers, service workers, and office staff) had a significantly longer duration of smoking than those with a professional or administrative job after adjusted for demographic characteristics, smoking history, and health status. Individuals who earned the lowest income and who had no education or were being illiterate smoked for 11% and 14% longer, respectively, relative to those who had the highest income or who had college or above education.The findings demonstrated the problem of long smoking duration and a pattern of social disparities in smoking duration among Chinese male smokers. Social disparities in smoking behavior may exacerbate the already existing social inequalities in health. Thus, policies and interventions to promote smoking cessation should pay more attention to disadvantaged social groups

Log-logistic Regression Models Estimating the Association between SES and Duration of Smoking among Male Ever Smokers Aged 18+, CHNS, 2006 (N = 2,637).

<p>^a Time ratios were computed by exponentiating the log-logistic regression coefficients.</p><p>*p<0.05, **p<0.01, ***p<0.001</p><p>Log-logistic Regression Models Estimating the Association between SES and Duration of Smoking among Male Ever Smokers Aged 18+, CHNS, 2006 (N = 2,637).</p

Sample Characteristics and Distribution of Smoking Duration among Male Ever Smokers Aged 18+, CHNS, 2006 (N = 2,637).

<p>^a nc refers to not being computed due to ties and/or insufficient uncensored cases.</p><p>^b Due to ties and/or insufficient uncensored cases, we can’t compute median durations of smoking for occupation and age group. To compare results, we estimated mean durations of smoking for occupation and age group, which tend to be lower than median durations of smoking.</p><p>Sample Characteristics and Distribution of Smoking Duration among Male Ever Smokers Aged 18+, CHNS, 2006 (N = 2,637).</p

Does social participation reduce the risk of functional disability among older adults in China? A survival analysis using the 2005–2011 waves of the CLHLS data

Abstract Background Existing studies in developed countries show that social participation has beneficial effects on the functional ability of older adults, but research on Chinese older people is limited. This study examined the effects of participating in different types of social activities on the onset of functional disability and the underlying behavioral and psychosocial mechanisms among older adults aged 65 and older in China. Methods The 2005, 2008, and 2011 waves of the Chinese Longitudinal Health Longevity Study were used. Life table analysis and discrete time hazard models were adopted to examine the relationship between social participation and functional disability. Social participation was defined as the frequencies of engaging in group leisure-time activities (i.e., playing cards/mahjong) and organized social activities, involving in informal social interactions (i.e., number of siblings frequently visited), and participating in paid jobs. Extensive social participation was measured by a composite index by adding up the four types of social activities that an older person was engaged in. Results After controlling for the effect of socio-demographic characteristics, health status, and health behavioral factors, extensive social participation is associated with a significant reduced risk for the onset of functional disability (hazard ratio [HR] = 0.92, p < 0.001). Different types of social participation affect the risk of functional decline through different mechanisms. Frequent playing of cards/mahjong is a protective factor for functional decline (HR = 0.78, p < 0.001), and the relationship is partially mediated by cognitive ability and positive emotions (accounting for 18.9% and 7.0% of the association, respectively). Frequent participation in organized social activities is significantly related to a reduced risk of functional decline (HR = 0.78, p < 0.001), and the association is mediated by physical exercises and cognitive ability (accounting for 25.7% and 17.7% of the association, respectively). Frequent visits from siblings has a strong inverse relationship with functional decline (HR = 0.75, p < 0.001). However, no significant association between paid job and functional decline is observed. Conclusion Extensive social participation, regular engagement in group leisure-time activities, organized social activities, and informal social interactions in particular may have beneficial effects on the functional health of older adults through behavioral and psychosocial pathways. The findings shed light for the importance of promoting social participation among older adults