Age Differences in Women's Perceptions of Their Health Problems and Concerns

This paper addresses age differences in women's perceptions of their health problems and concerns. The data are drawn from interviews with a stratified random sample of 356 women in Hamilton, Canada. The data show that women of all ages are concerned or worried about the major causes of death including heart disease, all types of cancer and road traffic accidents although younger women are more concerned with breast cancer and cancer of the womb. In terms of the health problems they have experienced, while stress and tiredness are common health problems reported by women of all ages, older women are more likely than the younger women to report life threatening health problems such as heart disease, lung disease and chronic diseases such as arthritis and osteoporosis. Information from in-depth interviews with 32 of the women reveal that the sources of stress, tiredness and depression lie in the social context of women's lives and differ for women of different ages. The authors conclude that it should not be assumed that women's health concerns and experiences are homogeneous. In research on women's health and in shaping women's health policy, it is important to recognize that there are fundamental differenceshealth problems; age differences

Workers' Knowledge of their Legal Rights and Resistance to Hazardous Work

Cet article présente les résultats d'une étude qui a porté sur les connaissances, les perceptions et les actions des travailleurs en matière de santé et de sécurité au travail. Elle visait à découvrir s'il existait une corrélation entre leur connaissance de la loi et leurs actions face à des risques. Pour ce faire, 492 travailleurs ont été interviewés. Ceux-ci provenaient de huit établissements du sud de l'Ontario qui incluaient des petites et grandes entreprises, du secteur privé et du secteur public, certaines syndiquées et d'autres non.Les variables retenues, pour établir des relations avec la connaissance de la loi, ont été regroupées en quatre catégories: caractéristiques de l'entreprise (importance, syndicalisation et secteur d'activité); connaissance et appréciation des problèmes touchant la santé et la sécurité au travail (perception des dangers, temps perdu à la suite d'accidents ou de maladies reliés au travail, comportement des contremaîtres sur les questions d'hygiène et de sécurité, harcèlement des salariés contestataires, connaissances de leurs représentants en matière d'hygiène et de sécurité); sentiment de maîtrise personnelle (dans l'exécution de leur tâche et dans le souci de leur santé et de leur sécurité); enfin, variables démographiques (âge, scolarité, sexe, langue). Les résultats indiquent que les travailleurs, dont la situation est meilleure dans l'entreprise et sur le marché du travail (syndiqués, de sexe masculin et possédant un degré de scolarisation plus élevé), étaient plus susceptibles de mieux connaître la loi. Il en était de même pour ceux qui ont indiqué avoir le sentiment de maîtriser leur travail, leur santé et leur sécurité. Les travailleurs considérant leur tâche dangereuse, conscients de la valeur de la contestation et connaissant leurs représentants en matière d'hygiène professionnelle et de sécurité, étaient aussi généralement mieux informés de leurs droits.Parce que trop peu de travailleurs avaient recours aux «mécanismes internes de responsabilisation» que prévoient la loi, l'action des travailleurs a été mesurée en utilisant le recours au refus de travailler. La vaste majorité de ceux-ci consistaient en négociations informelles avec les contremaîtres plutôt qu'en refus formels comme le prévoit la loi. La volonté de refuser les tâches dangereuses était plus fréquente chez ceux et celles qui étaient quelque peu au courant de la loi et qui étaient conscients de la nécessité d'avoir de meilleures mesures d'hygiène professionnelle et de sécurité pour surmonter les dangers dans leur milieu de travail. Les travailleurs de l'industrie recouraient d'avantage au refus de travailleur que les employés d'hôpitaux. Les salariés les plus âgés ainsi que les femmes étaient davantage enclins à refuser de travailler.On n'a trouvé aucun lien direct entre l'action des travailleurs et la syndicalisation, la connaissance de son représentant en santé et sécurité ainsi que le sentiment de maîtrise personnelle de la tâche. Cependant, ces facteurs ont pu avoir des effets indirects par leur relation avec la connaissance de la loi.Politiquement, ces données signifient que les travailleurs ont besoin plus que de l'information sur les risques en milieu de travail, il faut s'efforcer de les informer de leurs droits, principalement les femmes, les non-syndiqués et ceux dont la scolarisation est moindre. De plus, il importe de mieux évaluer ce qui, outre le manque de connaissance de la loi, empêche les travailleurs de recourir aux mécanismes existants pour atténuer les dangers découlant du travail.The paper presents data from a study of workers' knowledge, perceptions and actions regarding occupational health and safety. The correlates of workers' knowledge of health and safety legislation are analyzed, as well as the links between their knowledge and their resistance to hazardous work. The data suggest that workers who are most disadvantaged in the workplace are least likely to be aware of their rights. The correlates of action regarding health and safety are less clear, though knowledge of the legislation was related to resistance to hazardous work

Health, education, and social care provision after diagnosis of childhood visual disability

Aim: To investigate the health, education, and social care provision for children newly diagnosed with visual disability.Method: This was a national prospective study, the British Childhood Visual Impairment and Blindness Study 2 (BCVIS2), ascertaining new diagnoses of visual impairment or severe visual impairment and blindness (SVIBL), or equivalent vi-sion. Data collection was performed by managing clinicians up to 1-year follow-up, and included health and developmental needs, and health, education, and social care provision.Results: BCVIS2 identified 784 children newly diagnosed with visual impairment/SVIBL (313 with visual impairment, 471 with SVIBL). Most children had associated systemic disorders (559 [71%], 167 [54%] with visual impairment, and 392 [84%] with SVIBL). Care from multidisciplinary teams was provided for 549 children (70%). Two-thirds (515) had not received an Education, Health, and Care Plan (EHCP). Fewer children with visual impairment had seen a specialist teacher (SVIBL 35%, visual impairment 28%, χ2p < 0.001), or had an EHCP (11% vs 7%, χ2p < 0 . 01).Interpretation: Families need additional support from managing clinicians to access recommended complex interventions such as the use of multidisciplinary teams and educational support. This need is pressing, as the population of children with visual impairment/SVIBL is expected to grow in size and complexity.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited

Bi-allelic Loss-of-Function CACNA1B Mutations in Progressive Epilepsy-Dyskinesia.

The occurrence of non-epileptic hyperkinetic movements in the context of developmental epileptic encephalopathies is an increasingly recognized phenomenon. Identification of causative mutations provides an important insight into common pathogenic mechanisms that cause both seizures and abnormal motor control. We report bi-allelic loss-of-function CACNA1B variants in six children from three unrelated families whose affected members present with a complex and progressive neurological syndrome. All affected individuals presented with epileptic encephalopathy, severe neurodevelopmental delay (often with regression), and a hyperkinetic movement disorder. Additional neurological features included postnatal microcephaly and hypotonia. Five children died in childhood or adolescence (mean age of death: 9 years), mainly as a result of secondary respiratory complications. CACNA1B encodes the pore-forming subunit of the pre-synaptic neuronal voltage-gated calcium channel Cav2.2/N-type, crucial for SNARE-mediated neurotransmission, particularly in the early postnatal period. Bi-allelic loss-of-function variants in CACNA1B are predicted to cause disruption of Ca2+ influx, leading to impaired synaptic neurotransmission. The resultant effect on neuronal function is likely to be important in the development of involuntary movements and epilepsy. Overall, our findings provide further evidence for the key role of Cav2.2 in normal human neurodevelopment.MAK is funded by an NIHR Research Professorship and receives funding from the Wellcome Trust, Great Ormond Street Children's Hospital Charity, and Rosetrees Trust. E.M. received funding from the Rosetrees Trust (CD-A53) and Great Ormond Street Hospital Children's Charity. K.G. received funding from Temple Street Foundation. A.M. is funded by Great Ormond Street Hospital, the National Institute for Health Research (NIHR), and Biomedical Research Centre. F.L.R. and D.G. are funded by Cambridge Biomedical Research Centre. K.C. and A.S.J. are funded by NIHR Bioresource for Rare Diseases. The DDD Study presents independent research commissioned by the Health Innovation Challenge Fund (grant number HICF-1009-003), a parallel funding partnership between the Wellcome Trust and the Department of Health, and the Wellcome Trust Sanger Institute (grant number WT098051). We acknowledge support from the UK Department of Health via the NIHR comprehensive Biomedical Research Centre award to Guy's and St. Thomas' National Health Service (NHS) Foundation Trust in partnership with King's College London. This research was also supported by the NIHR Great Ormond Street Hospital Biomedical Research Centre. J.H.C. is in receipt of an NIHR Senior Investigator Award. The research team acknowledges the support of the NIHR through the Comprehensive Clinical Research Network. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, Department of Health, or Wellcome Trust. E.R.M. acknowledges support from NIHR Cambridge Biomedical Research Centre, an NIHR Senior Investigator Award, and the University of Cambridge has received salary support in respect of E.R.M. from the NHS in the East of England through the Clinical Academic Reserve. I.E.S. is supported by the National Health and Medical Research Council of Australia (Program Grant and Practitioner Fellowship)

Beyond Medical and Academic Agendas: Lay Perspectives and Priorities

One theme in the feminist literature on women and health concerns the social processes involved in the medicalization of women. Another major emphasis is on the social aetiology of disease. Neither of these approaches has emphasized women's own perspectives and priorities. In this article, the author outlines some neglected research issues and considers the role of medical, academic and lay perspectives in the formulation of policy.Un thème dans le discours féministe au sujet des femmes et la santé s'occupe des processus sociaux en jeu dans la médicalisation des femmes. On accorde aussi une importance particulière 1 l'étiologie sociale de la maladie. Aucune de ces façons de s'y prendre ne met l'accent sur les perspectives et les priorités des femmes elles-mêmes. Dans cet article, l'auteure présente quelques sujets de recherche négligés et examine le rôle des perspectives médicales, scolaires et profanes dans la formulation de la politique

The Social Context of Women's Health

HEALTH ISSUE: The discussion of health emphasizes the importance of analyses of social determinants of health. Social determinants permit the targeting of policies towards the social factors that impair or improve health. Two broad questions are considered: (i) what do we know about the social determinants of women's health? (ii) are there gender-related differences in health problems, and how we might explain them? KEY FINDINGS: While 'sex' may be used to denote the biological difference between women and men, it is an imperfect measure of 'gender'. It is argued that a single measure cannot hope to capture the complexity of gender nor the ways in which gender relations change over time and give rise to or exacerbate health problems. The literature on the social determinants of health shows the importance of placing a primary emphasis on addressing the social and economic sources of ill health at national, provincial and community levels. DATA GAPS AND RECOMMENDATIONS: Recent studies of gender differences in health point to a lack of data and to the importance of understanding changing gender relations; differences in power and access to resources between women and men, and changing expectations of appropriate gender roles and behaviours. Poverty, social exclusion, unemployment, poor working conditions and unequal gender relations have a profound influence on patterns of health and illness. We suggest some material markers of change that might be used in health surveillance. With a more complete understanding of gender's role in shaping daily lives, these markers could be refined and expanded