Suchergebnisse

Higher proportions of births outside marriage and more family breakdown indicate that children experience increased diversity of family circumstances at birth and during childhood. While England/Wales and Norway have many similar features, there are distinct differences in social and welfare policies. This article compares children's experiences in the two countries in relation to these policies. Emphasis is put particularly on the impact of consensual unions. Children are the statistical unit and data from surveys and national statistics are compared. In both countries there is considerable risk of family dissolution in the case of children born into consensual unions, but the more so in England/Wales than in Norway. Even though the rate of extramarital births is much higher in Norway than in England/Wales, the corresponding rate of family change is lower. The article suggests that behind parental break-up lies an old pattern of social stratification masked as family change.

SummaryThe characteristics of the first 200 cases of vasectomy reversal have been analysed. The mean time from vasectomy to reversal was 4.8 years. It varied according to the reason for requesting reversal, and was particularly short when the operation had been performed at the time of the partner's pregnancy. Thirty percent of the men were with the same partner and 70% a new partner. Vasectomy reversal cases tended to be younger than vasectomy patients as a whole but did not differ significantly in social class. In this series of reversals, spermatozoa were present in the ejaculate throughout the 20-week follow-up time in 80% of the men; the pregnancy rate was 44%.

Cover -- Half Title -- Title Page -- Copyright Page -- Original Title Page -- Original Copyright Page -- Table of Contents -- List of Tables -- Authors' Note -- Acknowledgements -- Foreword -- Introduction -- I: The Last Years at School -- 1 Teenagers' Disabilities and their Schooling -- 2 The Attainment of Independence and Responsibility -- 3 Social Life: Friendships and the use of Leisure -- 4 Fears and Aspirations about Marriage and Relations with the Opposite Sex -- 5 Psychological Adjustment and Problems -- 6 Factors Associated with Teenagers' Psychological Problems -- II: The Transition from School to Adult Life -- 7 Post-School Placements of the Follow-Up Group -- 8 Stresses Encountered during the Transition Year -- 9 Change and Development in the Post-School Year -- III: Support from Society and the Family -- 10 Provision made in Schools to Facilitate the Transition to Adult Life -- 11 Satisfaction with Vocational and other Services for School Leavers -- 12 Coping with Disability: Theoretical Issues and Findings on the Role of the Family and other Informal Resources -- 13 Conclusions and Recommendations -- Appendices -- A: The Sample: Selection Procedure and Background Information -- B: Useful Addresses -- References -- Index.

This paper focuses on 'normative talk' about grandparenting. It is based on a secondary analysis of a study involving 46 interviews with grandparents. It identifies two main cultural norms of grandparenting that emerged from the data – 'being there' and 'not interfering'. There were very high levels of consensus in the study that these constituted what grandparents 'should and should not' do. However, these two norms can be contradictory, and are not easy to reconcile with the everyday realities of grandparenting. The study found that norms of parenting and also of self determination were also very important for the grandparents in the study. They had a keen sense of what being a 'good parent' (to their own adult children) should mean – especially in terms of allowing them to be independent – but this could sometimes conflict with their sense of responsibility to descendant generations of grandchildren. Using the concept of ambivalence and drawing on the accounts of grandparents in the study, the paper explores and offers an explanation for both the coexistence and conflict between different sets of norms, as well as for the remarkably high levels of consensus about 'being there' and 'not interfering'. The paper concludes with a discussion of some of the limitations of the data and the analysis, and with suggestions for the development of further work in this area.

This paper focuses on 'normative talk' about grandparenting. It is based on a secondary analysis of a study involving 46 interviews with grandparents. It identifies two main cultural norms of grandparenting that emerged from the data - 'being there' and 'not interfering'. There were very high levels of consensus in the study that these constituted what grandparents 'should and should not' do. However, these two norms can be contradictory, and are not easy to reconcile with the everyday realities of grandparenting. The study found that norms of parenting and also of self determination were also very important for the grandparents in the study. They had a keen sense of what being a 'good parent' (to their own adult children) should mean - especially in terms of allowing them to be independent - but this could sometimes conflict with their sense of responsibility to descendant generations of grandchildren. Using the concept of ambivalence and drawing on the accounts of grandparents in the study, the paper explores and offers an explanation for both the coexistence and conflict between different sets of norms, as well as for the remarkably high levels of consensus about 'being there' and 'not interfering'. The paper concludes with a discussion of some of the limitations of the data and the analysis, and with suggestions for the development of further work in this area. © 2007 The Editorial Board of The Sociological Review.

Equity in healthcare has been a long-term guiding principle of health policy in India. We estimate the change in horizontal inequities in healthcare use over two decades comparing the older population (60 years or more) with the younger population (under 60 years). We used data from the nationwide healthcare surveys conducted in India by the National Sample Survey Organization in 1995-96 and 2014 with sample sizes 633 405 and 335 499, respectively. Bivariate and multivariate logit regression analyses were used to study the socioeconomic differentials in self-reported morbidity (SRM), outpatient care and untreated morbidity. Deviations in the degree to which healthcare was distributed according to need were measured by horizontal inequity index (HI). In each consumption quintile the older population had four times higher SRM and outpatient care rate than the younger population in 2014. In 1995-96, the pro-rich inequity in outpatient care was higher for the older (HI: 0.085; 95% CI: 0.066, 0.103) than the younger population (0.039; 0.034, 0.043), but by 2014 this inequity became similar. Untreated morbidity was concentrated among the poor; more so for the older (-0.320; -0.391, -0.249) than the younger (-0.176; -0.211, -0.141) population in 2014. The use of public facilities increased most in the poorest and poor quintiles; the increase was higher for the older than the younger population in the poorest (1.19 times) and poor (1.71 times) quintiles. The use of public facilities was disproportionately higher for the poor in 2014 than in 1995-96 for the older (-0.189; -0.234, -0.145 vs - 0.065; -0.129, -0.001) and the younger (-0.145; -0.175, -0.115 vs - 0.056; -0.086, -0.026) population. The older population has much higher morbidity and is often more disadvantaged in obtaining treatment. Health policy in India should pay special attention to equity in access to healthcare for the older population.

OBJECTIVES: We report hospitalisation trends for different age groups across the states of India and for various disease groups, compare the hospitalisation trends among the older (aged 60 years or more) and the younger (aged under 60 years) population and quantify the factors that contribute to the change in hospitalisation rates of the older population over two decades. DESIGN: Serial cross-sectional study. SETTING: Nationally representative sample, India. DATA SOURCES: Three consecutive National Sample Surveys (NSS) on healthcare utilisation in 1995-1996, 2004 and 2014. PARTICIPANTS: Six hundred and thirty-three thousand four hundred and five individuals in NSS 1995-1996, 385 055 in NSS 2004 and 335 499 in NSS 2014. METHODS: Descriptive statistics, multivariable analyses and a regression decomposition technique were used to attain the study objectives. RESULT: The annual hospitalisation rate per 1000 increased from 16.6 to 37.0 in India from 1995-1996 to 2014. The hospitalisation rate was about half in the less developed than the more developed states in 2014 (26.1 vs 48.6 per 1000). Poor people used more public than private hospitals; this differential was higher in the more developed (40.7% vs 22.9%) than the less developed (54.3% vs 40.1%) states in 2014. When compared with the younger population, the older population had a 3.6 times higher hospitalisation rate (109.9 vs 30.7) and a greater proportion of hospitalisation for non-communicable diseases (80.5% vs 56.7%) in 2014. Among the older population, hospitalisation rates were comparatively lower for females, poor and rural residents. Propensity change contributed to 86.5% of the increase in hospitalisation among the older population and compositional change contributed 9.3%. CONCLUSION: The older population in India has a much higher hospitalisation rate and has continuing greater socioeconomic differentials in hospitalisation rates. Specific policy focus on the requirements of the older population for hospital care in India is needed in light of the anticipated increase in their proportion in the population.

BACKGROUND: India's economic development and urbanisation in recent decades has varied considerably between states. Attempts to assess how overweight (including obesity) varies by socioeconomic position at the national level may mask considerable sub-national heterogeneity. We examined the socioeconomic patterning of overweight among adults in India's most and least economically developed states between 1998 and 2016. METHODS: We used state representative data from the National Family Health Surveys from 1998 to 99, 2005-06 and 2015-16. We estimated the prevalence of overweight by socioeconomic position in men (15-54 years) and women (15-49 years) from India's most and least economically developed states using multilevel logistic regressions. RESULTS: We observed an increasing trend of overweight prevalence among low socioeconomic position women. Amongst high socioeconomic position women, overweight prevalence either increased to a smaller extent, remained the same or even declined between 1998 and 2016. This was particularly the case in urban areas of the most developed states, where in the main analysis, the prevalence of overweight increased from 19 to 33% among women from the lowest socioeconomic group between 1998 and 2016 compared to no change among women from the highest socioeconomic group. Between 2005 and 2016, the prevalence of overweight increased to similar extents among high and low socioeconomic status men, irrespective of residence. CONCLUSIONS: The converging prevalence of overweight by socioeconomic position in India's most developed states, particularly amongst urban women, implies that this subpopulation may be the first to exhibit a negative association between socioeconomic position and overweight in India. Programs aiming to reduce the increasing overweight trends may wish to focus on poorer women in India's most developed states, amongst whom the increasing trend in prevalence has been considerable.

BACKGROUND: In India, the prevalence of overweight and obesity has increased rapidly in recent decades. Given the association between overweight and obesity with many non-communicable diseases, forecasts of the future prevalence of overweight and obesity can help inform policy in a country where around one sixth of the world's population resides. METHODS: We used a system of multi-state life tables to forecast overweight and obesity prevalence among Indians aged 20-69 years by age, sex and urban/rural residence to 2040. We estimated the incidence and initial prevalence of overweight using nationally representative data from the National Family Health Surveys 3 and 4, and the Study on global AGEing and adult health, waves 0 and 1. We forecasted future mortality, using the Lee-Carter model fitted life tables reported by the Sample Registration System, and adjusted the mortality rates for Body Mass Index using relative risks from the literature. RESULTS: The prevalence of overweight will more than double among Indian adults aged 20-69 years between 2010 and 2040, while the prevalence of obesity will triple. Specifically, the prevalence of overweight and obesity will reach 30.5% (27.4%-34.4%) and 9.5% (5.4%-13.3%) among men, and 27.4% (24.5%-30.6%) and 13.9% (10.1%-16.9%) among women, respectively, by 2040. The largest increases in the prevalence of overweight and obesity between 2010 and 2040 is expected to be in older ages, and we found a larger relative increase in overweight and obesity in rural areas compared to urban areas. The largest relative increase in overweight and obesity prevalence was forecast to occur at older age groups. CONCLUSION: The overall prevalence of overweight and obesity is expected to increase considerably in India by 2040, with substantial increases particularly among rural residents and older Indians. Detailed predictions of excess weight are crucial in estimating future non-communicable disease burdens and their economic impact. ; This study was supported in part by the Victorian Government's OIS Program, the Australian National Health and Medical Research Council (NHMRC Project no. 1122744), the Murdoch Children's Research Institute, and the Royal Children's Hospital Foundation (grant no. 2017-896). GA was supported by an NHMRC Early Career Fellowship (no. 1090462). MI was supported by the Munz Chair of Cardiovascular Prediction and Prevention. This study acknowledges the use of the following UK JIA cohort collections: The Biologics for Children with Rheumatic Diseases (BCRD) study (funded by Arthritis Research UK Grant 20747). The British Society for Paediatric and Adolescent Rheumatology Etanercept Cohort Study (BSPAR-ETN) (funded by a research grant from the British Society for Rheumatology (BSR). BSR has previously also received restricted income from Pfizer to fund this project). Childhood Arthritis Prospective Study (CAPS) (funded by Versus Arthritis, grant reference number 20542), Childhood Arthritis Response to Medication Study (CHARMS) (funded by Sparks UK, reference 08ICH09, and the Medical Research Council, reference MR/M004600/1), United Kingdom Juvenile Idiopathic Arthritis Genetics Consortium (UKJIAGC). Genotyping of the UK JIA case samples were supported by the Versus Arthritis grants reference numbers 20385 and 21754. This research was funded by the NIHR Manchester Biomedical Research Centre and supported by the Manchester Academic Health Sciences Centre (MAHSC). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. We would like to acknowledge the assistance given by IT Services and the use of the Computational Shared Facility at The University of Manchester. Finally, the CHOP data used were funded by an Institute Development Fund to the CAG center from The Children's Hospital of Philadelphia and by NIH grant, U01-HG006830, from the NHGRI-sponsored eMERGE Network.

Aims/hypothesis: We aimed to estimate the lifetime risk of diabetes and diabetes-free life expectancy in metropolitan cities in India among the population aged 20 years or more, and their variation by sex, age and BMI.Methods: A Markov simulation model was adopted to estimate age-, sex- and BMI-specific lifetime risk of developing diabetes and diabetes-free life expectancy. The main data inputs used were as follows: age-, sex- and BMI-specific incidence rates of diabetes in urban India taken from the Centre for Cardiometabolic Risk Reduction in South Asia (2010-2018); age-, sex- and urban-specific rates of mortality from period lifetables reported by the Government of India (2014); and prevalence of diabetes from the Indian Council for Medical Research INdia DIABetes study (2008-2015).Results: Lifetime risk (95% CI) of diabetes in 20-year-old men and women was 55.5 (51.6, 59.7)% and 64.6 (60.0, 69.5)%, respectively. Women generally had a higher lifetime risk across the lifespan. Remaining lifetime risk (95% CI) declined with age to 37.7 (30.1, 46.7)% at age 60 years among women and 27.5 (23.1, 32.4)% in men. Lifetime risk (95% CI) was highest among obese Indians: 86.0 (76.6, 91.5)% among 20-year-old women and 86.9 (75.4, 93.8)% among men. We identified considerably higher diabetes-free life expectancy at lower levels of BMI.Conclusions/interpretation: Lifetime risk of diabetes in metropolitan cities in India is alarming across the spectrum of weight and rises dramatically with higher BMI. Prevention of diabetes among metropolitan Indians of all ages is an urgent national priority, particularly given the rapid increase in urban obesogenic environments across the country. Graphical abstract.

AIMS/HYPOTHESIS: We aimed to estimate the lifetime risk of diabetes and diabetes-free life expectancy in metropolitan cities in India among the population aged 20 years or more, and their variation by sex, age and BMI. METHODS: A Markov simulation model was adopted to estimate age-, sex- and BMI-specific lifetime risk of developing diabetes and diabetes-free life expectancy. The main data inputs used were as follows: age-, sex- and BMI-specific incidence rates of diabetes in urban India taken from the Centre for Cardiometabolic Risk Reduction in South Asia (2010-2018); age-, sex- and urban-specific rates of mortality from period lifetables reported by the Government of India (2014); and prevalence of diabetes from the Indian Council for Medical Research INdia DIABetes study (2008-2015). RESULTS: Lifetime risk (95% CI) of diabetes in 20-year-old men and women was 55.5 (51.6, 59.7)% and 64.6 (60.0, 69.5)%, respectively. Women generally had a higher lifetime risk across the lifespan. Remaining lifetime risk (95% CI) declined with age to 37.7 (30.1, 46.7)% at age 60 years among women and 27.5 (23.1, 32.4)% in men. Lifetime risk (95% CI) was highest among obese Indians: 86.0 (76.6, 91.5)% among 20-year-old women and 86.9 (75.4, 93.8)% among men. We identified considerably higher diabetes-free life expectancy at lower levels of BMI. CONCLUSIONS/INTERPRETATION: Lifetime risk of diabetes in metropolitan cities in India is alarming across the spectrum of weight and rises dramatically with higher BMI. Prevention of diabetes among metropolitan Indians of all ages is an urgent national priority, particularly given the rapid increase in urban obesogenic environments across the country. Graphical abstract.