老龄化对储蓄和社会养老保障的影响研究

本文从一个两期的世代交叠模型入手,分析了人口老龄化对储蓄和社会养老保障支出的影响。在此基础上运用动态GMM模型对我国2000～2008年地区面板数据进行实证分析。研究结果表明:第一,人均居民储蓄滞后项对基期储蓄的影响作用较大且高度显著;当期老年人口抚养比对人均居民储蓄的影响为负,上期老年人口抚养比对居民储蓄并没有显著影响。第二,人均养老保障支出滞后项对当期人均养老保障支出影响作用较大且高度显著;当期老年人口抚养比对人均养老保障支出有促进作用,而上期老年人口抚养比抑制了人均养老保障支出的增加。     

Menopause Symptoms' Predictors: The Influence of Lifestyle,Health- and Menopause-Related,and Sociodemographic Characteristics

This research explores a causal model of menopausal symptoms in peri- and postmenopausal women. A community sample of 710 women was assessed regarding menopausal symptoms, and sociodemographic, health- and menopause-related, and lifestyle characteristics. Structural equation modelling was used. Menopausal status predicted skin/facial hair changes (β = .156; p <.001), vasomotor (β = .122; p <.001) and sexual symptoms (β = .158; p <.001). Age was significantly associated with cognitive impairment (β = .087; p = .003), aches/pain (β = .072; p = .006), urinary (β = .115; p = .004) and also sexual symptoms (β = .107; p = .021). Several menopausal symptoms are predicted, not only by menopausal status, but also by age progression, among other variables; this should be considered in the context of a well-adapted menopausal transition.     

Effect of Soy Isolate Protein and Resistance Exercises on Muscle Performance and Bone Health of Osteopenic/Osteoporotic Post-Menopausal Women

There are contradictory reports regarding the effect of soy protein isolate on bone health in menopause. The main objective of this study was to assess the influence of soy isolate protein intake and resistance exercises on isokinetic muscle strength, endurance, power, and bone health parameters in osteopenic/osteoporotic postmenopausal women. Sixty osteoporotic sedentary women (mean age 54.55 years) were randomly assigned to three groups: soy isolate protein (Group A), soy?+?exercise group (Group B), and control group (Group C). Group B performed supervised progressive resistance exercises 4 times/week for 12 weeks. Muscle performance was measured by isokinetic dynamometry, and bone health was measured by ultrasound densitometry. Analysis of variance showed significant bone and muscle strength gains (p < .05) both in Group A and B, with the improvements more pronounced in Group B. Significant muscle performance changes, after intervention, were evident and bone strength increases may parallel changes in muscle strength.     

Patterns and severity of menopausal symptoms among Jordanian women

We examined 359 women aged 45–65 years who visited Jordan University Hospital between February and November 2014. The menopausal symptoms were assessed using a validated Arabic version of the menopause rating scale. The mean age at menopause was 49.4 years. Women aged 50–55 years more frequently exhibited hot flushes and vaginal dryness. Although premenopausal women were 1.5 times more likely to experience irritability, perimenopausal women were more likely to experience hot flushes, physical and mental irritability, sexual problems, vaginal dryness, and joint and muscular discomfort. Hence, health care providers should focus on women at all stages of life.     

Age at the onset of menopause and its influencing factors in Turkish women in a rural area

This study was performed to identify menopausal age and its determining factors in women over 40 residing in the Dogubeyazit district of Agri, located in Eastern Turkey. This cross-sectional study was performed on a sample of 1,068 women, selected by simple random sampling among all district health center records of women aged 40 and greater, who were each attributed a random serial number. While 35.6% of the subjects had not yet reached menopause, 60.5% had entered it spontaneously and 3.9% surgically. Average age at spontaneous menopause was 47.4 ± 3.7 years and that of surgical menopause 45.1 ± 5.0. Age at marriage, age of last pregnancy, and the age of the subject’s mother at menopause affected menopausal status. Identifying menopausal age and its determining factors may modify the menopausal status of women and their management of the perimenopausal period.     

Body image,satisfaction with sexual life,self-esteem,and anxiodepressive symptoms: A comparative study between premenopausal,perimenopausal, and postmenopausal women

Menopause is an important life transition in women, and it is associated with significant physical and psychological changes. This study aimed at examining how the menopausal transition influences body image and satisfaction with sexual life. To this aim, body image dissatisfaction, sexual dissatisfaction, and self-esteem were compared in three groups of women with distinct menopausal status (premenopausal n = 142, perimenopausal n = 66, or postmenopausal n = 149), while controlling for depressive and anxiety symptoms and BMI. Using ANOVA between these three groups, we observed that dissatisfaction with body image was significantly higher in the perimenopausal sample compared with its premenopausal counterpart. In the postmenopausal sample, body image improved, as this group displayed body image scores close to the premenopausal level. In addition, sexual dissatisfaction was significantly increased in the perimenopausal and postmenopausal samples, which is compatible with the concept that higher body appreciation positively predicted sexual function. We conclude that body image dissatisfaction reaches a maximum during the perimenopausal phase, before returning to a level nearly identical between the premenopausal and the postmenopausal phases.     

Predictors of stress and depressive mood in Portuguese middle-aged women

ABSTRACT

This cross-sectional study investigates the predictors of psychological symptoms—stress and depressive mood—in a sample of middle-aged women. A community sample of 1,003 women filled in the questionnaires and instruments, which included the Depression, Anxiety and Stress Scales and the Life Events Survey; sociodemographic, health, and menopause-related and lifestyle information was also collected. Structural equation modeling was used to build the model that had stress and depressive mood as dependent variables. Health status (both physical and psychological), recent life events, income and menopausal phase were significantly associated with the frequency of stress and depressive symptoms. Additionally, educational level and parity were also significant predictors of depressive mood. This study emphasizes that psychological symptoms occurrence in midlife depends not only on personal variables (such as health and menopausal status) but also on contextual ones (including recent stressful events) that can be a strong influence on how middle-aged women feel.     

The Epidemiologic Transition Revisited: Compositional Models for Causes of Death by Age and Sex

For decades, researchers have noted systematic shifts in cause‐of‐death patterns as mortality levels change. The notion of the “epidemiologic transition” has influenced thinking about the evolution of health in different societies and the response of the health system to these changes. This article re‐examines the epidemiologic transition in terms of empirical regularities in the cause composition of mortality by age and sex since 1950, and considers whether the theory of epidemiologic transition presents a durable framework for understanding more recent patterns. Age‐sex‐specific mortality rates from three broad cause groups are analyzed: Group 1 (communicable diseases, maternal and perinatal causes, and nutritional deficiencies); Group 2 (noncommunicable diseases); and Group 3 (injuries), using the most extensive international database on mortality by cause, including 1,576 country‐years of observation, and new statistical models for compositional data. The analyses relate changes in cause‐of‐death patterns to changing levels of all‐cause mortality and income per capita. The results confirm that declines in overall mortality are accompanied by systematic changes in the composition of causes in many age groups. These changes are most pronounced among children, for whom Group 1 causes decline as overall mortality falls, and in younger adults, where strikingly different patterns are found for men (shift from Group 3 to Group 2) compared to women (shift toward Group 2 then Group 3). The underlying patterns that emerge from this analysis offer insights into the epidemiologic transition from high‐mortality to low‐mortality settings.     

Good Mothers Never Wane: Mothering at Menopause

ABSTRACT

Due to recent feminist scholarship, we know a considerable amount about women's mothering identities and activities, as well as the impact of mothering ideology on individual women. Nonetheless there are gaps in our knowledge about motherhood. For instance, we know mostly about experiences of mothers with young children, and an implicit assumption is that mothers are also fairly young themselves. Yet, what about mothers at midlife and beyond? What about menopausal mothers? This paper represents an initial attempt to explore motherhood experiences of middle-aged menopausal women. Findings presented in this article are based on 45 in-depth interviews with middle-class, heterosexual menopausal women in a midwestern state in 2001. Findings suggest that motherwork and the maintenance of “good” mothering ideology are still primary activities of women at menopause despite assumptions that menopausal women have completed mothering experiences and are now grandmothers (if caregivers at all). In analyzing menopausal mothers, I encourage broader explorations of women's experiences of both motherhood and menopause.     

Physical activity patterns in healthy middle-aged women

ABSTRACT

Exercise in healthy female adults around the menopausal transition has been routinely examined in leisure activities alone, potentially discounting the physical activity (PA) that is accumulated in household and outdoor domains. The purpose of this study was to quantify PA in healthy middle-aged women and to examine the extent to which the Center for Disease Control (CDC) PA guidelines were met through leisure, household, and outdoor activities. Methods: 440 healthy women, 51–64 years old, BMI ≥18.5 or < 40 kg/m², participated in the study using the Lifetime Physical Activity Questionnaire (LPAQ) to quantify PA. Results: 25.91% met the CDC PA guidelines if leisure time alone was examined. When multiple domains were included, 73.41% of the women met the PA guidelines. This percentage is much higher than the reported 20.6% of U.S. adults who met the guidelines in 2011. PA in women may be underrepresented in data limited to leisure time PA.     

Sexual function and help seeking for urinary incontinence in postmenopausal women

ABSTRACT

Urinary incontinence (UI) is a common condition, especially in middle-aged and older women. UI is known to affect sexual function. Many women with UI do not consult a doctor about their condition. The aim of this study was to determine the relationship of sexual function and help seeking in postmenopausal women with urinary incontinence. This cross-sectional correlation study took place from March to May 2012. The subjects were selected by a clustered sampling method from various zones of Rasht (North of Iran). The data were collected using personal data forms, Questionnaire for Urinary Incontinence Diagnosis, Incontinence Severity Index, and Incontinence Quality of Life questionnaire. Data were analyzed by SPSS17 at the significant level of P < .05 and then were compared by parametric and nonparametric tests. A total of 313 menopausal women aged 45 to 60 years (mean 52.9) were recruited for the study. The mean sexual function score was 31.07 ± 7.52. Only 27.3% of subjects seek care for urinary incontinence. There was a significant correlation between sexual function and help seeking. The results of this study indicate that there is a significant correlation between sexual function and help seeking in postmenopausal women who participated in the present study. Health-care professionals should pay more attention to sexual symptoms of UI and make patients aware of available treatments.     

Food Poverty,Vulnerability, and Food Consumption Inequality Among Smallholder Households in Ghana: A Gender-Based Perspective

We examined gender-based household welfare differences in Ghana among smallholder households. We measured disparities in welfare outcomes (food poverty, vulnerability, and food consumption inequality) across male and female household heads and identified the set of covariates influencing them. The study utilizes a dataset from a farm household survey undertaken in Northern Ghana from October to December 2018. A multistage sampling approach was adopted in selecting 900 farm households. The Oaxaca–Blinder mean and Recentered Inference Function decomposition techniques highlighted the sources of gender differentials in household welfare outcomes. The findings indicate a significant gap in food consumption expenditure per capita and household dietary diversity scores between male- and female- headed households, and these gaps are as high as 28.2% and 18.1%, respectively. However, there are no statistically significant differences in vulnerability to food poverty between male- and female-headed households. The Lorenz curves confirm inequality in gendered households’ food consumption expenditure and dietary diversity scores. This study highlights the existence of systemic female-headed household vulnerability to food poverty in Ghana. This study provides significant evidence of the need for policymakers to address food systems’ structural deficiencies and inequalities with gender in mind.

     

Iran’s Multi-ethnic Mosaic: A 23-Year Perspective

In this study, we embark on measuring inequality in Iran. We compute three measures of group-based inequality (Group-weighted Coefficient of Variation, Group-weighted Gini, and Group-weighted Theil) for the following outcomes: education, assets, income, and expenditure per capita. The groups are defined based on gender, ethnicity/language (Persian, Azeri, and other ethnic minorities), and region (urban versus rural and capital city versus other places) using 23 years of annual Household Expenditure and Income Surveys from 1990 through 2012. Inequality between groups based on religion (Muslim, non-Muslim), citizenship (Iranian, non-Iranian) are also studied using the 2006 census. Our analysis of the trend of horizontal inequality reveals substantial reduction in between-group inequalities over the 1990–2012 period. Yet, gender based income inequality remains high. The implications and underlying reasons for these results are discussed.

     

Catastrophic household expenditure on caesarean deliveries in India

The objectives of our study were to examine the (1) trends and patterns of caesarean deliveries in India and; (2) differentials in catestrophic household expenditure on caesarean deliveries. The paper used data from 71st round of the National Sample Survey, India. The analysis included 14,310 women, hospitalised for delivery during the last 365 days preceding the survey. The proportion of caesarean sections among institutional deliveries in India was 2.5% in 1992–1993, which increased to 23.9% in 2014. In private facilities, 47.8% deliveries were conducted through caesarean section, while in public facilities, this proportion was 8%. OOPE per delivery was US$157 which was 64.9% of the total cost of maternal health care. OOPE varied by type of delivery; US$283 for caesarean and US$77 for non-caesarean delivery. About 60% of households incurred the expenditure on caesarean section exceeding 40% of their capacity to pay. The incidence of catastrophic delivery expenditure declined with increased education and per-capita expenditure. Caesarean delivery in private facilities and a hospital stay of more than 48 h increased the chances of catastrophic expenditure. Interventions and regulations are necessary for both public and private sector to check unwarranted caesarean deliveries and hospital stays to reduce catastrophic expenditure.