Effect of body image on gestational weight gain in overweight and obese women

Problem or backgroundThere is little information available describing how women who are overweight or obese in pregnancy perceive their bodies, and in particular the effect of body image dissatisfaction on gestational weight gain.QuestionTo describe how women who are overweight or obese in pregnancy perceive their body, and the effect of body image on gestational weight gain.MethodsThis prospective nested cohort study evaluated self estimation of body weight, preferred body shape, dieting behavior, satisfaction with body weight and shape, and gestational weight gain in pregnant women who were overweight or obese, through self-completed questionnaire in early pregnancy in South Australia from October 2010 to February 2012.FindingsOf the 442 women who completed the questionnaire, 25.8% correctly identified their BMI, with 70.1% under-estimating and 4.1% over-estimating their BMI. Women who were obese were significantly less likely to correctly identify their BMI, as were younger women. Women who incorrectly identified their BMI were significantly more likely to have higher gestational weight gain (P < 0.001). Approximately 45% of women indicated dissatisfaction with their weight or body shape, with this being more common in women of higher parity and higher BMI. Dissatisfaction was significantly related to gestational weight gain.ConclusionWomen who report increasing dissatisfaction with their body size and shape are more likely to gain excessive weight during pregnancy. Further research should explore insights about maternal body image and diet related behaviors.     

A practical comparison of blinded methods for sample size reviews in survival data clinical trials

This paper presents practical approaches to the problem of sample size re-estimation in the case of clinical trials with survival data when proportional hazards can be assumed. When data are readily available at the time of the review, on a full range of survival experiences across the recruited patients, it is shown that, as expected, performing a blinded re-estimation procedure is straightforward and can help to maintain the trial's pre-specified error rates. Two alternative methods for dealing with the situation where limited survival experiences are available at the time of the sample size review are then presented and compared. In this instance, extrapolation is required in order to undertake the sample size re-estimation. Worked examples, together with results from a simulation study are described. It is concluded that, as in the standard case, use of either extrapolation approach successfully protects the trial error rates.     

Inclusion or Exclusion? Exploring Barriers to Employment for Low-Income Older Adults

Faced with economic uncertainty and declining retirement security, older adults have increasingly tried to remain in, or return to, the workforce in recent years. Unfortunately, a host of factors, such as ageism and changing skill requirements, present challenges for older adults seeking employment. Low-income older adults, in particular, may lack necessary education and skills and have limited access to job opportunities and training. In this review, we examine factors that inhibit and support employment for low-income older adults and explore the role of social work in facilitating their inclusion in the workforce.     

A Culture of Mutual Support: The Impact of Giving and Receiving of Practical and Emotional Support on African American Marital Satisfaction

Although the literature has discussed the extensive family network ties of African Americans and its implications for marital satisfaction, few studies incorporate primarily African American samples in studies of marital satisfaction and social networks. This study draws on a sample of African American married couples from the National Survey of American Life and explores the impact of mutual support, giving and receiving of practical and emotional support, on the marital satisfaction of husbands and wives. Results from the ordinal logistic regression analyses reveal that emotional support received from family and support given to friends are significantly related to husbands’ marital satisfaction whereas emotional support received from family and negative interaction with family contributes to wives’ marital satisfaction. Research and practice implications with African American married couples are discussed.     

Preparing Community Health Workers for Their Role as Agents of Social Change: Experience of the Community Capacitation Center

Current efforts to better integrate Community Health Workers (CHWs) into the health and social service systems are promising, but may be less effective if they fail to support the role of CHWs as social change agents. The way CHWs are trained influences the roles they play. In this article, we review the literature on CHW training and summarize lessons learned to date. We describe how the Community Capacitation Center in Oregon uses a combination of content, methodology, and values to prepare CHWs to make an optimal contribution to health. Recommendations for CHW training programs and policy makers are provided.     

Comparative Case Study as Social Impact Assessment: Possibilities and Limitations for Anticipating Social Change in the Far North

Social impact assessment (SIA) is increasingly an accepted component of environmental impact assessment and project evaluation throughout North America. Tools and methodologies utilized to conduct such assessments vary greatly and continue to evolve with time and experience. This paper follows the evolution of case study methods in social impact assessment, focusing primarily on the comparative diachronic method. Exploring the utility of this method, this paper compares the potential social and economic impacts of the Mackenzie Gas Project (MGP) in the community of Inuvik, Northwest Territories, with the known social and economic impacts of the Trans-Alaska Pipeline System (TAPS) in the community of Valdez, Alaska. Through such comparison, insights into potential impacts from the proposed Mackenzie Gas Project are assessed while also drawing attention to, and discussing, the specific strengths and weaknesses of a comparative case study approach to social impact assessment.     

Understanding the impact of early-life trauma in nursing home residents

Reactions to early life trauma can reemerge or be exacerbated in later life as coping resources and abilities are compromised by age-related changes and declines in health. For newly admitted nursing home residents, this can impact their receptiveness to assistance with care and elicit challenging reactions to environmental and situational triggers. Unfortunately, current assessment tools fail to account for reactions to early-life trauma. In this article, we review existing literature on early-life trauma and aging and introduce a hypothetical case to illustrate the importance of identifying nursing home residents with past trauma experiences.