Menopausal transition experiences and management strategies of Chinese immigrant women: a scoping review

Mind matters: a comparative study of self-reported severity of depression and cognitive symptoms in China and the USA

BACKGROUND

Individuals' interpretations of health are inherently subjective, influenced by diverse cultural background and upbringing. This study aimed to examine differences in self- reported severity of depression and cognitive symptoms among middle-aged and older adults from China and the United States.

METHODS

With data on middle-aged and older adults from the China Health and Retirement Longitudinal Study (CHARLS), Health and Retirement Study (HRS), and the Disability Vignette Survey (DVS), we conducted estimations utilizing generalized ordered probit models. These models captured respondents' ratings of each vignette character's health problem. To account for reporting heterogeneity in depression and cognitive severity, we subsequently applied a hierarchical ordered probit model for adjustment.

RESULTS

Compared to US respondents, Chinese respondents exhibited lower mean scores in self-rated depression and cognitive severity for both themselves and the vignette characters. Upon adjusting the results for reporting heterogeneity, it became evident that Chinese respondents experienced more pronounced depression (β = 0.202, p < 0.001) yet displayed better cognitive status (β = -0.239, p < 0.001) compared to their US counterparts. Notably, the thresholds employed by respondents to assess depression and cognitive status displayed systematic variations between the two countries, often showing non-parallel shifts (p < 0.05). Middle-aged and older adults in China maintained lower health assessment standards or expectations when compared to their US counterparts. Additionally, higher levels of education exerted a positive and protective influence on depression and cognitive status for individuals in both China and the United States. It's important to note that the effects of urban-rural areas and living arrangements varied across these populations.

CONCLUSIONS

Significant disparities were observed in self-rated levels of depression and cognitive severity between middle-aged and older adults in China and the United States. Moreover, these disparities extended to the criteria utilized in their assessments. Addressing mental health interventions and management for this demographic in both countries should be prioritized and bolstered.

Race and Ethnicity Impacts Patient-Reported Outcomes in Implant-Based Breast Reconstruction

BACKGROUND

Addressing social determinants of health is critical in achieving health equity, and of the many determinants, race and ethnicity are key contributors in postmastectomy breast reconstruction. The purpose of this study was to investigate the impact of race and ethnicity on patient-reported outcomes (PROs) after implant-based breast reconstruction (IBBR) and to provide reference values for each cohort.

METHODS

We identified all patients who underwent IBBR between January 2017 and August 2022 and completed the BREAST-Q longitudinally. Race and ethnicity were self-categorized as White, Asian, Black, or Hispanic. Reference values were established. Outcomes of interest were BREAST-Q scores preoperatively, and 6 months, 1 year, and 2 years postoperatively. Generalized estimating equation (GEE) modeling was performed to assess race and ethnicity as independent predictors of BREAST-Q scores.

RESULTS

Overall, 3281 patients were included, of whom 2479 (75.6%) were White, 296 (9.0%) were Asian, 239 (7.3%) were Black, and 267 (8.1%) were Hispanic. There were significant differences in Physical Well-being of the Chest at all timepoints; Satisfaction with Breasts and Psychosocial Well-being at preoperative, 6 months, and 1 year; and in Sexual Well-being at 1 year. GEE modeling showed that relative to White patients, Asian subjects scored significantly lower on all BREAST-Q domains, while Black and Hispanic patients scored significantly lower on the Physical Well-being of the Chest domain.

CONCLUSION

Racial and ethnic disparities persist within IBBR, with minority patients scoring lower on the BREAST-Q than White patients. This study suggests that more work is needed to understand and improve these PROs in minority patient populations. Individualized reference values may prove beneficial in assessing outcomes over time.

Women's expectations for system support for a healthy menopausal transition: A pilot study

BACKGROUND

This pilot study contributes to the knowledge on healthy menopause by adopting a person-centric, lifelong approach to support a healthy menopausal transition. It focuses on women's expectations of system support for this transition.

METHOD

Twenty-two online in-depth interviews were conducted with women of various ages, experiences, and backgrounds in the United Kingdom, ensuring representation across the menopausal transition journey - before, during and after menopause. The interviews explored perceptions and expectations of healthy menopause and the required support. User journey and systems frameworks guided data collection and analysis. The pilot aimed to verify the feasibility of the developed study approach and protocol.

RESULTS

A healthy menopausal transition is seen as preserving essential capacities to maintain normal daily activities despite bodily changes, a crucial aspect of ageing. Participants outlined a journey of awareness, contemplation of lifestyle adjustments, experimentation with new behaviours, and habit formation. These findings underscore the importance of fostering awareness and support for menopausal transition early in life. Participants also stressed the impact of the broader environment across the ageing journey, including education, research, health services, workplace dynamics, built environment, food industry, technology and innovation, media, advertising, and social networks.

CONCLUSIONS

This work highlights person-centric perceptions of healthy menopause, complementing existing biology-centred perspectives. By introducing a co-creation approach at the system level, it offers opportunities to define holistic support for the menopausal transition. The findings informed a knowledge exchange and ideation workshop with forty relevant system stakeholders to advance solution co-creation.

Menopause in a globalized world - A systematic literature review focussing on the challenge of health problems associated with menopausal transition among women with a migration background

Globalization and international migration movements have massively changed the population structure of most industrial nations in recent decades. The ever-increasing proportion of people with a migration background also poses a challenge for the medical sector. A particular problem is the stressful phase of the menopausal transition, which - although not a pathological phenomenon but part of the female life history - can lead to psychological and physical symptoms due to hormonal changes, which significantly impair the quality of life of the women affected. However, treatment concepts, as well as access to medical facilities and information, are geared towards Western women from high-income countries. Women with a history of voluntary or forced migration originating from non-Western countries represent a particularly vulnerable group. To enable personalized treatment, studies on menopausal transition in women with a migration background are required. The present review shows that studies on menopausal women with a migration background have been conducted primarily in classic immigration countries such as the USA, Australia, or the UK, but that there is a lack of such studies in countries with no long tradition as an immigration country, such as Austria or Germany. This is becoming a growing problem, as the number of menopausal women with a migration background is increasing.

Factors Affecting Diasporic Women's Quality of Life: A Systematic Review

Objective

This literature review assesses the factors that influence the quality of life of migrant women in the diasporic with the goal of improving their quality of life and creating more supportive social adjustment in the public health field.

Methods

The systematic review was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. We searched the databases of Scopus, PubMed, SAGE journal, Springer, and Google Scholar for scientific articles on the quality of life of diasporic and migrant women. We screened and removed duplicates, analyzed the full text of the articles to identify potentially relevant studies, and extracted data from matched articles.

Results

The literature search yielded 34 articles. Only 10 articles that met all inclusion criteria were included in the systematic review after peer review.

Conclusion

The literature shows that the quality of life of diasporic women is influenced by four main factors: sociodemographic predictors, social adjustment predictors, health-related predictors, and psychological predictors. Identifying them is important to improve quality of life and find the right solutions to improve the quality of life of marginalized groups in society. To improve the quality of life for diasporic women, I suggest implementing government policies such as language education, vocational training, stronger protection laws, and better healthcare access. Additionally, establishing cultural exchange and networking programs is crucial for fostering cultural understanding.

Optimising health after early menopause

The typical age at menopause is 50-51 years in high-income countries. However, early menopause is common, with around 8% of women in high-income countries and 12% of women globally experiencing menopause between the ages of 40 years and 44 years. Menopause before age 40 years (premature ovarian insufficiency) affects an additional 2-4% of women. Both early menopause and premature ovarian insufficiency can herald an increased risk of chronic disease, including osteoporosis and cardiovascular disease. People who enter menopause at younger ages might also experience distress and feel less supported than those who reach menopause at the average age. Clinical practice guidelines are available for the diagnosis and management of premature ovarian insufficiency, but there is a gap in clinical guidance for early menopause. We argue that instead of distinct age thresholds being applied, early menopause should be seen on a spectrum between premature ovarian insufficiency and menopause at the average age. This Series paper presents evidence for the short-term and long-term consequences of early menopause. We offer a practical framework for clinicians to guide diagnosis and management of early menopause, which considers the nature and severity of symptoms, age and medical history, and the individual's wishes and priorities to optimise their quality of life and short-term and long-term health. We conclude with recommendations for future research to address key gaps in the current evidence.

Ethephon promotes isoflavone accumulation in germinating soybeans by its acceleration of isoflavone biosynthetic pathway

Soybeans have medicinal value and are an oil crop with medicinal and food properties. The present work investigated two aspects of isoflavone accumulation in soybean. First, germination conditions for exogenous-ethephon-mediated accumulation of isoflavone were optimised through response surface methodology. Second, various influences of ethephon on the growth of germinating soybeans and isoflavone metabolism were investigated. The findings of the research led to the conclusion that exogenous ethephon treatment effectively facilitated the enrichment of isoflavones in soybeans during germination. Optimal germination conditions were obtained through a response surface optimization test, which yielded the following criteria: a germination time of 4.2 d, an ethephon concentration of 102.6 μM, and a germination temperature of 30.2 °C. The maximum isoflavone content was 544.53 μg/sprout FW. Relative to the control, the addition of ethephon significantly inhibited sprout growth. Exogenous ethephon treatment led to the phenomenon that peroxidase, superoxide dismutase, and catalase activities and their gene expression increased significantly in germinating soybeans. Meanwhile, the expression of genes related to ethylene synthetase increase under the effect of ethephon promoting ethylene synthesis. Ethylene multiplied the total flavonoid content of soybean sprouts relying on the increase in activity and gene expression of crucial isoflavone biosynthesis-related enzymes (phenylalanine ammonia-lyase and 4-coumarate coenzyme A ligase) during germination.

Perimenopause and/or menopause help-seeking among women from ethnic minorities: a qualitative study of primary care practitioners' experiences

BACKGROUND

Each woman's experience of the perimenopause and/or menopause is individual and unique. Research shows women from ethnic minorities often have different experiences from their White peers, and these are not being considered in conversations about the menopause. Women from ethnic minorities already face barriers to help-seeking in primary care, and clinicians have expressed challenges in cross cultural communication including the risk that women from ethnic minorities' perimenopause and/or menopause health needs are not being met.

AIM

To explore primary care practitioners' experiences of perimenopause and/or menopause help-seeking among women from ethnic minorities.

DESIGN AND SETTING

A qualitative study of 46 primary care practitioners from 35 practices across 5 regions of England, with patient and public involvement (PPI) consultations with 14 women from three ethnic minority groups.

METHOD

Primary care practitioners were surveyed using an exploratory approach. Online and telephone interviews were conducted and the data were analysed thematically. The findings were presented to three groups of women from ethnic minorities to inform interpretation of the data.

RESULTS

Practitioners described a lack of awareness of perimenopause and/or menopause among many women from ethnic minorities, which they felt impacted their help-seeking and communication of symptoms. Cultural expressions of embodied experiences could offer challenges to practitioners to 'join the dots' and interpret experiences through a holistic menopause care lens. Feedback from the women from ethnic minorities provided context to practitioner findings through examples from their individual experiences.

CONCLUSION

There is a need for increased awareness and trustworthy information resources to help women from ethnic minorities prepare for the menopause, and clinicians to recognise their experiences and offer support. This could improve women's immediate quality of life and potentially reduce future disease risk.

Interventions to reduce loneliness among Chinese older adults: A network meta-analysis of randomized controlled trials and quasi-experimental studies

This meta-analytic study investigates the effectiveness of different interventions in alleviating loneliness among Chinese older adults aged 50 years and above. We searched eight English databases, four Chinese databases, and grey literature. Thirty-four studies, including four randomized controlled trials (RCTs) and 30 quasi-experimental studies, were eventually included in the meta-analysis (n = 3843). Quality appraisal indicated risks of bias in the included studies. The pooled effect size was large and significant (Hedge's g = 0.84, 95% CI [0.54, 1.15]), indicating the effectiveness of interventions in reducing loneliness. However, the effect size may be overestimated due to publication bias. Moderation analyses showed significant differences in effect sizes by study designs and regions of studies. Network meta-analysis (NMA) indicated that hybrid and psychological interventions appeared to be advantageous over others. In addition, group-based delivery modes can add extra benefits to the interventions. This study adds to the knowledge of the effectiveness of current interventions in reducing Chinese older people's loneliness. However, the findings need to be interpreted with caution due to the relatively low study quality, considerable heterogeneity, and publication bias. Despite the limitations, this study offers valuable insights for future research, practice, and policy-making in reducing older people's loneliness.

Effect of Integrated Psychobehavioral Care on Emotional-Behavioral Responses, Cognitive Changes in Outpatients with Schizophrenia Followed Up: Based on a Prospective Randomized Controlled Study

Background

In recent years, influenced by the continuous improvement and development of the medical service model and the increasing demands of modern people for the quality of clinical care, the clinical treatment of schizophrenic groups has also received widespread attention and importance from all sectors of society. Psychobehavioral care is administered to patients during active antipsychotic treatment, which can maximize the patient's cooperation with clinical work and thus play an auxiliary role in treatment.

Aims

To investigate the impact of emotional-behavioral responses, cognitive changes in outpatient follow-up of schizophrenic patients with integrated psychobehavioral care.

Materials and Methods

One hundred cases of schizophrenia patients with outpatient follow-up in our hospital from March 2017 to March 2019 were selected as prospective study subjects and divided into a comparison group and an observation group of 50 cases each according to a random number table. Among them, the comparison group implemented conventional psychobehavioral care, and the observation group implemented integrated psychobehavioral care. The differences in compliance behavior, negative emotions, cognitive behavioral changes, and pain scores before and after care of schizophrenia patients in the outpatient follow-up were compared between the two groups.

Results

After care, the compliance behavior, negative emotions, cognitive behavioral changes, and pain scores of schizophrenia patients in both groups with outpatient follow-up were significantly improved and significantly higher in the observation group than in the comparison group, and statistics showed that this difference was statistically significant (P < 0.05).

Conclusion

Integrated psychobehavioral care combined with conventional psychobehavioral care can effectively enhance the compliance behavior of outpatient follow-up schizophrenia patients, improve the negative emotions and pain of patients, and facilitate the active treatment of patients to improve their prognosis. It has some reference value for outpatient follow-up schizophrenia patient care.

Menopausal experiences of South Asian immigrant women: a scoping review

IMPORTANCE AND OBJECTIVE

South Asians make up a significant portion of global immigration. Immigrants often face challenges when navigating the healthcare system, which can influence their experience during the menopausal transition. The purpose of this scoping review is to summarize the existing literature on South Asian immigrant women's menopausal experience.

METHODS

Various electronic databases were systematically searched to identify research articles. The menopausal experiences of South Asian immigrant women were examined.

RESULTS

A total of 11 studies were included in this scoping review. A variety of physical symptoms were reported, including vasomotor symptoms, musculoskeletal symptoms, somatic symptoms, and early onset of menopause. Psychosocial symptoms included anxiety, depression, and decreased memory/concentration. Cultural experiences were both positive and negative, depending on the connotations surrounding menopause. Individual facilitators for a healthy transition included education and employment. Familial barriers included a lack of knowledge and support. Community and societal factors were both positive and negative, depending on the level of acculturation. Self-management was the most widely used intervention.

DISCUSSIONS AND CONCLUSION

Findings of this scoping review can help guide the development and evaluation of menopause interventions for South Asian immigrant women. Culturally sensitive care, increased discussion on sexual health, support networks, and reduction of socioeconomic barriers are needed to address the health needs of South Asian immigrant women. Further research is needed to better understand South Asian immigrant women's menopausal needs and help guide intervention design.