Zeitschriftenartikel zum Thema „Menopause Social aspects“

Background: Menopause signifies the beginning of a non-reproductive phase from the reproductive period. Although it is considered a natural life transition, recent studies have indicated that a woman’s menopausal experience may impact her quality of life. While studies have examined Malaysian women’s knowledge and awareness of menopause, they have focused on the prevalence of menopausal symptoms and sociocultural aspects. These investigations also used a quantitative design that may have limited the information regarding the nature and experience of menopause. Objectives: This study explores women’s perceptions and understanding of their menopausal experience. Methods: A total of 20 menopausal women were recruited using purposive sampling through social media in the state of Pahang, Malaysia. In-depth semi-structured interviews were used to explore how they perceived their menopausal experience. The data were then analyzed using thematic analysis. Results: Three themes that emerged from the findings included perceptions of menopause, biopsychosocial changes and help-seeking behavior. For many Muslim women, menopause was perceived as a time for them to engage in religious commitment more than they had before. Conclusion: The study findings uncovered a knowledge gap and a lack of support for women impacted by menopause. Muslim women regarded their menopause phase as a time for them to engage in religious duty fully. These results indicate the need for a psychosocial intervention and educational program to ensure women a better transition throughout their menopausal phase.

Background: Menopause is one of the most significant events in a woman's life and brings in a number of physiological changes that affect the life of a woman permanently and can be influenced by various socio-demographic factors and coping activities. The objectives of the study were to determine the commonly reported menopausal symptoms among middle age women and to correlate identified menopausal problems with coping strategies found in participants.Methods: By using modified MRS questionnaire, 150 menopausal women aged 40-60 years were interview to document of 12 symptoms (divided into somatic, psychological and urogenital domain) commonly associated with menopause.Results: The mean age of menopause was 49.8 years (±4.9) (range 43 - 57 years). The most prevalent symptoms reported were joint and muscular discomfort (70.6%); physical and mental exhaustion (61.3%); and sleeping problems (59.3%). Followed by symptoms of anxiety (48.6%); irritability (45.3%) hot flushes and sweating (38.6; dryness of vagina (37.9%); depressive mood (38.0%). Other complaints noted were incontinence/Frequency of urine (27.3 and heart discomfort (23.3%). Perimenopausal women (47.2%) experienced higher prevalence of somatic and psychological symptoms compared to premenopausal (n=15.6) and postmenopausal (37.2%) women. However urogenital symptoms found more in postmenopausal group of women. There is a strong significant association between the menopausal symptoms and coping strategies adopted by the menopausal women.Conclusions: Symptoms have variable onset in relation to menopause. Some women experience symptoms earlier during perimenopause while some experience them at a later time. The application of various coping methods, including the establishment of social support networks, is warranted to enhance postmenopausal women’s behaviors in different aspects.

ABSTRAKLatar Belakang: Penurunan harga diri wanita menopause akan memengaruhi kualitas hidupnya. Namun demikian masih sedikit informasi yang menjelaskan hubungan harga diri dengan kualitas hidup wanita menopause. Tujuan: Mengetahui hubungan antara harga diri dengan kualitas hidup wanita menopause di Dusun Jogonalan Kidul Kasihan Bantul. Metode: Penelitian non eksperimen dengan rancangan penelitian cross sectional. Penelitian dilaksanakan pada Agustus-September 2011. Sebanyak 61 wanita menopause di Dusun Jogonalan Kidul Kasihan Bantul dipilih secara proporsional sampling. Semua wanita menopause yang memenuhi kriteria inklusi dan eksklusi penelitian dimasukkan ke dalam sampel penelitian. Data dikumpulkan menggunakan kuesioner Menopause Rating Scale (MRS), Rosenberg Self Esteem Scale (RSES) dan World Organization Quality of Live-Bref (WHOQOL-BREF). Ketiga kuesioner menggunakan versi Indonesia yang telah diuji validitas dan reliabilitasnya. Analisis data menggunakan Spearman Rank. Hasil: Lebih dari setengah responden (65,67%) memiliki harga diri tinggi. Keluhan yang paling banyak dirasakan oleh responden adalah keluhan rasa tidak nyaman pada otot dan persendian (77,05%). Hasil uji statistik menunjukkan bahwa harga diri memiliki hubungan yang bermakna (p<0,05) dengan semua domain kualitas hidup yaitu hubungan positif yang kuat (r=0,839) untuk domain fisik, (r=0,826) untuk domain psikologi, (r=0,822) untuk domain hubungan sosial, (r=0,643) untuk domain lingkungan. Kesimpulan: Ada hubungan antara harga diri dengan kualitas hidup wanita menopause di Dusun Jogonalan Kidul Kasihan Bantul. Lebih dari setengah responden memiliki harga diri tinggi. Untuk itu, penyuluhan pada aspek psikologis tetap harus ditingkatkan dan perlu dukungan dari petugas kesehatan lain.Kata kunci: harga diri, kualitas hidup, wanita menopauseCORRELATION BETWEEN SELF-ESTEEM AND QUALITY OF LIFE IN MENOPAUSAL WOMENABSTRACTBackground: A decline in self-esteem of menopausal women will affect their life quality. However, there is only a little information that explains the correlation between self-esteem and quality of life in menopausal women. Objective: To identify the correlation between self-esteem and quality of life in menopausal women at Jogonalan Kidul Hamlet, Kasihan, Bantul. Methods: This research is non-experimental with cross sectional design. It was conducted in August-September 2011. 61 menopausal women in Jogonalan Kidul Hamlet, Poor Bantul were selected through proportional sampling. All menopausal women who met the inclusion and exclusion criteria were included in the research sample. Data were collected using Menopause Rating Scale (MRS) questionnaires, Rosenberg Self Esteem Scale (RSES) and Quality of Live- Breve World Organization (WHOQOL-BREF). The three questionnaires were in Indonesian version of which validity and reliability had been tested. Data were analyzed using Spearman’s Rank. Results: More than half of respondents (65.67%) had high self-esteem. Complaints that were felt by most respondents were complaints of discomfort in the muscles and joints (77.05 The results of statistical test show that self-esteem had a significant correlation (p<0.05) with all domains of quality of life that is a strong positive correlation (r=0.839) for physical domain, (r=0.826) for psychological domain, (r=0.822) for social relations domain, (r=0.643) for environmental domain. Conclusion: There is a correlation between self-esteem and quality of life in menopausal women at Jogonalan Kidul Hamlet, Kasihan, Bantul. More than half of the respondents have high self-esteem. Therefore, counseling for psychological aspects should still be improved and supported by other healthcare workers.Keywords: self-esteem, quality of life, menopausal women

Menopausal phase could impact the physical, psychological, social, economic, spiritual and quality of life. Changes appear on the physical aspects could cause decreasing self-image in menopausal women, whereas the psychological changes that arise sometimes menopausal women experience a decrease in self-acceptance. The aim of this study is to prove the existence of increased acceptance and self-image menopausal women with Acceptance and Commitment Therapy. The design used is Quasy Experiment Pre-posttest with Controlled Group Design. The sample was menopausal women who are willing to become respondents as many as 40 people, divided into two groups: a control group of 20 people and 20 people treated group. Sampling technique using consecutive sampling. The independent variable for the provision of Acceptance and Commitment Therapy is divided into two sessions of four meetings (1x meeting two sessions). The dependent variable is self-acceptance and self-image menopausal women. Measuring instruments used in the form of a questionnaire. Analysis of data used computer software. The majority of respondents were married women, Muslim, Javanese, recent education junior high school and not working. The results proved statistically there was increasing acceptance between control and treatment groups (p = 0.000). Self-image measurement results proved no increase between control and treatment groups (p = 0.000). Acceptance and Commitment Therapy is highly effective for improving acceptance and self image in menopausal women. The active role of the respondents strongly supported upon the success of therapy and need the support of her husband and peers. Masa menopause dapat berdampak pada aspek fisik, psikologis, sosial, ekonomi, spiritual dan kualitas hidup seseorang. Perubahan yang muncul pada aspek fisik mengakibatkan penurunan gambaran diri wanita menopause, sedangkan perubahan psikologis yang muncul terkadang wanita menopause mengalami penurunan penerimaan diri. Tujuan dari penelitian ini adalah membuktikan adanya peningkatan penerimaan dan gambaran diri wanita menopause dengan Acceptance and Commitment Therapy. Desain yang digunakan adalah Quasy Experiment Pre-Posttest with Controlled Grup Design. Sampel penelitian ini adalah wanita menopause yang bersedia menjadi responden sebanyak 40 orang, dibagi menjadi dua grup, yaitu 20 orang grup kontrol dan 20 orang grup perlakuan. Teknik sampling menggunakan consecutive sampling. Variabel independen berupa pemberian Acceptance and Commitment Therapy empat sesi dibagi menjadi dua pertemuan (1x pertemuan dua sesi). Variabel dependen yaitu penerimaan diri dan gambaran diri wanita menopause. Alat ukur yang digunakan berupa kuesioner. Analisis data menggunakan software computer. Mayoritas responden adalah wanita menikah, beragama Islam, suku Jawa, pendidikan terakhir smp dan tidak bekerja. Hasil penelitian secara statistik terbukti ada peningkatan penerimaan diri antara grup kontrol dan perlakuan (p=0,000). Hasil pengukuran gambaran diri terbukti ada peningkatan antara grup kontrol dan perlakuan (p=0,000). Acceptance and Commitment Therapy ini sangat efektif untuk meningkatkan penerimaan dan gambaran diri pada wanita menopause. Peran aktif responden sangat mendukung kesusksesan terapi dan butuh dukungan dari suami dan teman sebaya. DOWNLOAD FULL TEXT PDF >>

The study aims to identify the extent of women’s awareness of the meaning of advanced age and the nature of the psycho-social aspects of health that they face in the advanced stages of life to come up with a suggested proposal for the contribution of social services to the development of women’s awareness of aspects of advanced life stages from a cognitive perspective. The samples of the study are women older than 40 who are either in their perimenopause or menopause phase. The size of the sample is (208) woman; (104) women from the health center Al-Olaya and (104) women from the health center in Al-Suleimaniah. The study results showed a decline in their awareness that this stage in their age constitutes the flow and movement phase (productivity and contribution) versus recession and showed a likely rate of (0.22 %) and came last in the results. Results of the study also showed low response rates regarding health and physical aspects such as the occurrence of hot flashes (12%), reduced fertility (9.95), and osteoporosis (7.5%). These rates underscore the lack of awareness of the respondents concerning these variables. On the other hand, the study showed a high awareness of the respondents with respect to psychological aspects such as the awareness of the feeling of neglect and lack of interest by others scored highest. Society’s perception of advanced age is one of the social realities which received (7.13 %) by respondents. The study recommends the need to activate the contribution of social services in the increase of women›s awareness of health, psychological and social manifestations of menopause and beyond

Urinary incontinence (UI) is a very common disorder in women, involving severe consequences on the patients’ perception of quality of life and sexuality. The aim of this contribution is to analyze the psycho-relational aspects linked to UI, focusing on sexual activity, self-perception of sexual competence and self-esteem. Urinary incontinence causes feelings of shame and inadequacy as well as low self-esteem; it may affect sexual activity, reducing sexual intercourse frequency. Many authors highlight a strong comorbidity between urinary incontinence and sexual dysfunctions, such as dyspareunia, vaginismus, hypo-active sexual desire, arousal and orgasm disorders. Literature analysis shows that changes in sexual activity are influenced not only by urinary incontinence symptoms but also by the disorder self-perception, by previous sexuality, menopause, social status and the partner's attitude. The etiological study of urinary incontinence shows that several different factors play a role in this disorder. Therefore, an integrated therapeutic approach is suggested, considering, besides the organic issues, the experience and feelings of patients as well as the consequences on their sexual and social life.

AbstractEarly menopause (EM) and premature ovarian insufficiency (POI) affect an estimated 10% of women and can precipitate a wide range of physiological and personal impacts. Receiving a diagnosis of EM/POI and navigating treatment can be complex experiences for women; however, qualitative research exploring these aspects of the condition is limited. Our study aimed to increase understanding of women's lived experiences of EM/POI encompassing its medical, social, and emotional dimensions. We conducted narrative interviews with 30 women aged 28 to 51 years with spontaneous and iatrogenic EM/POI and menopausal symptoms resulting from ovarian suppression therapy, and analyzed transcripts thematically. This article examines the prominent and under-researched themes of women's experiences of navigating “diagnosis” and treatment. Diagnosis emerged as a complex and changeable process wherein women had to negotiate a diagnosis of spontaneous EM/POI and grasp the meaning and probability of iatrogenic EM/POI. Navigating treatment entailed further complexity as women grappled with the risks and efficacy of hormonal and non-hormonal medications. The findings underline the intricacies of EM/POI as a biomedical phenomenon and highlight the need for health practitioners to recognize and respond to the challenges women face in coming to terms with the condition and managing its embodied effects.

IN AN EARLY VERSIONof Elizabeth Gaskell's Cranford sketches, “The Last Generation of England” (1849), the narrator expresses a “wish…to put upon record some of the details of country town life,…for even in small towns, scarcely removed from villages, the phases of society are rapidly changing” (319). Before she begins her ethnographic preservation project, however, the narrator provides a disclaimer, suggesting the difficulty of categorizing the various aspects of what she is about to write: “As for classing the details with which I am acquainted under any heads, that will be impossible from their heterogeneous nature; I must write them down as they arise in my memory” (319). She then goes on to provide precisely what she claims is impossible–a categorical litany of the local inhabitants, beginning with the daughters of “very old” families who, “if unmarried, retired to live in–on their annuities, and gave the ton to the society there” (319). The reader is quickly taken through the town's social register, from “widows of the cadets of these same families,” to “professional men and their wives,” to a “grade lower…a class of single or widow ladies,” and on “[b]elow again,” to “the shopkeepers,” “the usual respectable and disrespectable poor,” and “a set of young men, [hanging about] ready for mischief and brutality” (319–20). Through her description, the narrator performs a double disavowal; heterogeneity prevents classification, but that very heterogeneity is itself what produces the need to classify. The rural society that serves as a precursor toCranford(1851–53) represents a diversity that must be categorized–its hierarchy organized according to its uniqueness of place. Rendered as particular, readily-identifiable positions within the eccentric space of provincial English society, Cranford's denizens are inscribed through the Victorian fascination with taxonomy–a fascination with the seemingly paradoxical possibilities of “classing the details.”

Na vida das mulheres existem marcos concretos e objetivos que sinalizam diferentes fases ou passagens de suas vidas, tais como a menarca, o rompimento do hímen, a última menstruação. São marcos visíveis no corpo físico e cada cultura os investe de sua rubrica. Na nossa cultura, historicamente, associam-se à menopausa inúmeras afecções (físicas e psíquicas). A partir do trabalho de Robert Wilson, publicado no livro Eternamente Feminina (1966), a menopausa adquire o estatuto de doença e a sua prevenção, tratamento e cura vinculam-se à terapia de reposição hormonal (TRH). Os diferentes discursos que circulam sobre a menopausa em nossa cultura não só contribuem para que tal associação seja mantida, como partem do pressuposto que as questões relacionadas à menopausa e envelhecimentos se apresentam igualitariamente às mulheres, independentemente de sua condição física, psíquica, social, econômica e cultural. O estudo tem como objetivo abordar alguns aspectos da construção da menopausa em nossa cultura e simultaneamente mostrar o quanto este evento deve ser percebido em seu caráter particular e relativo, e não como sendo da ordem do universal ou padronizado.

Counseling Service for Women in Crisis is an out-patient unit of the Department of Psychiatry (Clinical Center “Dr Dragisa Misovic) engaged in mental health prevention. It was established in co-ordinance with contemporary directives of the World Health Organization which emphasizes health care for women as one of its priorities. The service addresses clients with coping problems during biological and/or psychosocial transitional and crisis periods. Members of the professional team are: a female psychiatrist-psychotherapist also trained in other aspects of women's health, family therapist, social worker, relaxation therapist and nurse with additional midwife skills. When treating women in menopause, pregnancy and confinement cooperation with departments of gynecology and obstetrics is regular and reciprocal. In addressing pregnant and breast- feeding clients non-pharmacological methods are first choice therapy (psychotherapy, relaxation, acupuncture). Psychosocial adverse events reported by our clients (marital conflicts, divorce, abuse, bereavement, loss of job, mobbing...) often require collaboration with social services, legal organs and non-government organizations. Care-givers of oncology and dementia patients with psychosomatic problems are referred to us as well as women after diagnosis and treatment of breast cancer by relevant departments and institutions. This service with its multidisciplinary approach is a contribution to contemporary programs of mental health prevention in Serbia.

Background: Menopause can have psychological, physical, and vasomotor symptoms along with sexual dysfunction, Current health care model fail to recognize that these symptoms profoundly affect a woman’s personal and social functioning and ultimately her quality of life. Hence, this study aims to assess the Quality of life of post-menopausal women and finding out socio-demographic factors affecting quality of life.Methods: A cross-sectional study in an urban slum area was undertaken and 105 females between 45-65 years of age were interviewed using menopause-specific quality of life (MENQOL) questionnaire.Results: The mean age of these study participants was 54.13±4.05 (45-62) years. Out of 105 post-menopausal women included in the study, 20% were illiterate, 26.7% had completed education up to Secondary school level. Total MENQOL scores ranged from 62-148 and total mean score was 101.3±23.44.Conclusions: Menopause affected not only physical health of a woman but also affects psychosocial aspect of life and this was well evident from the present study where MENQOL scores were higher indicating poor quality of life after menopause. Ageing, lower education, lower socio-economic status, unemployment and no spouse support were contributing to the poor quality of life.

Background: Menopause is the end of a women’s menstrual cycle and reproductive years. For some women the transition is without major problems; others struggle with various psychological and physical symptoms. Regular walking exercise can be an easy way to maintain physical and mental health. Previous focus groups revealed that women enjoy and want the social aspect of walking groups. Objectives: The goal of this study is to test use and effectiveness of a walking app platform specific for menopausal women that allows them to connect with each other to schedule walks in Edmonton, and track the effect of walking on their symptom changes. Methods: Women will be recruited from the Edmonton Menopause clinics and by word of mouth. Interested and consented women receive login information to use the app to schedule and sign-up for walks. Women will complete menopause-specific QOL and symptom questionnaires at their first login and will be prompted to complete them monthly thereafter. Women will also be asked to record their walking durations and intensities. Participating women will be invited to focus groups to discuss their experience using the app. Descriptive statistics will be applied to analyze data collected at the backend from questionnaires and surveys, and qualitative content analysis will be applied to analyze the audio-recorded focus groups. Results: A prototypic online application has been created including a user manual. Access is restricted and all potential participants will be screened after their first login by the research team prior to gaining full access. Women will then be able to use the app features for schedules and surveys. Data collected at the back end by the researchers will determine the use and effectiveness of the app and explore the impact of social walking on menopause symptom changes. Conclusion: This is the first social platform of this kind created specifically for menopausal women. Ultimately we hope that this platform will empower women to seek lifestyle changes such as walking exercises and connect with each other on the communality of menopause. Testing the use and effectiveness of the app will help us to improve and further develop the app.

Menopause is defined as the complete cessation of the menstrual cycle in women for twelve consecutive months. Although menopause is an important aspect of the female reproductive health cycle, it is often ignored. Women may experience different menopausal and postmenopausal symptoms ranging from mild to severe. In the present study, a cross-sectional survey of 200 women in their postmenopausal years was conducted across Delhi and the National Capital Region (NCR). A pretested questionnaire was given to a random population of postmenopausal women to record various postmenopausal symptoms and the coping strategies adopted by them. The mean age of menopause of the sample population was 47.48 years, and body mass index seemed to affect the age of onset of menopause. The majority of women experienced postmenopausal symptoms, with 95.28% experiencing more than one symptom, ranging from fatigue and sleep disturbances to severe symptoms such as anxiety attacks, palpitations and joint pains. Many women used different coping strategies, such as changes in lifestyle and social interaction with other women experiencing menopause. Very few women used hormone replacement therapy as a coping mechanism and most of them were ignorant about the same. Interestingly, both education and working status were observed to affect the adoption of coping strategies by women in Delhi–NCR. The results of the study emphasize the need of addressing the problems of the postmenopausal population and incorporating the same in the national healthcare programme.

Male ageing is in focus nowadays. The aim of this study was to investigate conceptions of the male menopause (also known as andropause) in the educational and professional literature of Finnish physicians from 1982 to 2002, and the main point of interest was how the presentation of the male menopause and its treatments have changed. Published items for analysis were retrieved from the two main Finnish medical journals and from introductory gynaecology and urology textbooks using keywords for male ageing and hormones. It was found that disagreements about the male menopause have been marked. Some authors described it as a consequence of the decline in gonad functioning that comes with increased age, and some argued that we are making a disease out of normal ageing, but its association with sexual problems has risen in prominence: libido and potency disorders have recently been identified as symptoms. The treatment provided for male menopause was androgens, about which opinions diverged, especially the effect of androgen therapy on cardiovascular diseases and osteoporosis. New forms of testosterone treatment have been eagerly adopted, but opinions varied on the appropriate duration of the therapies. By the 2000s, the male menopause was increasingly likened to the female menopause, with emphasis upon the similar symptoms. While gerontological thinking largely sees the male menopause as an aspect of ageing and a normal condition, the andrological approach regards it as a treatable disease and its rapid adoption can be seen as a reflection of both private and public concerns about increased longevity.

A Doença Arterial Coronária (DAC) é uma doença multifatorial e muitos dos fatores de risco para o seu desenvolvimento (ligados aos aspectos biológicos) já foram estudados e devidamente mensurados em sua importância. Os determinantes sociais dessa doença, responsável pelo maior número de mortes na cidade de São Paulo, foram pouco estudados e sua importância, negligenciada. No Brasil, as pesquisas sobre o tema são ainda incipientes e a importância da DAC, em mulheres, continua sendo subestimada, mesmo quando os dados estatísticos mostram que ela vem crescendo. As mulheres, hoje, vivem mais e, portanto, têm a possibilidade de enfrentar a doença e ainda de sobreviverem muitos anos após a menopausa, trazendo esse fato um grande impacto social. Nosso objetivo, nessa pesquisa, de caráter descritivo, foi estabelecer uma relação entre o perfil socioeconômico e cultural e os indicadores de exclusão social, encontrados em mulheres após a menopausa e com DAC, em tratamento no ambulatório de Coronariopatias do Instituto Dante Pazzanese de Cardiologia. Os resultados podem nos ajudar a entender melhor a doença e as necessidades das pacientes diante das várias formas de exclusão social que vivenciam em seu cotidiano e apontar medidas mais eficazes para programas de prevenção secundária. O diálogo entre as diferentes áreas de conhecimento, como a Medicina, a História e o Serviço Social, estabelecido para a análise dos resultados, trouxe uma compreensão abrangente dos fenômenos estudados trazendo à luz aspectos da exclusão social e discriminação de gênero, vivenciados pelas pacientes até então desconhecidos e, portanto, não valorizados pela equipe multidisciplinar.

Anthropology is the science concerning human populations and the holistic analysis of biological, behavioral, cultural and social processes. Excluding human pathology accepted universally as within the field of medicine, it has been suggested that everyone who studies aspects of the human body is actually doing physical anthropology even if they do not realize it.

Latar belakang Kualitas hidup manusia ditentukan oleh tingkat sosiodemografi, status kesehatan umum dan rongga mulut yang saling berkaitan. Ras dan suku menentukan genetika dalam merespon keradangan, kerentanan jaringan rongga mulut terhadap bakteri atau injuri, meregulasi hormon reproduksi, dan sindrom menopause. Akan tetapi hubungan faktor tersebut masih belum banyak terungkap, khususnya pada Suku Osing. Suku Osing merupakan salah satu suku yang masih memegang kuat adat istiadat.Tujuan penelitian ini adalah untuk mengetahui status kesehatan rongga mulut wanita suku Osing. Metode Penelitian observasional dengan desain cross sectional.Subyek penelitian dikelompokan menjadi kelompok usia produktif dan menopause. Pada subyek penelitian dilakukan pemeriksaan status kesehatan rongga mulut meliputi jumlah gigi yang tersisa di rongga mulut, indeks periodontal, karies dan kebersihan rongga mulut. Semua data dikategorikan kemudian akan dilakukan uji korelasi non parametric (p?0,05). Hasil Kelompok wanita usia menopause pada penelitian ini sudah mengalami menopause dalam kurun waktu 5-10 tahun.Jumlah gigi wanita usia menopause lebih sedikit dibanding wanita usia produksif (p?0,05). Wanita usia menopause lebih banyak menderita penyakit periodontal yang bersifat irreversible (2,65 ± 0,35) daripada wanita usia produktif (1,16 ± 0,27). Indeks karies kelompok wanita usia menopause (D=166, M=570) lebih tinggi dibanding wanita usia produktif (D=247, M=162). Akan tetapi, kedua kelompok ini mempunyai tingkat kebersihan mulut yang sama. Selain itu terdapat hubungan antara tingkat kebersihan mulut, penyakit periodontal, karies dan lamanya menopause (R>0,3). Simpulan Status kesehatan rongga mulut wanita usia menopause suku Osing di Desa Kemiren, Kecamatan Glagah, Banyuwangi lebih buruk dibanding wanita usia produktif. Akan tetapi, perlu penelitian lebih lanjut mengenai faktor-faktor yang mempengaruhi status kesehatan rongga mulut tersebut. Background Social-demography, health status, and oral health specify a quality life, which all of them are correlated. Races and ethnic assign genetic aspect, especially in inflammation respond, oral tissue susceptibility to bacterial infection and injuries, hormone regulation, and menopause syndrome. However, the relationships are unexplored yet, especially in osingese. Osingese is one of ethnic which hold the customs strongly. The objective of this study was to know the oral health status of Osingese Women. Method This study was observational with a cross-sectional design. The subjects were classified into productive and menopause age. All of the subjects were examined their oral health, including remain teeth, periodontal index, caries index, and oral hygiene index. All of the data were categorized and analyzed by non-parametric correlation analysis (p?0.05). Result Menopause aged group experienced menopause period about 5-10 years. The number of teeth of the menopause group was less than productive group (p?0.05). The menopause group more sustained irreversible periodontal diseases (2.65 ± 0.35) than the productive group (1.16 ± 0.27). Caries index in the menopause group (D=166, M=570) was higher than the productive group (D=247, M=162). However, their oral hygiene index was the same. Moreover, there presented the relationship between oral hygiene, caries index, periodontal index, and menopause status (R>0.3). Conclusion Oral health status menopause aged osingese women was poorer than the productive group. However, it needed further study to investigate the other factor influencing oral health status. Keywords: caries, periodontal disease, oral hygiene, menopause, Osingese

<p>Menopause ranked among reproductive health is one of the issues that requires special consideration because of the position of women. In terms of the elimination of inequalities in gender-related health, it is important to investigate this issue in a holistic approach. Today with the increasing length of life, the time that spent in menopause period is increasing too. Accepted physiological event menopause leads to changes in physiological, mental, social and sexual ways. Changes in the levels of reproductive hormones lead to menstrual cycle disruption, vasomotor symptoms, sleep disorders and mood changes. As menopause period develops with pathological events which threaten life, impair quality of life and affect marriage relationship, it is an important period needs to be addressed by health professionals. In this context, identifying mental problems gone through in menopause period is important in terms of holistic approach. Women in menopause periods should be addressed in the biopsychosocial and cultural integrity and health professionals should determine women who are at risk of mental problems at an early stage and should provide support in a mental aspect.</p><p> </p><p><strong>Özet</strong></p><p>Üreme sağlığı içinde yer alan menopoz, kadınların konumlarından dolayı özel yaklaşım gerektiren konulardan biridir. Cinsiyete bağlı sağlıkta eşitsizlik durumunun ortadan kaldırması açısından bütüncül yaklaşım içerisinde bu konunun araştırılmış olması önemlidir. Günümüzde yaşam süresinin uzaması ile birlikte menopoz döneminde geçirilen süre de artmaktadır. Fizyolojik bir olay olarak kabul edilen menopoz kadında fizyolojik, mental, sosyal ve cinsel yönden birçok değişimler yaşanmasına neden olmaktadır. Üreme hormonlarının düzeylerindeki değişiklikler sonucu adet döngüsünde bozulma, vazomotor belirtiler, uyku bozuklukları, duygu durum değişiklikleri görülebilmektedir. Menopoz dönemi yaşamı tehdit edici, yaşam kalitesini bozucu ve evlilik ilişkisini etkileyen patolojik olaylarla birlikte seyrettiği için sağlık profesyonelleri tarafından ele alınması gereken önemli bir dönemdir. Bu bağlamda menopoz döneminde yaşanan ruhsal sorunların belirlenmesi bütüncül yaklaşım açısından önem taşımaktadır. Menopoz döneminde olan kadınlar biyopsikososyal ve kültürel bütünlük içinde ele alınmalı, sağlık profesyonelleri, ruhsal sorunlar yönünden risk altında olan kadınları erken dönemde belirlemeli, ruhsal yönden destek almalarını sağlamalıdır.</p>

This study examined relationships among job, partner, and parent role quality and psychological well being in midlife black (n = 51) and white (n = 56) women employed in occupations varying by socioeconomic status (SES). Oversampling for black women ensured balanced occupational representation, allowing investigation uncontaminated by SES. Instruments included Baruch and Barnett's Rewards and Concerns Scales, Bradburn Affect Balance Scale, and Center for Epidemiological Studies Depression Scale (CES-D). Better well being scores were reported by black women than whites, and by professionals than non-professionals. However, when race, occupational group, and menopausal status were held constant in a multiple regression analysis, partner role quality was significantly related to both well being scores, parent role quality was related to life satisfaction only, and job role quality was not related to either. Nurses in the workplace can help women identify problematic aspects of their multiple social roles, and facilitate resolution of problems to improve worker health.

This study examined the relationship between perceived emotional intelligence and health-related quality of life in middle-aged women. 99 middle-aged Spanish women, who studied in two adult schools, volunteered to participate. 49 were premenopausal and 45 were postmenopausal. These women completed the Trait Meta-Mood Scale and Health Survey SF–36. Scores were analyzed according to social, physical, and mental health, menopausal status, and scores on perceived emotional intelligence. Then, the data regarding the mental and physical health of the premenopausal and postmenopausal women were compared after controlling for age. No associations between menopausal status and health-related quality of life were found. Perceived skill at mood repair was significantly associated with scores on health-related quality of life in these middle-aged women. These findings provide empirical evidence that aspects of perceived emotional intelligence may account for the health-related quality of life in midlife including social, physical, and psychological symptoms.

OBJETIVO: Analisar os sentidos atribuídos à voz por mulheres após a menopausa. MÉTODOS: Foram coletados dados de 148 mulheres nos prontuários médicos, entre fevereiro de 2000 e outubro de 2001, no Programa da Saúde da Mulher no Climatério, do ambulatório de ginecologia de um hospital na cidade de Curitiba, Estado do Paraná. Dentre a população total foram selecionadas intencionalmente 30 mulheres entre 48 e 59 anos, que não se consideravam profissionais da voz, no mínimo há 12 meses em amenorréia, e que foram entrevistadas com um roteiro temático, constituído de questões semi-estruturadas. Cada entrevista foi gravada e transcrita. A descrição, análise e interpretação foram fundamentadas pelas representações sociais, por meio do discurso do sujeito coletivo, com aproximações à hermenêutica-dialética. RESULTADOS: Os 27 discursos coletivos estruturados denotaram o relacionamento da voz às características biológicas, psicológicas e aspectos sociais do cotidiano, com a identificação de mudanças vocais no decorrer da vida. CONCLUSÕES: Foi possível observar representações sociais de natureza comunicacional e funcional, que salientaram a voz como elemento de constituição da identidade pessoal, concebida na pertinência social. A pesquisa sugere novas investigações fundamentadas nas ciências sociais, simultâneas aos estudos epidemiológicos, e a necessidade de se refletir sobre o processo de terapêutica vocal aplicado sobre uma laringe mais vulnerável, além de priorizar uma proposta de assistência integral à mulher no climatério, com enfoque sobre a saúde da voz.

La biomedicalización es un fenómeno que implica la intervención de los saberes y tecnologías biomédicos en cada vez más aspectos de la vida, con un aumento de su jurisdicción desde la enfermedad a la salud y, hoy en día, sobre la gestión de los cuerpos y las vidas. Con el fin de concretar la complejidad del fenómeno, este artículo apuesta por diseccionar la biomedicalización en diferentes dimensiones: el biologicismo, la patologización, el uso de tratamientos y el control sanitario. El proceso de biomedicalización no ha sido homogéneo, pues no acontece de manera similar ante cualquier condición, cualquier colectivo ni cualquier lugar. Una mirada centrada en las mujeres da cuenta de que este proceso ha afectado a algunas condiciones de sus vidas: menstruación, menopausia, fertilidad, sexualidad, parto, lactancia, cuerpo, salud mental y violencia. Para ello, el artículo aporta algunos trabajos clave del Estado español.

SUMMARY OBJECTIVES The outbreak of coronavirus disease (COVID-19) is a public health emergency of international concern. Inflammatory changes are part of COVID-19 pathophysiology and this might generate a higher thromboembolic risk in patients using combined hormonal contraception and menopausal hormone therapy. We aimed to discuss the main aspects related to this issue and propose management strategies for women affected by COVID-19. METHODS This narrative review collected information from several articles published since the beginning of the outbreak of the new coronavirus disease about the pathophysiology, stage of the disease, the occurrence of thrombotic events, and the risk of thromboembolism in users of contraception and hormonal therapy. RESULTS This article consolidates clinical parameters about the risk of venous thromboembolism in users of contraception and menopausal hormone therapy emphasizing the probable increase of that risk in women with suspected or confirmed COVID-19 and bringing safer recommendations. CONCLUSIONS In this scenario, apart from the fundamental orientations of preventive measures, like social isolation and hygiene, it is important that all female health professionals have knowledge of the new rules and adopt safety measures, especially on the prescription of hormonal therapy and contraception.

5550 Background: Various histological types of gynecological tumors may develop from different etiological aspects. The observed differences in cancer incidence are mainly due to different individual and social risk factors. Step toward establishing a nation wide registry is being taken in this study. Methods: To give a relative frequency of female genital tract malignant tumors in Iran we designed a cross-sectional study included 450 women with definite diagnosis of gynecological cancer based on pathologic reports in five pathologic centers, Iran University of Medical sciences, Tehran, 1995–2005. WHO classification of gynecological tumors and International Federation of Gynecology and Obstetrics (FIGO) were used as basis of study. Spss 14 and correlation test was used for data analysis. Results: The average age of diagnosis was (50±0.7). 49.6% were menopausal. 82.7% were multipar. 89.8% were nonsmoker. 9.3% had history of using OCP. Ovarian cancers (55.5%), uterus cancers (24.9%) and cervical cancers (19.6%) were diagnosed. Surface epithelial-stromal tumor was the most frequent type of ovarian tumors (78.4%). Endometrial adenocarcinoma (70.5%) and squamous cell carcinoma (83%) were most frequent types of uterus and cervical cancers respectively.Well differentiated tumors were seen in 45%, 37% and 36% of uterus, cervical and ovarian tumors. In tumors of uterus and cervix the most frequent stage of diagnosis was stage IIA. The most metastatic diagnosed cases were seen between ovarian tumors (39.7%). Conclusions: Comparison with data published as review articles in NEJM till 2006, the most frequent gynecologic cancer in our study (ovarian cancer) is different to them; also the median age of our patients is lower than them. [Table: see text] No significant financial relationships to disclose.

Abstract Estrogens are steroid hormones that affect many aspects of brain function, including cognition, social behavior, and neuroprotection. It is well-known that estrogens are synthesized in the ovaries. Estrogens are also synthesized in the brain, where aromatase is expressed in specific regions. Importantly, estrogens play crucial roles in the brain, even at extremely low levels. Current assays lack the necessary sensitivity and/or specificity to measure brain-synthesized estrogens. Furthermore, current methods focus on only 17β-estradiol and generally disregard other estrogens that are synthesized in the brain. Here, we developed a method to measure several estrogens simultaneously, with high sensitivity and specificity. To improve sensitivity, we derivatized estrogens with 1,2-dimethylimidazole-5-sulfonyl-chloride (DMIS). We used liquid chromatography tandem mass spectrometry (LC-MS/MS) to examine a panel of eight estrogens: 17β-estradiol, 17α-estradiol, estrone, estriol, 2-hydroxyestradiol, 4-hydroxyestradiol, 2-methoxyestradiol, and 4-methoxyestradiol. After derivatization, we have improved sensitivity 20-fold, detecting as little as 0.01 pg per sample, demonstrating that our method is extremely sensitive. For each analyte, we have identified a distinct retention time as well as 2 scheduled multiple reaction monitoring (sMRM) transitions that were used as quality control criteria for clear identification. Therefore, we are able to distinguish each estrogen (even stereoisomers) by the chromatographic separation and the sMRM, demonstrating that our method is highly specific. This method has been applied to microdissected brain samples. Initially, we used a songbird model because songbirds have high levels of aromatase and 17β-estradiol in specific brain regions. We were able to simultaneously quantify multiple estrogens in small amounts of brain sample (1-2 mg). We examined seasonal changes of estrogens in the brain and blood. Future work will apply this method to mouse, rat, and human samples and expand the panel of estrogens examined. Our ultra-sensitive assay is essential for small animal models, where estrogen measurement is extremely challenging because of the limited amount of brain tissue. This novel technique will also have wide-ranging applications for basic research and clinical testing, including estrogen measurement in humans with low estrogen levels, such as men, pre-pubertal children, and post-menopausal women.

Abstract Introduction. The term “quality of life” has been present in the literature for a long time now. It was created in the middle of the last century in Western Europe and from the societal perspective the term initially defined the level of material life, gradually being expanded to other aspects of human life, like happiness, education, broadly defined individual freedom and health. Aim. To analyze differences by gender and place of residence in perception of quality of life based on data from the assessment of thrombocytopenia impact on daily activities using TSIDAV vignette among Polish patients. Material and methods. We assessed the impact of thrombocytopenia symptoms on patients’ daily activities using TSIDAV vignette. We wanted to understand the reason for different perception of symptoms and why visible symptoms are perceived as worse by women in comparison to men. We analyzed the groups by age and place of residence. Results. Within 48 collected questionnaires, 31 were provided by women and 17 by men. As many as 29% of men declared the biggest impact on daily activities due to petechiae and easy bruising. The same symptoms were assessed as having significant impact on daily activities by 68% and 65% of women respectively. The results in relation to the two symptoms were similar in terms of impact: both men and women assessed it as high impact, however in general, a lower proportion of men identified this as an issue. As many as 53% of the pre-menopausal women declared the thrombocytopenia impact on daily activities as very high. Similar results were observed in the male group. Those before retirement age assessed disease symptoms as very high in comparison to the group of older patients. No significant differences in relation to place of residence were observed. During literature research we found that depending on patients’ gender, the perception of the impact of disease on patients quality of life may often differ. Conclusions. We found out that the perception of disease symptoms impact on quality of life is different by women and men. That may be the result of different factors such as the influence of social roles determined for each sex. At the same time, the perception of the impact of thrombocytopenia symptoms on daily activity almost does not depend on age or place of residence of neither women nor men.

A Incontinência Urinária (IU) tem grande impacto na qualidade de vida da mulher, por ser um sintoma que causa desconforto, vergonha, perda da autoconfiança e limitações sociais. Pode aparecer em qualquer fase do ciclo vital da mulher: na infância e adolescência é comum que seja precedida de urgência miccional; no ciclo gravídico-puerperal é decorrente de alterações próprias da reprodução e acima dos 30 anos é mais associada ao esforço [1].Qualquer queixa de perda urinária é definida como IU pela International Continence Society (ICS), sendo subdividida em três subtipos: de esforço (IUE); de urgência (IUU) e mista (IUM) [2]. É muito importante o aprofundamento de estudos e pesquisas sobre a IU feminina, já que as mulheres acometidas se excluem do meio social na perspectiva de se autoproteger dos incômodos provocados pelas perdas urinárias diárias.Os fatores de risco relacionados à IU ainda não são bem definidos, sendo os mais citados: idade, raça, índice de massa corporal (IMC), mudança de peso, ocupação, hipertensão, uso de diurético, diabetes, doença neurológica, menopausa, ingestão de café, fumo, tosse frequente, constipação, histerectomia, perineoplastia, atividade física, paridade e tipo de parto [3].Mesmo com os prejuízos em sua qualidade de vida, a maioria das mulheres com IU reluta em procurar o diagnóstico e tratamento. Nas pacientes com queixa de IU, é recomendado que se especifiquem as circunstâncias, a frequência e a gravidade das perdas, incluindo-se na abordagem: anamnese, exame físico, questionários de qualidade de vida, diário miccional, teste do absorvente e o estudo urodinâmico (EUD) [4].Muitas mulheres com queixas de IU são encaminhadas para realização de EUD ou urodinâmica, com o propósito de reproduzir os sintomas urinários em condições controladas e mensuráveis, realizando o diagnóstico com dados objetivos, visando: detectar anormalidades e fazer a distinção entre os vários mecanismos fisiopatológicos que causam a IU; identificar fatores para a disfunção urinária; tentar predizer a repercussão dessas alterações sobre o trato urinário, além de confirmar os efeitos do tratamento e interpretar as razões de falha terapêutica [2]. Entretanto, este exame possui algumas peculiaridades que podem interferir no resultado: é um exame invasivo e constrangedor devido à cateterização vesical e retal; dificuldade do paciente de urinar na frente do examinador; infusão vesical de líquido que não é urina, temperatura do líquido infundido, ritmo de infusão acima do fisiológico, posicionamento do paciente e a cateterização vesical, constatando-se também disúria após o exame e possibilidade de infecção do trato urinário.Quem trabalha em unidade de urodinâmica ouve diversas queixas de mulheres de como a IU afetou sua vida, em especial: não poder passar férias na casa de parentes, não ter mais relações sexuais, não poder praticar esporte e até evitar beber água. Ficam vulneráveis também durante o exame urodinâmico, manifestando sentimentos de vergonha, de desconforto e até de dor.São necessárias pesquisas mais abrangentes sobre a prevalência e fatores de risco associados à IU, com vistas a obter dados que permitam ações de prevenção de agravos e intervenções de melhoria de qualidade de vida. A IU feminina constitui um amplo campo de investigação para pesquisadores de diferentes áreas profissionais em saúde, nos aspectos de diagnóstico, terapêutica e outras diretrizes e protocolos assistenciais multi e interprofissionais, que contribuam para a melhoria da qualidade de vida das mulheres afetadas.

Background: Menopause phase in women is the time when menstrual cycle stops which is followed by obvious psychological and physical changes and occurs 3 – 4 years. The psychological and physical changes in menopause women will affect the quality of their life. Therefore, supports from the close people, especially from their husbands are needed. Objective: This study aimed to find out the correlation between husband support and the life quality of menopause women. The type of this research was quantitative research using correlation analysis with cross sectional approach with the total of 126 respondents. The technique used in taking the sample was Purposive sampling technique. Chi Square test was used as the bivariate test. Finding: The research finding showed that p-value was 0.032. Conclusion: There was a correlation between husband support and the life quality of menopause women. Suggestion: There should be a follow-up research about the factors which affect the life quality of menopause women such as psychological, physical aspects, social relationship and environment surrounding the menopause women.

Menopause involves both physiological and psychological manifestations that result from hormonal changes Basically health is understood as the perfect equilibrium of body, mind, intellect and soul. The person who enjoys lightness of body, slowness of breathing, calmness of mind, control over emotions, action in relaxation and blissful awareness is said to be healthy. Women’s health is bound up with social, cultural and economic factor that influence all aspect of their lives and consequences are born by women themselves. Yoga is a physical and mental practice that involves the body, mind and spirit. The practice, which originated in India, is designed to enhance awareness, create a mind-body-spirit balance, cleanse, heal and strengthen the body, liberate the true self and, as practiced today, improve fitness. Keywords: Menopausal problem Management Yoga Therapy

São discutidos aspectos ligados não somente ao controle médico exercido em relação à mulher, através da medicalização em diversas fases de sua vida reprodutiva, mas também o controle social a que são subme- tidas, principalmente quando esta função desaparece, na menopausa. A relação entre seus papéis de reprodutora de indivíduos e de produtora de bens e de serviços é analisada em função das diversas formas de controle sobre a sexualidade feminina, concluindo os autores pela necessidade de se pensar em uma crise "produzida culturalmente", cujos estudos e pesquisas devem ser contextualizados.

Welcome to this special issue titled “Women’s Life and Trauma in Individual and Collective Narratives” of the East European Journal of Psycholinguistics. Narratives, both oral and written, play an important role in helping the individual make sense of their lives and the world they live in. Narrative research is focused on the elicitation and interpretation of people’s narrative accounts of their lived experiences. In recent decades, there has been an enormous growth in the use of narrative inquiry and narrative-based research with diverse theoretical orientations and methodologies grounded in various disciplines of the social sciences and humanities including anthropology, psychology, psycholinguistics, sociology, history and literary studies as well as in medicine and clinical research (Chase, 2005, 2011; Holstein & Gubrium, 2012; Kleinman, 1988; Charon, 2006). According to Chase (2005), most narrative researchers treat narrative as a distinctive form of discourse that shapes meaning through the concerted ordering of story material with speakers providing particular understandings of personal action and experiences by organizing events and objects into meaningful patterns, connecting subjects, actions, events, and their consequences over time. As narrative research has become increasingly complex and rigorous, this special issue was planned to gain insight into the narrative research being conducted by international scholars with a focus on women and trauma, broadly defined. The call for papers attracted many high-quality submissions from authors representing various countries. The special issue contains a collection of ten papers, each providing a unique perspective and understanding of trauma in women’s lives and its reflection in narrative inquiry. Just as women’s voices are varied, so too are the narratives presented. Women are represented as narrators; as subjects of the narration and as characters in the narrative. The authors also present a broad spectrum of approaches to the empirical analysis of narrative material ranging from social media content, life stories, clinical and educational interventions, and literary works. In the first paper of the special issue, Bifulco’s article seeks to explore links between selected investigative child abuse interview accounts using narratives elicited through the Childhood Experience of Care and Abuse (CECA) clinical interview guide and analyzed using the Linguistic Inquiry and Word Counts (LIWC) text analysis programme (Francis & Pennebaker, 1992) which identifies characteristics of speech associated with trauma. Her paper examines the potential of combining these approaches to systematically analyze and interpret trauma narratives. In the second article, the contextual backdrop for the narratives is the COVID-19 pandemic. In her article, Kostruba analyzes narratives collected online to gain an understanding of how specific social restrictions, stay-at-home orders particular to the pandemic affected all aspects of life including psychological well-being. Her study also used LIWC psycholinguistic analysis of these current pandemic narratives to identify markers of traumatic experience and identify possible gender differences in the ways women experienced (and continue to experience) the COVID-19 global pandemic. The importance of social and cultural context is apparent in the next article which draws on literary texts as the source material. For Aguilar Lopez & Miguel Borge, the drama The Gold Ribbon by María Manuela Reina, written and situated in the 1980s, a decade that for Spain implied a more obvious abandonment of the most traditional conceptions of the role of women, serves as the unit of analysis. The authors describe the divergent worldview models of the older versus younger characters, reflecting both a generational and gender divide around topics such as success, infidelity, and matrimony. Aguilar Lopez & Miguel Borge aim to identify if, how and why the dramatist is able to reach out to the general public through her play to create social awareness and give voice to the women who rebelled against the traditional social and gender roles. The next paper in this series focuses on the emerging field of post-traumatic growth (PTG) defined by Tedeschi & Calhoun (2004) as a “positive psychological change experienced as a result of the struggle with highly challenging circumstances.” Drawing on therapeutic narratives from women participating in a psychotherapy workshop, Lushyn & Sukhenko utilize dialectical understanding and discourse analysis to identify and assess the women’s descriptions and definitions associated with post-traumatic development and growth with a further attempt to provide practical implications for psychological practice. A set of the articles (#5-7) in this special issue target traumas associated with transition, be it gender transition or women and girls transitioning to another life phase (adolescence; menopause) and the emotional, social and cultural experiences connected to these transitions. Martynyuk’s article combines methodological tools of conceptual metaphor theory and narrative psychology with theoretical assumptions of the intersubjective psycholinguistic approach to meaning making and exploring transgender transition narrative metaphors. Her dataset consists of 16 TED talks videos by transgender individuals discussing their experiences of transitioning which provide Martynyuk the opportunity to conduct a narrative and visual analysis of the metaphors that are given coherence by the textual, social, cultural, and historical context of the narrative, as well as by the interactive situational context reflected in the video recordings. The article by Nair & George puts the menopausal woman as the focus of the narrative inquiry. The authors interviewed a group of male spouses about their knowledge, attitudes and beliefs about perimenopause and their experiences associated with the physical, psychological, and social changes occurring in the lives of their wives. The menopausal transition can be a period of stress, even lead to trauma if left unnoticed or unsupported. Nair & George used qualitative data software to analyze the interview data and thematic analysis to arrive at themes which could inform programs which could raise awareness about the perimenopausal and menopausal life stages of women to help both partners understand and cope with the individual, family and societal changes which occur during this life period. On the opposite end of the life spectrum, Shirazi et al, investigate whether narrative-based interventions in the school context can increase children’s emotional intelligence (EI) and whether oral and written narrative elements have a different effect on students' EI. The underlying premise is that children share their emotional experiences through narratives and stories and high-quality narratives are beneficial for children’s wellbeing and development. The research project was conducted with almost one hundred 12-year old Iranian girls who attend Yasuj city schools in southwestern Iran. Results highlighted the importance of oral and combined oral/written language modes and their merged narrative elements on the development of emotional intelligence, particularly for children who are in the language minority. The final set of articles (#8-10) make use of nostalgia and intergenerational narratives of historical trauma. Todorova & Padareva-Ilieva apply an interdisciplinary and multimodal approach to describe and classify written messages and images collected through social media in Bulgaria during the COVID-19 pandemic crisis. Findings revealed that much of the communications through social media during that period was largely nostalgic and that the main role of the Facebook social media platform is to unite people in times of isolation, to raise their spirit and save them from the traumatic experience they may encounter during a global health crisis. Zaporozhets & Stodolinska analyze the concept of border through a content analysis of the Little House children’s book series which are narrated from the lived experiences and perspective of the author Laura Ingalls Wilder based on her childhood in a settler and pioneer family in the United States in the late 1800s. The territorial and metaphorical borders depicted in Wilder’s works are interwoven and influenced by her reminiscences of historical, biographical, gender, and psychological peculiarities. This journal issue concludes with a cross-cultural analysis of narrative reflections associated with two 20th century genocides: the Holodomor in Ukraine (1932-1933), and the Holocaust (1939-1944). Zasiekina et al recruited second (“mothers”) and third (“daughters”) generations of Holodomor and Holocaust descendants in Ukraine and Israel to share their family narratives and experiences of the genocide. The study applied inductive thematic analyses that progressed from description to interpretation, and showed the centrality of five emerging themes in both mothers’ and daughters’ narratives. The findings of their research have important implications for future practice of creating narratives with survivors of massive trauma and their offspring and stress the importance of creating a traumatic narrative to aid the healing process resulting from the transmission of historical and collective trauma and provides direction for clinical providers in designing treatment plans for individuals with genocide in their life history. In summary, the articles that make up this special journal issue reinforce the view that narrative research and inquiry provides researchers and clinicians multiple lenses and approaches through which to analyze and interpret narrative data. The subsequent results of each narrative analysis can give voice to a broad range of women and girls, while at the same time guide policy and inform educational interventions and therapeutic programs.

Abstract Purpose We evaluated the impact of menopause-associated vasomotor symptoms (VMS) on sleep. We also sought to establish the content validity of Patient-Reported Outcomes Measurement Information System (PROMIS) short form Sleep-Related Impairment and Sleep Disturbance measures in postmenopausal women with moderate to severe VMS. Methods Cross-sectional, in-person, qualitative interviews were conducted in the United States (Texas, Illinois) and European Union (UK, France) with women aged 40–64 years experiencing moderate to severe VMS (≥35/wk). Main outcomes were impact of VMS on sleep based on concept elicitation and content validity of PROMIS Sleep-Related Impairment and Sleep Disturbance short forms via cognitive debriefing. Results Thirty-two women (US: n = 16; EU: n = 16) participated. A majority (US: 93.8%; EU: 93.8%) said VMS affected sleep; specifically, they had sleep interrupted by sweating or overheating and had difficulty returning to sleep. Sleep disturbance was the most bothersome aspect of VMS (US: 75%; EU: 50%). VMS-associated sleep disturbance affected next-day work productivity, mood, relationships, daily activities, concentration, social activities, and physical health. Participants found both PROMIS sleep measures relevant and easy to answer; the Sleep Disturbance measure was considered the most relevant. Participants had no difficulty remembering their experiences over the 7-day recall period and found the response options to be distinct. Conclusion VMS associated with menopause significantly interferes with sleep and next-day functioning (e.g., work productivity), supporting assessment of sleep outcomes in studies evaluating treatment of VMS. Women with moderate to severe VMS found that the PROMIS Sleep-Related Impairment and Sleep Disturbance short forms assessed constructs important to understanding sleep in the context of menopause-associated VMS.

Neste artigo se apresenta um dos aspectos de que se ocupa o Projeto Atlas Linguístico do Brasil (ProjetoALiB), o Léxico do português brasileiro. Dessa forma, este trabalho investiga como a linguagem de indivíduos apresenta marcas linguísticas específicas que constroem, mantêm e projetam a identidade de faixa etária em inquéritos do Projeto ALiB a partir da utilização do léxico como fator diageracional dos indivíduos no grupo etário do qual fazem parte. A metodologia empregada consistiu na realização das seguintes etapas: 1) leitura de textos teóricos referentes ao tema proposto; 2) escolha e formação do corpus, constituído de inquéritos das capitais do Projeto ALiB; 3) análise do corpus a fim de verificar marcas linguísticas transmissoras da construção, projeção e manutenção da identidade social de faixa etária. As análises dos inquéritos selecionados buscam estudar os itens lexicais presentes no campo semântico corpo humano (conjuntivite / dor d'olhos) e ciclos da vida (menstruação e entrar na menopausa), com o intuito de verificar a seleção lexical realizada por informantes de diferentes faixas etárias das diferentes capitais do país. A análise do corpus possibilitou realizar o registro e a documentação da diversidade lexical do português falado no Brasil, seguindo os princípios da Geolinguística moderna Pluridimensional em que o registro segue os parâmetros diatópicos e diastráticos.

Introduction: Conceptualizing DisabilityThe two most prominent models for understanding disability are the medical model and the social model (“Disability”). The medical model locates disability in the person and emphasises the possibility of a cure, reinforcing the idea that disability is the fault of the disabled person, their body, their genes, and/or their upbringing. The social model, formulated as a response to the medical model, presents disability as a failure of the surrounding environment to accommodate differently abled bodies and minds. Closely linked to identity politics, the social model argues that disability is not a defect to be fixed but a source of human experience and identity, and that to disregard the needs of people with disability is to discriminate against them by being “ableist.”Both models have limitations. On the one hand, simply being a person with disability or having any other minority identity/-ies does not by itself lead to exclusion and discrimination (Nocella 18); an element of social valuation must be present that goes beyond a mere numbers game. On the other hand, merely focusing on the social aspect neglects “the realities of sickness, suffering, and pain” that many people with disability experience (Mollow 196) and that cannot be substantially alleviated by any degree of social change. The body is irreducible to discourse and representation (Siebers 749). Disability exists only at the confluence of differently abled minds and bodies and unaccommodating social and physical environs. How a body “fits” (my word) its environment is the focus of the “ecosomatic paradigm” (Cella 574-75); one example is how the drastically different environment of Cormac McCarthy’s The Road (2006) reorients the coordinates of ability and impairment (Cella 582–84). I want to examine a novel that, conversely, features a change not in environment but in body.Alien LegsTim Farnsworth, the protagonist of Joshua Ferris’s second novel, The Unnamed (2010), is a high-powered New York lawyer who develops a condition that causes him to walk spontaneously without control over direction or duration. Tim suffers four periods of “walking,” during which his body could without warning stand up and walk at any time up to the point of exhaustion; each period grows increasingly longer with more frequent walks, until the fourth one ends in Tim’s death. As his wife, Jane, understands it, these forced excursions are “a hijacking of some obscure order of the body, the frightened soul inside the runaway train of mindless matter” (24). The direction is not random, for his legs follow roads and traffic lights. When Tim is exhausted, his legs abruptly stop, ceding control back to his conscious will, whence Tim usually calls Jane and then sleeps like a baby wherever he stops. She picks him up at all hours of the day and night.Contemporary critics note shades of Beckett in both the premise and title of the novel (“Young”; Adams), connections confirmed by Ferris (“Involuntary”); Ron Charles mentions the Poe story “The Man of the Crowd” (1845), but it seems only the compulsion to walk is similar. Ferris says he “was interested in writing about disease” (“Involuntary”), and disability is at the core of the novel; Tim more than once thinks bitterly to himself that the smug person without disability in front of him will one day fall ill and die, alluding to the universality of disability. His condition is detrimental to his work and life, and Stuart Murray explores how this reveals the ableist assumptions behind the idea of “productivity” in a post-industrial economy. In one humorous episode, Tim arrives unexpectedly (but volitionally) at a courtroom and has just finished requesting permission to join the proceedings when his legs take him out of the courtroom again; he barely has time to shout over his shoulder, “on second thought, Your Honor” (Ferris Unnamed 103). However, Murray does not discuss what is unique about Tim’s disability: it revolves around walking, the paradigmatic act of ability in popular culture, as connoted in the phrase “to stand up and walk.” This makes it difficult to understand Tim’s predicament solely in terms of either the medical or social model. He is able-bodied—in fact, we might say he is “over-able”—leading one doctor to label his condition “benign idiopathic perambulation” (41; my emphasis); yet the lack of agency in his walking precludes it from becoming a “pedestrian speech act” (de Certeau 98), walking that imbues space with semiotic value. It is difficult to imagine what changes society could make to neutralize Tim’s disability.The novel explores both avenues. At first, Tim adheres to the medical model protocol of seeking a diagnosis to facilitate treatment. He goes to every and any (pseudo)expert in search of “the One Guy” who can diagnose and, possibly, cure him (53), but none can; a paper in The New England Journal of Medicine documents psychiatrists and neurologists, finding nothing, kicking the can between them, “from the mind to body back to the mind” (101). Tim is driven to seek a diagnosis because, under the medical model, a diagnosis facilitates understanding, by others and by oneself. As the Farnsworths experience many times, it is surpassingly difficult to explain to others that one has a disease with no diagnosis or even name. Without a name, the disease may as well not exist, and even their daughter, Becka, doubts Tim at first. Only Jane is able to empathize with him based on her own experience of menopause, incomprehensible to men, gesturing towards the influence of sex on medical hermeneutics (Mollow 188–92). As the last hope of a diagnosis comes up empty, Tim shifts his mentality, attempting to understand his condition through an idiosyncratic idiom: experiencing “brain fog”, feeling “mentally unsticky”, and having “jangly” nerves, “hyperslogged” muscles, a “floaty” left side, and “bunched up” breathing—these, to him, are “the most precise descriptions” of his physical and mental state (126). “Name” something, “revealing nature’s mystery”, and one can “triumph over it”, he thinks at one point (212). But he is never able to eschew the drive toward understanding via naming, and his “deep metaphysical ache” (Burn 45) takes the form of a lament at misfortune, a genre traceable to the Book of Job.Short of crafting a life for Tim in which his family, friends, and work are meaningfully present yet detached enough in scheduling and physical space to accommodate his needs, the social model is insufficient to make sense of, let alone neutralize, his disability. Nonetheless, there are certain aspects of his experience that can be improved with social adjustments. Tim often ends his walks by sleeping wherever he stops, and he would benefit from sensitivity training for police officers and other authority figures; out of all the authority figures who he encounters, only one shows consideration for his safety, comfort, and mental well-being prior to addressing the illegality of his behaviour. And making the general public more aware of “modes of not knowing, unknowing, and failing to know”, in the words of Jack Halberstam (qtd. in McRuer and Johnson 152), would alleviate the plight not just of Tim but of all sufferers of undiagnosed diseases and people with (rare forms of) disability.After Tim leaves home and starts walking cross-country, he has to learn to deal with his disability without any support system. The solution he hits upon illustrates the ecosomatic paradigm: he buys camping gear and treats his walking as an endless hike. Neither “curing” his body nor asking accommodation of society, Tim’s tools mediate a fit between body and environs, and it more or less works. For Tim the involuntary nomad, “everywhere was a wilderness” (Ferris Unnamed 247).The Otherness of the BodyProblems arise when Tim tries to fight his legs. After despairing of a diagnosis, he internalises the struggle against the “somatic noncompliance” of his body (Mollow 197) and refers to it as “the other” (207). One through-line of the novel is a (failed) attempt to overcome cartesian duality (Reiffenrath). Tim divides his experiences along cartesian lines and actively tries to enhance while short-circuiting the body. He recites case law and tries to take up birdwatching to maintain his mind, but his body constantly stymies him, drawing his attention to its own needs. He keeps himself ill-clothed and -fed and spurns needed medical attention, only to find—on the brink of death—that his body has brought him to a hospital, and that he stops walking until he is cured and discharged. Tim’s early impression that his body has “a mind of its own” (44), a situation comparable to the Strange Case of Dr Jekyll and Mr Hyde (1886; Ludwigs 123–24), is borne out when it starts to silently speak to him, monosyllabically at first (“Food!” (207)), then progressing to simple sentences (“Leg is hurting” (213)) and sarcasm (“Deficiency of copper causes anemia, just so you know” (216)) before arriving at full-blown taunting:The other was the interrogator and he the muttering subject […].Q: Are you aware that you can be made to forget words, if certain neurons are suppressed from firing?A: Certain what?Q: And that by suppressing the firing of others, you can be made to forget what words mean entirely? Like the word Jane, for instance.A: Which?Q: And do you know that if I do this—[inaudible]A: Oof!Q: —you will flatline? And if I do this—[inaudible]A: Aaa, aaa…Q: —you will cease flatlining? (223–24; emphases and interpolations in original except for bracketed ellipsis)His Jobean lament turns literal, with his mind on God’s side and his body, “the other”, on the Devil’s in a battle for his eternal soul (Burn 46). Ironically, this “God talk” (Ferris Unnamed 248) finally gets Tim diagnosed with schizophrenia, and he receives medication that silences his body, if not stilling his legs. But when he is not medicated, his body can dominate his mind with multiple-page monologues.Not long after Tim’s mind and body reach a truce thanks to the camping gear and medication, Tim receives word on the west coast that Jane, in New York, has terminal cancer; he resolves to fight his end-of-walk “narcoleptic episodes” (12) to return to her—on foot. His body is not pleased, and it slowly falls apart as Tim fights it eastward cross-country. By the time he is hospitalized “ten miles as the crow flies from his final destination”, his ailments include “conjunctivitis”, “leg cramps”, “myositis”, “kidney failure”, “chafing and blisters”, “shingles”, “back pain”, “bug bites, ticks, fleas and lice”, “sun blisters”, “heatstroke and dehydration”, “rhabdomyolysis”, “excess [blood] potassium”, “splintering [leg] bones”, “burning tongue”, “[ballooning] heels”, “osteal complications”, “acute respiratory distress syndrome”, “excess fluid [in] his peritoneal cavity”, “brain swelling”, and a coma (278–80)—not including the fingers and toes lost to frostbite during an earlier period of walking. Nevertheless, he recovers and reunites with Jane, maintaining a holding pattern by returning to Jane’s hospital bedside after each walk.Jane recovers; the urgency having dissipated, Tim goes back on the road, confident that “he had proven long ago that there was no circumstance under which he could not walk if he put his mind to it” (303). A victory for mind over body? Not quite. The ending, Tim’s death scene, planned by Ferris from the beginning (Ferris “Tracking”), manages to grant victory to both mind and body without uniting them: his mind keeps working after physical death, but its last thought is of a “delicious […] cup of water” (310). Mind and body are two, but indivisible.Cartesian duality has relevance for other significant characters. The chain-smoking Detective Roy, assigned the case Tim is defending, later appears with oxygen tank in tow due to emphysema, yet he cannot quit smoking. What might have been a mere shortcut for characterization here carries physical consequences: the oxygen tank limits Roy’s movement and, one supposes, his investigative ability. After Jane recovers, Tim visits Frank Novovian, the security guard at his old law firm, and finds he has “gone fat [...] His retiring slouch behind the security post said there was no going back”; recognising Tim, Frank “lifted an inch off [his] chair, righting his jellied form, which immediately settled back into place” (297; my emphases). Frank’s physical state reflects the state of his career: settled. The mind-body antagonism is even more stark among Tim’s lawyer colleagues. Lev Wittig cannot become sexually aroused unless there is a “rare and extremely venomous snak[e]” in the room with no lights (145)—in direct contrast to his being a corporate tax specialist and the “dullest person you will ever meet” (141). And Mike Kronish famously once billed a twenty-seven-hour workday by crossing multiple time zones, but his apparent victory of mind over matter is undercut by his other notable achievement, being such a workaholic that his grown kids call him “Uncle Daddy” (148).Jane offers a more vexed case. While serving as Tim’s primary caretaker, she dreads the prospect of sacrificing the rest of her life for him. The pressures of the consciously maintaining her wedding vows directly affects her body. Besides succumbing to and recovering from alcoholism, she is twice tempted by the sexuality of other men; the second time, Tim calls her at the moment of truth to tell her the walking has returned, but instead of offering to pick him up, she says to him, “Come home” (195). As she later admits, asking him to do the impossible is a form of abandonment, and though causality is merely implied, Tim decides a day later not to return. Cartesian duality is similarly blurred in Jane’s fight against cancer. Prior to developing cancer, it is the pretence for Tim’s frequent office absences; she develops cancer; she fights it into remission not by relying on the clinical trial she undergoes, but because Tim’s impossible return inspires her; its remission removes the sense of urgency keeping Tim around, and he leaves; and he later learns that she dies from its recurrence. In multiple senses, Jane’s physical challenges are inextricable from her marriage commitment. Tim’s peripatetic condition affects both of them in homologous ways, gesturing towards the importance of disability studies for understanding the experience both of people with disability and of their caretakers.Becka copes with cartesian duality in the form of her obesity, and the way she does so sets an example for Tim. She gains weight during adolescence, around the time Tim starts walking uncontrollably, and despite her efforts she never loses weight. At first moody and depressed, she later channels her emotions into music, eventually going on tour. After one of her concerts, she tells Tim she has accepted her body, calling it “my one go-around,” freeing her from having to “hate yourself till the bitter end” (262) to instead enjoy her life and music. The idea of acceptance stays with Tim; whereas in previous episodes of walking he ignored the outside world—another example of reconceptualizing walking in the mode of disability—he pays attention to his surroundings on his journey back to New York, which is filled with descriptions of various geographical, meteorological, biological, and sociological phenomena, all while his body slowly breaks down. By the time he leaves home forever, he has acquired the habit of constant observation and the ability to enjoy things moment by moment. “Beauty, surprisingly, was everywhere” (279), he thinks. Invoking the figure of the flâneur, which Ferris had in mind when writing the novel (Ferris “Involuntary”), Peter Ferry argues that “becoming a 21st century incarnation of the flâneur gives Tim a greater sense of selfhood, a belief in the significance of his own existence within the increasingly chaotic and disorientating urban environment” (59). I concur, with two caveats: the chaotic and disorienting environment is not merely urban; and, contrary to Ferry’s claim that this regained selfhood is in contrast to “disintegrating” “conventional understandings of masculinity” (57), it instead incorporates Tim’s new identity as a person with disability.Conclusion: The Experience of DisabilityMore than specific insights into living with disability, the most important contribution of The Unnamed to disability studies is its exploration of the pure experience of disability. Ferris says, “I wanted to strip down this character to the very barest essentials and see what happens when sickness can’t go away and it can’t be answered by all [sic] of the medical technology that the country has at its disposal” (“Tracking”); by making Tim a wealthy lawyer with a caring family—removing common complicating socioeconomic factors of disability—and giving him an unprecedented impairment—removing all medical support and social services—Ferris depicts disability per se, illuminating the importance of disability studies for all people with(out) disability. After undergoing variegated experiences of pure disability, Tim “maintained a sound mind until the end. He was vigilant about periodic checkups and disciplined with his medication. He took care of himself as best he could, eating well however possible, sleeping when his body required it, […] and he persevered in this manner of living until his death” (Ferris Unnamed 306). This is an ideal relation to maintain between mind, body, and environment, irrespective of (dis)ability.ReferencesAdams, Tim. “The Unnamed by Joshua Ferris.” Fiction. Observer, 21 Feb. 2010: n. pag. 19 Sep. 2018 <https://www.theguardian.com/books/2010/feb/21/the-unnamed-joshua-ferris>.Burn, Stephen J. “Mapping the Syndrome Novel.” Diseases and Disorders in Contemporary Fiction: The Syndrome Syndrome. Eds. T.J. Lustig and James Peacock. New York: Routledge, 2013. 35-52.Cella, Matthew J.C. “The Ecosomatic Paradigm in Literature: Merging Disability Studies and Ecocriticism.” Interdisciplinary Studies in Literature and Environment 20.3 (2013): 574–96.De Certeau, Michel. The Practice of Everyday Life. 1980. Trans. Steven Rendall. Berkeley: U of California P, 1984.Charles, Ron. “Book World Review of Joshua Ferris’s ‘The Unnamed.’” Books. 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