We conducted a systematic review investigating body fat distribution in older adults and its association with morbidity and mortality. Our search yielded 2,702 citations. Following three levels of screening, 25 studies were selected to evaluate the association between body fat distribution and comorbidity, and 17 studies were used in the mortality analysis. Most of the selected studies in our analyses used anthropometric measures, e.g., body mass index (BMI), waist circumference, and waist-hip ratio; relatively few studies used direct measures, such as body fat/lean mass, and percentage body fat. Studies reported inconsistent findings regarding the strongest predictor(s) of morbidity and mortality. However, the majority of studies suggested that BMI per se was not the most appropriate predictor of morbidity and mortality in the elderly because of its inability to discern or detect age-related body fat redistribution. In addition, studies using BMI found that the optimal BMI range for the lowest mortality in the elderly was overweight (25 kg/m2 ≤ BMI < 30 kg/m2) or mildly obese (30 kg/m2 ≤ BMI < 35 kg/m2). Our findings suggest that the current clinical guidelines, recommending that overweight and obesity are major risk factors for increased morbidity and mortality are not applicable to this population. Therefore, the central message of this review is to admonish the government to establish new guidelines specifically for this population, using a combination of body fat distribution measurements, and to certify that these guidelines will not be applied to inappropriate populations.

By taking a reflexive approach to research methodology, this article contributes to discussions on power dynamics and knowledge production in the social studies of children. The author describes and analyzes three research methods that she used with children — drawing, child-led tape-recording and focus group discussions. These methods were carried out during 15 months of research in a low-income urban settlement in Zambia with children (ages 8—12) caring for sick parents or guardians. The research raises two points concerning current conceptions of children’s research methodology. First, it is necessary to investigate what so-called ‘child-oriented’ research methodologies accomplish for adult researchers. Second, acknowledging that children have their own reasons for participating in research and investigating these reasons may offer a more comprehensive view of children’s experiences and needs.

The Rutgers Series in Childhood Studies is dedicated to increasing our understanding of children and childhoods throughout the world, reflecting a perspective that highlights cultural dimensions of the human experience. The books in this series are intended for students, scholars, practitioners, and those who formulate policies that affect children's everyday lives and futures. A British Cataloging-in-Publication record for this book is available from the British Library.Copyright © 2017 by Jean Hunleth All rights reserved No part of this book may be reproduced or utilized in any form or by any means, electronic or mechanical, or by any information storage and retrieval system, without written permission from the publisher. Please contact Rutgers University Press, 106 Somerset Street, New Brunswick, NJ 08901. The only exception to this prohibition is "fair use" as defined by U.S. copyright law.∞ The paper used in this publication meets the requirements of the American National Standard for Information Sciences-Permanence of Paper for Printed Library Materials, ANSI Z39. 48-1992. www.rutgersuniversitypress.org Contents ixChildren as Caregivers is based on research I carried out in Lusaka during a time that spanned nearly ten years (2005, 2006, 2007 to 2008, and 2014). However, the ideas for the research took root much earlier when I was a Peace Corps volunteer in Eastern Province and then Central Province, Zambia (1999Zambia ( -2002. As a water sanitation volunteer in the village of Kapichila, near Lundazi, I was able to witness many things children accomplished for their families, and also the unacknowledged work that children put into global health projects. I thank Maxwell Banda and Anya Gondwe for opening their home to me and for putting their grandchildren in charge of introducing me to village life. Tikali, Regina, Suzgo, and Mattress taught me many lessons about children's creativity and the diversity of childhood experiences. I continue to carry these lessons throughout my career.I have incurred many debts since starting the project that led to this book. I am beyond grateful for my longtime mentor, Karen Tranberg Hansen, whose deep knowledge of Africanist scholarship and her decades of research in Lusaka provided the foundation for my own work. Helen Schwartzman introduced me to the anthropology of childhood and pushed me to think creatively and critically about research with children. I thank both Karen and Helen for their unwavering support and the countless hours they have spent mentoring me through the years. I have benefited from the mentorship of so many other people, particularly Edward Fischer, Bill Leonard, Rebecca Wurtz, Caroline Bledsoe, Virginia Bond, Cathy Zimmerman, Brad Stoner, and Aimee James, who have all encouraged me, in different ways, to weave together my interests in anthropology and public health.I have many people to thank in Zambia. My research affiliation with the Zambia AIDS Related Tuberculosis project (ZAMBART) proved vital, both when I was in Zambia and also back in the ...

Based on ethnographic fieldwork in Lusaka, Zambia, this article puts forth the concept of imaginal caring to examine a form of caring that is fantastical, exaggerated, and counterfactual. To develop this concept, I take the vantage point of young children (ages eight through twelve) who lived in households with persons who were suffering from tuberculosis and HIV. The children were involved in providing day‐to‐day care in many ways. They were also constrained in their efforts to give and show care because of their social positions, their access to resources, and their small human bodies. Through a series of examples, I demonstrate the ways in which children created and played with often visual images of giving care to family members in the past, present, and future. I show that fantastical imaginations and images of children's involvement in caring not only expressed that they cared for others but also served as ways for them to provide or perform care. There were high social and personal stakes for children in not being able to care for others, and children's efforts to care imaginally responded to such stakes, envisioning futures different from those scripted for them by global health discourses and the conditions of marginalization and exclusion into which they were born.

Structures of power and inequality shape day-to-day life for individuals who are poor, imposing waiting in multiple forms and for a variety of services, including for healthcare (Andaya, 2018a; Auyero, 2012; Strathmann and Hay, 2009). Constraints, such as the age requirements for Medicare, losing employer-provided health insurance, or the bureaucracy involved in filing for disability often require people to wait to follow recommendations for medical treatments. In 2016–2017, we conducted 52 narrative interviews in St. Louis, a city with significant racial and economic health inequities and without Medicaid expansion. We interviewed people with one or more chronic illnesses for which they were prescribed medication and who identified as having difficulties affording their prescriptions. Throughout the interviews, participants frequently recounted 1) experiences of waiting for care, along with other services, and 2) the range of strategies they utilized to manage the waiting. In this article, we develop the concept of active waiting to describe both the lived experiences of waiting for care and the responses that people devise to navigate, shorten, or otherwise endure waiting. Waiting is structured into healthcare and other social services at various scales in ways that reinforce feelings of marginalization, and also that require work on the part of those who wait. While much medical and public health research focuses on issues of diagnostic or treatment delay, we conclude that this conceptualization of active waiting provides a far more productive frame for accurately understanding the emotional and physical experiences of individuals who are disproportionately poor and made to wait for their care. Only with such understanding can we hope to build more just and compassionate social systems.