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PubMed2005

Toxic masculinity as a barrier to mental health treatment in prison.

The current article addresses gender issues that become magnified in prison settings and contribute to heightened resistance in psychotherapy and other forms of mental health treatment. Toxic masculinity involves the need to aggressively compete and dominate others and encompasses the most problematic proclivities in men. These same male proclivities foster resistance to psychotherapy. Some of the stresses and complexities of life in men's prisons are explored. The relation between hegemonic masculinity and toxic masculinity is examined. The discussion proceeds to the interplay between individual male characteristics and institutional dynamics that intensify toxic masculinity. A discussion of some structural obstacles to mental health treatment in prison and resistances on the part of prisoners is followed by some general recommendations for the therapist in this context.

Gender Identity↗
PubMed2003

Depressive symptoms in intellectual disability: does gender play a role?

BACKGROUND: Gender issues remain largely unaddressed in the dual diagnosis arena, even in the area of depression where there is a 2:1 female to male ratio in the general population. This paper argues that women with intellectual disability (ID) report higher levels of depressive symptoms than men with ID and that risk factors for depression identified for women in the general population are relevant to this group. METHOD: Findings are based on structured interviews with 99 men and women with ID, with corroborative information provided from caregivers and casebook reviews. RESULTS: Overall, women reported higher levels of depression than men. Individuals with higher depression scores were more lonely and had higher stress levels than individuals with lower scores. Women with higher depression scores were more likely to report coming from abusive situations, to have poor social support from family and to be unemployed when compared to women with lower scores, but similar differences were not found when comparing men with higher and lower depression scores. CONCLUSION: Men and women who report experiencing these psychosocial correlates of depression should be a target group for future prevention efforts, taking gender specific concerns into consideration.

Adaptation, Psychological↗
PubMed2005

Gender differences in prevalence of drug use among high risk adolescents in Israel.

BACKGROUND: The use of tobacco, alcohol and illicit drugs is considered to be primarily a male problem. Many studies of drug use in the general population have reinforced this assumption. Other recent findings, however, call the extent of gender differences into question. METHODS: Self report data were collected from 911 high risk adolescents who ranged from 12 to 18 years. RESULTS: Last 30 day use was used to compare the youth. Significant findings show girls use cigarettes more than boys; boys use all types of alcohol more than girls; and, boys use marijuana and hashish more than girls. No differences were reported in terms of the patterns of ecstasy, inhalants, prescription drugs, LSD, amphetamines, cocaine, crack cocaine, opium and heroin. Boys more than girls were inclined to binge drink. Boys and girls reported similar patterns of being in a car with a driver who had been drinking and driving a car after drinking. Boys more than girls take loans in order to obtain drugs; girls more than boys were able to acquire drugs without having to use their own money; and boys more than girls gambled to acquire drugs. DISCUSSION: With the exception of cigarettes, boys use drugs and engage in problem behavior more than girls. Underage drinking and driving is a serious behavior problem reported by male and female youth. This factor and binge drinking should be targeted as priority prevention issues. Gender differences in prevalence of drug use among high risk adolescents should be monitored to verify what may be a growing problem among female adolescents in the country and elsewhere (Litt, I., (2003). Drugs and adolescent girls. (editorial). Journal of Adolescent Health, 32, 1-2).

Adolescent↗
PubMed2005

Practice and clinical decision-making autonomy among Hellenic critical care nurses.

BACKGROUND: Nursing autonomy has been associated with better patient-outcomes; therefore, it is a priority for critical care nursing management. Low authority has been a persistent complaint of Hellenic intensive care unit nurses; however, issues of nursing autonomy have not been previously addressed empirically in Hellas. PURPOSE: To investigate: (1) the perceived contribution to clinical decision-making, (2) the degree of autonomy in technical tasks, and (3) factors related to practice autonomy in critical care nurses in Hellas. Additionally, because of the lack of sufficient tools, this study also aimed to construct and to validate a new tool for assessing practice and clinical decision-making autonomy among Hellenic intensive care unit nurses. MATERIALS AND METHODS: A Hellenic intensive care nursing autonomy scale, focused on technical aspects of care, was developed through literature review, a panel of experts and a pilot study in a random sample of 120 respondents. Items were refined by factor analysis, which revealed three major conceptual categories of autonomy: (1) basic technical, (2) advanced technical, and (3) clinical decision. Hellenic intensive care nursing autonomy (Likert 4, range: 38-152), was distributed to all nurses employed in intensive care units in Hellas (n = 807; attrition: 27%). Comparisons, correlation and multivariate regression were employed. RESULTS: The Hellenic intensive care nursing autonomy scale exhibited appropriate reliability (Cronbach's alpha = 0.86) and validity properties. Autonomy scores were moderate (mean: 105.24 +/- 9.58). Highest autonomy was attributed to basic technical tasks, followed by advanced technical tasks and decision-making. Male gender and higher education were predictors of higher overall, advanced technical and decision-making autonomy (P = 0.01). Bachelor degree graduates scored higher in decisional autonomy (P = 0.03). Intensive care unit experience and type of intensive care unit were also important determinants of decisional autonomy (P = 0.02). CONCLUSIONS: The results revealed moderate autonomy in technical tasks and low decisional autonomy among Hellenic intensive care unit nurses. Factors related to the educational preparation of nurses, gender issues and institutional characteristics might hinder intensive care unit nurses' autonomy in Hellas.

Adult↗
PubMed1989

Some determinants of the male analyst's capacity to identify with female patients.

This paper reviews some recent literature on gender issues in the analytic dyad, and then focuses specifically on the male analyst-female patient dyad. In order for male analysts to work effectively with female patients they must be able to identify with feminine concerns and dynamics. The paper discusses the male analyst's attempts to master castration anxieties, provoked by such identifications, in order to permit his female patients' concerns to resonate within him. He uses early maternal identifications in working with the pre-phallic material of his female patients, and he uses less readily neutralized direct identifications with his mother (and other women) to address his female patients' phallic concerns. The importance of resolving conflicts around the organization of a stable and mature masculine identity in his training analysis is emphasized, since the male analyst's freedom to use feminine identifications constructively in his work is dependent on it.

Anxiety, Castration↗
PubMed1993

Women's lives and sex: implications for AIDS prevention.

Preliminary findings from the Women and AIDS program, a research grants program of the International Center for Research on Women in Washington, D.C. that supports 17 studies in developing countries worldwide, provide a glimpse into the complex interaction between women's social and economic status and risk of HIV infection. In many settings, the cultural norms that demand sexual fidelity and docile and acquiescent sexual behavior among women permit--and sometimes even encourage--early sexual experimentation, multiple partnerships, and aggressive and dominating sexual behavior among men. Drawing upon the finding from the program, the paper analyzes how such cultural norms, together with women's social and economic dependency, can limit a woman's ability to negotiate safer sex with her partner; restrict her access to information and knowledge about her body; force her to sometimes barter sex for survival; increase her vulnerability to physical violence in sexual interaction; and compromise her self-esteem. The findings highlight the limitations of the current HIV/AIDS prevention strategy for reducing women's risk of HIV, and underline the urgency for an approach to prevention that is grounded in the realities of women's lives and sexual experiences--an approach that recognizes the relationship between the dynamics of gender relations, sexual behavior, and HIV risk.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Changes in adolescents' sexuality between 1970 and 1990 in West-Germany.

Based on two studies (using semistructured interviews) of 16- and 17-year-old West German urban adolescents, the first in 1970 (N = 602) and the second in 1990 (N = 415), this paper traces the changes in young people's sexual behavior and attitudes during the past two decades: (i) The marked trend in the 1960s towards having coitus and petting at an ever earlier age does not seem to have continued; the changes noted in the incidence of heterosexual experiences since 1970 are minimal. (ii) Boys feel themselves less at the mercy of their sexual urges than they used to and tend to link sexuality with love and a steady relationship more than they did 20 years ago; there was a similar though less pronounced change among girls. (iii) Girls now get less pleasure and satisfaction out of sexual encounters, and in heterosexual situations take the initiative and control more than they used to. (iv) There is no evidence that the problem HIV/AIDs had a marked influence on the changes described. Results of the comparative studies are discussed in the context of current developments in man/woman relationships and the debate on gender issues.

Acquired Immunodeficiency Syndrome↗
PubMed2007

[Sex education in practice and science in Germany].

Sex education in Germany has a history full of conflict and ideological change between emancipatory, reforming, and repressive tendencies. As a science, sex education has only recently gained independence from its mother disciplines theology, medicine, psychology, and sociology and at the same time has taken a critically constructive position towards sexual science. Its topics range from dissemination of knowledge about biological processes and contraception to relationship concerns, sexual orientation, gender issues, sexual transgression, moral, and ethical questions. Sexual socialization happens nearly everywhere. Sexual education takes place mainly in families, elementary education, and school, but increasingly also in all other areas of education, social work, and health service. Its clientèle are no longer exclusively children and adolescents but increasingly adults of every age group. Subjects such as AIDS, sexual abuse, and teenage pregnancy have contributed to governmental funding of projects and training in sex education. Thus, sex education still reaches from mere protection from dangers to fostering or maintaining psychological health.

Germany↗
PubMed2005

Gender differences in factors associated with psychological distress among immigrants from low- and middle-income countries--findings from the Oslo Health Study.

OBJECTIVE: Despite the high rate of migration from low- and middle-income countries to high-income countries, there is still a lack of comprehensive studies of gender-specific differences in psychological distress in a diverse group of immigrants. We compared psychological distress between male and female immigrants from low- and middle-income countries living in Oslo, and identified factors associated with distress for men and women, separately. METHOD: A cross-sectional survey with self-administered questionnaires was conducted among 1536 immigrants from low- and middle-income countries living in Oslo. The Hopkins Symptom Checklist (HSCL-10) was used to measure psychological distress. Data on their sociodemographic characteristics, negative and traumatic life events, and social integration and possible discrimination in the Norwegian society were also collected. RESULTS: One-fourth of the study population was found to be psychologically distressed, with almost equal levels among men and women. Lack of salaried job and recent negative life events were independently associated with psychological distress for both genders. Furthermore, experience of denial of job and past traumatic experiences were other associated negative factors among men, while visits made by Norwegians appeared as a protective factor against distress among men. Older age, Middle East background, living without a partner, and experiencing denial of housing were other associated negative factors among women. CONCLUSION: Our findings show that, except for adverse living conditions, there are gender differences with regard to factors associated with psychological distress among immigrants living in Oslo. Such gender issues are relevant for assisting immigrants in the integration process as well as for future research in migration and health.

Adult↗
PubMed1998

The opportunity costs of childbearing: more than mothers' business.

"This paper is an argument about gender relations. It takes the entwined themes of men's interests in parenthood, the sex division of labour and its evolution, policy for gender equity and policy to support the level of social reproduction. The emphasis on women's employment as a determinant of low fertility has to be supplemented by an examination of the assumption that only women's time use is affected by child-rearing.... Descriptive evidence about the paid and unpaid work of couples and parents is presented, largely secondary material from the UK."

Behavior↗
PubMed1999

Quality-of-life studies in patients with ambiguous genitalia.

No published study to date has adequately addressed the quality of life (QOL) of intersexuals, although three studies reviewed some of these aspects. A tool specifically for studies in intersexuality is being developed. A pilot survey tested by this author using questions from a population-specific, standardized QOL survey tool was evaluated by use on a small sampling of an intersexual patient test population. The group comprised ten adult intersexuals with an average age of 34.2 years (range: 22-47 years). Survey results disclosed that all considered themselves healthy and physically active. Family relationships were described as generally good, though in discussion most showed some family problems that centered on gender issues. Six had many friends, three had some, and one had few. Eight of the ten had experienced orgasm. Only two felt they trusted doctors. All but one were partially or completely satisfied with their overall physical appearance. Those who had surgery were distressed by the appearance of their genitals, some expressing complete dissatisfaction. With development of sensitive survey tools reflecting the attitudes and concerns of this special population, important issues relating to intersexuality can be addressed.

Adult↗
PubMed2006

Immigration and HIV/AIDS in the New York Metropolitan Area.

Because the HIV pandemic undergoes continual change in its locations and affected populations, it is crucial to study HIV risk behaviors among mobile and immigrant groups within and across borders. The impact of cross-cultural migrations and the importance of studying that impact in terms of demographic characteristics as well as cultural and environmental factors has not received adequate attention in public health research. This collaborative analysis utilizes data from three studies of immigrant groups in New York to describe and compare these factors that provide the context for risk and prevention of HIVAIDS and other health challenges. Data discussed were obtained utilizing multi-method approaches to identify and describe HIV risks among both new and more established immigrant populations within the urban settings of North America, with NYC as a central focus. Demographic and epidemiological data situate the analysis within the larger contexts of US migration and the HIV/AIDS epidemic in NYC. The authors identify risk and protective factors embedded to varying degrees in immigrants' multiple cultures and sub-cultures. The three populations studied include: 1) new Hispanic immigrants from the Dominican Republic, Mexico and Central America; 2) West Indian (Caribbean) immigrants from Jamaica, Trinidad/Tobago and other anglophone Caribbean nations; and 3) South Asian immigrants from India (Indian Americans). The paper seeks differences and commonalities, focusing on the social, attitudinal and behavioral factors that contribute to increased HIV/AIDS vulnerability among these populations. The data presented also identify some of the attitudes and behaviors of individuals and groups, as well as other facilitators and obstacles to transmission for immigrants as they adapt to new environments. Topics addressed include factors affecting HIV/AIDS vulnerability of immigrant groups, goals and expectations, health and mental heath issues, gender role change, sexual risk, alcohol and other drug use, perception of HIV/AIDS risk and implications for prevention.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Individual psychodynamic psychotherapy with older adults: perspectives from a nurse psychotherapist.

This report reviews both historical and current literature pertaining to individual psychodynamic psychotherapy with older adults. Demographic projections for significant increases in the geriatric population are presented and linked with implications for mental health. Barriers to geriatric psychotherapy are examined, and themes common among older persons are identified. Benefits of psychotherapy to patients and psychotherapists are summarized. Literature on adult developmental theory is explored. Unique aspects of gender issues, transference, countertransference, and termination as described in the literature are presented. Implications for nursing practice include a recommendation for increased nursing efforts in the areas of practice, research, and theory building.

Aged↗
PubMed2005

Gender-specific practice guidelines for coronary artery bypass surgery: perioperative management.

Gender differences in coronary bypass surgery have been the focus of numerous publications in recent years. Unfortunately these publications have contradictions that leave surgeons with conflicting recommendations for care. To help resolve these inconsistencies, The Society of Thoracic Surgeons (STS) Workforce on Evidence-Based Surgery has carried out an objective review of published information in this field. The STS Workforce recognizes that there are important gender issues associated with referral bias, the impact of body size, psychosocial factors, and postoperative support, but the intent of this guideline is to focus specifically on perioperative management. As with all practice guidelines, our goal is to gather the most important information, analyze the information in a logical and unbiased fashion, and make recommendations based solely on the available evidence.

Anemia↗