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The gender shift in veterinary medicine: cause and effect.

The gender shift in veterinary medicine has paralleled other changes in debt and income. Cause and effect are complex and often confused. Popular notions of the priorities of the new generation of men and women are often not supported by research studies. Recent data reveal new insights into questions surrounding the gender issue.

Female↗

Evaluation of the parents as primary sexuality educators program.

PURPOSE: To determine the effectiveness of a sexuality education program designed to help parents become more confident and competent in communicating with their children about sex and sexuality. METHODS: Parents attending a four- to five-part workshop series between February 2001 and April 2002 were recruited to participate. A total of 27 workshop series were conducted at various sites in neighborhoods with high teen pregnancy and STD rates. For each series, program staff administered written pre- and post-workshop surveys to parents and parent surrogates. A follow-up telephone survey was conducted with participants 10 weeks after the last workshop. Matched pre-workshop and follow-up surveys were obtained from 174 participants. RESULTS: Comparison of follow-up to pre-workshop responses revealed that more participants thought discussing sexuality with their children was very important (83% vs. 75%; p < .01). More participants also reported that they often initiate conversations with their children on a variety of topics including sex/intercourse, human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), pregnancy, sexuality and gender issues, and their personal standards for sexual behavior. Participants also became more comfortable discussing sensitive topics with their children. At follow-up, more participants responded that they were very comfortable answering their children's questions on the above topics. (All p values < .01.) CONCLUSIONS: The Parents as Primary Sexuality Educators program may be an effective way to increase parent-child communication about health, sexuality, and values. Enhancing parents' ability to communicate expectations and values about sexuality may help support children in making healthy decisions about sexual behavior as adolescents.

Adolescent↗

The medical and ethical aspects of photography in the sexual assault examination: why does it offend?

This paper reviews the literature in respect to the photo-colposcopic examination of anogenital injury in the sexually assaulted child, considered to be the 'gold standard' of examination, and how this compares with gross visualisation, still the standard procedure in adult examinations. It then examines the claim that, because the presence of injury does not provide a distinction between consensual and non-consensual intercourse in adults, photo-documentation is unnecessary medically and constitutes an invasive procedure which is ethically unacceptable. The paper questions whether the unwillingness of forensic physicians to extend photo-colposcopy to the examination of adult victims is related more to political and gender issues than to claims made on ethical and medical grounds, and concludes that any move to ban anogenital photography in adult forensic examinations (currently under consideration in the author's own jurisdiction) would possibly constitute an interference with independent clinical judgment and an incursion into the patient's right to evidence-based medicine.

Adult↗

Perioperative nurses and sexual harassment.

Sexual harassment is widespread in health care. Recent Australian research reveals this type of abuse is a significant cause of stress among perioperative nurses. This article investigates the nature and effects of sexual harassment of RNs in the OR. Specifically it explores the nature of sexual harassment, its occurrence in nursing generally and among perioperative nurses in particular, gender issues, effects, costs, and legal aspects. The article concludes with strategies that can be employed by individual nurses and organizations to combat sexual harassment.

Australia↗

Behavioral phenotyping of transgenic and knockout mice: experimental design and evaluation of general health, sensory functions, motor abilities, and specific behavioral tests.

Rigorous experimental design can minimize the high risk of false positives and false negatives in the behavioral phenotyping of a new transgenic or knockout mouse. Use of well established, quantitative, reproducible behavioral tasks, appropriate Ns, correct statistical methods, consideration of background genes contributed by the parental strains, and attention to litter and gender issues, will maximize meaningful comparisons of -/-, +/-, and +/+ genotypes. Strategies developed and used by our laboratory are described in this review. Preliminary observations evaluate general health and neurological reflexes. Sensory abilities and motor functions are extensively quantitated. Specific tests include observations of home cage behaviors, body weight, body temperature, appearance of the fur and whiskers, righting reflex, acoustic startle, eye blink, pupil constriction, vibrissae reflex, pinna reflex, Digiscan open field locomotion, rotarod motor coordination, hanging wire, footprint pathway, visual cliff, auditory threshold, pain threshold, and olfactory acuity. Hypothesis testing then focuses on at least three well-validated tasks within each relevant behavioral domain. Specific tests for mice are described herein for the domains of learning and memory, feeding, nociception, and behaviors relevant to discrete symptoms of human anxiety, depression, schizophrenia, and drug addiction. An example of our approach is illustrated in the behavioral phenotyping of C/EBPdelta knockout mice, which appear to be normal on general health, neurological reflexes, sensory and motor tasks, and the Morris water task, but show remarkably enhanced performance on contextual fear conditioning.

Animals↗

A strategy for empowerment: the role of midwives in computer systems implementation.

The procurement and implementation of patient administration systems has been done on numerous occasions in the past. The Rotunda project however encompassed major bespoke clinical developments which were going to impact upon large clusters of midwives, and medical staff to a lesser extent. A broad based four level structured methodology was used to implement the project which is significantly ahead of schedule. This methodology together with its strengths and weaknesses is comprehensively discussed. The empowerment of midwives, their roles in systems analysis and design, software testing and organisational re-engineering is described. The importance of undertaking comprehensive computer training is highlighted and a compact 10 h information technology course coupled with ongoing educational and related activities which could be adopted by any organisation is documented. The seven deadly sins of project management are mapped out. An update on benefits realisation is provided. Gender issues are also discussed.

Computer Systems↗

Feminist psychodynamic psychotherapy of eating disorders. Theoretic integration informing clinical practice.

Ideas derived from feminism and psychoanalytic theory can be combined for the integrated treatment of eating disorder patients. For a large subgroup of patients who continue to have a poor quality of life or inadequate symptom control (despite customary psychopharmacologic and cognitive behavioral interventions), feminist psychodynamic psychotherapy may prove lifesaving. This article explores how the patient may come to grasp more deeply the multiple roles her symptom has played in her psychological survival. Practical suggestions to enrich the psychotherapy as the patient traverses the natural struggles of adult life are emphasized. The importance of understanding and working with transference and countertransference issues while helping the patient accept life's paradoxes, ambiguities, and potential avenues for growth are underscored. The author reviews eight specific areas that warrant attention in psychotherapeutic exploration from a feminist psychoanalytic perspective (Culture as Bedrock Issue; Gender as Organizer of Behavior, Ownership of Body; Moral Development; Development of Personal Voice; Emphasis on Adult Development; Sexual Concerns; and Aggressive Conflicts).

Culture↗

Carbohydrate-deficient transferrin for detection and monitoring of sustained heavy drinking. What have we learned? Where do we go from here?

Carbohydrate-deficient transferrin (CDT) has been widely investigated as a biological marker of heavy alcohol consumption. In general, it has been found to be at least as sensitive and probably more specific than gamma-glutamyltransferase (GGT). Because the two analytes are not highly correlated, their use in parallel enhances the sensitivity of detection of heavy alcohol consumption, especially in clinical populations. Women as a group produce more CDT under natural conditions and may produce less CDT in response to heavy drinking. Carbohydrate-deficient transferrin has found a place in the monitoring of alcoholics during treatment. Changes in CDT levels from individualized baseline values seem to be more sensitive to lower level relapse drinking than is the use of raw cut-off values. There are some conditions such as severe liver disease in which higher than normal levels of CDT are produced, thereby reducing the specificity of this marker for detecting heavy drinking under certain conditions. Future directions for the use of CDT include standardization and automation of measurement technology, evaluation of how to use it wisely in myriad medical and institutional settings, understanding more thoroughly the gender issues in its production, and greater evaluation of its performance as a monitoring tool during treatment and follow-up situations. How to combine CDT with both verbal tools of alcohol assessment and newer biological markers will also need more extensive evaluation.

Alcohol Drinking↗

The impact of husband's and wife's education and occupation on family size in Zimbabwe.

This paper assesses the impact of husband's and wife's education and occupation on family size in Zimbabwe. Results from the 1988 Male Fertility Survey indicate that husband's education had a strong negative effect, and wife's education had a moderate negative effect on the number of children ever born. Contrary to the literature, wives who were not employed had significantly fewer children than those who work in agriculture, and fewer, but not significantly, than those in non-agricultural occupations. Findings show the importance of husband's education and the changing dynamics of wife's occupation in fertility decline.

Age Factors↗

Community perceptions of reasons for preference for consanguineous marriages in Pakistan.

Although the recent Pakistan Demographic and Health Survey (DHS) show that two-thirds of marriages in Pakistan are consanguineous, the sociocultural determinants of such marriages remain largely unexplored. This paper examines the relative importance of the three commonly perceived reasons for such marriages: religious, economic and cultural. The analysis is based on qualitative data collected in 1995 from multi-ethnic and multi-religious communities in Karachi, the largest city of Pakistan. Results show that consanguineous marriages are preferred across all ethnic and religious groups to a varying degree, and that parents continue to be the prime decision-makers for marriages of both sons and daughters. The major reasons for a preference for consanguineous marriages are sociocultural rather than any perceived economic benefits, either in the form of consolidation of family property or smaller and less expensive dowries. Among Muslims, following religious traditions is the least commonly cited reason for such marriages. Despite the reported sociocultural advantages of consanguineous marriages, such unions are perceived to be exploitative as they perpetuate the existing power structures within the family.

Adolescent↗

Partner influences and gender-related factors associated with noncondom use among young adult African American women.

We examined the partner influences and gender-related correlates of noncondom use among African American women. The prevalence of noncondom use was 45.3%. Women whose sexual partners were noncondom users were four times more likely to believe that asking their partner to use a condom implied he was unfaithful, three times as likely to have a partner who resisted using condoms, three times more likely to receive AFDC, twice as likely to be sexually nonassertive, three times more likely to believe that it was not difficult to find an "eligible" African American man, and three times as likely to have had one sexual partner. HIV prevention tailored towards African American women should address these partner influences and gender-related factors.

Adult↗

Gender differences in mate selection preferences: a test of the parental investment model.

Evolutionary-related hypotheses about gender differences in mate selection preferences were derived from Triver's parental investment model, which contends that women are more likely than men to seek a mate who possesses nonphysical characteristics that maximize the survival or reproductive prospects of their offspring, and were examined in a meta-analysis of mate selection research (questionnaire studies, analyses of personal advertisements). As predicted, women accorded more weight than men to socioeconomic status, ambitiousness, character, and intelligence, and the largest gender differences were observed for cues to resource acquisition (status, ambitiousness). Also as predicted, gender differences were not found in preferences for characteristics unrelated to progeny survival (sense of humor, "personality"). Where valid comparisons could be made, the findings were generally invariant across generations, cultures, and research paradigms.

Female↗

The politics of sex research and constructions of female sexuality: what relevance to sexual health work with young women?

By examining the relationship between the cultural construction of female sexuality and the lack of potential for many young heterosexual women to be truly sexually healthy this paper submits that messages for women within HIV prevention programmes can be confused, confining and at times dangerous to women's health and well-being. It is suggested that these messages also reinforce a traditional, biologically determined medical understanding of female sexuality that does not take note of social or culturally based research or commentary on female experience or female desire, but rather confines many women to sexual restrictions, doing little to empower women to prevent sexual risk-taking. The ideological basis of the discussion within this paper is informed by the awareness that applications and understandings of 'sexuality' are diverse and contested within sex research traditions and will influence the choice of research concerns. The 'deterministic' explanation of sexuality that 'sexuality' (the abstract noun referring to the quality of being 'sexual', Williams 1983) is your fate or destiny and that biology causes the patterns of sexual life, is abandoned in this paper in favour of a search for a definition of sexuality which brings together a host of different biological and mental possibilities which are given meaning only in social relations. This allows for a framework for the study of sexuality that relates it to other social phenomena, particularly economic, political and social structures (Foucault 1979); in other words, a study of the 'social construction' of sexuality. This paper suggests that health care professionals need to develop an awareness of the diversities within female sexuality and gain insight into their own values and assumptions about female sexuality if these are not to inhibit effective approaches and interventions in the areas of HIV and sexual health.

Attitude to Health↗

An oral history project in mental health nursing.

The main aim of this study was to produce material which would support, or alternatively challenge the content of a piece of historical writing, based largely on primary archival sources. The method chosen was to replicate and develop an earlier oral history project, which was carried out to discover and report on trained nurses who could offer their impressions of both the practical and theoretical frameworks of psychiatric care. The work described here took that project a stage further by focusing on a single organization, and developing the line of inquiry by adding topics of contemporary interest, such as gender issues, ethnicity, the management of violence and nurses' roles in treatment. Apart from comparisons and contrasts with the previous study, subsidiary interest was to reflect on the intrinsic value and continuing relevance of the material, or the lack of it. The process section considers the problems and dynamics of the interview situation, and how this may have affected the material produced and what this implied for the interpretation. The study confirms an assumption of the usefulness of oral history, as a record, additional to the written documents, which enriches the descriptions of historical processes.

Female↗

A personal and historical investigation of the career trends of UK graduate nurses qualifying between 1970 and 1989.

AIM: To explore from a personal and historical perspective key career trends of UK graduate nurses qualifying between 1970 and 1989. BACKGROUND: During the 1970s and 1980s, graduate nurses qualifying from UK academic institutions with nursing and degree qualifications were a controversial minority. Concerns about their practical ability and role resulted in considerable quantitative research about graduate nurse careers. Whilst such research identified key graduate nurse career trends, these trends have yet to be explored from a qualitative perspective. DESIGN: This descriptive study used a phased approach: first, a literature review of earlier studies to identify key career trends of UK graduate nurses qualifying between 1970 and 1989, and second, an exploration of these trends from the perspective of six graduate nurses qualifying during this period using semi-structured interviews. Third, archival material was used to set career trends and interview data within their historical context. FINDINGS: The literature indicated that most graduate nurses remained clinically based, especially in community and intensive care, with few in senior posts above charge nurse/health visitor level (G-grade). Analysis of interview data revealed four major themes significantly influencing graduate nurse careers: wanting to be clinical nurses, the effect of organizational structures and systems, being a woman, and careers by accident not design. CONCLUSION: Graduate nurses interviewed aspired to clinical posts, yet this was not what some in nursing expected of them during the 1970s and 1980s. The ability of these graduate nurses to fulfil personal career aspirations and develop their careers depended on many factors, not fully acknowledged in earlier studies. For example, organizational structures and systems often delayed fulfilment of career aspirations. Significantly, gender issues embedded within nursing adversely affected career progression of those interviewed, even in the 1990s. In particular, although nurses can combine work and family commitments, for those interviewed this was often at the expense of their career development.

Career Choice↗

Women and alcohol: misrepresented and misunderstood.

Women's use of alcohol has been increasing over the last few decades. The physical, psychological and social effects of alcohol are more severe for women than for men. The underlying causes of women's drinking differ from those of men, which poses a challenge to nurses working in the specialist field of alcohol misuse. This article explored women's relationship with alcohol and treatment services, and identified that these treatment services are not specific to women's needs. To conclude, in order to offer women sensitive services, practitioners need knowledge of gender issues.

Alcoholism↗

A review of the effectiveness of agriculture interventions in improving nutrition outcomes.

OBJECTIVES: To review the impact of agriculture interventions on nutritional status in participating households, and to analyse the characteristics of interventions that improved nutrition outcomes. DESIGN: We identified and reviewed reports describing 30 agriculture interventions that measured impact on nutritional status. The interventions reviewed included home gardening, livestock, mixed garden and livestock, cash cropping, and irrigation. We examined the reports for the scientific quality of the research design and treatment of the data. We also assessed whether the projects invested in five types of 'capital' (physical, natural, financial, human and social) as defined in the Sustainable Livelihoods Framework, a conceptual map of major factors that affect people's livelihoods. RESULTS: Most agriculture interventions increased food production, but did not necessarily improve nutrition or health within participating households. Nutrition was improved in 11 of 13 home gardening interventions, and in 11 of 17 other types of intervention. Of the 19 interventions that had a positive effect on nutrition, 14 of them invested in four or five types of capital in addition to the agriculture intervention. Of the nine interventions that had a negative or no effect on nutrition, only one invested in four or five types of capital. CONCLUSIONS: Those agriculture interventions that invested broadly in different types of capital were more likely to improve nutrition outcomes. Those projects which invested in human capital (especially nutrition education and consideration of gender issues), and other types of capital, had a greater likelihood of effecting positive nutritional change, but such investment is neither sufficient nor always necessary to effect change.

Agriculture↗