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PubMed1997

Cultural malpractice. The growing obsolescence of psychology with the changing U.S. population.

With the changing demographics occurring in the United States, psychology must make substantive revisions in its curriculum, training, research, and practice. Without these revisions, psychology will risk professional, ethical, and economic problems because psychology will no longer be a viable professional resource to the majority of the U.S. population. In particular, this article discusses the need for psychology to address issues of ethnicity/culture, gender, and sexual orientation.

Cultural Diversity↗

PubMed2005

Why are you bringing up condoms now? The effect of message content on framing effects of condom use messages.

According to prospect theory (A. Tversky & D. Kahneman, 1981), messages advocating a low-risk (i.e., easy, low-cost) behavior are most effective if they stress the benefits of adherence (gain framed), whereas messages advocating a risky behavior are most effective if they stress the costs of nonadherence (loss framed). Although condom use is viewed as a low-risk behavior, it may entail risky interpersonal negotiations. Study 1 (N = 167) compared ratings of condom use messages advocating relational behaviors (e.g., discussing condoms) or health behaviors (e.g., carrying condoms). As predicted, loss-framed relational messages and gain-framed health messages received higher evaluations. Study 2 (N = 225) offers a replication and evidence of issue involvement and gender as moderators. Results are discussed with reference to the design of condom use messages.

Adult↗

PubMed2002

Methodological issues in male caregiver research: an integrative review of the literature.

UNLABELLED: PURPOSE OF THE PAPER: The purpose of this integrative review of the literature is to identify sampling and analysis issues related to gender in caregiver research in the nursing and health literature. BACKGROUND: Men provide approximately 28% of the care in the home to functionally impaired elders in the United States of America (USA), and because of demographic predictions are expected to provide more in the future. Social science research related to male caregivers has been criticized as having many limitations. A critical review of the nursing and health literature would be helpful to nursing researchers and clinicians by identifying limitations in caregiving research related to gender and providing direction for future research. METHODS: A literature search using the CINAHL database and the terms 'family caregiver', 'dementia', and 'male' was conducted. Thirty-six articles were retrieved, reviewed, and abstracted. FINDINGS: Thirteen articles were qualitative studies, 22 were quantitative, and one had both qualitative and quantitative components. Many of the studies used small samples, and no analysis was included by gender. Most of the samples were convenience samples, with many being self-selected. There was also a lack of analysis of data by family relationship. No qualitative studies and only nine of the quantitative studies included analysis of the data by gender. Studies that reported by gender were all cross-sectional. CONCLUSIONS: There is a need for caregiver research that has larger samples of males, and includes analysis by gender and family relationship. There is also a need for more intervention studies that are well controlled, and evaluate the effect of the intervention on both male and female caregivers.

Aged↗

PubMed1998

The healing process, the road to recovery and positive mental health.

This paper is designed to explore and examine the experience of loss following a hysterectomy. The painful aftermath of the ordeal and the work involved in the healing process are outlined and discussed from both a personal and professional perspective. The manuscript highlights a number of inner struggles that had to negotiated before an equilibrium in mental health and wellbeing was successfully achieved. The forces that move the dialogue forward from one theme to the other are complex in their simplicity. The enigmatic dimensions of physical pain and emotional torment are expressed and worked through in a sensitive and intimate manner. The mysteries of internalized, conflicting messages on socialization issues, such as gender roles and living in and identifying with only one culture are discussed and debated. In addition, the disharmony between spiritual ideals, the meaning and purpose of life, the process of self-actualizing and the physical realities involved in living are identified and elaborated upon. Embroidered within the tapestry of the text is the need to revisit the curriculum for the education and training of mental health nurses to enhance the quality and provision of effective, humane and therapeutic nursing care.

Adaptation, Psychological↗

PubMed2003

Review of evidence and explanations for suboptimal screening and treatment of dyslipidemia in women. A conceptual model.

Screening and treatment rates for dyslipidemia in populations at high risk for cardiovascular disease (CVD) are inappropriately low and rates among women may be lower than among men. We conducted a review of the literature for possible explanations of these observed gender differences and categorized the evidence in terms of a conceptual model that we describe. Factors related to physicians' attitudes and knowledge, the patient's priorities and characteristics, and the health care systems in which they interact are all likely to play important roles in determining screening rates, but are not well understood. Research and interventions that simultaneously consider the influence of patient, clinician, and health system factors, and particularly research that focuses on modifiable mechanisms, will help us understand the causes of the observed gender differences and lead to improvements in cholesterol screening and management in high-risk women. For example, patient and physician preferences for lipid and other CVD risk factor management have not been well studied, particularly in relation to other gender-specific screening issues, costs of therapy, and by degree of CVD risk; better understanding of how available health plan benefits interact with these preferences could lead to structural changes in benefits that might improve screening and treatment.

Communication↗

PubMed2005

[Women's Health in Austria].

In 1995 the World Health Organisation introduced a decade dedicated to women's health issues. In promoting Gender Mainstreaming, the European Union set an important impulse too. Figures and facts show, that these initiatives lead to a better perception of the needs pertaining to women's health. First of all, it is important to see women in their different contexts of life and their social stresses in association with harmful risks. Important topics in the future will be the feminisation of age, the increasing appearance of breast cancer, over-medication, especially in relation to problems of psychological health, social and women-specific answers to the rapid research pace in reproductive medicine and genetics. The trend of standardisation of the female body, and connected to it sanitary questions, remains to be still problematic.

Aging↗

PubMed1998

The ethics of care: a feminist virtue ethics of care for healthcare practitioners.

In this paper I seek to distinguish a feminist virtue ethics of care from (1) justice ethics, (2) narrative ethics, (3) care ethics and (4) virtue ethics. I also connect this contemporary discussion of what makes a virtue ethics of care feminist to eighteenth and nineteenth century debates about male, female, and human virtue. In conclude that by focusing on issues related to gender--primarily those related to the systems, structures, and ideologies that create and sustain patterns of male domination and female subordination--we can begin to appreciate that true care and bona-fide virtue can flourish only in societies that treat all persons with equal respect and consideration.

Empathy↗

PubMed2000

A feminist critique of research on women's work and health.

Research on women's work and health largely has failed to incorporate gender into the models of the processes through which work influences well-being. In this article, the research on women's work and health is critiqued from a feminist perspective; male-oriented and ethnocentric views on women's work are negated, and gender and socioeconomic issues are highlighted and included in the picture of women's work. Male-centered and ethnocentric views and assumptions on women's work are prevalent in the whole research process, and methodological limitations due to the distorted views are indicated. Based on the critique, some implications for future research on women's work and health are proposed.

Attitude to Health↗

PubMed2007

Factors associated with HIV/AIDS high-risk behaviours among female injection drug users.

This study examined factors associated with reporting engaging in HIV/AIDS high-risk behaviours at two different time points spaced one year apart for a sample of 185 women who were active injection drug users (IDUs). The high-risk behaviours included injecting drugs in the past six months, having shared needles in the past six months and having engaged in unprotected sexual activity in the past thirty days. Through logistic regression modelling it was identified that living with a spouse at year one was significantly and positively associated with high-risk behaviours at both time points. Being prescribed medications for psychological or emotional problems as well as testing positive for the HIV/AIDS virus were significantly and negatively associated with reporting high-risk behaviours at both time points. These results suggest that spousal relationships may play an important role in HIV/AIDS high-risk behaviours of women drug users. An implication of this study is the need to focus on how spousal relationships and issues such as gender and empowerment should be incorporated into the design and implementation of HIV/AIDS prevention and treatment programs. The benefits of comprehensive mental health diagnosis and treatment services as well as HIV testing in reducing harm to female IDUs and their partners are also discussed.

Adolescent↗

PubMedDate not supplied

Contextualizing group rape in post-apartheid South Africa.

Collective male sexual violence is part of a continuum of sexual coercion in South Africa. This paper is based on long-term ethnographic work in an urban township in the former Transkei region. Drawing on intensive participant observation and interviews with young men in particular, it attempts to make sense of emergent narratives relating to streamlining, a local term for a not uncommon form of collective sexual coercion involving a group of male friends and one or more women. The paper begins with an overview of existing anthropological literature on collective male sexual violence, going onto elaborate the different scenarios associated with group sexual violence in the fieldsite. It seeks to provide a multi-layered contextualization of the phenomenon by considering prevailing gender discourses, subcultural issues pertaining to the urban tsotsi phenomenon, the rural practice of ukuthwala (bride capture), young working-class Africans' experiences of marginalization, and the complex links between political economy and violence in this setting.

Adult↗

PubMed1998

Toward a better residency.

Residency programs can be improved by careful consideration of seven elements germane to resident life and education. A curriculum, the course of study, should be established. A balance between service and education must be maintained. Supervision by faculty and residents' willingness to be supervised ensures patient safety as well as teaching. Residents, faculty, and the program itself require frequent evaluation. A pleasant working environment is important. Sensitivity to issues of culture, gender, and ethnicity should be maintained by the program director, the faculty, and residents. Finally, the importance of stress in the lives of residents should be understood.

Culture↗

PubMed2000

Tobacco smoking and risk of hip fracture in men and women.

BACKGROUND: Previous findings suggest that tobacco smoking increases the risk of hip fracture in women. A similar adverse effect of smoking is suspected to be present in men, but bone mineral density studies have raised the concern that men may be more sensitive to the deleterious effect of smoking on bone than women. In this study we prospectively determined the influence of current, previous, and cumulative smoking history on risk of hip fracture in men and women and addressed the issue of possible gender difference in the susceptibility to tobacco smoking. METHODS: Pooled data from three population studies conducted in Copenhagen with detailed information on smoking habit. A total of 13,393 women and 17,379 men, initially examined between 1964 and 1992, were followed until 1997 for first admission due to hip fracture. The relative risks (RR) of hip fracture associated with smoking were estimated by means of multiplicative Poisson regression models. RESULTS: During follow-up, 722 hip fractures were identified in women, and 447 in men. After adjustment for potential confounders, including body mass index, female current smokers had an RR of hip fracture of 1.36 (95% CI: 1.12-1.65) and male smokers 1.59 (95% CI: 1.04-2.43) relative to never smokers. In both sexes, the RR of hip fracture gradually increased by current and accumulated tobacco consumption. The RR were consistently higher in men than in women, but the test for interaction between sex and tobacco smoking was insignificant. After 5 years, male ex-smokers had an adjusted RR of 0.73 (95% CI: 0.55-0.98) relative to current smokers, while no significant decrease in risk was observed in female ex-smokers (RR = 0.91; 95% CI: 0.72-1.17)). Approximately 19% of all hip fractures in the present study population were attributable to tobacco smoking. CONCLUSION: Tobacco smoking is an independent risk factor for hip fracture in men and women, and there appears to be no gender differences in smoking related risk. Smoking cessation reduces the risk of hip fracture in men after 5 years, while the deleterious effect of smoking seems to be more long-lasting in female ex-smokers.

Adult↗

PubMed2002

Helping medical school faculty realize their dreams: an innovative, collaborative mentoring program.

Junior faculty wishing to achieve successful careers in academic medicine face many challenges. To facilitate faculty in their career development, the authors implemented and evaluated an innovative collaborative, or peer-group, mentoring program at their medical school. Based on Rogerian and adult learning principles, the program incorporated development of skills in key areas for career development, a structured values-based approach to career planning, and instruction in scholarly writing. The 80-hour program has so far been conducted twice over two academic years (1999-2001) with 18 faculty (50% women). Quantitative and qualitative methods were used in the evaluation. Program attendance was 89%. All participants completed a written academic development plan, an exercise they rated as valuable. They also completed an average of one to three manuscripts for publication. Evaluation data highlighted the critical nature of a supportive learning environment and the reasons participants chose to attend the program consistently. Key meaningful outcomes for most participants were: (1) identification of their core values; (2) a structured process of short- and long-term career planning based on these core values; (3) the development of close, collaborative relationships; (4) development of skills in such areas as gender and power issues, negotiation and conflict management, scholarly writing, and oral presentation, and (5) improved satisfaction linked to participants' decisions to remain in academic medicine. Participants developed a sense of personal transformation and empowerment. The authors conclude that collaborative mentoring offers a new approach to faculty development that addresses limitations of traditional approaches in a satisfying and cost-effective way.

Faculty, Medical↗

PubMed1996

Nurse midwives as primary care providers for women.

As we approach the 21st century, the prospect of a new healthcare system in the United States should prompt us to reopen the question of who can best meet the healthcare needs of women. Nurse midwives are advanced practice nurses educated in the field of primary health care for essentially normal women and newborns. Their focus is wellness and health education. Once patients are introduced to the concept of a nurse practitioner and the services provided, the majority are satisfied with the quality of the care received. Evidence suggests that women, if given a choice, prefer the ministrations of a female practitioner over that of a male for their intimate healthcare needs. As a predominantly female group, nurse midwives are an excellent source of qualified providers for women. In this article, the cost effectiveness of nurse practitioner care and the issue of provider gender are discussed. A case for the utilization of nurse midwives as primary healthcare providers for women is presented.

Cost-Benefit Analysis↗

PubMed2002

Nursing home administrator compensation: pay equity and determinants of salary.

This study evaluates the issue of gender-based pay inequality. Male NHAs earn 7 percent more than female NHAs, but factors such as education, experience, tenure, facility size, ownership, location, competition, and emphasis on private pay census account for the difference. The findings, however, indicate that racial inequalities and gender differences among married NHAs may be present, requiring further investigation. Key implications of the results are discussed.

Data Collection↗

PubMed1998

Multiple variables explain the variability in the decrement in VO2max during acute hypobaric hypoxia.

PURPOSE: We used multiple regression analyses to determine the relationships between the decrement in sea level (SL, 760 Torr) VO2max during hypobaric hypoxia (HH) and variables that could alter or be related to the decrement in VO2max. METHODS: HH conditions consisted of 682 Torr, 632 Torr, and 566 Torr, and the measured independent variables were SL-VO2max, SL lactate threshold (SL-LT), the change in hemoglobin saturation at VO2max between 760 and 566 Torr (delta SaO2max), lean body mass (LBM), and gender. Male (N = 14) and female (N = 14) subjects of varied fitness, training status, and residential altitude (1,640-2,460 m) completed cycle ergometry tests of VO2max at each HH condition under randomized and single-blinded conditions. RESULTS: VO2max decreased significantly from 760 Torr after 682 Torr (approximately 915 m) (3.5 +/- 0.9 to 3.4 +/- 0.8 L.min-1, P = 0.0003). Across all HH conditions, the slope of the relative decrement in VO2max (%VO2max) during HH was -9.2%/100 mm Hg (-8.1%/1000 m) with an initial decrease from 100% estimated to occur below 705 Torr (610 m). Step-wise multiple regression revealed that SL-VO2max, SL-LT, delta SaO2max, LBM, and gender each significantly combined to account for 89.03% of the variance in the decrement in VO2max (760-566 Torr) (P < 0.001). CONCLUSIONS: Individuals who have a combination of a large SL-VO2max, a small SL-LT (VO2, L.min-1), greater reductions in delta SaO2max, a large LBM, and are male have the greatest decrement in VO2max during HH. The unique variance explanation afforded by SL-LT, LBM, and gender suggests that issues pertaining to oxygen diffusion within skeletal muscle may add to the explanation of between subjects variability in the decrement in VO2max during HH.

Adult↗

PubMed2000

Weight loss and plasma lipids.

Although weight loss is associated with improvements in the plasma lipid profile, factors other than weight loss per se are involved. Energy restriction resulting in even modest weight loss suppresses endogenous cholesterol synthesis, which contributes to observed decline in circulating lipid concentrations. Whether individuals have stabilized weight or are still actively losing weight affects the magnitude of LDL cholesterol reduction as well as the direction of HDL cholesterol change. Hence, it is important to consider the timing of lipid measurements in the interpretation of the plasma lipid response to weight loss. Another important factor is the dietary composition of the weight loss strategy, with evidence that dietary fatty acid profile and amount can differentially influence the lipid response similar to that observed in energy balance studies. Other issues such as gender, and exercise during weight loss are also relevant. However, whether the lipid changes that are observed in the short term are sustained in the long term and whether the manner of weight loss has any impact on long-term outcomes remains to be determined.

Dietary Carbohydrates↗

PubMed2005

The recruitment phoenix: strategies for attracting medical students into obstetrics and gynecology.

In less than a decade, the popularity of obstetrics and gynecology as a career choice has declined significantly. The American College of Obstetricians and Gynecologists (ACOG) and the Association of Professors of Gynecology and Obstetrics (APGO) are working to develop a multifaceted approach aimed at reversing this trend. We report on the findings and action plan developed by the ACOG Medical Student Recruitment Task Force as well as the current activities of APGO related to recruitment. Strategies include improving the quality of the medical student clerkship, frankly addressing gender and lifestyle issues that dissuade students from choosing obstetrics and gynecology as a career, and engaging students early in their medical school careers through student interest groups and mentoring programs.

Career Choice↗