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PubMedDate not supplied

Informed lay preferences for delivery of racially varied pharmacogenomics.

OBJECTIVES: To understand public perceptions and opinions of three options for prescribing medicine: individualized genetic testing, race-based prescription, and traditional prescription. METHODS: Focus groups in urban, suburban, and rural communities over-sampled for minority groups conducted from February through April, 2001 in Georgia. RESULTS: Group members (N = 102) identified individualized genetic testing as providing the best quality of care (60% of talk turns; 75% in postdiscussion anonymous survey), but stipulated the need for protection from the invasion of privacy, discrimination, and prohibitive cost. Most individuals chose genetic testing because it provided individualized attention, and African-Americans indicated they would choose genetic testing even if the costs were high. Overall, individuals were suspicious of race-based prescription. Analyses for degree of suspicion revealed a main effect for race and an interaction effect for race and gender. CONCLUSIONS: If issues of cost, discrimination, and privacy are addressed, lay individuals prefer genetic testing as the basis for prescription of medicines that exhibit racially patterned response variation.

Attitude to Health↗
PubMed2007

Does the association between alcohol consumption and depression depend on how they are measured?

BACKGROUND: Inconsistent findings regarding the relationship between alcohol consumption and depression, including whether the relationship is J-shaped or U-shaped, may be at least partly due to the types of measures used for both alcohol consumption and depression. METHODS: We conducted a general population survey using random digit dialing (RDD) and computer-assisted telephone interviewing (CATI) with 6,009 males and 8,054 females aged 18 to 76 years. The survey included 4 types of alcohol measures (frequency, usual and maximum quantity per occasion, volume, and heavy episodic drinking) covering both the past week and the past year, and 2 types of depression measures (meeting DSM criteria for a clinical diagnosis of major depression, recent depressed affect). RESULTS: The overall relationship between depression and alcohol consumption did not vary by gender or type of depression measure but did vary significantly by type of alcohol measure, with the strongest relationship found for heavy episodic drinking and high quantity per occasion. There were also significant gender interactions with both depression and alcohol measures, with females showing a stronger relationship than males when depression was measured as meeting the criteria for major depression and when alcohol consumption was measured as quantity per occasion or heavy episodic drinking. There was some evidence of a J-shaped relationship, that is, greater depression among abstainers compared with those who usually drank 1 drink and never drank as much as 5 drinks for both former drinkers and lifetime abstainers when depression was measured as recent symptoms of depression but the J shape was found only for former drinkers when depression was measured as meeting the criteria for major depression and did not reach statistical significance in some analyses. CONCLUSIONS: The results of the present study suggest that measurement and gender are key issues in interpreting findings on the relationship between alcohol and depression. First, depression is primarily related to drinking larger quantities per occasion, less related to volume, and unrelated to drinking frequency, and this effect is stronger for women than for men. Second, the overall relationship between depression and alcohol consumption is stronger for women than for men only when depression is measured as meeting a clinical diagnosis of major depression and not when measured as recent depressed affect. Finally, while there was some evidence that former drinkers had slightly higher rates of major depression and higher scores on recent depressed affect compared with light drinkers, there was no evidence that light drinking was protective for major depression when compared with lifetime abstainers, although light drinkers did report fewer recent symptoms of depressed affect.

Adolescent↗
PubMed1998

Genetic counseling: clinical and ethical challenges.

After explaining the origin, nature, and goals of genetic counseling, we consider the impact of the Human Genome Project on its practice. In light of the availability of presymptomatic tests for late-onset disorders and the possibility of preventive behavior or treatment, we examine the apparent conflict between nondirectiveness and directiveness in genetic counseling. We discuss views of genetic counselors, medical geneticists, and counselees on specific issues, and document gender differences in attitudes toward genetic ties to offspring. Because genetic discrimination and unequal access to genetic services are likely to increase with advances in genetics, we conclude that efforts of genetic counselors to adhere to the principle of justice or equity in their practice cannot be successful without governmental and public support, as well as support from researchers and colleagues in health care.

Ethics, Medical↗
PubMed2007

Yemeni families and child lead screening in Detroit.

This project was an exploratory effort to screen and treat immigrant Yemeni children who were at high risk for lead poisoning. The Detroit metropolitan area is home to the largest number of Arabic immigrants in the United States. In addition, Detroit has the largest rate of childhood lead poisoning in the state of Michigan. No published studies were found that explored the prevalence of lead poisoning among Yemeni children in Michigan. Immigrant children from countries where knowledge of lead poisoning is limited may be particularly vulnerable because of difficulties in language and accessing health care. Children's Hospital of Michigan CATCH School Mobile Health Center conducted this health-screening project. This article reports on the gender and health issues encountered during the community outreach lead testing effort within a Yemeni neighborhood in Detroit.

Arabs↗
PubMed2006

A voice in the wilderness: gay and lesbian religious groups in the Western United States.

The paper describes a study of gay and lesbian religious groups located in the United States between the Mississippi River and the Pacific Ocean between March of 1989 and June of 1993. The researcher found 684 groups to have existed at some time in the region and conducted interviews to document 468 of these groups. While a history of these groups dates back to the 1930s in the region, large groups still existing today did not begin to form until the late 1960s. The six most common goals of the groups were social and support needs, worship, denominational and social politics, community service, and leadership in the gay and lesbian community. Being focused on gay and lesbian issues has an influence on when and how they came into existence (in the beginnings of the gay and lesbian movement, in response to the AIDS crisis, in response to anti-gay legislative initiatives), has an influence on the kinds of key themes addressed (ordination of gay and lesbian people, same-sex marriage, service for people with AIDS, sexual ethics in scripture), and has an influence on relationships with the larger community (shunning or inclusion in the larger society and in the larger religious community). However, the stronger influence is their identity as religious (and, therefore, social) institutions. They experience the same pressures of mainstream religion and as social institutions by facing issues of diversity, gender, age, politics, race, and disease. They face the same challenges as any religious institution today of being prophetic, responsive, changing, traditional, true, relevant, and even noticed. A distinct feature is their role on the fringes. They are on the fringe of religious life and on the fringe of gay and lesbian life.

Female↗
PubMedDate not supplied

Beliefs in the future as a positive youth development construct: conceptual bases and implications for curriculum development.

This paper outlines the conceptual bases of 'beliefs in the future' as a positive youth development construct and the implications for curriculum development. Based on the concepts of hope and optimism, 'beliefs in the future' comprises (i) valued and attainable goals; (ii) the ability to plan goal-directed pathways and alternative ones in times of difficulties; (iii) positive appraisal of one's capabilities and efforts and (iv) positive and realistic expectancies of the future. With reference to the adolescents' cognitive advancement and developmental needs, as well as gender and cultural issues, ten units that promote beliefs in the future for Secondary 1-3 students in Hong Kong are designed in the Project P.A.T.H.S., supported by the Hong Kong Jockey Club Charities Trust. In the Secondary 1 curriculum, the goal of the units is to guide students to develop realistic and optimistic future orientation. In the Secondary 2 and 3 curricula, the goals of the units are to enhance students' optimistic future orientation as well as hopeful goal-directed thoughts and motivation in the aspects of academic achievement and future careers.

Adolescent↗
PubMedDate not supplied

Positive identity as a positive youth development construct: conceptual bases and implications for curriculum development.

According to the theories of Erikson, Marcia, and Higgins, adolescents who can cultivate a clear and positive identity after their developmental struggles in adolescence often advance more smoothly into adulthood. Identity is organized, learned, and dynamic, and subjective evaluation of an individual's identity has emotional consequences for that individual. This paper discusses literature on the nature and importance of identity and presents strategies such as self-esteem enhancement, management of exploration and commitment, as well as reduction of self-discrepancies to help adolescents develop functional identity. Significant determinants of a person's identity development, namely gender and cultural issues, are also addressed as they are important in designing the "Positive Identity Development" package of Positive Adolescent Training through Holistic Social Programmes (P.A.T.H.S.), supported by the Hong Kong Jockey Club Charities Trust, to help adolescents develop a positive identity.

Adolescent↗
PubMed2005

Practical management of the intersex infant.

Intersex occurs when the appearance of the internal or external genitalia is at variance with normal development for either sex. The first question asked by, and of new parents in relation to their offspring is often "Is it a boy or a girl"? A rational approach, based on knowledge of normal prenatal sexual development, and based on a careful physical examination to guide further investigation, is required to reach a diagnosis. We briefly review prenatal sexual development to provide a background to the assessment of genital ambiguity in the newborn. Aspects of physical examination are discussed in detail, with reference to published normative data where possible. We provide a classification of genital ambiguity and an approach to differential diagnosis. We highlight some of the many syndromes associated with genital ambiguity, with reference to their genetic basis where possible. In 46,XX individuals, the commonest cause of genital ambiguity is congenital adrenal hyperplasia due to 21-hydroxylase deficiency; however, in 46,XY individuals the differential diagnosis is wide, and may remain unexplained, even after extensive investigation. Two algorithms are presented, one of which provides an initial approach based on the presence of a uterus and palpable gonads alone, and a second illustrating a comprehensive differential diagnosis of the undervirilised 46,XY individual. We discuss our approach to sharing information on the diagnosis and management with the parents and highlight the early involvement of an experienced multidisciplinary team. Finally, we consider current controversial issues relating to gender assignment and management of genital ambiguity.

Chromosome Aberrations↗
PubMed2005

Submission, inhibition and sexuality: masochistic character and psychic change in Austen's Mansfield Park.

Mansfield Park is Austen's most controversial novel. 'Squarely taking on such issues as class, gender, sexuality, religion, education, theatricality, and colonialism, Mansfield Park now appears to occupy a more critical place in Austen's canon and in literary and cultural history generally than that perennial favorite, Pride and prejudice' (Johnson, 1998, p. xiii). Austen's heroine, Fanny Price has generated heated controversy because of the provocative contradictions in her character which this paper argues tally with the psychoanalytic understanding of moral masochism within the masochistic character As a child neglected at home and then sent to a frightening new environment, in which she was lowest and last, Fanny Price needed the love and protection even of those who mistreated her. She needed to control and influence them with submission and the inhibition of her aggressive impulses and through a vigilant scrupulousness. Austen created a plot in which she also dramatized the seeds of change that lie within the submissive character, within the repressed and inhibited psychosexual desire linked to the father which can drive the reemergence of wishes for love and satisfaction in situations of relative safety.

Adult↗
PubMed2004

The hand that rocks the cradle rocks the boat: the empowerment of women.

The obstacles to equality for women have changed from external to intrapsychic. The relational characteristics of women, such as nurturing and connecting with others, are now regarded as desirable attributes for the workplace. Adult growth and achievement models are based on the so-called masculine characteristics of separation, individuation, and independence. Relational theory supplies an alternative model called growth-in-connection, which stems from the feminine characteristics of connection, collectivity, and interdependence. Women's fears of exercising power, men's resistance to sharing power, the traditional ways in which women attain power are all concerns that are examined. Real power lies in exercising leadership, which implies risk-taking. Exploring the gender disequilibrium in issues of power--both the female advantage and the female disadvantage-as exemplified by the glass ceiling and its origins--helps to clarify the issues involved in empowerment.

Female↗
PubMed1998

[Analysis of Services Targeting Family Violence Against Women in Greater Metropolitan Buenos Aires, Argentina]

This study presents a diagnosis and evaluation of the availability of services related to family violence against women in Greater Metropolitan Buenos Aires, Argentina. The paper focuses on institutional development, theoretical foci, intervention modalities, and production of information and research. Existing networks and interprofessional relationships are also described. Results point to several noteworthy theoretical perspectives. Some programs include gender as an issue, while others do not. The relationship (more informal than formal) between governmental and nongovernmental organizations is also a relevant issue. The paper concludes by proposing these institutional experiences as a model for the design of new public health policies.

Journal Article↗
PubMed1998

Relationship between muscle fiber composition and functional capacity of back muscles in healthy subjects and patients with back pain.

Back muscles are important to the stability of the lumbar spine. Muscle fiber composition may give some indication of the functional capacity of these muscles. This review explores the relationship between muscle fiber composition and functional capacity of back muscles. The reference values for the type and size of the muscle fibers found in the back musculature of healthy subjects and patients with back pain are also presented. A high percentage of type I fibers, which are larger in size than type II fibers, has been found in back muscles at the thoracic and lumbar levels. This is in accordance with the postural function of these muscles. The diameter of type II fibers is smaller in females than males, which may partly explain the lesser strength and greater endurance capacity of back muscles in females. Due to the limited amount of pertinent data, no conclusive evidence is available regarding age-related changes in muscle fiber composition in the musculature of the back. In patients with lumbar disorders, pathological changes and selective atrophy of type II fibers are seen, and these can be changed with adequate exercises. Further research is suggested to address issues related to gender, age, back pain, and exercise and their effects on the apparent back muscle fiber composition.

Aging↗
PubMed2001

[Tobacco smoking and risk of hip fracture in men and women. Results from the Hovedstadens Center for Prospective Population Studies].

INTRODUCTION: In the present population-based cohort study, we prospectively determined the influence of current, previous, and cumulative smoking history on the risk of hip fracture in men and women and addressed the issue of possible gender difference in susceptibility to tobacco smoking. MATERIAL: A total of 13,393 women and 17,379 men, initially examined between 1964 and 1992, were followed up until 1997 for their first admission because of hip fracture. RESULTS: During follow-up, a total of 1169 hip fractures were identified. After adjustment for potential confounders, female current smokers had a relative risk of hip fracture of 1.36 (1.12-1.65) and male smoked 1.59 (1.04-2.43) relative to those who have never smoked. In both sexes, the relative risk of hip fracture gradually increased with current and accumulated tobacco consumption. A test for interaction between gender and smoking habits was insignificant. Men who stopped smoking for more than five years had a lower risk of hip fracture than men who currently smoked, whereas no such risk reduction was seen in female ex-smokers. CONCLUSION: Tobacco smoking is an independent risk factor for hip fracture in men and women, and there appears to be no gender differences in the smoking-related risk. Men who stopped smoking for more than five years had lower risk of hip fracture than men who currently smoked, whereas no such risk reduction was seen in female ex-smokers.

Adult↗
PubMed1998

New materials for AIDS education at school.

According to a newly-published Joint UN Programme on HIV/AIDS (UNAIDS) review of data from four continents, good-quality sex education helps delay first intercourse and leads to lower levels of teenage pregnancy and sexually transmitted diseases (STDs). The following materials may be useful: 1) Learning and teaching about AIDS at school, Geneva: UNAIDS Technical Update, October 1997. An eight-page document analyzes why AIDS education in schools is often denied to young people and suggests ways to overcome these problems; 2) Integrating HIV/STD prevention in the school setting: a position paper, Geneva: UNAIDS, 1997. This is a two-page document with programming principles, best practice to date, and goals in school AIDS education, from a life skills perspective; 3) Impact of HIV and sexual health education on the sexual behavior of young people: a review update, Geneva: UNAIDS, 1997. From a comprehensive literature review of evaluated interventions, 46 are presented that had an impact on behavior. Effects on age at first intercourse, sexual activity and protected sex, as well as gender and media issues in the context of education programs, are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Cambodia. Programmatic approach to IEC on reproductive health.

Various UNFPA-funded population programs are now in place in six provinces and the capital and some more are in the pipeline. The ones currently being implemented include projects on maternal and child health and birth spacing, national population census, improvement of family health of displaced persons, and socio-economic research. Those in the pipeline are population education in the school system, gender and population issues, and population and environment. All the programs mentioned have implications for information, education and communication (IEC). To implement these programs effectively, UNFPA and the government realized the need for IEC support. To provide a coherent, integrated and holistic approach to the provision of IEC support to all the UNFPA-funded population activities, a programmatic approach to IEC was developed with the assistance of CST adviser on population communication, Mr. Francisco Roque. The IEC program will basically support the government policy of providing voluntary birth spacing services as a means to promote better maternal and child health through IECM activities; and to provide adequate information to selected target groups required to bring about desired behavioral changes in responsible reproductive decision-making and lifestyle. The target groups to be reached include: service providers and health workers, policymakers and administrators, women of reproductive age, men, and the adolescents aged 15-19 as well as teachers and trainers. The IEC interventions hope to create awareness of the benefits of birth spacing, introduce population concepts in curricula and appropriate health/teaching materials in selected medical schools and secondary schools, reduce misconceptions, provide proper counseling, and sustain government's interest and commitment to the population program.

Asia↗
PubMedDate not supplied

Emotional competence as a positive youth development construct: conceptual bases and implications for curriculum development.

This paper outlines the conceptual bases of 'emotional competence' as a positive youth development construct and the implications for curriculum development in junior secondary schools. In essence, 'emotional competence' includes (i) identifying personal feelings and those of others; (ii) managing emotional reactions and communication; and (iii) building self-managing strategies to cope with negative emotions and adversities. By considering adolescents' developmental progression, gender and cultural issues, eight units of positive youth development are designed in the P.A.T.H.S. Project, supported by the Hong Kong Jockey Club Charities Trust, to promote 'emotional competence' in Secondary 1 to 3 students in Hong Kong. In the Secondary I curriculum, the goals of the units are to develop student's awareness of their emotions and proper expression of them. In the Secondary 2 curriculum, the goals of the units are to enhance students' understanding of others' emotions and the importance of communicating emotions in relationships. In the Secondary 3 curriculum, the goal is to enhance students' adaptive coping strategies in the face of adversities.

Adaptation, Psychological↗
PubMedDate not supplied

Spirituality as a positive youth development construct: conceptual bases and implications for curriculum development.

This paper outlines the conceptual bases of 'spirituality' as a positive youth development construct and the implications for curriculum development in junior secondary schools. In essence, spirituality embraces (i) connectedness with others that includes other people and a higher being, (ii) establishing personal beliefs and values, and (iii) the search of answers to the meaning of life. By considering adolescents' cognitive development and other developmental needs, gender and cultural issues, ten units of positive youth development programmes are designed to foster spirituality in Secondary 1 to 3 students in Hong Kong. These programme units constitute part of the P.A.T.H.S. Project supported by the Hong Kong Jockey Club Charities Trust. In the Secondary 1 curriculum, the goal of the units is to facilitate students to connect with other people and a higher being. In the Secondary 2 curriculum, the goals of the units are to help students reflect on their possessions in life and reevaluate the meaning of their life from people who experience great agony. In the Secondary 3 curriculum, the goals are to help students search for the meaning of life.

Adolescent↗
PubMed1996

Women as leaders.

The role of women as leaders has undergone considerable review in recent years, both outside and within the dental profession. Growing awareness of gender as an issue in leadership has focused attention on leadership styles and qualities with particular emphasis on the differences between male and female approaches. Further research is proposed, specifically on leadership within the dental profession. Trends are identified which lead to optimistic conclusions as to the future involvement of women in leadership in dentistry.

Dental Research↗