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PubMed1993

Gender and support for mental health research.

Grants awarded by the Ontario Mental Health Foundation (OMHF) between 1986 and 1991 were analyzed for their relevance to male and female mental health topics following earlier research by Stark-Adamec in 1981. OMHF fellowships and scholarships, 1986 to 1991, National Health Research and Development Program funding, 1989 to 1990 and 1990 to 1991 funding by the Medical Research Council were also examined. Essentially, funding focused on neither gender; issues concerning gender and mental health were seldom involved in research funded by these agencies.

Bias↗
PubMedDate not supplied

Substance dependency treatment for adolescents: practice and research.

This paper reviews the more common treatment approaches that address adolescent substance abuse and the spectrum of problems which often attend involvement with drugs. The most common outpatient treatment approaches for adolescents are 12-step based programs and family-based therapies which may be used separately or in conjunction with each other. The therapeutic community is a residential approach, characterized by the use of the peer community itself to facilitate social and psychological change in individuals. Both outpatient and residential modalities have demonstrated effectiveness in working with adolescents. Ideally, the type of intervention will depend upon the young person's needs, in particular the extent and effects of his/her drug use, as well as the level of other problems. Overall, treatment must address a range of concerns of special relevance to adolescents because of their age and dependency status; for example, developmental stage, cultural issues, and gender issues.

Adolescent↗
PubMedDate not supplied

Probable Alzheimer's disease: gender-related issues.

Probable Alzheimer's disease is diagnosed by exclusion when no other disorder--such as stroke, brain infection, or vitamin deficiency--can be found to account for specific cognitive change. Although probable Alzheimer's disease affects both men and women, studies in many different populations show that between 1.5 and 3 times as many women as men suffer from probable Alzheimer's disease. For women with the disease, one needs to consider behavioral and cognitive problems, therapeutic issues, and other gender-related risks. Additionally, social, psychological, and emotional variables play a role in the female caregiver's burden.

Alzheimer Disease↗
PubMed1990

A study of the role of gender in family therapy training.

A survey of the role of gender in family therapy training programs was conducted by the Women's Task Force of the American Family Therapy Association (AFTA) in order to determine the extent to which gender issues were included in the curriculum. Questionnaires were sent to 285 programs in the U.S., Canada, and overseas. Only 19% (n = 55) of the original sample participated, with the East Coast representing the largest proportion of respondents. Findings revealed that the three most frequently addressed gender issues are: 1) the impact of cultural and economic conditions on single, female-headed families; 2) gender issues associated with wife abuse; and 3) an examination of the implications of the therapist's gender in therapy interventions. Only 27 programs identify with a feminist model or have a clearly defined sense of gender awareness. A significant finding associated with the introduction of feminist content was the difficulty of integrating gender issues with major theoretical models. Trainee resistance and lack of faculty awareness were also considered obstacles to including gender in program curriculum.

Cultural Characteristics↗
PubMed1997

Gender and equity in health sector reform programmes: a review.

This paper reviews current literature and debates about Health Sector Reform (HSR) in developing countries in the context of its possible implications for women's health and for gender equity. It points out that gender is a significant marker of social and economic vulnerability which is manifest in inequalities of access to health care and in women's and men's different positioning as users and producers of health care. Any analysis of equity must therefore include a consideration of gender issues. Two main approaches to thinking about gender issues in health care are distinguished--a 'women's health' approach, and a 'gender inequality' approach. The framework developed by Cassels (1995), highlighting six main components of HSR, is used to try to pinpoint the implications of HSR in relation to both of these approaches. This review makes no claim to sociological or geographical comprehensiveness. It attempts instead to provide an analysis of the gender and women's health issues most likely to be associated with each of the major elements of HSR and to outline an agenda for further research. It points out that there is a severe paucity of information on the actual impact of HSR from a gender point of view and in relation to substantive forms of vulnerability (e.g. particular categories of women, specific age groups). The use of generic categories, such as 'the poor' or 'very poor', leads to insufficient disaggregation of the impact of changes in the terms on which health care is provided. This suggests the need for more carefully focused data collection and empirical research.

Cost-Benefit Analysis↗
PubMedDate not supplied

Gender inequity: an issue for quality assessment researchers and managers.

This article explores the question of whether the issue of gender inequity can and should be included in the different models of quality assessment gaining ground internationally. The discussion is divided into three parts: reflections on some of the conceptual issues that justify research on gender equity in health services; a brief review of the literature that provides empirical data in this area; and comments on the challenges faced by researchers in this field, and possible ways to incorporate gender indicators into quality assessment research and management.

Female↗
PubMedDate not supplied

["I'm just a civil servant--neutral and sexless". About the resistance against the gender perspective and the risk of gender bias in medicine].

In medicine a gender perspective includes taking into consideration not only biology but also the cultural and psychosocial aspects of being a woman or a man. Unawareness or denial of gendered norms in society and/or of the power asymmetry between women and men can lead to resistance to gender issues and to the risk of gender bias in clinical medicine as well as in medical research and education. In a theoretical model presented in this paper the resistance and the bias risk are analysed in relation to assumptions about sameness/difference and equity/inequity between women and men. Such an analysis could facilitate the implementation of a gender perspective in settings and situations where resistance to gender issues is met.

Attitude of Health Personnel↗
PubMed1988

Generational equity: issues of gender and race.

Recent attempts to portray the relative affluence of the current generation of older Americans as causing economic hardship for younger generations are examined in this paper. This argument, commonly referred to as the "generational equity" thesis, ignores the basic issues of gender and race. We argue that: the elderly are more sharply stratified into rich and poor than younger groups, the official poverty level used by the federal government underestimates the number of poor older persons living in poverty, and that older women and minorities have disturbingly high rates of poverty. Reducing current federal benefit levels to the elderly would do little to alleviate the problems experienced by younger generations, and would cause severe hardship for many older people. Women and minorities would be especially hard hit by such reductions since they are more likely to be poor than white males.

Adult↗
PubMed2003

Incorporating sexual and reproductive health care in the medical curriculum in developing countries.

Medical educators have a responsibility to train physicians and other health professionals in the core competencies needed to improve the sexual and reproductive health of their communities. Yet sexual and reproductive health care is significantly under-represented in the basic educational curriculum for medical and other health professionals, as well as in continuing medical education and professional development programmes for practising physicians and other health professionals. The Commonwealth Medical Association Trust is developing a model curriculum on sexual and reproductive health that can be integrated into undergraduate medical education and used with appropriate amendments for continuing medical education. This paper outlines topics for inclusion in the curriculum and three strategies for incorporating core components of sexual and reproductive health in the curriculum--by developing themes that can be integrated into the general curriculum in a multi-disciplinary fashion, adding free-standing modules as electives, and delegating cross-cutting issues such as gender issues and adolescent reproductive health to courses run by other departments. It argues for the use of problem-solving and case-based learning methodologies, as well as lectures, as the best way to teach health professionals how to provide information, counselling and support for sexual and reproductive health, as well as to cover the range of prevention and treatment needs of women and men seeking these services.

Curriculum↗
PubMed1994

An overview of sexual harassment.

OBJECTIVE: A few widely publicized cases have made sexual harassment a salient subject in the 1990s. This article reviews the topic in a comprehensive manner, with particular attention to demographic information, psychosocial consequences, appropriate therapeutic interventions, and related psychological issues. METHOD: Computerized literature searches were used to identify research and review papers from psychiatry and psychology journals. Nonscientific works that provide additional information are also cited. RESULTS: The literature suggests that sexual harassment is a widespread phenomenon, affecting 42% of women and 15% of men in occupational settings, 73% of women and 22% of men during medical training, and lower percentages in other educational settings. Despite the pervasive nature of this problem, only 1%-7% of victims file formal complaints. Sexual harassment produces an array of psychological and physical symptoms in over 90% of victims, and 12% seek help from mental health care professionals. Self-doubt is a central issue regardless of gender, but in instances where the perpetrator is male and the victim is female, there are ramifications unique to the trauma of gender-based abuse. It is critical that therapists avoid contributing to the process of "second injury" and not imply that patients have brought their troubles on themselves. Key therapeutic tasks include empathy, validation, and empowerment. CONCLUSIONS: Few experimental studies have focused on the victims of sexual harassment, and none have focused on the perpetrators. Psychiatry can play an invaluable role in the assessment and treatment of victims, the fostering of education and research in this area, and the understanding of underlying psychological and gender issues.

Female↗
PubMed1996

Treatment of perinatal cocaine addiction: use of the modified therapeutic community.

Treatment outcome was evaluated for perinatal cocaine addicts admitted to a hospital-based day treatment clinic, organized as a modified therapeutic community (TC) modality. The perinatal program consisted of a specialized track for women embedded within this larger coed day treatment clinic. A total of 87 perinatal women (28 pregnant at intake, the remaining 59 postpartum) were compared with cohorts of nonperinatal women (N = 63) and men (N = 158) admitted during the period of evaluation (September 1989 through December 1993). In logistic regression analysis, successful discharge urine status (last three urines prior to discharge drug-free) was associated with current child custody involvement (odds ratio = 2.80, 95% C.I. = 1.16-6.72), entering treatment when not postpartum (odds ratio = 0.15, 95% C.I. = 0.05-0.42), and taking psychiatric medication (odds ratio = 2.04, 95% C.I. = 1.11-3.72). Both pregnant and postpartum perinatal women showed a similar pattern of shorter treatment as compared with nonperinatal women and male clients, averaging 2 months of treatment as compared with 4 months for nonperinatal clients. Factoring out pregnancy and postpartum status, the women in treatment fared as well as men with respect to both retention and discharge urine standings. This finding indicates that programmatic modifications need to address specific perinatal issues and not gender issues per se. Also, a differential pattern in discharge urine status of women who enter treatment while pregnant vs. those who enter when postpartum suggests that outreach and recruitment be targeted, but not limited, to pregnant women.

Adult↗
PubMed1999

Nursing research: can a feminist perspective make any contribution?

As more than 90% of the RSA's nurses are women and as at least 50% of the health care clients are also women, nursing research can definitely benefit by incorporating feminist research approaches. Specific feminist research issues which could be relevant to nursing research include: inherent themes in feminist research feminist research methodology gender stereotypes and nursing research gender-based stereotypes of researchers potential benefits of incorporating feminist research approaches in nursing research. Most formal models of nursing, and thus also most nursing research based on these models, ignore gender issues. Thus they ignore part of the social reality of nursing and might provide distorted images of nursing. A feminist approach to nursing research could enhance the reality-based gender issues relevant to nursing specifically, and health care generally, and contribute towards rendering effective health care within a multidisciplinary health care context.

Female↗
PubMed2003

[Few and sporadic gender elements in the medical curriculum at Umea. Physicians play a key role when implementing suggestions for improvement].

An investigation was conducted at the medical school in Umeå Sweden, to get a picture of the education that was offered to the students about gender and gender issues in medicine during the autumn of 2001. A few ambitious examples were reported but as a whole a gender perspective was lacking and not co-ordinated between courses. There was no space in the curriculum for gender theory, which implied that all teachers that paid attention to a gender perspective had to start from the beginning. They had no idea what ideas and theories had already been discussed. When sex or gender were focused on it was foremost biological aspects that were put forward while social, psychological and cultural aspects were not illuminated. No attention was paid to sex or gender bias. The abuse of women was in the curricula only three times during the five and a half years of medical training. Based on this inventory a proposal to develop education on gender issues has been outlined and approved by the faculty board.

Attitude of Health Personnel↗
PubMed2005

Working with girls living on the streets in East Africa: professionals' experiences.

AIM: This paper reports a study elucidating the meaning of caring for girls of the street, as experienced by female staff members working with street children in Eastern Africa. BACKGROUND: The phenomenon of children living on the streets is a global and escalating problem, and girls are presumed to be especially vulnerable. In East Africa, the traditional extended family system is rapidly breaking down and traditional gender values seem to remain. This was the context for investigating female carers' experience of caring for girls. METHOD: Interviews were conducted with 37 project staff members working with children living on the streets in the framework of non-governmental organizations in Kenya, Uganda and Tanzania between 1997 and 1998. Transcribed text from female interviewees (n = 13) working with girls of the street was analysed using a phenomenological-hermeneutic approach. FINDINGS: The meaning of caring for girls of the street for female professional carers in East Africa was comprehensively understood as counselling the girls to integrate the past of their adverse life stories with their present identity. Counselling meant conveying visions for a possible re-direction of the life stories, from being a girl of the street into being an accepted family girl. Caring in this context meant being squeezed between ethical demands and gender values. Experiencing frustration and powerlessness was related to gender structures in society, having to fight the grip of street culture, and a lack of professional tools. Hope and satisfaction were related to success in changing the course of life stories of girls and to seeing possibilities for contributing to empowerment of girls and community members. CONCLUSIONS: Gender issues are critical to care provided to girls of the street. Carers felt that they lacked relevant knowledge and support. Ethical aspects and gender issues in relation to professional care for vulnerable girls ought to be addressed in nursing education and practice, not only for developing countries, but also as a matter of global interest.

Adaptation, Psychological↗
PubMed2002

[Gender-sensitive public health publications in Germany? Results of a review of literature].

BACKGROUND: The project 'Gender Bias - Gender Research' investigates how far gender issues are considered in German-language Public Health journals. Target is the analysis of the publication practice in Public Health in order to point out status, deficits and perspectives of gender-specific research. METHODS: We developed a standardised evaluation instrument, which covers the semantic, methodical-technical and contentual area regarding gender issues and evaluated all original contributions of the years 1990, 1995 and 1999 in the journals 'Das Gesundheitswesen', 'Sozial- und Präventivmedizin' and 'Zeitschrift für Gesundheitswissenschaften'. 268 (of 517) contributions applied to persons (in contrast to i. e. programmes, institutions) and were completely analysed. RESULTS: The main part of the contributions take women and men into account, but do not consider them continuously in all parts of the research process and in this way do not fulfil all requirements for gender-sensitive research. Gender finds most consideration on the semantic level. Less than half of the authors consider the different situation of women and men in the formulation in hypotheses, sampling, or data analysis, and only 35 % of them make reference to this in their conclusions. We found differences between the examined journals and years. CONCLUSIONS: The concerns of women and men should be considered at all levels of research. Attention should be paid to this when writing, reviewing and publishing contributions.

Female↗