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PubMed1998

Prevention of disturbed eating behaviour: a prospective intervention study in 14- to 19-year-old Swiss students.

Subsequent to an epidemiological study on eating behaviour in adolescents, a prospective study was carried out to examine the effect of health promotion lessons on disturbed eating behaviour. From the original sample (t1, n = 1944), a subgroup of 314 students of both sexes, 14-19 years of age, was selected. Participants came from a total of 20 classes in which a high percentage of students exhibited disturbed eating behaviour. Ten classes were then randomly selected to receive health promotion lessons (intervention group, high-risk; IGHR), while the other 10 classes served as controls (control group, high-risk; CGHR). The Eating Attitudes Test (EAT-26), the Giessen Physical Complaint List for Children and Adolescents (GSCL-C) and the Self-Report Symptom Check-List (SCL-90-R) were administered shortly before (t2) and 3 months after (t3) the interventions. The three health promotion lessons dealt with issues concerning beauty ideals, gender differences in psychosexual maturation and body awareness, healthy eating behaviour, physiology of nutrition, early symptoms of eating disorders and therapeutic approaches. The data analyses revealed an improvement on all three symptom scales for both groups between t2 and t3, but there were no significant differences between the IGHR and CGHR groups. When data from high-scoring female participants only were analysed (HRf-IGHR and HRf-CGHR), the multivariate analysis revealed a significant interaction between time and group (15.2% of variance explained). Our experiences in implementing health promotion lessons that conveyed knowledge about eating disorders and addressed physical and psychological issues in a more general way indicated that these interventions can be carried out in schools, and may contribute to increases in physical and psychological well-being in a high-risk population of adolescents.

Adolescent↗
PubMed2003

[Clinical characteristics and gender identity among eating disordered patients subtypes].

BACKGROUND: Gender identity is a relevant issue in the approach to eating disorders. AIM: To compare psychological and behavioural characteristics and traits of gender identity among women with eating disorders and its subtypes and non eating disordered female subjects. MATERIAL AND METHODS: An structured clinical interview based on the DSM-IV diagnostic criteria for eating disorders, the EAT-40 (Eating Attitudes Test), the Eating Disorders Inventory (EDI) and the Bem Sex Role Inventory (IBRS) were administered to 58 compulsive-purgative anorectics (AN/BN group), 15 restrictive anorectics (AN group), 33 patients suffering from eating disorder not otherwise identified, 33 purgative bulimics and to 82 female students without eating disorders. RESULTS: Patients with eating disorders ranked significantly higher on the EAT-40 and EDI and all its items (p < 0.001). The AN/BN group ranked significantly higher on the EDI (p < 0.001) and on Drive for thinness, Perfectionism and interpersonal distrust (p < 0.001). The AN group ranked higher on Maturity fears (p < 0.001). The BN group ranged higher on Body dissatisfaction, Ineffectiveness and Interoceptive awareness (p < 0.001). Patients with eating disorders were significantly identified with Feminine category and subjects without eating disorders with Androgynous and Undifferentiated categories on the IBRS (p = 0.002). The AN group showed the highest percentage on Feminine category and the lowest on Androgynous and Undifferentiated categories. All the groups rejected and approved feminine, masculine and neutral qualities. CONCLUSIONS: Femininity emerged as the main trait of gender identity in patients suffering from eating disorders, in contrast to androgyny, showed by healthy women.

Adult↗
PubMed2001

Survey of veterinary technical and professional skills in students and recent graduates of a veterinary college.

OBJECTIVES: To determine perceptions of veterinary technical and professional skills among veterinary students and recent graduates. DESIGN: Cross-sectional study. SAMPLE POPULATION: 281 students and 142 recent graduates from the Ontario Veterinary College. PROCEDURE: A survey was designed and administered to first- through fourth-year students and veterinarians who had graduated either 1 or 6 years before survey administration. RESULTS: Overall response rate was 70%. Learning about technical and professional skills was highly valued. Most participants felt they had not received instruction about professional skills, but those who had felt more competent about them. Perceptions of competence increased slightly with increased comfort discussing emotional veterinary issues with instructors. Neither gender nor increased age was related to increased feelings of competence. Almost all fourth-year students felt competent and comfortable about examining an animal with the client present, assessing suffering, diagnosing parvovirus infection, performing surgery, and working as group members. However, many did not feel competent or comfortable about delivering bad news, setting time limits yet providing quality service, helping clients with limited funds make treatment decisions, dealing with demanding people, and euthanasia. Feelings of competence and comfort were closely related but were not identical. CONCLUSIONS AND CLINICAL RELEVANCE: In the interests of best preparing entry-level veterinarians, technical and professional skills need to be emphasized in a learning environment where students feel comfortable discussing emotional veterinary issues. A professional skills curriculum addressing underlying self-awareness, communication, and interpersonal issues, as well as procedural matters, would likely increase the proportion of fourth-year students who feel competent and comfortable about professional skills by the end of their undergraduate training.

Adult↗
PubMed2001

Breaking away from grounded identity? Women academics on the Web.

The World Wide Web has provided a new way for academics to find out about others' work and to present versions of their identity. In previous discussions we analyzed how people present themselves in this new medium, in terms of Goffman's ideas of the presentation of self, and commented on gender differences and how issues of credibility and authority are handled by women academics in their homepages. This paper reports discussions with women academics about how they have responded to this opportunity, both in how they present themselves in their own pages, and how they deal with the problems involved in presenting an individual identity within an institutional Web page framework. In presenting themselves in personal homepages, many women academics feel a need to establish their credentials and entitlement to an academic identity. However, the vulnerability of themselves as women remains part of their persona as academics. For example, they were ambivalent about the use of a self-photo on their homepages (most wanted to avoid it, but found it friendly and validating on other women's pages). The discussion considers how far new technology provides opportunities for new forms of identity, or how far the identity presented on the Web is still grounded in people's physical and institutional existence. Women academics feel that the Web has given them new freedom and reduces some traditional gender and status differences (as has been found with other aspects of electronic communication), but they are still wary of it being "yet another way of carrying on the same old gender plot."

Communication↗
PubMed1993

Homosexual and bisexual identity in sex-reassigned female-to-male transsexuals.

Descriptions of female-to-male transsexuals who are sexually attracted to men are rare. This is a report on nine of them. Their awareness of gender dysphoria preceded their awareness of their attraction to men. Their wish to undergo sex reassignment as a means of resolving their gender dysphoria superseded any concerns about their sexual orientation or sexual adaptation after surgery. Several had had sexual relationships with men before sex reassignment which were unsatisfactory because these men viewed our subjects as women. After sex reassignment, the subjects successfully established sexual relationships with gay men; in some of them even penovaginal intercourse was part of their sexual activities. While hormonally and surgically reassigned, none of our subjects had had phalloplasty. All nine subjects were interviewed and given psychological tests measuring sexual satisfaction and psychological adjustment. Their results were compared to those of a group of self-identified gay men. No major differences in sexual satisfaction and psychological adaptation were found. The phenomenon of female-to-male transsexuals who develop a sexual orientation toward men may be more common than previously thought. Regarding female gender dysphoric individuals, our findings challenge the issue of using sexual orientation in classification systems of gender dysphoria syndromes and as a risk factor in the decision regarding sex reassignment. Further, our study invites us to rethink the genital criterion in the assessment of sexual orientation.

Adult↗
PubMed2006

Report on the conference on 'Men, women, and medicine: a new view of the biology of sex/gender differences and aging' held in Berlin, 24-26th February 2006.

The first world wide symposium on the topic of gender-specific medicine provided the latest research on differences in sex and/or gender in medicine and medical care. The presentations ranged beyond the topic of reproduction to encompass the entire human organism. This report critically reviews three issues that emerged during the Conference: gender mainstreaming, the concept of sex/gender differences and the issue of men's health. It suggests that the interdisciplinary concept of gender-specific medicine has to be mirrored by the integration of social and cultural studies into medical research and practice.

Aging↗
PubMed1998

Phonetically cued word-fluency, gender differences and aging: a reappraisal.

Five-hundred and three normal subjects were given a phonetically cued word-fluency task in order to investigate the controversial issue of the influence of gender and aging on this task. Subjects were requested to say in one minute all the words that occurred to them, beginning with a given letter (F, P and L). Besides the expected significance of education, we observed a female advantage, but not a significant decline in the performance with aging. However, the slope of the line expressing word fluency as a function of age was different between females and males, indicating a greater sensitivity to aging for males. We provide inner and outer tolerance limits for this test in the normal population and give a formula useful for adjusting the raw scores on the basis of gender and education. The results are discussed with reference to previous findings and some hypotheses about the origins of the female advantage in PWF.

Adolescent↗
PubMed1984

The psychobiology of play: theoretical and methodological perspectives.

The social play of pairs of juvenile rats can be brought under tight experimental control using social deprivation, and it can be objectively quantified by measurement of pinning behavior. Research and conceptual issues concerning this paired-encounter procedure are summarized, including issues related to measurement, gender differences (and the absence thereof), relations between play and aggression, the regulatory processes interacting with and underlying play, the neurochemical and neuroanatomical substrates of play, the functions of play in dominance and other adult behaviors. Existing results suggest the operation of a harmoniously operating brain process which generates a unique emotive brain process that is appropriately referred to as social play. Although the concept of play remains to be adequately defined, the position is advocated that rigorous psychobiological analysis will ultimately provide an empirical definition based upon neural circuit characteristics. Analysis of the underlying circuits may help reveal the manner in which more complex levels of behavioral competence arise ontogenically, and work in the area may yield clues to the genesis of several psychopathologies.

Age Factors↗
PubMed2006

Does prenatal care increase access to child immunization? Gender bias among children in India.

Prenatal care appears to serve as a trigger in increasing the chances for access to subsequent health care services. Although several previous studies have investigated this connection, none have focused specifically on how parents' behavior differs before and after learning the gender of their babies. Investigating parents' behavioral changes after the child's birth provides a quasi-natural experiment with which to test the gender discrimination hypothesis. This issue was examined here, using a rich family health survey data set from India. We find evidence for the triggering effect of prenatal care on immunization only among rural boys, but we find no compelling evidence for this effect among other sub-samples. This finding suggests two things, which are not mutually exclusive. One is that the information spillover from prenatal care has a much larger impact in rural areas, where alternative sources of information are scarce, compared with urban areas. The other is that the sex of a child is a critical factor in producing different levels of health care behavior in rural areas, where sons are favored and more valued than in urban areas.

Adolescent↗
PubMed2001

Models of acculturation and health behaviors among Latino immigrants to the US.

A basic premise of much of the health research conducted with immigrant groups is that culturally based behaviors change over time as a result of acculturation, i.e., interaction with the mainstream US culture. However, models of acculturation have not taken into account how group-specific characteristics and the varying social and political contexts immigrant groups face may impact the acculturation process. In this study of 150 families, we examined the inter-relationship of indicators of acculturation among two Latino groups to discern the impact of gender and country of origin on the relationship between variables. Results indicated that increased years of residence in the United States had the predictable impact of increased competence in English and increased use of English, but had differing impact by country of origin on the cultural orientation of the respondents' environment and on ethnic identification. Also, gender was associated with differing levels of English language use and with perceived social acceptance, such that males used more English and reported less social acceptance than females. Loading separately from the language and cultural behavior variables, this factor, perceived social acceptance, merits research as a predictor of service use given that respondents understood non-acceptance as resulting from being identified as Latino. not from behaving differently from the mainstream. The differing patterns of association by country of origin and by gender and the measurement issues these raise, highlight the importance of specifying more complex models of a cculturation than is done typically in research with Latinos.

Acculturation↗
PubMed2003

Zimbabwean adolescents' condom use: what makes a difference? Implications for intervention.

PURPOSE: To examine risk and resilience factors at multiple ecological levels related to Zimbabwean adolescents' practice of protected or unprotected sex. METHODS: Data were collected from adolescents in eight secondary schools in Zimbabwe. A 140-item instrument designed by the authors assessed adolescent perceptions, behaviors, and attitudes. Youth who had engaged in sexual intercourse (n = 730) were included in analyses. Risk and resilience factors related to self, peer, family, and community domains were examined. Data were analyzed separately by gender using discriminant analysis to identify factors that predict whether youth engage in safe or unsafe sex. RESULTS: Boys who engaged in safe sex were older, more likely to report their parents were there when needed, spent more time in extracurricular activities, and reported a lower drop out likelihood. Girls who engaged in safe sex worried about HIV/AIDS more than those who engaged in unsafe sex. CONCLUSIONS: Although both boys and girls need medically correct sexuality education, including education on HIV/AIDS and sexually transmitted diseases (STDs), the findings suggest that such education is not enough. Program planners must consider the influences of multiple ecological levels. Gender differences raise several issues for intervention.

Acquired Immunodeficiency Syndrome↗
PubMed2003

Retention, adherence, and compliance: special needs of HIV-infected adolescent girls and young women.

PURPOSE: To demonstrate that whereas all HIV-infected youth evidence complex factors that challenge retention in care and adherence to treatment, HIV-infected females have additional issues that are gender-specific. METHODS: Preliminary data from a subset of 21 adolescent/young women under age 25 from the Whole Life mental health-perinatal HIV care project were analyzed to illustrate the needs of these patients. RESULTS: Of the 21 young women assessed, all but one was of minority background, and a sizeable majority had limited education (<high school diploma) and were quite poor (incomes <$500/mo.). Nearly 67% first learned of their HIV status between ages 16 and 19 years. More than three-fourths were pregnant and, of these, more than one-third entered prenatal care in the last trimester. More than half had responsibility for one to two other children. Two-thirds reported having unprotected sex in the prior 6 months. Nearly 43% had CD4 counts of 500 or below. About one-third screened positive for a mental health problem, and the majority reported a striking frequency of exposure to abusive events and traumatic losses across their short lifetimes. CONCLUSIONS: Adolescent girls and young women have unique needs for developmentally appropriate medical and psychosocial approaches to promote retention and adherence.

Adolescent↗
PubMed1987

Public policy and older people--where are we going?

During much of the 1960s and 1970s, housing and welfare provision for older people were part of the cinderella services (Means and Smith, 1985) that the majority of both practitioners and social scientists were happy to leave to the remit of a relatively small group of dedicated specialists. However, the 1980s have seen an important shift to that, as Johnson (1985), remarked, 'old age is now in fashion'. The six books under review represent one manifestation of this important trend. All the books agree that a major reason why an interest in older people is no longer a form of 'professional suicide' (Phillipson, 1982, p.107) is the cost implications of demographic trends. A government concerned to reduce public expenditure is faced with a significant growth in the old who are extensive users of expensive health and social services. This review article will begin by explaining briefly the main focus and arguments of each book. This will underline the diversity of issues addressed and perspectives taken. However, certain underlying themes are raised in all these books which will be discussed in the second half of the review. Are elderly people a homogeneous group? How do issues of class and gender impinge upon older people? What would represent the most appropriate spread of housing, health and social services provision for older people? What changes are feasible in the present fiscal and political climate? What directions should be argued for with regard to longer term policies?

Aged↗
PubMed1999

Metabolism of tricyclic antidepressants.

1. Despite the considerable advances in the treatments available for mood disorders over the past generation, tricyclic antidepressants (TCAs) remain an important option for the pharmacotherapy of depression. 2. The pharmacokinetics of TCAs are characterized by substantial presystemic first-pass metabolism, a large volume of distribution, extensive protein binding, and an elimination half-life averaging about 1 day (up to 3 days for protriptyline). 3. Clearance of tricyclics is dependent primarily on hepatic cytochrome P450 (CYP) oxidative enzymes. Although the activities of some P450 isoenzymes are largely under genetic control, they may be influenced by external factors, such as the concomitant use of other medications or substances. Patient variables, such as ethnicity and age, also affect TCA metabolism. The impact of gender and related reproductive issues is coming under increased scrutiny. 4. Metabolism of TCAs, especially their hydroxylation, results in the formation of active metabolites, which contribute to both the therapeutic and the adverse effects of these compounds. 5. Renal clearance of the polar metabolites of TCAs is reduced by normal aging, accounting for much of the increased risk of toxicity in older patients. 6. Knowledge of factors affecting the metabolism of TCAs can further the development and understanding of newer antidepressant medications.

Antidepressive Agents, Tricyclic↗
PubMed2006

Psychosocial impacts on caregivers of people living with AIDS.

Estimates show that by 2010 up to six million South Africans will be HIV-infected. Simultaneously, public health care resources are overstretched and communities and families are taking more responsibility for providing care. However, little work in South Africa has investigated the possible psychosocial impacts on caregivers. This study investigates psychosocial impacts at household level with reference to gender, programme, and policy implications. Forty-five in-depth interviews were held with primary caregivers of people living with AIDS (PWA). Participants were recruited using purposive and snowball sampling. Forty-three respondents were women, signifying that gender is an important issue in this context. Data were analysed using a grounded theory approach. Care giving placed considerable demands on caregivers, which was exacerbated by insufficient support, dire poverty and the added responsibilities of caring for other household members. Lack of basic resources was common and chronic, and care giving impacted negatively on employment and social life. Stigma and prejudice towards caregivers was common and exacerbated stress levels. Assessment of support received from various sources ranged widely. The lack of support was often debilitating. Respondents who felt supported linked this support to improved psychosocial status. Recommendations for policy on home-based care are outlined.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Violence, homelessness, and HIV risk among crack-using African-American women.

This study compares the characteristics of out-of-treatment, homeless, crack-using African-American women with those who are not homeless to determine what risks and protective factors differentiate the two groups. From 1999 to 2001, 683 out-of-treatment, African-American crack-using women (of whom 219 were categorized as homeless) were interviewed and serologically tested. Risk factors that were examined include adverse childhood experiences, psychological distress, physical health, violence and victimization, drug use, and risky sex behaviors. Protective factors that were examined include marital status, education, public assistance, and the responsibility of caring for children. Overall, both groups of women started crack use in their mid-twenties and started drug use with alcohol in their teenage years, though differed significantly on each risk factor examined. Logistic regression analysis found that variables associated with increased odds of being homeless are physical abuse before age 18, crack runs greater than 24 hours, income less than dollars 500 in the last 30 days, depression, and current cigarette smoking. Protective factors found are marital status, living with children under 18, having had a physical in the past year, and receiving money from welfare in the last 30 days. Being sexually assaulted in the past 90 days was marginally associated with homelessness in the model. These findings, specific to crack-using African-American women, suggest that not only do these women overall report painful histories and currently stressful lives, but homeless women are more likely than women who are not homeless to have experienced childhood abuse and are more involved with drug use. Interventions designed for these women need to consider gender, cultural, and contextual issues that not only incorporate aspects of risk reduction related to violence, alcohol use, and comorbid conditions, but also linkages that will address housing issues, education, and skills for independence.

Adult↗
PubMedDate not supplied

Integrating women's health concepts in a nursing course.

The author presents concepts and teaching strategies incorporated into a maternal-newborn nursing course that are inclusive of a women's health perspective during the childbearing years. Concepts such as role, gender, culture, and sociopolitical issues are examined in the context of the women's life during the childbearing years. Specific teaching strategies emphasizing experimental learning are discussed. Strategies to enhance students' critical thinking abilities are presented.

Curriculum↗
PubMed1999

The dimensionality of the 12-item version of the Eating Attitudes Test. Confirmatory factor analyses.

The assumed three-dimensional structure of the 12-item version of the Eating Attitudes Test was examined by confirmatory factor analysis in a non-clinical sample of 224 female and 261 male adolescents in grade 8 aged 14-15 years. Alternative models were examined. Data did neither support a three-dimensional structure, nor a one-dimensional structure using twelve items. Three dimensions were supported when one and three items were omitted from the girls' and boys' analyses, respectively. A second order factor structure was supported in both genders. Conceptual and psychometric issues are discussed. A discussion of the measurement domain of the eating problem construct in non-clinicals is warranted.

Adolescent↗