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PubMed2000

Sex cells: gender and the language of bacterial genetics.

Between 1946 and 1960, a new phenomenon emerged in the field of bacteriology. "Bacterial sex," as it was called, revolutionized the study of genetics, largely by making available a whole new class of cheap, fast-growing, and easily manipulated organisms. But what was "bacterial sex?" How could single-celled organisms have "sex" or even be sexually differentiated? The technical language used in the scientific press - the public and inalienable face of 20th century science - to describe this apparently neuter organism was explicit" the cells "copulated," had "intimate contact," "conjugal unions," and engaged in "menage a trois" relationships. And yet, to describe bacteria as sexually reproducing organisms, the definition of sex itself had to change. Despite manifold contradictions and the availability of alternative language, the notion of sexually active (even promiscuous) single-celled organisms has persisted, even into contemporary textbooks on cell biology and genetics. In this paper I examine the ways in which bacteria were brought into the genetic fold, sexualized, and given gender; I also consider the issues underlying the durability of "bacterial sex."

Bacteriology↗
PubMed2002

Medical student attitudes toward the doctor-patient relationship.

CONTEXT: Medical educators have emphasized the importance of teaching patient-centred care. OBJECTIVES: To describe and quantify the attitudes of medical students towards patient-centred care and to examine: (a) the differences in these attitudes between students in early and later years of medical school; and (b) factors associated with patient-centred attitudes. METHODS: We surveyed 673 students in the first, third, and fourth years of medical school. Our survey utilized the Patient-Practitioner Orientation Scale (PPOS), a validated instrument designed to measure individual preferences towards various aspects of the doctor-patient relationship. Total PPOS scores can range from patient-centred (egalitarian, whole person oriented) to disease- or doctor-centred (paternalistic, less attuned to psychosocial issues). Additional demographic data including gender, age, ethnicity, undergraduate coursework, family medical background and specialty choice were collected from the fourth year class. RESULTS: A total of 510 students (76%) completed data collection. Female gender (P < 0.001) and earlier year of medical school (P = 0.03) were significantly associated with patient-centred attitudes. Among fourth year students (n = 89), characteristics associated with more patient-centred attitudes included female gender, European-American ethnicity, and primary-care career choice (P < 0.05 for each comparison). CONCLUSION: Despite emphasis on the need for curricula that foster patient-centred attitudes among medical students, our data suggest that students in later years of medical school have attitudes that are more doctor-centred or paternalistic compared to students in earlier years. Given the emphasis placed on patient satisfaction and patient-centred care in the current medical environment, our results warrant further research and dialogue to explore the dynamics in medical education that may foster or inhibit student attitudes toward patient-centred care.

Attitude to Health↗
PubMed2000

Rural mental health: neither romanticism nor despair.

This paper explores the relationship between rural places and mental health. It begins with a definition of mental health and an outline of the data that have led to the current concern with promoting positive mental health. We then consider aspects of rural life and place that contribute to positive mental health or increase the likelihood of mental health problems. Issues identified include environment, place, gender identity, violence and dispossession and the influence of the effects of structural changes in rural communities. The paper concludes with a discussion of some of the determinants of resilience in rural places, including social connectedness, valuing diversity and economic participation.

Australia↗
PubMed2001

Treatment for childhood acute lymphoblastic leukaemia: the fathers' perspective.

Research on parental adaptation to a child's chronic illness is still scant, and this is particularly so in relation to the experience of treatment for paediatric Acute Lymphoblastic Leukaemia (ALL). The work that does exist on parental reactions tends to conflate maternal responses with paternal responses, as fathers are usually seen as having a secondary role. Consequently, little is known about how fathers cope with treatment for childhood ALL. The present discussion seeks to make a contribution to this area by presenting findings on the paternal experience of treatment for paediatric ALL from a longitudinal study conducted at Royal Children's Hospital in Brisbane, Queensland. The findings from this research clearly indicate the emotional pain that fathers face in their struggle to accept the diagnosis of a serious, life-threatening illness such as ALL in their child. The findings challenge the notion of the make stereotype by showing that the shock of diagnosis, the emotional pain of coping with the illness, the expression of pain through tears, the desire to be with the child, the struggle to cope with the medical interventions, and concerns about other family members are not gender specific, but are rather issues common to both parents.

Adaptation, Psychological↗
PubMed1999

Gender differences in knowledge, attitude, behavior and perceived oral health among adolescents.

A cross-sectional dental questionnaire census survey was conducted in classrooms of 17,280 students aged 13-18 years in Skaraborg County, Sweden. The overall response rate, based on school attendance on the test day, was 91% with no gender differences at the senior level, and 86% (boys 87%, girls 85%) at the upper secondary level. The aim was to examine gender differences in knowledge, attitude, behavior and perceived oral health. A retest study showed good agreement. Thirty-one percent of the girls and 21% of the boys flossed regularly. Eleven percent reported daily candy consumption, with no significant gender difference. Girls, however, more often than boys considered their own consumption to be too high. This gender difference in attitude was most pronounced among older daily consumers (odds ratio (OR) = 5.8 [3.7-9.2]). Oral health was regarded as important by a majority of the students (95%). Girls considered sound teeth to be more important than did boys, both among the younger (OR = 1.7 [1.4-2.1]) and the older (OR = 2.4 [1.9-3.1]) adolescents. It is concluded that most adolescents had a positive dental attitude and perceived their own oral health to be good. Poorer knowledge and behaviors concerning oral health were demonstrated. Gender differences existed in most issues. Girls scored more favorably on behavioral measures, showed more interest in oral health, and perceived their own oral health to be good to a higher degree than did boys.

Adolescent↗
PubMed1994

Gender bias in the abstractness of verbs and adjectives.

Participants of both sexes were asked to write responses to sentences about members of both sexes exhibiting socially desirable or undesirable behaviors. Using Semin and Fiedler's (1988) coding scheme, I analyzed the sentences for the abstractness of the verbs and adjectives. As predicted, when the participants wrote about socially desirable behaviors performed by someone of their own gender, they used more abstract words than when they wrote about undesirable behaviors. The opposite effect was not found when the participants wrote about the other gender; possibly there was no true out-group in this study. The bias occurred even though gender was not a salient issue at the time; therefore, a more subtle bias than has been shown previously may exist.

Adult↗
PubMed2002

Improving medical students' comfort with, and skill in handling, gender-related inquiries during the residency selection process.

OBJECTIVE: Previous work has identified that medical students experience instances of gender discrimination and sexual harassment during the residency selection process (i.e., "audition" elective rotations, residency interviews, and career counseling).(1,2) Examples of such instances include male students who report being counseled away from obstetrics-gynecology and a female student who reported being asked about her sexual orientation because of an expressed interest in breast disease. Students also report confusion about what constitutes an appropriate question or inappropriate gender-related comments. A common example is questioning about plans for child care during residency. We developed an education intervention focused on gender- and family-related issues that may arise during the residency selection process in an attempt to improve our students' ability to (1) recognize appropriate and inappropriate questions and situations and (2) handle such situations in a professional manner. DESCRIPTION: Our educational intervention is a voluntary, intense, active learning situation composed of four parts. First, data outlining the problem-including personal stories of students-are presented. Second, a faculty member with dual experience as a residency training director and dean for student affairs presents examples of appropriate and inappropriate questions (both types of questions can be uncomfortable if not contemplated in advance), potential ways to approach these questions, and a thoughtful approach for the student to take when integrating his or her experiences during the residency selection process with ultimate decisions about career and ranked programs. During the third part of the workshop, students draw two cases of 15 potential situations from a hat. They work in pairs, first to identify whether the case outlines an appropriate or inappropriate situation and second to develop and practice their responses. The session concludes with open discussion about the various scenarios and responses. DISCUSSION: This workshop has been well received by our medical students. In post-workshop surveys, students universally reported that the session was useful. Ninety percent of attendees felt better able to recognize appropriate and inappropriate questions and situations during the residency selection process. Seventy-seven percent of students reported that they felt better able to handle inappropriate situations during the residency selection process in a professional manner. Student comments reflected great satisfaction with the interactive nature of the exercise, interest in expanding the amount of time dedicated to the workshop, and a desire for clear rules about what can/cannot be said. Faculty offering the workshop reported satisfaction doing the workshop and noted that the greatest challenge in presenting the material is balancing the discussion about reasonable responses to inappropriate behaviors with the students' interest in performing well on all interviews in order to maximize their options. Interest in the program has resulted in the authors' being invited to share the workshop at an upcoming GME retreat for the institution's program directors. Based on these results we plan to continue the workshop in an expanded version. In addition, we plan to use this format of the workshop as a springboard for similar sessions for medical students interested in confronting issues of discrimination and harassment in the educational setting.

Female↗
PubMed1996

Pharmacotherapy of attention-deficit hyperactivity disorder across the life cycle.

OBJECTIVE: To evaluate the scope of the available therapeutic armamentarium in attention-deficit hyperactivity disorder (ADHD). METHOD: The literature of medication trials in ADHD was systematically reviewed, with attention to issues of psychiatric comorbidity, age, gender, and ethnic background. RESULTS: One hundred fifty-five controlled studies of 5,768 children, adolescents, and adults have documented the efficacy of stimulants in an estimated 70% of subjects. The literature clearly documents that stimulants not only improve abnormal behaviors of ADHD, but also self-esteem, cognition, and social and family function. However, response varied in different age groups and with certain comorbid conditions. In addition, there is an impressive body of literature documenting the efficacy of tricyclic antidepressants on ADHD in more than 1,000 subjects. Studies of alternative antidepressants, antipsychotics, antihypertensives, and other compounds were also reviewed. CONCLUSIONS: The available literature indicates the important role of psychopharmacological agents in the reduction of the core symptoms of ADHD and associated impairments. More research is needed on alternative pharmacological treatments and to further evaluate established therapeutics beyond school-age Caucasian boys. In addition, more research is needed on the efficacy of treatment for comorbid ADHD, use of combined medications, and the combination of medication and psychosocial treatment.

Adolescent↗
PubMed1995

Risk profile screening.

The recovery period following hospitalization for a CHD event is an ideal time to assess a patient for risk factors and to offer intervention. Frequently, the nurse is the single source of such care and has opportunity to educate the patient and offer suggestions for life-style modifications that can reduce the recurrence of CHD events. This article describes modifiable risk factors and methods of assessment, cites sources for management and general health screening method, that can provide a comprehensive assessment of health risks. Gender or ethnic-specific issues, have been highlighted. A very brief mention of age-specific risk factors is included.

Coronary Disease↗
PubMed2005

Narrative ARTifice and women's agency.

The choice to pursue fertility treatments is a complex one. In this paper I explore the issues of choice, agency, and gender as they relate to assisted reproductive technologies (ARTs). I argue that narrative approaches to bioethics such as those by Arthur Frank and Hilde Lindemann Nelson clarify judgments about autonomy and fertility medicine. More specifically, I propose two broad narrative categories that help capture the experience of encounters with fertility medicine: narratives of hope and narratives of resistance. This narrative typology captures the inevitable conflict that women feel when they become subjects of fertility medicine. On the one hand, they must remain hopeful; on the other, they must not surrender themselves completely. Nelson's account of counterstories as narratives of resistance helps us see how women can reconcile the experience of a strong desire to have children with the desire to remain authentic and whole.

Coercion↗
PubMed2004

Diversity and professional excellence.

There are compelling moral and practical reasons why the memberships in professions should mirror the populations that they serve. In order to address this general issue more exactly, this essay will confine itself to a particular case as an emblem for the general point. The particular case is the profession of orthopedic surgeons in the United States. From an examination of this specific case, it is hoped that more general issues of racial, ethnic, and gender fairness within the professions will also be addressed.

Achievement↗
PubMedDate not supplied

An analysis of posthospitalization telephone survey data.

As part of a study of patient-centered care outcomes that requires the ability to be interviewed by telephone after hospitalization, 4,600 adult patients on 118 medical-surgical units in 17 midwestern hospitals selected by stratified random sampling were identified as potential subjects. This article describes response-rate differences and reasons for nonparticipation by gender, age, ethnicity, and race. Issues related to understanding and reporting response rates, reducing losses due to ineligibility, dealing with refusals, and tailoring survey approaches to special populations are discussed.

Adult↗
PubMedDate not supplied

Electromyographic responses of lower leg muscles to upward toe tilts as a function of age.

EMGs were recorded from the gastrocnemius and anterior tibialis muscles of 77 adult subjects in response to perturbation of stance by upward toe tilts. Subjects aged 22-88 y were initially grouped in seven decades (20s-80s). Each presented a history free of ear disease, eye disease not correctable by lenses, neurological disease, and persistent difficulty with balance or dizziness. All demonstrated functionally normal balance for their age on routine dynamic posturography. EMG recordings yielded onset and offset latencies, durations, and integrated amplitudes of the short and medium latency responses of the gastrocnemius and the long latency responses of the anterior tibialis. Analysis of the data revealed statistically significant left-right differences in amplitude of response and statistically significant height, gender, and age effects. Procedural issues were discussed; data were summarized for normative purposes; and suggestions were made for dealing with statistically significant differences in a clinical environment.

Adult↗
PubMed1997

Associations between ADHD and psychoactive substance use disorders. Findings from a longitudinal study of high-risk siblings of ADHD children.

This article investigates the relationship between attention-deficit/hyperactivity disorder (ADHD) and psychoactive substance use disorders (PSUD) in siblings of ADHD and normal-control probands and addresses issues of psychiatric comorbidity and gender. Using DSM-III-R structured diagnostic interviews and blind raters, the authors conducted a 4-year follow-up of siblings. ADHD and male gender predicted higher rates and an earlier onset of PSUD after adjusting for high-risk status, other psychiatric disorders, and age. Risk was particularly high if the siblings had ADHD plus conduct disorder. This study's findings confirms the authors' prior report high-lighting the importance of drug and alcohol prevention and cessation programs aimed at ADHD youth and their siblings, particularly those with comorbid conduct disorder.

Adolescent↗
PubMed1998

The perceptions of first-year medical students on animal and human experiments in physiology.

This study was conducted to ascertain the attitudes of first year medical students to human and animal experimentation, while undergoing a course in Muscle and Nerve experimental Physiology. At the time of administration of the questionnaire, students had been exposed to both human as well as animal experiments. Approximately 81% of the students preferred human experiments (P < 0.05). This preference, however, was related more to the issue of enjoyability rather than the extent to which the experiment contributed to overall understanding and learning. 55% of students identified ethical issues related to laboratory experimentation. Gender and academic performance were not determinants of student's attitude to animal and human experimentation, although ethical insight was. The results suggest that while students recognize the importance and value of animal experiments, they would prefer the introduction of a larger number of human experiments.

Adult↗
PubMed1998

Family practice residency programs and the graduation of rural family physicians.

BACKGROUND AND OBJECTIVES: Family practice residency programs graduate about 600 rural physicians each year. Increases in resident positions have not increased the numbers who choose rural practice. This study examines the relationship between program characteristics and the graduation rate of rural physicians. METHODS: From 1994-1996, we sent an annual survey to the directors of all nonmilitary family practice residency programs; 353 programs (96% response rate) returned questionnaires. Weighted least-squares regression was used to analyze the relationship between program factors and the percentage of graduates who chose practices in 1992, 1993, and 1994 in towns of less than 25,000 not adjacent to a larger metropolitan area. RESULTS: Family practice residency programs that graduated more rural physicians had more required rural and obstetrical training months, had a full or partial rural mission, were located in more rural states, had the program director as the rural contact, had a procedural emphasis, had fewer residents who were minorities or female, and used fewer types of other major graduate programs for rotations. CONCLUSIONS: This study outlines the important contribution of rural emphasis and training in family practice residency programs. Future studies should explore rural, procedural, and obstetrical training interventions and examine gender, minority, and program location issues.

Career Choice↗
PubMed2004

Parent-adolescent conflict in early adolescence.

This study explored parent-adolescent conflict during the early years of adolescence (ages 11 to 14). The responses of 357 youths in Grades 6, 7, and 8 to the Issues Checklist (Prinz, Foster, Kent, & O'Leary, 1979) revealed frequent conflicts with parents over a sizable number of issues during this period, peaking in Grade 7 between parents and sons, with exchanges between parents and daughters consistently more than those with sons across the three grades. There was considerable variation in both the frequency and intensity of conflict across specific issues. In addition, a consistent pattern of gender-typing was observed in conflicts between parents and daughters, reflecting traditional gender role stereotypes. The results of this study point to the importance of examining both the frequency and intensity of conflict, the specific issues over which there is conflict, and the gender of the participants in order to more fully understand the nature of parent-adolescent conflict during early adolescence.

Adolescent↗
PubMed2005

Why can't a man be more like a woman? Sex, power, and politics.

Conflicts between male and female reproductive agendas continue to play out in contemporary issues of sex, power, and politics. Viewing gender through the lens of biologic evolutionary psychology reveals persistent controversies surrounding women's rights. The history of oral contraceptives compared with that of erectile dysfunction drugs is just one example of the disparity between female and male reproductive choices. Contraceptives, maternal mortality, abortion, and domestic violence are issues directly influenced by politics, religion, and gender biases. Ultimately, everything that can we can do to give women control over their bodies and their fertility is not only just and humane, but it also changes the world for the better. The United States must restore its leadership in international family planning--ensuring reproductive freedoms could be the genesis of other freedoms.

Developing Countries↗