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PubMed2004

Prevention of postnatal distress or depression: an evaluation of an intervention at preparation for parenthood classes.

OBJECTIVES: To determine the effectiveness of a psychosocial intervention, provided to expectant couples in routine antenatal classes, on the postpartum psychosocial adjustment of women and men. DESIGN: A 3*3 between subjects randomised control design was utilised. The two factors were condition and self-esteem. Preparation for Parenthood programs were randomly allocated to one of three conditions: usual service ('control'), experimental ('empathy'), or non-specific control ('baby-play'). The latter condition controlled for the non-specific effects of the intervention, these being: the provision of an extra class; asking couples to consider the early postpartum weeks; and receiving booster information after the antenatal class, and again shortly after the birth. Women and men were categorised into three levels of self-esteem, as measured antenatally: low, medium and high. METHODS: 268 participants were recruited antenatally. Interview data and self-report information was collected from 202 of these women at 6 weeks postpartum, and 180 women at 6 months postpartum. The intervention consisted of a session focusing on psychosocial issues related to becoming first-time parents. Participants discussed possible postpartum concerns in separate gender groups for part of the session, and then discussed these issues with their partners. Hypothetical scenarios depicting stressful situations in the early postpartum weeks for women and men were discussed, with solutions that parents have found useful given to the participants. In the non-specific control condition, the session focused on the importance of play with a baby, with videotapes and discussion around how parents can play with infants. RESULTS: At 6 weeks postpartum there was a significant interaction effect between condition and self-esteem on maternal adjustment. Women with low self-esteem, who had received the intervention, were significantly better adjusted on measures of mood and sense of competence than low-self-esteem women in either of the two control conditions. There were no main or interaction effects by 6 months postpartum. The beneficial effect at 6 weeks was related to partners of these women being more aware of how the mother was feeling, and with women reporting greater satisfaction with the sharing of home and baby tasks. There were no significant main or interaction effects for men at either time point, other than men with low self-esteem reporting poorer adjustment. CONCLUSIONS: This brief and inexpensive intervention was effective in reducing postpartum distress in some first-time mothers at 6 weeks postpartum. The effectiveness of this intervention was related to an increased level of awareness in the men as to how their partners were experiencing the early postpartum weeks. That the effect was only evident for women who, antenatally, reported being low in self-esteem, is an important advance in our knowledge of the effectiveness of such prevention programs. No previous studies have investigated the differential effectiveness of such programs depending upon the woman's level of self-esteem, and this finding indicates that future work should measure this variable. These findings should be understood in the context that the population sampled were those attending preparation for parenthood classes, and thus different interventions will be needed for couples who do not attend such classes. This brief psychosocial intervention can be readily applied to antenatal classes routinely conducted in hospitals or the community.

Adult↗
PubMed1999

Reference distributions for the negative acute-phase proteins, albumin, transferrin, and transthyretin: a comparison of a large cohort to the world's literature.

Clinical interpretation of the acute-phase proteins--albumin, transferrin, and transthyretin--has been hampered by the lack of accurate and precise methods for quantifying the levels and a stable and respected reference material. Now that these issues have been addressed, the community is faced with the need for credible age- and gender-specific reference values. The number of publications that address this issue, even for an analyte as familiar as albumin, is small and, in most cases, such publications lack the relevant data that would allow a combined experience to be created. We have identified 40 studies that meet our criteria: a description of the study participants' health status, of the statistical methodology, and of the laboratory technique and/or reference material used. Few of these studies reported values stratified by gender. A summary of the published median levels by age is presented for the three analytes, along with our own age- and gender-specific medians based on a large cohort. Ten of the studies presented a 95 percent reference range, in close agreement with ours where selection was based upon reported diagnosis rather than upon determination of individual health status. This meta-analysis provides support for the reliability of our recently published methodology and reference data for the clinical interpretation of individual albumin, transferrin, and transthyretin values. As with most laboratory measurements, clinical interpretation requires that other laboratory and clinical factors be considered.

Acute-Phase Proteins↗
PubMed1990

The development of intimate relationships in late adolescence.

Adolescence is a time of burgeoning social relationships. Further, adolescents begin to develop the capacity to be intimate. Yet, little attention has been paid to the development of intimacy in adolescence. In this paper, relationship maturity, a developmental conception of intimacy, is presented as a unifying conceptual framework for understanding these intimate involvements as part of a major developmental process. Relevant empirical literature is reviewed. Issues addressed include: specific contexts of intimacy in adolescence, the role of gender in intimacy development, the interplay of identity and intimacy development, and the effects of social issues on this process.

Adolescent↗
PubMed1999

Does Math-Fact Retrieval Explain Sex Differences in Mathematical Test Performance? A Commentary.

We focus on four issues in commenting on Royer et al.'s work testing their hypothesis that sex differences in test performance can be explained by differences in math-fact retrieval latency. The first issue is whether the studies conducted by Royer et al. directly test their hypothesis; we argue that they do not. The second issue involves questions about the strength of the gender differences in math-fact retrieval. The third is whether math-fact retrieval should be considered the major mechanism in explaining the differences in test performance. In considering this third issue we discuss other theories regarding the nature of math problem solving that are useful for understanding test performance differences between males and females. The fourth issue is what particular experiential differences boys and girls have in math classrooms could contribute to the sex differences in test performance. We also consider sex differences in math attitudes and motivation. Copyright 1999 Academic Press.

Journal Article↗
PubMed1992

Research on first-episode psychosis: report on a National Institute of Mental Health Workshop.

The need to focus increased research on patients experiencing their first episode of psychosis was emphasized in A National Plan for Schizophrenia Research. To develop strategies for enhancing research in this area, a National Institute of Mental Health Workshop on First-Episode Psychosis was held in 1991. The topics discussed at that workshop are summarized, with key issues including the following: (1) the need for better operational definitions of onset, end of an episode, and relapse of psychosis; (2) careful consideration of inclusion and exclusion criteria related to age, gender, prior treatment, comorbid substance abuse, and similar issues; (3) the challenge of finding patients never exposed to neuroleptics and the value of entering first-episode patients into standardized treatment protocols; (4) the design of followup studies; (5) strategies to increase the pool of applicants; and (6) approaches for increasing power through data sharing and collaboration between groups.

Age Factors↗
PubMed2004

Post-migration changes in gender relations among Ethiopian couples living in Canada.

The Ethiopian community ofToronto, Canada, has identified the prevention of marital conflict and partner abuse as a priority issue. Previous research and community discussions suggested that changes in gender relations following migration contribute to both marital conflict and partner abuse. The objective of this community-based pilot study was to explore post-migration changes in gender relations among Ethiopian couples in order to inform the development of violence-prevention strategies. Qualitative research methods and analyses were used. In-depth interviews and focus-group discussions were conducted with 8 couples who had been married in Ethiopia and migrated to Toronto. The findings indicate changes in gender relations following migration as well as concordant and discordant patterns of change. Change was found to be associated with factors such as age, number of years married, experience in a third country, and gender-role socialization. Implications for future research and nursing practice are discussed.

Canada↗
PubMed2005

Fetal gender determination and the male:female population ratio in Bangladesh.

Gender determination of the fetus can be an important issue to parents, especially in Bangladesh and other South Asian countries. This study was conducted to determine how often we can detect the gender of the fetus and whether the gender ratio of the fetus correlated with the gender ratio of the population as determined by the census. Fetal gender ratio of male and female was found to be 1.04:1; the population gender ratio of the same period was 1.038:1. This study was conducted from March 1999 to December 2001.

Bangladesh↗
PubMed1991

Interim report of the DSM-IV Subcommittee on Gender Identity Disorders.

This article summarizes the discussions and recommendations of the DSM-IV Subcommittee on Gender Identity Disorders, a subcommittee of the Child Psychiatry Work Group, regarding diagnostic issues. The issues reviewed include placement in the nomenclature, the concept of a spectrum of gender dysphoria rather than discrete levels of symptomatology, criticisms of current diagnostic criteria, subtyping by sexual orientation, and proposed changes in diagnostic criteria for the current DSM-III-R diagnoses of Gender Identity Disorder of Childhood, Transsexualism, and Gender Identity Disorder of Adolescence or Adulthood, Nontranssexual Type.

Adolescent↗
PubMed1992

1992 Omnibus Survey. Portrait of the professions.

The portrait of our professions has changed in recent years, and the changes are quite positive. For example, the number of speech-language pathologists and audiologists who reported that they are unemployed and seeking employment has decreased while salaries reportedly continue to increase. These findings are especially encouraging given the current economic times. They represent a continuing demand for the valuable contributions that speech-language pathologists and audiologists can make in today's society. Caseload characteristics illustrate a different picture compared with data from previous years. Audiologists and speech-language pathologists both reported an increase in service provision to the birth-5 population. In addition, the severity of caseloads for speech-language pathologists has substantially decreased from that of previous years. The issues of support personnel, the AuD degree, and gender discrimination evoked expression of strong opinion. Based on the responses to these questions and the comments that accompanied them, it is apparent that there are many questions that need to be addressed before these issues reach consensus. We must continue to work together until we create a balanced picture. All in all, the portrait of the ASHA membership is both colorful and attractive--definitely suitable for framing. We should be proud of the progress that we have made over the years and of the image that we are creating for our professions. As we continue to take brush in hand, remember that each one of us can make a difference in the direction of our future. So splash on the colors and keep it bright!

American Speech-Language-Hearing Association↗
PubMed2003

Prices, policies and youth smoking, May 2001.

Youth smoking continues to be an important public health problem. Many policy tools designed to reduce youth smoking are based on economic principles. This paper describes the economic and policy context of tobacco use aiming at reducing youth smoking and explains the economic rationale for tobacco control tools such as excise tax and price, clean indoor air laws, youth access laws and the broad provision of health information to the public. An overview of economic models of addiction provides the framework for empirical analysis of the impact of these policies. This is followed by a summary of the empirical evidence of the effectiveness of various tobacco control tools that are primarily economic in nature. The most consistent finding in this literature is that higher cigarette prices discourage youth smoking. Compared to the effects of cigarette taxation and price on youth smoking, the evidence on the effectiveness of the youth access laws and clean indoor air laws are still mixed and inconclusive. More research is needed to address issues such as: (1) the effects of gender, age, race and socio-economic status on the relationship between tobacco control policies and youth smoking; (2) better measurement of the outcome variables to account for the multi-dimensional nature of dependence; and (3) the effects of excise taxes and other tobacco control policies with regard to a host of dimensions of smoking such as initiation, cessation, and more generally the trajectories of tobacco use that would include patterns of progression, maintenance, regression, cessation, and relapse. More frequently collected longitudinal data than those currently available are needed to address the above issues. Understanding smoking behavior cannot be achieved without incorporating familial and other social contexts.

Adolescent↗
PubMed1995

Rural homes and urban dwellings? Gender, migration and the importance of tenure in Gaborone, Botswana.

"The issue of return migration has been widely debated in African migration literature in view of strong rural-urban ties and urban growth based largely on in-migration. On the basis of fieldwork in Botswana, it is argued that there are important gender differences in terms of the commitment to rural and urban areas. It has been postulated in past studies that the decision to remain in towns depends in part upon urban tenure and it is argued that home owners are more likely than tenants to be permanent urban dwellers. Again, there are important gender differences and women appear to be more committed to the urban dwelling than men."

Africa↗
PubMed2003

Some considerations on sexuality and gender in the context of AIDS.

Gender has become a major conceptual tool for understanding the evolving HIV pandemic globally. As such, it has provided a powerful way to see the structure of relations between men and women as central to various epidemics, and added weight to our understanding of HIV infection as not simply an individual experience of disease. Yet, as a concept, gender has its blind spots. This paper argues that there are four issues central to our understanding of how the HIV pandemic moves and develops that are not necessarily best understood through an analysis that uses gender alone, namely: women's vulnerability, men's culpability, young people's sexual interests and marginalized sexual cultures. The paper proposes using sexuality as a framework for analysing these issues and seeks to utilise developments in critical sexuality research to add to gender as a way to increase the capacity to respond to the HIV/AIDS crisis.

Attitude to Health↗
PubMed2004

[Gender differences in premature mortality and avoidable deaths].

OBJECTIVE: This paper aims to describe and to analyse disparities between men and women for "premature" mortality rates (deaths before 65 year-old). The study is particularly focused on "avoidable" causes of death. These types of deaths are greatly related to risk behaviours such as alcohol abuse, tobacco abuse or dangerous driving. Taking account of these indicators ("premature" and "avoidable" mortality) enables to study health status discrepancies by gender and to characterize specific public health issues in France including high rates of "premature" mortality and risk behaviours. METHODS: The analysis is based on exhaustive mortality data from 1980 to 1999 supplied by the Centre for epidemiology of medical causes of death (CepiDc-INSERM). Specific causes of death closely related to risk behaviours are classified as "avoidable": lung and upper airways cancers, cirrhosis, alcoholic psychosis, traffic accidents, aids and suicide. The contribution of these categories in the global male overmortality was assessed according to different demographic and geographic characteristics. RESULTS: Within "premature" mortality, males experience greater burden of "avoidable" mortality (sex-ratio: 4 versus 2). The gender differences are mainly due to injuries and suicides in the younger age groups and to tobacco and alcohol-related cancers (lung and upper airways) in the 45-64 years age group. The recent decline in "premature" mortality sex-ratio is explained by an increase of these two cancers for females. Among european countries, the French male overmortality is especially marked and mainly attributable to "avoidable" causes of death. CONCLUSION: "Avoidable" and "premature" mortality provide useful tools for the follow-up of health status in France particularly because of high risk behaviours and prevention inadequacy. Reducing gender discrepancies will depend mainly on public health policies in terms of primary prevention.

Adolescent↗
PubMed2002

Primary prevention research on incontinence in older adults.

Primary prevention research on urinary incontinence in older adults is in its nascent phase. Most clinical research has focused on secondary or tertiary prevention, that is, testing interventions to cure, improve, or manage incontinence. When urinary incontinence is recognized as a public health issue, resources become available to reduce the risk of incontinence and prevent its occurrence. Methodological issues that face nurse researchers desiring to conduct primary prevention research include inadequate theory and outcome development, need for gender and culturally sensitive measurement instruments, and sampling and design issues. Rather than viewing primary prevention as a futile endeavor, nurse researchers must combine the roles of researcher and advocate, articulating the vision for primary prevention, and developing sound clinical studies to prevent urinary incontinence in the older adult population.

Aged↗
PubMed1996

Breaking through the glass ceiling: an industrial perspective.

Many companies have recognized that the workforce of the future will be significantly more diverse than in the past. A substantial number of these new employees will be women. Industry must create an environment that attracts the best, brightest, and most talented women and provide an environment that empowers them to reach their full potential. Barriers to advancement, such as the real or perceived "glass ceiling," inhibit the individual and ultimately negatively affect the company. Successful companies will recognize that gender diversity is a critical business strategy and implement aggressive programs to assist women in breaking through the glass ceiling. Gender diversity initiatives should include examination of quality of life issues, training and development, organizational policies and practices, and management accountability. Mentoring programs clearly play an important role in gender diversity programs. Personal mentoring experiences in academic and corporate environments, as well as a pilot mentoring program at Land O'Lakes, will be discussed.

Animal Husbandry↗
PubMed2001

Timing of initial exposure to maternal major depression and children's mental health symptoms in kindergarten.

BACKGROUND: Little is known about the influence on child mental health symptoms of the timing of initial exposure to maternal major depression or whether the timing is associated with 'pure' or co-occurring internalising and externalising symptoms. AIMS: To address these issues, while also taking account of child gender and family socio-economic status. METHOD: In a prospective community-based study, 421 kindergarten teachers rated children's symptoms. Previous assessments of maternal major depression indicated whether children were first exposed during infancy, in the toddler/pre-school period, or never. RESULTS: Exposure during infancy was associated with high internalising symptoms, especially when co-occurring with high externalising symptoms. Initial exposure in the toddler/pre-school years increased the risk of 'pure' externalising symptoms among girls. CONCLUSIONS: The association of child mental health symptoms with the timing of initial exposure to maternal depression highlights the need for effective prevention and intervention strategies addressed to the developmental issues of each period.

Adolescent↗
PubMedDate not supplied

Gender differences and conduct disorder among American Indian adolescents in substance abuse treatment.

Studies have found high prevalences of conduct disorder among youth in residential substance abuse treatment programs, but no studies have examined this issue among American Indian adolescents while taking into account gender differences. The Diagnostic Interview Schedule for Children, Youth Version and the Composite International Diagnostic Interview, Substance Abuse Module were used to determine the diagnostic status of 89 American Indian adolescents aged between 13 and 18 years who were admitted to a residential treatment program. Seventy-four percent of the adolescents met full DSM-IV criteria for conduct disorder. More than 85% of the participants met at least one criterion for conduct disorder. Conduct disorder was common among both boys and girls in this sample of American Indian adolescents, but the specific antisocial behaviors displayed and their relationships to other psychiatric disorders varied by gender.

Adolescent↗
PubMed1997

The lesbian and gay liberation movement in the Presbyterian Church (U.S.A.), 1974-1996.

Since its founding in 1974, Presbyterians for Lesbian & Gay Concerns (PLGC) has led the movement toward full participation and membership for lesbian and gay people in the Presbyterian Church (U.S.A.). This is a story of that movement, told by a participant. It traces the development of current antigay policies in the church in 1976-78 in response to the first openly gay candidate for the ministry, PLGC's efforts to overturn these policies at annual General Assemblies, the growth of the pro-gay More Light Churches movement among Presbyterian congregations, the increasing number of antigay ecclesiastical court cases, study and dialogue on lesbian and gay issues across the denomination, and controversies over same-gender marriage, all culminating in the 1996 General Assembly, which endorsed civil rights for lesbian and gay couples, but also voted to send the controversial issue of lesbian and gay ordination to the 171 regional presbyteries of the church for an up or down vote. The battle for lesbian and gay equity in the church may well continue decades longer. Equity for gays and lesbians in society will not be fully won until the religious establishment learns how to apply its most basic principles of love, nurture, inclusive welcome, and support to lesbian and gay people.

Christianity↗