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PubMed2001

Health Workers for Change as a health systems management and development tool.

In this paper we draw overall conclusions concerning the Health Workers for Change (HWFC) methodology as a management and health systems development tool. We examine how HWFC has contributed to an elucidation of the four main themes with which this special Issue is concerned, namely: the value of participatory training; the need for gender sensitivity in health services; the impact of the HWFC intervention on gender sensitivity and quality of care in health services; and the ability to replicate the HWFC intervention in a variety of cultural and geographical sites. The paper concludes that HWFC is a useful health systems development tool, discusses other applications of HWFC beyond those reported in this Issue and makes several recommendations concerning its future use.

Adolescent↗
PubMed2004

Women are silver, women are diamonds: conflicting images of women in the Cambodian print media.

This paper examines 116 articles related to sexual and reproductive health translated into English from the Khmer press from April 1997 to February 2004. These excerpts were found in The Mirror, a publication of the non-governmental organisation Open Forum of Cambodia, which collates and reviews all issues of the Khmer press on a weekly basis. Five major themes were identified: the politics of women's health, government regulation and control, the sex industry in Cambodia, rape, and the HIV epidemic. Discourse analysis of these articles in the context of other sources and experience allows a gendered exploration of the reporting of sexual and reproductive health and rights issues in Cambodia by the Khmer print media. The reports explore the contested political empowerment of women in this strongly hierarchical society, and the mechanisms used to regulate and control sexual activity The expanding sex industry and associated sexual trafficking are reported, together with the corruption of legal structures designed to regulate health systems and protect women and children from sexual exploitation and rape. The growing problem of AIDS and successes in reducing HIV transmission through the collaboration of sex workers in the 100% condom use policy is documented, and the tensions implicit in a cultural representation of women that both protects and constrains women are explored.

Cambodia↗
PubMed2003

Extending preimplantation genetic diagnosis: the ethical debate. Ethical issues in new uses of preimplantation genetic diagnosis.

The use of preimplantation genetic diagnosis (PGD) to screen embryos for aneuploidy and genetic disease is growing. New uses of PGD have been reported in the past year for screening embryos for susceptibility to cancer, for late-onset diseases, for HLA-matching for existing children, and for gender. These extensions have raised questions about their ethical acceptability and the adequacy of regulatory structures to review new uses. This article describes current and likely future uses of PGD, and then analyses the ethical issues posed by new uses of PGD to screen embryos for susceptibility and late-onset conditions, for HLA-matching for tissue donation to an existing child, and for gender selection. It also addresses ethical issues that would arise in more speculative scenarios of selecting embryos for hearing ability or sexual orientation. The article concludes that except for sex selection of the first child, most current extensions of PGD are ethically acceptable, and provides a framework for evaluating future extensions for nonmedical purposes that are still speculative.

Genetic Predisposition to Disease↗
PubMed2006

Origin and goals of the "Gender Symmetry" Workshop.

This article provides a brief account of the historical background to the Gender Symmetry Workshop and describes its major goals. The Workshop is a successor to an earlier workshop co-sponsored by the Centers for Disease Control and Prevention and the National Institute of Justice in 1998, namely the Workshop on Building Data Systems for Monitoring and Responding to Violence Against Women. Some key issues that were left unresolved in that workshop provided the rationale for holding the Gender Symmetry Workshop. The Workshop was designed to cover three topic areas: (1) a typology of violence, (2) measurement issues, and (3) women's use of violence.

Battered Women↗
PubMed2007

Mental health nurses' experiences of schizophrenia rehabilitation in China and India: a preliminary study.

Nursing methods based on Western models may not be culturally relevant to patients from ethnic minority groups or other countries. In order to meet the needs of all patients, more research is needed to understand the cultural and social factors that influence nursing approaches. This paper reports preliminary open-ended discussions with mental health nurses in China and India in order to gain insights into the cultural and social issues that surround social rehabilitation of patients with schizophrenia. Rehabilitation methods included cognitive behavioural therapy, psychosocial methods, and employment/vocational training. Several cultural and social issues drive the rehabilitation process in both countries, including the use of traditional medicine and healers, emphasis on family involvement, stigma, gender inequality, and lack of resources. Participants in both countries were working hard to tackle some of these issues, but also expressed need for improved resources. The study provides an insight into the cultural and social factors that shape schizophrenia rehabilitation in China and India, and serves as a baseline for further research about nursing across cultures. The study also highlights the marked differences in attitudes, values, and behaviours across cultural groups that need to be considered by nursing professionals to ensure that services are culturally competent.

Attitude of Health Personnel↗
PubMed1988

Recommended changes in pediatric education: the impact on pediatrician involvement in health care delivery to adolescents.

In an attempt to examine the extent of implementation of the recommendations issued by the Task Force on Pediatric Education for increased emphasis on adolescent medicine during residency training, pediatricians' perceptions of their skills and abilities to provide health care to adolescents were evaluated. A sample of 558 pediatricians selected at random and 385 members of the American Academy of Pediatrics' Section on Adolescent Health (SAH) completed a 41-item questionnaire. The physicians' perceived levels of skill in ten areas were analyzed while simultaneously assessing the impact of SAH membership, year of graduation from medical school, gender, and percentage of practice time devoted to adolescents on each issue. SAH members, as expected, ranked their levels of skill significantly higher than did the other pediatricians in all areas surveyed. A significant percentage of the SAH pediatricians, however, indicated that their skills were acquired through postresidency fellowship training. There was an increasing trend among all pediatricians in their perceived levels of skill to deliver health care to adolescents during the past several decades, but there has been no appreciable increase in such perceived skill levels since the task force issued its recommendations. In fact, pediatricians graduating from medical school in the decade prior to 1976 who are not SAH members ranked their skills higher than did non-SAH pediatricians who graduated in the past 10 years. These data lead to the conclusion that the recommendations of the Task Force on Pediatric Education have not been adequately implemented.

Adolescent Medicine↗
PubMedDate not supplied

Gender-specific health care in diabetes mellitus.

This article reviews information on health care issues of specific clinical relevance for women with diabetes mellitus (type 1, type 2, and gestational diabetes mellitus), high-lighting several topics that require careful attention by the physician and the diabetes management team. Type 2 diabetes is more prevalent among women than men, making prevention and early detection particularly important in the treatment of women. Major areas of health care concern for women with diabetes include cardiovascular disease, mental health, infections, and contraception and fertility. Knowledge of lifespan issues from adolescence through menopause is crucial to the management of women with diabetes.

Adolescent↗
PubMed2004

The impact of age, gender, race, and ethnicity on the diagnosis and treatment of depression.

OBJECTIVE: To review issues related to culture and ethnicity that influence diagnosis, treatment, and response for patients who have major depressive disorder (MDD). SUMMARY: People from different ethnic and cultural groups may present with MDD differently. Communication, clarity, and collaboration are key to successful patient-provider relationships. Often, patients. presentation involves somatic complaints, or symptoms that have not traditionally been associated with a diagnosis of depression. People from minority groups may be less trusting, less adherent, and more skeptical than others. Further, chronic medical illnesses may result in MDD, and patients from ethnic minorities often respond to medications differently from whites. Each patient.s culture and ethnicity must be addressed when they present. Clinicians should always ask,.Are there any cultural issues at work here?. CONCLUSION: Cultural competence is a journey, not a destination, and every provider must learn to question carefully, appreciate culture.s role, and help patients work with them to achieve a better mental and physical health status.

Adult↗
PubMed2006

The reproduction of gender: housework and attitudes towards gender equality in the home among Swedish boys and girls.

The housework Swedish girls and boys age 10 to 18 do, and their attitudes towards gender equality in the home are studied. One aim is to see whether the work children do is gendered and if so, whether they follow their parents', often gendered, pattern in housework. A second aim is to see whether children's attitudes are influenced by their parents' attitudes and practices. When it comes to issues like these, Sweden is of special interest because in 1995, Sweden was appointed the most gender equal country in the world by the United Nations. The data used were the Swedish Child Level of Living Survey 2000 (see http://www.sofi.su.se/LNU2000/english.htm), a data set that includes extensive first-hand information from both children and their parents. The results indicate that girls and boys in two-parent families are more prone to engage in gender atypical work the more their parent of the same sex engages in this kind of work. The fact that girls still do more housework than boys in all families independent of, among other things, the parental division of housework and the mother's educational level indicates that housework to some extent signifies gender also to children. However, no clear relation is found between the parents' division of work and the child's attitude towards gender equality in the home. Neither is there any clear relation between the parents' attitude towards gender equality in the home and the children's attitude to the same topic.

Adolescent↗
PubMed2001

Client experience of gender in therapeutic relationships: an interpretive ethnography.

The purpose of this study was to explore clients' experiences of gender in therapeutic relationships in order to inform therapists of critical issues from clients' perspectives. To capture clients' views, the researchers chose an interpretive ethnographic design that used unstructured, collaborative interviews with clients who had worked with both female and male therapists. The interviews were analyzed using procedures developed by Kvale (1996), who emphasizes the importance of including the client's voice in data gathering, analysis, and final presentation. The results were reviewed with the clients to insure accurate presentation of their views. The final results were organized into six themes: client-therapist connection, male therapists, female therapists, topics discussed, effectiveness, and confounding factors. Researchers discuss the implications of gender-stereotyped behavior in therapy, the relationship between therapist gender and therapeutic alliance, and recommendations for practicing gender-sensitive therapy.

Adolescent↗
PubMed2003

The cultural context of gender, identity: female genital, excision and infibulation.

Our goal is to explore the practices of female genital excision and infibulation as they relate to gender identity and the acculturation process in Canada. We examined relevant research on these issues and share the results of a nationwide project conducted in 1997-1999 among 162 Canadian immigrants from regions in Africa where practices of excision and infibulation are still in effect. Our discussion of gender identity is inextricably linked to notions about the ways in which girls, women, and virginity are socially constructed. The complexity of the acculturation process along with the integration within a host society is highlighted and the conflicting identities available to women are brought to the fore.

Acculturation↗
PubMed1998

Gender and physical therapy career success factors.

BACKGROUND AND PURPOSE: Gender and profession are thought to affect how career success is perceived as well as how it is achieved. This study investigated items considered important in defining career success for male and female physical therapists. The study also explored the relationship among gender, beliefs about career success, and career experiences. SUBJECTS AND METHODS: Data were obtained through an investigator-developed survey. The self-report questionnaire consisted of 78 items in 4 areas: descriptive information, items important in characterizing career success, items perceived to enhance or inhibit career success, and items assessing self-esteem. Questionnaires were mailed to a random sample of active physical therapist members of the American Physical Therapy Association (N = 5,000). The response rate was 38.1% (n = 1,906). RESULTS: Both men and women selected indicators such as practicing ethically, improving patient health, and feeling satisfied over high income or status when describing career success. All respondents agreed that clinical competency and motivation are key factors related to achieving career success. Family issues, full-time employment, and flexibility of practice conditions emerged as primary gender differences. CONCLUSION AND DISCUSSION: A unique set of indicators describe physical therapy career success. Gender differences in its description and factors that influence its achievement are related primarily to family issues. Career success for women depends to a greater degree on the ability to manage family responsibilities in conjunction with employment opportunities.

Adult↗
PubMed2000

Attitudes toward homosexuality in Shreveport-Bossier City, Louisiana.

Two anonymous questionnaires assessing attitudes toward gay issues were administered to adults living in the Shreveport/Bossier City, Louisiana area. In both, demographic data were obtained regarding gender, education, religion, age and marital status. In the second questionnaire, family groups were given the questionnaire. In the first survey, the results generally supported previous findings that religiosity, gender, and education at or below the high school level appeared to be associated with negative attitudes toward gay and lesbian issues. The variable most frequently associated with positive attitudes toward gay and lesbian issues was whether or not the individual had at least one gay friend, relative, or acquaintance. In the second study, the questionnaire was analyzed in terms of the entire group of subjects, family groups, and family positions. This second questionnaire indicated that similarities are most likely to exist among mothers and daughters, and same sex siblings. In regard to family members, wives/mothers and daughters had more positive attitudes toward homosexuality than sons, fathers, grandparents, other relatives, and in-laws.

Attitude↗
PubMed1990

The adolescent-to-adult transition: discouragement among jobless black youth.

Although many youth experience difficulty in the school-to-work transition, increasing numbers of black youth face more chronic difficulties that have far-reaching developmental implications. This chapter examines both objective and subjective aspects of chronic joblessness among black youth, with emphasis on gender differences in discouragement over job searches and related developmental issues. A life cycle approach to role strain and adaptation provides a coherent framework to guide theoretical inquiry into jobless black youth in America. Role-strain adaptation processes have special appeal because they provide a coherent conceptual base for studies on the nature, antecedents, and consequences of chronic difficulty in job search. Two basic notions in the proposed role-strain adaptation approach to joblessness among black youth are that discouragement in the job search and self-blame increase the risk of maladaptive responses to objective barriers and that objective and subjective cultural resources facilitate adaptive response patterns. The role-strain adaptation paradigm not only provides a parsimonious framework but also builds on a diverse theoretical and empirical literature (Barnett, Beiner, and Baruch, 1987; Bowman, 1989; Goode, 1960; Kahn and others, 1964; Merton, 1968; Pearlin, 1983; Sarbin and Allen, 1968). Role-strain adaptation models allow one to go beyond past studies on black youth, which have primarily been descriptive rather than theoretical and predictive. In addition to the foregoing benefits, a major virtue of the life cycle approach to job search strain processes is its explanatory power throughout the life span (Allen and Vande Vliert, 1981; Erikson, 1980; George, 1980; Levinson and others, 1978). A life cycle framework avoids common misconceptions that occur with a narrow focus on job search strain among black youth that fails to consider the continuity in chronic role-strain adaptation processes. In a broader life-span framework, the interrelated concepts of human development and cultural adaptation have unique explanatory power. Elsewhere (Bowman, 1989) I have noted that to develop means to grow out of, to evolve from--where experiences at one life stage not only follow but emerge directly from preceding life experiences. The related concept of adaptation involves a continuing process of incorporating past experiences into new patterns to strategically meet the challenge of changing life demands without undue compromise. For black youth faced with chronic joblessness, effective adaptation may require preserving core cultural patterns from prior generations, while also transforming such core patterns into new strategies to cope with job search barriers in postindustrial America.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗