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PubMed2006

Qualities and attributes desired in menopause clinicians.

OBJECTIVE: To assess the qualities and attributes desired in menopause clinicians. DESIGN: Women > or =45 years of age (n=72) were surveyed about the qualities and attributes desired in their physician. Surveys were performed in physician waiting rooms in Connecticut. RESULTS: Although fewer men are entering the practice of ObGyn, more than 88% of peri- and post-menopausal women believe that gender does not affect the quality of their women's health provider. Among the 68 women from whom valid data were obtained, experience (95.6%), knowledge (95.6%), and ability (92.6%) were the most important qualities. Only 4.2% listed gender in the top three most important qualities. If the patient's visit was for wellness- and screening-related issues, 6.6% (n=4) preferred a male, 13.1% (n=8) preferred a female, and 80.3% (n=49) had no preference for gender. The percentage of patients preferring to see a female was slightly higher (29.2%) if the visit was for a pelvic exam, while the percentage preferring to see a male (14.5%) was greater if care involved gynecological surgery. CONCLUSIONS: As medical practices meet the increasing demand of menopausal women, it is helpful to know the qualities and attributes that patients desire. Menopause clinicians should seek to convey experience, knowledge, and competence to their patients. A menopause practice should strive for a well-diversified team that will bring these qualities to menopausal patients. Given the shifting balance of male and female ObGyn providers, when hiring providers or establishing a menopause clinic, it is helpful to know that gender diversification is of minor importance.

Aged↗
PubMedDate not supplied

The experience of head injury on the impairment of gender identity and gender role.

OBJECTIVES: This study explored the disruption of gender identity and gender role as a result a traumatic brain injury (TBI). METHOD: Four adults (two men, two women) who sustained a TBI between the ages of 18 and 30 years and were at least 1 year postinjury participated in six 1-hr interviews concerning changes in (a) perceived masculinity or femininity, (b) involvement in intimate relationships, (c) enactment of gender roles, and (d) organization of activities that support gender roles. RESULTS: The men expressed greater feelings of gender inadequacy postinjury than did the women and appeared to have greater difficulty resolving rites of passage (e.g., achievement of the adult work role, marriage, parenting) and developmental issues characteristic of the life stage at which they experienced their injury. The men appeared to depend more heavily on traditional gender-specific activities before and after injury to define and support gender role; the women relied more on cross-gender activities. The women appeared to be able to maintain more preinjury activities postinjury than did the men. CONCLUSION: Postinjury possession of a personally satisfying sense of gender appears to be related to the ability to maintain much of the preinjury activities that defined and supported the participants' sense of masculinity or femininity. The ability to satisfactorily resolve rites of passage or developmental issues characteristic of the life stage at which the brain injury occurred appears to be related to the ability to participate in activities that define and express gender role during that particular life stage.

Adolescent↗
PubMed2004

Gender difference in brain perfusion 99mTc-ECD SPECT in aged healthy volunteers after correction for partial volume effects.

BACKGROUND: Previous reports have yielded controversial results concerning gender differences in regional cerebral blood flow (rCBF). To elucidate this issue, we compared 99mTc ethyl cysteinate dimer single photon emission computed tomography (SPECT) images for brain perfusion between aged-matched healthy men and women after correction for partial volume effects (PVEs). METHODS: Brain perfusion SPECT in the resting state was performed on 40 healthy, right-handed subjects, 20 men and 20 women, with an age range of 58-86 years, who did not differ sociodemographically. PVE correction was performed using grey matter volume measured by magnetic resonance imaging. Statistical parametric mapping was used for the analysis of the adjusted rCBF images of relative flow distribution. RESULTS: The PVE correction revealed that women had higher rCBF in left inferior frontal gyrus, bilateral middle temporal gyri, and left superior temporal gyrus. Men had higher rCBF in left superior frontal gyrus, right medial frontal gyrus, right superior parietal lobule, right postcentral gyrus, right cerebellum, right middle frontal gyrus, right fusiform gyrus, and right precuneus. CONCLUSION: Significant gender differences in rCBF existed in these healthy volunteers. The PVE correction of SPECT images revealed gender differences that were consistent with the universal findings of better performance on verbal tasks in women and on visuospatial tasks in men.

Aged↗
PubMed1988

Multidisciplinary team evaluation of school dysfunction. An analysis of utilization.

Little is known of the characteristics of children experiencing school dysfunction who are evaluated by multidisciplinary teams. The records of 87 children seen during a calendar year were reviewed and information was gathered regarding their age, sex, and referral source. In addition, the chief concerns of the child's parents and educators, and the diagnostic outcome, were considered. Boys were more likely to have been referred for behavioral problems than for academic issues. Girls were seen at an earlier age. Younger children were more likely to have been referred by physicians. While there was a significant association between gender and reason for referral, we found no such relationship between gender and final diagnostic classification. Variables in the utilization of evaluation services are described. Cognizance of these issues should lead to improved provision of care to all children experiencing school dysfunction.

Adolescent↗
PubMed2004

Determinants of self-reported mental health using the British household panel survey.

BACKGROUND: The study of self-reported mental health is a fairly recent area for economists, although sociologists, psychologists and public health specialists have been studying it for years. One methodological problem with earlier research is that there are many unobserved characteristics of individuals that may be correlated with self-reported mental health. Neglecting these factors may lead to biased estimates of the effects of variables such as income, education, health, etc. Panel data enables us to control for unobserved individual specific effects, whereas a cross-section study or time series study cannot. AIMS OF THE STUDY: This paper examines the determinants of self-reported mental health in UK using data from the first eight waves of the British Household Panel Survey. In particular, we are interested in assessing the effect of education on self-reported mental health which other studies have ignored. METHODS: The measure of self-reported mental health used in this paper is the General Health Questionnaire (GHQ). To account for the possible correlation between the unobserved individual effects and some explanatory variables, a Hausman Taylor's instrumental variables estimator (HT) is employed. In order to derive this estimator, one has to distinguish between variables that are correlated with the individual specific effects (endogenous) and variables which are uncorrelated with the individual specific effects (exogenous). This HT estimator also allows for estimating the parameters corresponding with time invariant variables such as education and ethnicity. RESULTS: The evidence presented here confirms that mental health scores mentioned on the GHQ are significantly related to job status, age, marital status and self-assessed health status. The results also show no evidence that income impacts on self-reported mental health. Ethnicity is also found to deteriorate self-reported mental health yet the effect is not significant. The results of this paper also show that education had no significant impact on self-reported mental health. IMPLICATIONS FOR MENTAL HEALTH POLICY: Issues related to unemployment and social cohesion may be relevant factors in the prevention of mental illness. Policies aimed at improving these factors have an impact on the mental health status of society. In consideration of the evidence of gender differential in mental health, mental health policies should take into account properly this issue. IMPLICATIONS FOR FURTHER RESEARCH: In order to draw definite conclusions, it is important to formally test the presence of attrition bias as well as expand the sample to include more waves. Still, we are concerned about the issue of weak correlation between the instruments and potential endogenous variables. Additionally, we have to bear in mind that inconsistent estimates may potentially occur if the partition of the variables in subsets of endogenous and exogenous is not correctly specified. These issues need further research. The estimation technique also presented in this paper may be applied to a wide range of health services research.

Family↗
PubMed1991

Gender differences in tobacco use.

Gender differences in overall tobacco use clearly exist. In general, men are more likely to use tobacco products than are women. However, this simple generalization, ignoring type of tobacco products, time, and culture, masks many more interesting gender differences in tobacco use. There are pronounced gender differences in tobacco use of specific tobacco products within some cultures but not others. Yet these differences have changed across time, including narrowing and widening of this gender gap, depending on culture and tobacco product. This article addresses these issues and presents possible psychosocial, biological, and psychobiological explanations for these phenomena. In addition, the implications of these differences and ways to learn more about these important differences are discussed.

Adult↗
PubMed2004

Psychosocial issues among gay- and non-gay-identifying HIV-seropositive African American and Latino MSM.

This qualitative study examined sociocultural and behavioral factors including sexual health, sexual identity, and sexual risk among HIV-seropositive African American and Latino men who have sex with men (MSM) who also have a history of sexual abuse. Twenty-three men participated in 4 focus groups, responding to conceptually organized questions regarding the relationship between histories of violence and sexual and drug-related HIV risk behaviors for reinfection and transmission. Consensual qualitative research methods were used to analyze audiotaped transcriptions. Seven domains focusing on consensual and nonconsensual sexual practices, cultural and gender-bound beliefs, and social expectations were identified. Implications of these psychosocial issues for HIV-seropositive gay- and non-gay-identifying African American and Latino MSM with histories of sexual abuse in future interventions are discussed.

Adult↗
PubMed2004

Race/ethnicity and gender disparities in the utilization of a school-based hepatitis B immunization initiative.

OBJECTIVE: To determine if participation and completion rates in a school-based hepatitis B vaccination program differ based on individual demographic factors including insurance status, race, and gender. METHODS: From 1998 through 2001, a school-based adolescent hepatitis B immunization initiative targeted elementary schools with a high percentage of free lunch and "at risk" students and provided free hepatitis B immunization (0,1, and 4 month schedule) during school hours. Demographic data were collected regarding potential enrollees in the project. The rate of return of consent/refusal forms, participation rates, and immunization completion rates were determined. Analyses were completed using the z statistic, frequencies, and stratified Chi-square analyses. RESULTS: Families of female children (p <.0001) and those with insurance or Medicaid were more likely than those with no insurance (p <.0001) to respond by returning a consent or refusal form and were also more likely to participate in the program by receiving at least one immunization dose (p <.0001 for both analyses). Participation rates also varied by race (p <.0001) with black and Hispanic potential enrollees participating more frequently than white and Asian potential enrollees. Females among black (p =.012) and Hispanic (p <.0001) participants and participants of Asian race/ethnicity (p <.0001) were more likely to complete the vaccination series. CONCLUSIONS: Even when access issues are eliminated as a potential barrier to hepatitis B immunization, gender and race disparities exist in the participation in, and completion of, the hepatitis B immunization series given in the schools. Race and gender clearly play separate and distinct roles in health care utilization, unrelated to the traditional variables of socioeconomic status often associated with access to care.

Adolescent↗
PubMed2005

Patient choice cesarean--the Maine experience.

BACKGROUND: Patient choice cesarean refers to elective primary cesarean in the absence of a medical or obstetrical indication. The purpose of this study was to determine obstetricians' attitudes and practices with respect to patient choice cesarean in Maine, United States. METHODS: A questionnaire was sent to all Maine Fellows of the American College of Obstetricians and Gynecologists actively practicing obstetrics, after receiving institutional review exemption. Data were analyzed using descriptive statistics, Fisher exact, or chi-square tests. RESULTS: Seventy-eight of 110 (70.9%) obstetricians responded. Of these, 60 of 71 (84.5%) respondents performed or were willing to perform patient choice cesarean. However, 15 of 71 (21.1%) preferred a cesarean delivery for themselves (women) or partners (men). Indications included urinary continence (53.3%), adverse previous birth experience (41.7%), anal continence (35.0%), concern for fetal death or injury (33.3%), and fear of childbirth, preservation of sexual function, or pelvic organ prolapse (26.7% each). Less frequent were pain (11.7%), convenience (8.3%), and provider availability (10.0%). In addition, 82.1 percent believed medical evidence and 85.9 percent believed ethical issues sometimes or always supported patient choice cesarean. Responses were similar by gender, age, and time interval from training completion with two exceptions. Women under age 35 years were more likely to opt for a cesarean delivery themselves (p = 0.04), and 42.9 percent of respondents under age 35 years interpreted the medical literature as supporting cesarean in all cases versus 4.2 percent of older colleagues (p = 0.008). Sixty-four of 78 (82.1%) respondents would find a randomized trial of planned vaginal versus planned cesarean delivery helpful in addressing the issue of patient choice cesarean. CONCLUSIONS: Although Maine obstetricians were willing to perform patient choice cesarean, few preferred this delivery mode for themselves or their partners. A randomized trial of planned vaginal versus planned cesarean delivery is highly desired.

Adult↗
PubMed1996

Increased risk of familial late-onset Alzheimer's disease in women.

The role of gender in the pathogenesis of Alzheimer's disease (AD) is an important issue that remains controversial. We compared men and women in late-onset familial AD kindreds for the risk of developing AD by studying 26 well-characterized familial AD kindreds from the Oregon Alzheimer Disease Center and, for confirmation, an additional 32 kindreds from the National Cell Repository (NCR) at the Indiana University Alzheimer Disease Center. Comparing women to men, the age-adjusted odds ratio estimates were 3.2 (p = 0.0002) for the Oregon data and 2.3 (p = 0.004) for the NCR data. These results suggest that gender is an independent risk factor for familial late-onset AD and may play a role in the pathogenesis of this disease.

Age of Onset↗
PubMed1995

Patterns of self-disclosure across social support networks: elderly, middle-aged, and young adults.

Self-disclosure has generally been examined as a unidimensional construct which relates to intimacy in developing relationships. Self-disclosure also serves many functions in established relationships, such as with close friends and family. Moreover, the functions served by self-disclosure may vary depending upon the adults' gender and stage in the life-span. In this study, such issues are examined with regard to elderly, middle-aged, and young adults' use of four functions of self-disclosure: self-expression, self-clarification, social control, and social validation. Findings support the claim that greater intergenerational distance is related to less self-disclosure among members of a social network. Further, elderly adults self-disclose more often to family than to friends, while young adults self-disclose to friends more often than to family. Implications for self-disclosure within the areas of gender, social support, and social comparison are discussed, and the appropriateness of adults' disclosure patterns within a framework of life stages is considered.

Adult↗
PubMed2001

Women and traumatic brain injury.

Women with TBI have been inadequately studied in relation to most aspects of pathophysiology, recovery, health and behavioral issues, and community integration. This is not entirely surprising in light of the preponderance of men with TBI but also reflects the traditional tendency of medical researchers to concentrate their efforts on men. Although most of the residual effects of TBI are gender-neutral, women may present some unique problems in relation to pain and endocrine issues, reproduction, and sexual functioning In addition, a woman's roles as wife, mother, and daughter are likely to result in a different constellation of family dynamics when TBI is introduced. Attention to enrollment of women in research studies and the increasing number of multi-institutional studies of TBI may provide enlightenment on these issues in the future.

Behavioral Symptoms↗
PubMed2001

Feminist conceptualizations of women's madness: a review of the literature.

BACKGROUND: Gender is one aspect of an individual's identity that has been widely debated and discussed in relation to many different aspects of social life. The literature review explores how gender stereotypes affect women and their experience of mental illness. The aim is to demonstrate how a feminist perspective provides a useful lens through which women's experience of mental illness can be viewed. METHODS: The papers were identified by a computerized search of the CINAHL, Medline, BIDS ISI and Mental Health Nursing Collection databases and a hand search. All papers were screened and subjected to critical review. RESULTS: A theoretical framework was developed that reflected two key themes to emerge from the feminist literature on women and mental illness, namely psychiatry as a method of socially controlling women and the medicalization of women's unhappiness. In addition the complexities and contradictions in the feminist arguments are highlighted. CONCLUSION: The paper concludes by considering the implications of the issues raised for nursing practice by drawing attention to the current debates on the need to focus on gender relations rather than just on women's issues.

Female↗
PubMed1995

The psychology of delegation.

There are many issues and fears surrounding the concept of delegation, both by the delegator and the delegatee. The factors that affect these issues and fears include individuals' achievement motivation, fear motivation, worry about the consequences of delegation, concern about power, and worry about loss of control. This article suggests several practical techniques to select a staff that will function well in delegation, to help staff work through delegation fears, to assist different genders to understand and work with each other, and to manage power and control issues when they emerge.

Fear↗
PubMed2003

Experimental tests of an attitudinal theory of the gender gap in voting.

This research examined the hypothesis that gender gaps in voting stem from differences in the extent to which men and women agree with candidates' issue stances. Two initial experiments portraying candidates by their sex and attitudes and a third experiment that also included information about political party produced the predicted attitudinal gender-congeniality effect: Participants of each sex reported greater likelihood, compared with participants of the other sex, of voting for the candidate who endorsed positions typically favored more by their own sex than the other sex. In addition, this gender-congeniality effect was present among Republican and independent participants but absent among Democratic participants because Democratic men as well as women favored candidates who advocated the positions typically favored by women. Interpretation invoked the importance of group interest based on gender as an influence on women's voting.

Adult↗
PubMed1995

The emergence of problem-drinking women as a special population in need of treatment.

This chapter chronicles the development of advocacy for improvements in alcohol treatment services for women during the 1970s and 1980s, tracing its influence in terms of real change in treatment systems in the United States. We follow the development of a "women's alcoholism movement" from its inception in the late 1970s through its transition during the late 1980s into a broader movement focused on drug abuse and perinatal addiction. We describe the new governing images of problem-drinking women that advocates presented, their claims about the nature of substance abuse problems in women, and their recommendations for a more "gender-sensitive" treatment system. We also review increased federal involvement in this issue over the course of the 1980s, as pressure mounted on policymakers to respond to the crisis over drug-exposed infants by making treatment services more accessible to women. The chapter concludes by considering these developments from the perspective of national treatment system statistics, finding modest growth in specialized and women-only treatment units, as well as moderate increases in the representation of women in substance abuse treatment caseloads.

Alcoholism↗
PubMed1999

Occupational cancer among women: research status and methodologic considerations.

Occupational causes of cancer have not been well-evaluated among women. An increase in the number of women in the work force in jobs with potentially hazardous exposures during the past few decades raises the question as to whether there is a need to enhance our efforts in this area. The inability to evaluate occupational causes of female gynecologic tumors in studies of men, plus the potential for variation in outcome responses between men and women because of gender-based exposure and susceptibility differences, underscore the need for investigations specifically focused on women. Investigations of occupational exposures and cancer risk among women may require design considerations that differ somewhat from studies of men. Issues to consider include the impact of studying outcomes with high survival (e.g., breast cancer), gender-specific exposure patterns and toxicokinetic processing of some chemicals, special limitations in the use of the general population as the referent, and the need to control for established risk factors for gynecologic tumors.

Cohort Studies↗