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At least 1,693 records · Page 94Linked to original sources
PubMed1994

Immunization referral practices of pediatricians in the United States.

OBJECTIVE: Concerned about alarmingly low rates of immunization among some young US children as well as disturbing trends in vaccine availability and delivery, the American Academy of Pediatrics sought to examine national trends in referral for immunization among US pediatricians. METHODS: A self-administered eight-page questionnaire on issues in childhood immunization was mailed to a random sample of the AAP's 36,000 US resident members. Four rounds of the survey yielded a sample size of 1246, for a response rate of 77%. RESULTS: A majority of respondents reported referral of some patients for immunization; reported reasons for referral focused on issues of cost to the patient. Personal characteristics of pediatricians (age and gender) were not related to referral practices. Pediatricians practicing in solo or group settings were 2.8 times as likely as those in clinics or other settings to refer patients for immunization. Those in nonmetropolitan areas were nearly twice as likely as those in large metropolitan areas to refer for immunization. When setting and location were controlled, pediatricians who reported that their states had programs to provide all vaccines free or at reduced cost were much less likely to indicate that they referred patients for immunization. CONCLUSIONS: A majority of US pediatricians refer some of their patients to other providers for immunizations because of financial reasons. Children outside of metropolitan areas may be at particular risk for problems of availability of and access to immunizations. This study raises, once again, the issue of differential health care access for children based on payment mechanisms.

Adult↗
PubMed1996

Asia on the move: research challenges for population geography.

This paper "summarises some of the major changes which have occurred in international migration to, from, and within Asia in the last two decades....A number of theoretical challenges are put forward regarding the complex interrelationships between international population movements, economic development and social change. The employment of systems approaches, neoclassical economic theory, social networks and institutional approaches, and the potential role of population geography in developing a more comprehensive explanation of the changing dynamics of international migration in the region, are discussed. Also considered are the gender dimension in migration, remittance flows and their consequences, and policy issues."

Asia↗
PubMed2006

Oral chromium(VI) does not affect the frequency of micronuclei in hematopoietic cells of adult mice and of transplacentally exposed fetuses.

Chromium(VI) compounds are genotoxic in a variety of cellular systems. Their potential carcinogenicity is affected by toxicokinetic patterns restricting bioavailability to certain targets, and by metabolic pathways affecting interaction of chromate-derived reactive species with DNA. Epidemiological data indicate that chromium(VI) can be carcinogenic to the human respiratory tract following inhalation at doses that are only achieved in certain occupational settings. However, concern has been raised that adverse effects may also result from oral intake. In order to further explore this issue, we performed studies in BDF1 and Swiss mice of both genders and various age. Sodium dichromate dihydrate and potassium dichromate were administered either with the drinking water, up to a concentration of 500 mg chromium(VI)/l for up to 210 consecutive days, or in a single intragastric dose of 17.7 mg/kg body weight. Under these conditions, no increase of the micronucleus frequency was observed in either bone marrow or peripheral blood erythrocytes. Conversely, the same compounds induced a clastogenic damage following intraperitoneal injection, which by-passes detoxification mechanisms. In addition, due to the hypothesis that susceptibility may be increased during the period of embryogenesis, we treated pregnant mice, up to a concentration of 10mg chromium(VI)/l drinking water. There was no effect on the numbers of fetuses/dam and on body weight of fetuses. Again, no toxic or genotoxic effect was observed either in bone marrow of pregnant mice or in liver and peripheral blood of their fetuses. Thus, even at doses that largely exceed drinking water standards (up to 10,000 times) or by massive intragastric administration, chromium(VI) is not genotoxic to hematopoietic cells of either adult mice or transplacentally exposed fetuses. These conclusions are consistent with the poor toxicity and lack of carcinogenicity of oral chromium(VI), and are mechanistically explained by the high efficiency of chromium(VI) detoxification processes in the gastrointestinal tract.

Administration, Oral↗
PubMed2004

'I am not the kind of woman who complains of everything': illness stories on self and shame in women with chronic pain.

In this study, we explore issues of self and shame in illness accounts from women with chronic pain. We focused on how these issues within their stories were shaped according to cultural discourses of gender and disease. A qualitative study was conducted with in-depth interviews including a purposeful sampling of 10 women of varying ages and backgrounds with chronic muscular pain. The women described themselves in various ways as 'strong', and expressed their disgust regarding talk of illness of other women with similar pain. The material was interpreted within a feminist frame of reference, inspired by narrative theory and discourse analysis. We read the women's descriptions of their own (positive) strength and the (negative) illness talk of others as a moral plot and argumentation, appealing to a public audience of health personnel, the general public, and the interviewer: As a plot, their stories attempt to cope with psychological and alternative explanations of the causes of their pain. As performance, their stories attempt to cope with the scepticism and distrust they report having been met with. Finally, as arguments, their stories attempt to convince us about the credibility of their pain as real and somatic rather than imagined or psychological. In several ways, the women negotiated a picture of themselves that fits with normative, biomedical expectations of what illness is and how it should be performed or lived out in 'storied form' according to a gendered work of credibility as woman and as ill. Thus, their descriptions appear not merely in terms of individual behaviour, but also as organized by medical discourses of gender and diseases. Behind their stories, we hear whispered accounts relating to the medical narrative about hysteria; rejections of the stereotype medical discourse of the crazy, lazy, illness-fixed or weak woman.

Adult↗
PubMed2001

Stress, loneliness, and depression in Taiwanese rural community-dwelling elders.

This study examined the stressors and stress levels, loneliness, and depression experienced by Taiwanese rural elders and determine if differences in the level of stress were associated with specific person-environmental characteristics. The relationship between stress and depression was also explored. A total of 201 older rural community residents participated in the study. Findings showed that rural elders experienced a number of stressors related to health and family issues. Differences in the degree of stressfulness of individuals differed by gender, educational level, living arrangement, and socioeconomic status (SES). Findings in this study also showed that there was a high association among stress level, depressive symptoms, and mood status. The findings of this study will assist community health policy-makers in determining the need for health-related services for rural elders experiencing these problems.

Affect↗
PubMed2001

Promoting screening and early detection of cancer in men.

Gender is a factor in the risk assessment for many diseases. It may also impact on the way in which men assess their personal health or illness status and take action to prevent illness or promote well-being. This paper is focused on three objectives: (i) to foster an understanding of gender differences in health promoting behaviors; (ii) to review three health issues affecting males for which dissemination of health education, increased personal awareness and early detection may be beneficial in the reduction of morbidity and mortality; and (iii) to offer suggestions for nurses and other health care professionals to promote positive patient-provider interactions within a health-care framework for action.

Attitude to Health↗
PubMed1994

Water-level representation by men and women as a function of rod-and-frame test proficiency and visual and postural information.

In the water-level task, it has been repeatedly shown that, compared with men, women more often fail to represent the surface of a liquid as horizontal regardless of the tilt of the container. An attempt was made to reduce this robust gender gap through the manipulation of relevant upright references conveyed both by the position of the stimuli and the posture of the subject. It was reasoned that bringing the women to focus on such gravitational references through postural adjustment might help their performance equal that of men, thus shedding some light on the nature of the difficulty they experience in the standard setting. A lesser effect was anticipated among men. However, the results showed that, even after controlling for proficiency in the correlated visuospatial situation of the rod-and-frame test, the performance of men always surpassed that of women. Irrespective of gender, water-level representation on vertical sheets was unaffected by the subject's posture, whereas it improved when horizontal sheets were coupled with the most unstable posture. Whereas the persistence of the yet-unaccounted-for gender difference was underscored, the contributions of visual and postural cues issued at arm and full-body levels were discussed.

Adolescent↗
PubMed2001

Temporal trends and ethnic variations in amenable mortality in Singapore 1965-1994: the impact of health care in transition.

BACKGROUND: Amenable mortality is used to assess the effects of health care services on gains in mortality outcomes. Possibly differing patterns of trends in amenable mortality may be expected in economically less developed countries, which have undergone rapid epidemiological transition and recent reforms in health care systems, but such studies are scarce. This study was set up to examine the trends in amenable mortality in Singapore from 1965 to 1994; to estimate the relative impact of medical care and primary preventive policy measures in terms of gains in mortality outcomes; to examine ethnic differences in amenable mortality among Chinese, Malays and Indians. METHODS: Age-standardized mortality rates were calculated for 16 amenable causes of death in Singapore for six 5-year periods (1965-1969,..., 1990-1994), and for each of the three main ethnic groups for three periods (1989-1991, 1992-1994, 1995- 1997). Amenable mortality rates were divided into those which can be reduced by timely therapeutic care for 'treatable' conditions (e.g. asthma and appendicitis), or by primary preventive measures for 'preventable' conditions (e.g. lung cancer and motor vehicle injury). RESULTS: Amenable mortality was higher in males (age-standardized rate 109.7 per 100 000 population) than in females (age-standardized rate 60.7 per 100 000 population). Amenable mortality declined by 1.77% a year in males and 1.72% a year in females. By comparison, the average yearly decline in non-amenable mortality was 0.91% in males and 1.17% in females. The decline in amenable mortality was largely due to 'treatable' causes rather than a decline in mortality due to 'preventable' causes of death. Amenable mortality was lowest for Chinese and highest for Malays. Over the recent 9-year period from 1989 to 1997, amenable mortality declined more in Chinese than in Malays and Indians. However, Indian females showed by far the sharpest decline, whereas Indian males, by contrast, showed an increase in amenable mortality, due to both treatable and preventable causes. CONCLUSIONS: In line with findings from European countries, amenable mortality in Singapore declined more than non-amenable mortality. There were more significant gains in mortality outcomes from medical care interventions than from primary preventive policy measures. Gender and ethnic differences in amenable mortality were also observed, highlighting issues of socioeconomic equities to be addressed in the financing and delivery of health care.

Adolescent↗
PubMedDate not supplied

Progress in the moral reasoning of baccalaureate nursing students between program entry and exit.

Changes in moral reasoning between entry into and exit from a baccalaureate nursing program and the relationship between student characteristics and moral reasoning at entry and exit were explored in this descriptive study. The moral reasoning of four cohorts of students was measured using the Defining Issues Test (DIT). Admission grade point average, prior college credits, and gender accounted for 10% of the variance in DIT P% scores at entry and 14% of the variance at exit from the program. Female students had significantly higher moral reasoning scores than men. Age did not contribute significantly to explaining DIT score variance. DIT P% scores at entry for all four cohorts were within the range of reported norms for college students. Exit scores for all four cohorts were between the normative means for undergraduate students and graduate students. DIT P% score gains between entry and exit were significant for all four cohorts. Students whose entry scores were in the lowest categories had the greatest mean gains.

Adult↗
PubMed2004

[Gender, health professions and public health].

In this article we review the main results of historical-social research on gender and medical practice, propose a model for applying a gender perspective to the study of healthcare professions, and analyze some current forms of gender bias in Spanish public health societies and publications. The main conclusions indicate: the historic construction of gendered professional identities; the existence of vertical segregation by sex in scientific societies and in journal editorial boards; the existence of androcentric practices in the scientific journals, exemplified by the style of using the initial letter of the authors' first name; the fact that scientific societies do not collect data by sex; the difficulties that all of this implies for quantitative investigations that study the sex variable and adopt a gender perspective; and the need to promote qualitative research on the issue.

Female↗
PubMed2006

Symptoms versus impairment: the case for respecting DSM-IV's Criterion D.

Diagnosing ADHD based primarily on symptom reports assumes that the number/frequency of symptoms is tied closely to the impairment imposed on an individual's functioning. That presumed linkage encourages diagnosis more by Diagnostic and Statistical Manual of Mental Disorders (4th ed.) style symptom lists than well-defined, psychometrically sound assessments of impairment. The current study correlated measures reflecting each construct in four separate, large-scale ADHD research samples. Average correlation between symptoms and impairment accounted for less than 10% of variance. Symptoms never predicted more than 25% of the variance in impairment. When an ADHD group was formed according to a measure of current symptoms, the sample size shrunk by 77% when a criterion-based measure of impairment was added. The partial unlinking of symptoms and impairment has implications for decisions about the diagnostic process, research criteria for participant inclusion, prevalence estimates, gender ratios, evaluation of treatment effects, service delivery, and many other issues.

Adolescent↗
PubMed1995

Women's narratives in primary care medical encounters.

OBJECTIVE: This study asked how women's narratives of social and emotional problems are dealt with in primary care encounters. Our conceptual work extended perspectives from narrative analysis to focus on elements of ideology, social control, underlying structure, and features of discourse that appear marginal to medicine's technical tasks. METHOD: Based on a critical review of both quantitative and qualitative techniques in research on patient-doctor communication, we developed an interpretive method with criteria to guide sampling, transcription, interpretation, and presentation of findings. We applied the method to encounters which were selected randomly from a data base derived from a stratified random sample of 336 audiotaped encounters involving patients and primary care internists. FINDINGS: As shown by illustrative encounters, women's narratives in primary care often express emotional troubles related to gender roles. Medical discourse in these encounters tends to marginalize contextual issues that contribute to women's distress. Such discourse conveys acceptance of reproductive commitments, medical management of psychic distress, and lack of criticism regarding social problems that affect women. CONCLUSIONS: Narrative analysis clarifies the medical processing of women's emotional problems that derive in large part from the social context of medicine. Women patients and medical practitioners often deal with these issues in primary care encounters rather than in psychiatric settings. These findings suggest directions for improving the discourse of primary care encounters.

Antidepressive Agents↗
PubMed2005

[Determining students health information needs at the Service of Inter-university Preventative Medicine in Bordeaux].

At the request of the Service of Academic Preventative Medicine (APM) in Bordeaux, this study was carried out in the year 2000 and aimed to identify the health information needs of the university's student population. The questionnaire, which was completed by the students themselves, mainly explored health information needs, health status and the students' living conditions. Of the 370 total students coming from all University disciplines who participated in this study, a majority of them were women (61%), with the median age of 21 years old. The majority of students (69%) said that they were stressed and/or depressed and more than one-third were tired. Nearly 20% of the students were smokers, 9% declared that they regularly drank alcohol and 7% of them reported that they never consulted a physician. When asked specifically about their health information needs, they expressed a preference for receiving information on sexually transmitted diseases, how to stay in good health and on issues like psychology, depression and suicide. These themes differed according to gender and risk behaviour. These results permitted a better understanding of the students' health information needs and provided the knowledge necessaryin order to streamline and appropriately adapt the APM's activities for the following academic year in order to be more focused to respond to these needs.

Adult↗
PubMed1999

Lowering fibrinogen levels: clinical update. BIP Study Group. Bezafibrate Infarction Prevention.

The preliminary conclusions from the BIP Study on the issue of fibrinogen are: (1) baseline fibrinogen was associated with age, gender, behavioral variables, lipid profile and severity of coronary heart disease. Furthermore, baseline fibrinogen emerged as an independent predictor of cardiovascular events in patients with coronary artery disease; (2) reduction of fibrinogen was not associated with a decrease in cardiac events in patients with coronary artery disease; (3) however, in patients with high baseline fibrinogen levels, reduction of fibrinogen was associated with a decrease in the incidence of primary endpoints, cardiac death and ischemic stroke. Further analysis from the BIP Study and additional data from other studies are necessary in order to clarify the possible association between fibrinogen alteration and cardiovascular events.

Aged↗
PubMed2000

Using rights and the law to reduce women's vulnerability to HIV.

Cathi Albertyn's paper, an edited and updated version of her presentation at "Putting Third First," argues that both human rights and the law can play an important, if limited, role within a wider set of national and international strategies to reduce women's vulnerability to HIV. It analyzes the nature of women's vulnerability to HIV/AIDS, and highlights some of the issues and lessons in using rights and the law to advance gender equality and reduce women's vulnerability to HIV/AIDS.

Developing Countries↗
PubMed2004

Allied health professional students' perceived level of comfort in clinical situations that have sexual connotations.

This study examined the anticipated level of comfort of 1,132 higher education students enrolled across physical therapy, occupational therapy, medical radiation sciences, rehabilitation counseling, leisure and health sciences, and behavioral health science professional courses. Participants were asked to indicate their anticipated level of comfort for a range of clinical interactions that have sexual implications. More than half of the students anticipated that they would not feel comfortable in dealing with the issues raised in 9 of the 19 sexually themed items. Significant gender differences were identified for some of these items. These gender differences should be taken into account when developing sexuality curricula. Feelings of discomfort when interacting with clients could impede appropriate therapeutic interventions. Further research investigating the nature and cause of discomfort in clinical settings is required. Studies that examine the usefulness of sexuality education programs in increasing practitioner comfort also should be carried out.

Adolescent↗
PubMed1991

Vulnerability to alcoholic liver disease.

Epidemiological evidence suggests a direct relationship between alcohol consumption and the prevalence of cirrhosis. However, the observation that only 8-30% of alcoholics develop cirrhosis illustrates that individual susceptibility mediates the relationship between alcohol consumption and cirrhosis. This chapter examines the factors that may influence individual risk for alcoholic liver disease. These factors include individual differences in alcohol metabolism and consumption patterns, gender, HLA antigens, family alcoholism history, and immune responsiveness. Important methodological issues in each of these areas are addressed also. From the available evidence, the hypothesis is advanced that there is an underlying vulnerability to liver disease in some individuals, and that alcohol use, although a necessary condition, is not sufficient to trigger disease in all individuals.

Alcohol Drinking↗
PubMed1995

Interpolating demography with families and households.

This paper argues that the field of household and family demography serves a critical role in the development of our understanding of the determinants and consequences of population trends. Like the community, families and households are situated between the two levels at which demographic research is ordinarily conducted--the individual and the nation-state. The results of the papers in this issue are used to illustrate the critical ways that intergenerational and gender relationships shape demographic processes.

Adolescent↗