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PubMed2006

The Mpondombili Project: preventing HIV/AIDS and unintended pregnancy among rural South African school-going adolescents.

Unintended pregnancy, HIV and other sexually transmitted infections are major threats to the health of South African youth. Gendered social norms make it difficult for young women to negotiate safer sex, and sexual coercion and violence are prevalent. Sexual activity among adolescents is influenced strongly by conservative social norms, which favour abstinence. In reality, most young people are sexually active by the end of the teen years. Girls' decision to have sex is often a passive one, influenced by partners. The Mpondombili Project is a school-based intervention in rural KwaZulu-Natal that aims to promote delay in the onset of sexual activity and condom use as complementary strategies for both sexually experienced and inexperienced youth. Interactive training was carried out with peer educators, teachers and nurses over a 15-month period, and a manual developed. The intervention was implemented in late 2003 with 670 adolescents in two schools. Issues covered included HIV/STI transmission, risk behaviours, HIV testing, pregnancy and contraception, gender inequality, sexual communication and negotiation, managing abusive situations, fear of AIDS, stigma and discrimination and sexual rights. The diversity of young people's relationships and vulnerability to sexual risk call for the promotion of both risk avoidance (delay in sexual initiation) and risk reduction (condom use) together, regardless of ideology, especially where HIV is well-established, to protect their health.

Adolescent↗
PubMed1999

Patients' views on quality of care: a comparison of men and women.

AIM: This study set out to explore gender differences among medical and surgical acute care inpatients regarding their perceptions of actual care conditions as well as their evaluation of the subjective importance of various care conditions. BACKGROUND: Firstly, the literature reports inconsistent findings regarding male and female patients' views on care. Secondly, the instruments used in most previous research are not derived from a patient perspective. METHODS: The sample consisted of 831 patients (48% were women and 52% were men) at two Swedish hospitals. Data were collected using the questionnaire 'Quality from the Patient's Perspective'. FINDINGS: Male and female patients tended to evaluate the actual care received similarly. However, women tend to assign the different care aspects higher subjective importance. CONCLUSION: More research is needed to illuminate the reasons why men and women hold these different values. Until these issues are better understood, there is no valid basis on a group (gender) level to give specific practical recommendations to nursing managers.

Acute Disease↗
PubMed2001

Self-esteem matters: racial & gender differences among rural southern adolescents.

Self-esteem does matter! It matters so much that Oprah dedicated an entire issue of "O" magazine to address the subject. "It's a woman's most treasured possession" (Winfrey, 2000a). Self-esteem has a profound influence on adolescent health promotion behaviors. This study contributes to understanding the role self-esteem plays in the behavior of adolescents. Utilizing a secondary data analysis, race and gender self-esteem differences among adolescents were investigated. The sample of 1,237 students (46% African-American and 52% White) from rural southern areas consisted of 744 females and 493 males. Self-esteem was assessed using the Miller Self-esteem Questionnaire (SEQ). The Hendricks Perceptual Health Promoting Determinants Model (HPHD) provided the theoretical framework for the study. The results of the study revealed a statistically significant difference in various aspects of self-esteem according to race and gender. African-Americans and males had a higher self-esteem which is consistent with many prior studies.

Adolescent↗
PubMed2004

Gender bias against male obstetrician-gynecologists in women's magazines.

OBJECTIVE: To evaluate whether gender bias against male obstetricians and other male physicians is found in popular women's magazines. METHODS: Issues of Cosmopolitan, Fitness, Glamour, Good Housekeeping, Ladies Home Journal, and Redbook were searched for medically related articles from July 2001 to December 2002. The articles were analyzed for the number and gender of physicians quoted, the number of gender-specific pronouns and negative gender-specific pronouns, and the number of pictured physicians by gender. RESULTS: Female obstetrician-gynecologists were interviewed as health care resources 47-80% of the time, which is higher than expected when compared with the American College of Obstetricians and Gynecologists membership numbers (P < .01). A similar phenomenon was found when discussing physicians in general (P < .001). Female physicians were more than 20 times more likely to have an identifying photograph. Pronouns used to identify negative physician traits accounted for 17% of the total pronouns when identifying female obstetrician-gynecologists and other specialties but accounted for 92% of the total pronouns when identifying male obstetrician-gynecologists and 77% of the pronouns when identifying other male physicians (P < .001). In 5 magazines, physicians had their quoted gender pronouns changed from gender neutral to reflect female-specific pronouns. CONCLUSION: In women's interest magazines, there is a gender bias against male obstetrician-gynecologists as well as male physicians in general. This may serve to undermine the physician-patient relationship and be detrimental to women's health care. LEVEL OF EVIDENCE: III.

Gynecology↗
PubMed1999

Leadership perspectives on the philosophy and rationale of diversity in the United States.

The uneasy civil rights consensus of the 1960s and 1970s has become frayed in civic and legal culture, and now it somehow must be mended. Defining discrimination, condemning it, regulating it, and remedying it are complicated issues. To find a solution is not rocket science; it is harder than rocket science. What is the moral cost of making decisions about people based on immutable characteristics like race and gender? In a 1995 review of affirmative action conducted by the author for President William Clinton, one issue was that discrimination can take place without the victim being aware of it. Victims of discrimination cannot litigate what they cannot see. This is but one justification for voluntary affirmative action. The debate about such measures, however, is fueled by sharp differences regarding basic questions of values, and perceptions of how much discrimination exists. Not many prejudices will be abandoned when people are presented with rational, social science evidence about crime, victimization, and the extent of discrimination. Experiences, including experiences with people who are different, are the most powerful tool for changing people's sense of community and people's values.

Attitude↗
PubMed2006

The playmate and play style preferences structured interview: a comparison of children with gender identity disorder and controls.

The present study compared the sex-typed preferences for playmates and play styles in children referred for concerns about their gender identity development (199 boys, 43 girls) with that of controls (96 boys, 38 girls). Each child was administered the Playmate and Play Style Preferences Structured Interview (PPPSI) developed by Alexander and Hines (Alexander, G. M., & Hines, M. (1994). Child Development, 65, 869-879). In the two single dimension conditions (playmates and play styles), the controls significantly preferred same-sex playmates and same-sex play styles whereas the gender-referred children significantly preferred cross-sex playmates and cross-sex play styles. Effect sizes ranged from 1.56-2.78. In the conflict condition (which required a choice between same-sex playmates and cross-sex play styles vs. cross-sex playmates and same-sex play styles), there was a general indication of a hierarchical preference for the preferred play style in the single dimension condition as opposed to the preferred playmate except for the gender-referred boys, who showed an inverted pattern. For the gender-referred group, the PPPSI data were significantly correlated with other measures of sex-typed behavior, providing evidence of predictive validity. The PPPSI also discriminated between probands threshold and subthreshold for the diagnosis of gender identity disorder. The results were discussed in relation to both basic and applied issues in the assessment of sex-typed behavior in children.

Child↗
PubMed2004

Breaking through the glass ceiling: women in executive leadership positions--Part I.

Women have had their share of difficulties climbing the corporate ladder in their chosen professional roles. Excellent role models exist for nurses to look up to as role models for leadership and executive level positions. Nurses and women must strive to achieve their goals of attaining executive/management level positions in their respective organizations. The glass ceiling still exists; however, women are slowly eroding that glass barrier and reaching their professional goals. In reviewing the struggles that men in nursing have encountered in a predominantly female profession, one realizes that stereotypical attitudes do cross gender lines. The authors conclude that executive level positions need to be opened more to women, just as the nursing profession must be more welcoming to men. The profession of nursing will only become stronger with gender diversity. Women encounter barriers when aspiring to executive level positions. In the next issue of SCI Nursing, the authors will report on what the evidence says about women in leadership roles, and the challenges they have and will continue to face.

Career Mobility↗
PubMed2001

Sexual behaviors, sexual orientation and gender identity in adult intersexuals: a pilot study.

PURPOSE: Sexual preference and adjustment of intersexuals have rarely been investigated. Interview techniques were used to explore these issues. MATERIALS AND METHODS: Ten adult intersexuals (average age 34.2 years) were randomly selected from Intersex Society of North America members. Of the 10 subjects 8 had initially been gender assigned as female and 2 as male. A structured telephone interview was used to assess sexual orientation, sexual activity and satisfaction with gender assignment. RESULTS: Sexual debut occurred at age 18.1 years (range 15 to 22). At debut, 4 females and 2 males engaged in heterosexual intercourse, and 4 females engaged in gynephilic (female) sexual contact. Despite female gender assignment of 8 and initial heterosexual activity by 4 subjects, the final choice of a sexual partner was female in all 8. Both males had initial heterosexual contact but only 1 continued to prefer female partners. Current number of sexual partners averaged 0.9 (range 0 to 2) and total number of sexual partners ranged from 1 to 300. Currently, 9 subjects are in a committed sexual relationship and 8 are able to achieve orgasm. Of the subjects 8 preferred being identified as intersexual, 1 male as male and 1 female as female. Two intersexuals with initial female gender assignment were undergoing male reassignment. CONCLUSIONS: Most intersexuals preferred being identified as intersexual and had female partners. Most reported being satisfied with overall physical appearance but satisfaction with genitalia was highly variable. Based on these results, further study of a larger population is warranted.

Adult↗
PubMed2004

Male pseudohermaphroditism: long-term quality of life outcome in five 46,XY individuals reared female.

We assessed the adult quality of life of five medical chart-selected genetic males (ages 29-34 years) assigned and reared as females due to ambiguity of the external genitalia. All five were treated following the traditional method proposed by John Money and colleagues in 1955, commonly referred to as the "optimal gender policy". The adult follow-up assessment included physical and endocrinological evaluation, completion of self-report questionnaires, and a semi-structured interview assessing gender identity, sexual experience and orientation. Quality of life domains assessed by questionnaire included health-related issues, satisfaction with health-care management, emotional distress, and relationship satisfaction. Vaginoplasty in four out of five patients was initially unsuccessful. Four patients had periodic lapses in adherence to hormone replacement therapy. Gender role behavior across development was masculine relative to norms for women. All participants reported a female gender identity without a history of gender dysphoria. The majority of participants (four of five) reported being sexually active and in long-term relationships (three heterosexual, one homosexual). Current emotional adaptation and health-related quality of life are within the normal range for four participants. Sex assignment of 46,XY individuals with ambiguous genitalia as females is compatible with a positive quality of life.

Adult↗
PubMed1995

African women carry the message. World Conference on Women.

The African Women's Network (AWN), organized by CEDPA alumnae at the Cairo population conference, has expanded its ranks and is bringing the Cairo consensus on women's empowerment to hundreds of NGOs throughout the continent. In November, AWN participants at the African NGO Regional Forum in Dakar helped to draft the Plan of Action for the World Conference on Women in Beijing, ensuring that key Cairo issues--including reproductive health care, sustainable development and poverty alleviation, the impact of AIDS on women, and gender equity--were addressed. With support from the UNFPA, the AWN and CEDPA organized a "Population Tent" at the forum, which highlighted family planning and reproductive health projects in Africa. AWN collaborated with the Senegal women's organization Yewwu Yewwi, the African Population Advisory Committee (APAC), and FEMNET, which is organizing African NGO participation for Beijing. Further expanding awareness of Cairo issues, CEDPA alumnae and staff members Khadijat L. Mojidi, Belkis Giorgis, and Andrea Okwesa conducted workshops on advocacy, gender and development, community-based family planning, and adolescent reproductive health programs.

Africa↗
PubMed2005

Patient preference for providers' gender at a primary health care setting in Alexandria, Egypt.

OBJECTIVE: The aim of this study is to determine patient's gender preferences in choosing general practitioners and specialists for both general and specific health issues at primary health care centers in Alexandria, Egypt. METHODS: A descriptive cross-sectional study was conducted at Smouha Health Center, Alexandria Governorate, Alexandria, Egypt. The study was conducted between the period January -- March 2004. A pre-designed questionnaire was used. The format included 3 main sections, namely, socio-demographic, beliefs towards provider's gender, and providers' preferences of patients. RESULTS: Both male and female patients preferred a male physician for consultation and clinical management of cases. The highest percentage of male patients (81.4%) and female patients (41.0%) preferred physician of the same gender, and such preference was of personal reasons for males (97.9%) and females (96.6%), while basing on traditions and norms for male (62.9%) and female (63.4%). Significant results of the stepwise logistic regression analysis in relation to socio-demographic factors on provider preference revealed that job and income were the significant determinants of gender preference for the sample under study. CONCLUSION: Patients prefer physicians of the same gender, but in actual practice a male physician is believed to be more competent.

Adult↗
PubMed2005

Is there a gender difference on the association between informal work and common mental disorders?

Economic activity in Brazilian women has been increasing in recent years, particularly in the form of under- and self-employment, which allows more flexibility in the work schedule and facilitates part-time work, a crucial issue for women reconciling family duties and the need for a remunerated occupation. This paper investigates the gender difference in the association between employment status and common mental disorders (CMD). A cross-sectional survey of a random sample of private households included 683 adults aged 15 years and over living in Olinda, Brazil. The self-reporting questionnaire (SRQ-20) was used to estimate the prevalence of CMD. The association between unemployment and CMD for men (OR=1.77, 95% CI 0.8-3.9) was in the same direction as that found for women (OR=2.66, 95% CI 1.1-6.3), but not significant. In contrast to this, while women working in the informal sector were more likely to be a case of CMD than formal workers (OR=3.02, 95% CI 1.3-7.2), no difference was found for informally working men (OR=1.08, 95% CI 0.5-2.4). The estimated OR for female informal workers was out of the 95% confidence intervals of the corresponding OR estimated for males, and the test for interaction was statistically significant (p=0.04). From a policy perspective, the value of encouraging people to take informal work depends both on how quickly individuals can be moved out of unemployment into informal work compared to other destinations, and how well individuals fare once in informal work. The results of the present study suggest that working outside the protection of employment legislation and with limited opportunity for skill use may be a risk for women's mental health.

Adolescent↗
PubMed1999

The care of women with AIDS: special needs and considerations.

The growing number of women being diagnosed with HIV/AIDS mandates the need to focus attention on the special needs of this population. Although women have many of the same devastating physical manifestations of HIV infection as men do, they face unique psychological and social issues that influence their ability to respond to their disease in the same ways. Women with HIV/AIDS are disproportionally poor or minority women who lack resources to maintain their health. It is impossible to address HIV infection in women without considering such factors as poverty, discrimination, and gender role expectations. This article uses a biopsychosocial framework to discuss a range of specific issues affecting the health and well-being of women with HIV/AIDS.

Female↗
PubMed1999

Design and reliability of pediatric HealthQuiz: preliminary report of a comprehensive, computerized, self-administered child health assessment.

The time available for pediatric ambulatory visits is rarely sufficient to permit a truly comprehensive health assessment. We hypothesized that a reliable, computerized, self-administered questionnaire could be designed to screen for a full range of pediatric health issues and provide a comprehensive health database for pediatric patients. An age- and gender-specific pediatric questionnaire of 478 questions was formatted to elicit only a "Yes," "No," or "Not Sure" response and structured in a branched, decision-tree format. The initial draft was reviewed for content by pediatric experts in Canada and the United States and revised in accordance with their suggestions. The questionnaire was divided into two modules, Medical Peds, covering biomedical issues and Prevent Peds, covering prevention, psychosocial, educational, and safety topics. Cognitive interviews were carried out with 132 parents in pediatric ambulatory care centers in Chicago and Halifax, with use of scripted and nonscripted probe questions, to ensure comprehensibility among patients with widely varying educational levels and health knowledge. Reliability was tested in 100 parents of children aged 1 month to 12 years, through use of five different test-retest sequences. Respondents' impressions were surveyed on completion of the procedure. Following content reviews, and cognitive and reliability testing, the total bank of questions was reduced to 375. As a result of the use of branching logic, individual parents answered an average of 111 Prevent Peds and 144 Medical Peds questions. Average time required to complete the entire questionnaire was 13 minutes for Prevent Peds and 19 minutes for Med Peds. Retesting within 36 hours showed an overall 97% concordance of response pairs in the Medical Peds and Prevent Peds questionnaires. There were no statistically significant differences in test-retest reliability between different sequence formats used, (e.g., HealthQuiz followed by personal interview, or HealthQuiz vs. HealthQuiz). A few questions that frequently elicited "Not Sure" responses were eliminated. As a result, the majority of questions elicited either a "Yes" or "No" response. Pediatric HealthQuiz identified a wide spectrum of child health problems that are often overlooked in routine health visits. Parents completing Pediatric HealthQuiz indicated a high degree of satisfaction with the procedure. Most reported that they believed the information would improve their child's health care.

Canada↗
PubMed1993

Recent development in alcoholism:sociology.

This chapter reviews several domains of sociological research conducted in the field of alcohol studies during the last decade. The domains are organized within the sociostructural, social constructionist, and distribution of consumption theoretical perspectives. Discussions of the current state of the field and definitional and measurement issues are also included. Within the sociostructural perspective, sociocultural theories, social deviance theories, age, gender, ethnic, and occupational group differences, and other related deviant behaviors are examined. Several examples of applications of social constructionist theory are included covering the new temperance movement, the Mothers Against Drunk Driving movement, Alcoholics Anonymous, and the Children of Alcoholics movement. In the section on distribution of consumption models, alcohol availability and drunk driving control policies are discussed. There are several sociopolitical issues that need to be addressed in the next decade and further collaboration across disciplines is warranted.

Alcohol Drinking↗
PubMed1996

Current issues relating to psychosocial job strain and cardiovascular disease research.

The authors comment on recent reviews of cardiovascular job strain research by P. L. Schnall and P. A. Landsbergis (1994), and by T. S. Kristensen (1995), which conclude that job strain as defined by the demand-control model (the combination of contributions of low job decision latitudes and high psychological job demands) is confirmed as a risk factor for cardiovascular mortality in a large majority of studies. Lack of social support at work appears to further increase risk. Several still-unresolved research questions are examined in light of recent studies: (a) methodological issues related to use of occupational aggregate estimations and occupational career aggregate assessments, use of standard scales for job analysis and recall bias issues in self-reporting; (b) confounding factors and differential strengths of association by subgroups in job strain-cardiovascular disease analyses with respect to social class, gender, and working hours; and (c) review of results of monitoring job strain-blood pressure associations and associated methodological issues.

Blood Coagulation Factors↗
PubMedDate not supplied

Diabetes mellitus: its impact on women.

Diabetes mellitus is a serious chronic illness. It affects approximately 16 million people in the United States, half of whom are undiagnosed. The prevalence of non-insulin-dependent diabetes is higher in women than in men, and more women die each year from diabetes than from breast cancer. Its complications, retinopathy, nephropathy, neuropathy and cardiovascular disease, exact a heavy toll on the individual with diabetes, as well as society. Because of its significant morbidity and mortality in women, diabetes deserves a place in the concerns designated "women's health issues." It deserves more research attention and especially more public awareness, since many of its devastating complications can be prevented by improved detection and control. This review examines the available data concerning the impact of diabetes on women, as well as gender differences in the incidence of diabetes and its complications. It will also discuss life cycle issues which are specific to women.

Contraception↗
PubMed2003

A further discussion on revisiting the classification of household composition among elderly people.

This discussion is a reaction to the DeVos article on the classification of households also in the current issue of Journal of Cross-Cultural Gerontology. The need for cross-national and comparative gerontological research is growing. Household composition is a compelling subject for such research, but there is a concurrent increase in the need for flexible and valid classification schemes. The DeVos classification represents an excellent step toward understanding households on a global level. Additional considerations not covered by DeVos include the gender of the coresident child, pseudo-coresidence, and living with grandchildren. These additional issues may complicate classification and, in the end, it is up to the individual researcher to choose schemes based on research questions, guiding theory, and available data. Yer, having a standard as a starting point reduces the complexity of the task of defining a classification scheme to be used comparatively across societies.

Aged↗