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PubMedDate not supplied

Women are less likely to be admitted to substance abuse treatment within 30 days of assessment.

The information gathered in a centralized intake unit (CIU) allows payers and administrators to examine if there are access issues for their population. For this study, the authors examined whether there were gender differences in the rate at which people are admitted to treatment within 30 days of assessment. Of the 5,004 individuals seeking publicly-funded substance abuse treatment in Detroit for the years 1996-97, 50.3% of those assessed at the CIU actually entered treatment. Women (31% of the people assessed) had a lower rate of admission (45% for women versus 53% for men) a difference that was maintained even after controlling for known risk factors. Women who were given priority for admission (i.e., those who were pregnant, had children, or injected drugs) had a higher rate of admission than other women (73% versus 39%), but only 17% of the women presenting were included in the priority groups. Men who were injecting drugs (a priority group) also had a higher rate of admission than other men (83% versus 49%). In multivariate analysis controlling for priority groups and known risk factors, women were still less likely to be admitted to treatment within 30 days of admission than men. Establishing priorities improves the rate of admission within 30 days of assessment for those groups, but more needs to be done to improve the admission rate for women. These results demonstrate that a CIU allows administrators to monitor for access issues.

Adult↗
PubMedDate not supplied

Body image issues for children and adolescents with burns.

Body image is a far-reaching, multidimensional, dynamic concept. Because burn injuries threaten the integrity of both the physical and psychologic identity, body-image issues related to burn injuries appear to be a meaningful area of investigation. Little research has been done to directly assess body-image issues for children and adolescents with burns. We reviewed the general findings that body-image adaptation occurs and is influenced by gender, social support, burn severity, overall adjustment, and developmental stage. It is suggested that body-image revision, if it occurs, is largely successful, but body-image issues may not be directly related to psychosocial adjustment after a burn injury.

Adaptation, Psychological↗
PubMed1995

Emerging trends in the application of the social sciences to health and medicine.

Tensions are inevitable between funders seeking to solve specific health care issues within existing frameworks and many social scientists who see health and health care as reflections of societal stratification and processes of power and control. Many current and impending issues require deep scrutiny of values and meaning systems as they relate to class, gender, ethnicity and other forms of social differentiation. Interdisciplinary efforts provide social scientists important problem-solving opportunities but also occasions to refine disciplinary theories and methods. In recent years such efforts have resulted in increased sensitivity to demographic imperatives, prospective investigations, social experimentation, a growing appreciation of the complexity of life trajectories, development of more complex models of causation and remediation, and a revival of interest in meaning systems and their effects on ultimate outcomes. Social scientists have come to play a variety of roles in health services and policy research that contribute to a fruitful interplay of theory and practice. Major roles include helping to frame issues and how they are attacked; anticipating emerging trends, issues and problems; monitoring health and the provision of health services; evaluation and assessment; and implementation processes. The contributions of the social sciences to understanding complex organizational arrangements, structures, cultures, managerial approaches, financial arrangements and regulatory processes are increasingly evident and part of a culture of informed thinking.

Delivery of Health Care↗
PubMed2004

The power dynamics perpetuating unsafe abortion in Africa: a feminist perspective.

Tens of thousands of African women die every year because societies and governments either ignore the issue of unsafe abortion or actively refuse to address it. This paper explores the issue of abortion from a feminist perspective, centrally arguing that finding appropriate strategies to reclaim women's power at an individual and social level is a central lever for developing effective strategies to increase women's access to safe abortion services. The paper emphasises the central role of patriarchy in shaping the ways power plays itself out in individual relationships, and at social, economic and political levels. The ideology of male superiority denies abortion as an important issue of status and frames the morality, legality and socio-cultural attitudes towards abortion. Patriarchy sculpts unequal gender power relationships and takes power away from women in making decisions about their bodies. Other forms of power such as economic inequality, discourse and power within relationships are also explored. Recommended solutions to shifting the power dynamics around the issue include a combination of public health, rights-based, legal reform and social justice approaches.

Abortion, Induced↗
PubMed2006

A cross-sectional multivariate analysis of children's attitudes towards disabilities.

BACKGROUND: Past research has shown that children can be biased against peers with disabilities, but the association of attitudes with gender, age and disability preferences, as well as interactions between these variables, are unclear. The objectives of this study were to examine these issues in a cross-sectional, split-plot study to clarify: (1) if elementary school children's attitudes towards peers with disabilities are related to age, gender and type of disability; (2) if interactions between these variables exist; and (3) if convergent validity could be achieved across three theoretically linked dependent variables. METHODS: One hundred elementary school children between 4 and 10 years old were assessed for attitudes towards target children with no disability, a physical or an intellectual disability, and a combined intellectual/physical disability. Measures were completed in an interview format. RESULTS: Attitudes towards a target child with physical disabilities and a target child without disabilities did not differ. There was a significant interaction for age and disability. Attitudes towards target children with intellectual and intellectual/physical disabilities were negatively biased, and were negatively associated with age. Results were consistent across measures except for a main effect of gender in one measure and a gender by age interaction in another. CONCLUSIONS: Children's attitudes appear to be associated with several factors, including age and the presence or absence of disability. Gender differences in attitudes may be because of gender-based response biases rather than disability biases. Because of the multifaceted nature of childhood attitudes, cross-sectional designs with several dependent and independent variables provide an opportunity to examine consistency of results across measures and potential interactions between factors that may not be uncovered when variables are examined in isolation.

Age Factors↗
PubMed2005

An oligonucleotide microarray for transcriptome analysis of Schistosoma mansoni and its application/use to investigate gender-associated gene expression.

Global profiling transcriptomes of parasitic helminths offers the potential to simultaneously identify co-ordinately expressed genes, novel genetic programs and uniquely utilized metabolic pathways, which together provide an extensive and new resource for vaccine and drug discovery. We have exploited this post-genomic approach to fabricate the first oligonucleotide DNA microarray for gene expression analysis of the parasitic trematode Schistosoma mansoni. A total of 17,329 S. mansoni DNA sequences were used to design a microarray consisting of 7335 parasite elements or approximately 50% of this parasite's transcriptome. Here, we describe the design of this new microarray resource and its evaluation by extending studies into gender-associated gene expression in adult schistosomes. We demonstrate a high degree of reproducibility in detecting transcriptional differences among biologically replicated experiments and the ability of the microarray to distinguish between the expression of closely related gene family members. Importantly, for issues related to sexual dimorphism, labour division, gamete production and drug target discovery, 197 transcripts demonstrated a gender-biased pattern of gene expression in the adult schistosome, greatly extending the number of sex-associated genes. These data demonstrate the power of this new resource to facilitate a greater understanding into the biological complexities of schistosome development and maturation useful for identifying novel intervention strategies.

Animals↗
PubMed1998

Psychological aspects of pregnancy in the military: a review.

OBJECTIVES: In the past 20 years, more women have joined the armed forces than ever before. Consequently, the management of pregnant service members has raised important medical and administrative issues. Recent studies comparing service-women with their civilian counterparts have shown a significantly increased rate of pregnancy complications. This paper explores the psychosocial milieu in which active duty pregnancies occur and attempts to elucidate the psychological stressors that may contribute to the increased complication rate. METHODS: The literature on pregnancy in the military and the existing regulations governing its medical and administrative management are reviewed. Case material is presented and analyzed. RESULTS AND CONCLUSIONS: Three types of psychological stressors are identified and discussed: lack of social supports, the pressures of minority status, and the institutional reactions to gender roles. The author proposes mandatory education for military leaders regarding sensitivity to women's reproductive issues as well as specialized briefings for women inductees on the realities and risks of pregnancy in the military.

Adult↗
PubMed2002

Women's health issues and residents' knowledge.

The American Board of Internal Medicine has stated that women's health and gender-based medicine should be included in internal medicine residency curricula. We surveyed resident perceptions of curricular adequacy in domestic violence and coronary artery disease compared to actual knowledge using a 17-item Likert survey and a knowledge-based questionnaire (n = 86). Ninety-one percent of the residents rated inadequacies in the women's health curriculum. Of residents who rated the domestic violence curriculum as adequate, 26% were unable to describe two factors in detection, triage, and treatment of these patients. Of residents who rated the cardiac disease curriculum adequate, 26% were unable to describe two gender differences in risk factors, presentation, and prognosis of coronary disease. A gap exists between perceptions of residency curricular adequacy and actual knowledge in domestic violence and coronary disease in women.

Clinical Competence↗
PubMed2002

Sex selection and disability avoidance: is their opposed treatment conceptually consistent?

Sex selection and disability avoidance receive opposed treatment in bioethics literature, legislative practice and public opinion. However, some theorists question this state of affairs by drawing analogies between the harmful consequences of these practices. This paper shares their disapproval of gender selection and disability avoidance, but bases its resistance to these practices on an examination of the concepts of gender and disability. Here it identifies conceptual confusions as another cause of approval of sex selection and disability avoidance. Further, in clarifying the nature of the concepts at issue, and their relationship with the subjects that they apply to, this discussion highlights the existence of relevant analogies between the concepts of gender and disability. Here the social construction and universality of gender and disability allow their differential treatment to be resisted at the conceptual level, creating a strong foundation for more consequentialist arguments against sex selection and disability avoidance.

Abortion, Eugenic↗
PubMedDate not supplied

Predicting problem drinking in college students: gender differences and the CAGE questionnaire.

Adolescents and young adults are among the highest users of alcohol and other drugs in the United States. One of the tools most commonly employed in screening for problem drinking and alcohol dependence is the CAGE questionnaire. Research has indicated, however, that not only may the CAGE be a poor detection device for identifying youthful substance abuse, but it may particularly lack strength in the detection of alcohol abuse by young women. The current study examined the predictive power of the CAGE relative to other common assessment indicators of youthful substance abuse in a sample of college students. It focused on the relative predictive power of the CAGE in detecting a high level of drinking-related problems. In addition, the interaction of gender and a positive CAGE score was included in the logistic regression analysis to test the hypothesis that the CAGE is predictive for men but not for women. Results suggest that the CAGE is a relatively weak predictor of alcohol-related problems in this sample of college students, and it lacks predictive power for detecting, problems in college women. Issues concerning substance-abuse assessment in young people are discussed, with special consideration given to gender differences.

Adolescent↗
PubMed1999

Communication about sexual issues: mothers, fathers, and friends.

PURPOSE: To identify the content, characteristics, and comfort level of discussions about sexuality held between mothers and their early adolescent children and to determine the extent to which the conversations predicted sexual values and initiation of sexual intercourse of the adolescent. METHODS: This was part of a larger study to evaluate the impact of personal family characteristics on human immunodeficiency virus risk-reduction behavior among low-income predominately African-American adolescents, ages 13-15 years. Adolescents attending a metropolitan community-based afterschool program and their mothers were invited to participate in a 1-hour interview. Mothers and adolescents were interviewed separately. The interview included questions about the type of information related to sexuality that adolescents discussed with mothers, fathers, and friends; in addition, mothers were asked what topics they discussed with their adolescents. Four hundred five adolescents and 382 mothers participated. Some mothers had more than one adolescent in the study. RESULTS: The results showed that both male and female adolescents were more likely to discuss sexual topics with their mothers than their fathers. Male adolescents were more likely than female adolescents to discuss sex-based topics with their fathers. Both male and female adolescents were less likely to discuss sex-based topics with their friends than with their mothers, but more likely to discuss these topics with their friends than their fathers. Content of conversations of male adolescents was fairly consistent among mothers, fathers, and friends, and sexually transmitted disease/acquired immune deficiency syndrome and condom use were popular topics of discussion. Female adolescents tended to talk about the menstrual cycle with their mothers, sexual abstinence with their fathers, and sexual intercourse with their friends. Adolescents who reported a greater number of topics discussed with their mothers were more likely not to have initiated sexual intercourse and to have conservative values, whereas adolescents who reported a greater number of topics discussed with their friends were more likely to report the initiation of intercourse and more "liberal" sexual values. Both male and female adolescents were most comfortable discussing sexual issues with their friends. Male adolescents were less comfortable talking to mothers, but more comfortable talking to their fathers than were females. Mothers were likely to report feeling very comfortable talking about almost all discussion areas. Fathers' comfort level was not measured, as they were not directly questioned. CONCLUSION: Early adolescence (13-15 years old) is characterized by more sex-based discussions with mothers than friends or fathers. Daughters and sons discuss different topics with their fathers, although discussion by both genders with fathers is limited. If an adolescent talks more with the mother about sexual issues than with friends, he/she is less likely to initiate sexual intercourse and more likely to have conservative values. This points to the importance of fostering good communication and comfort between parents and adolescents about sexual issues.

Adolescent↗
PubMed2005

Health selection in a 14-year follow-up study--a question of gendered discrimination?

Health selection, as one of the several possible explanations for social inequities in health, has been receiving more attention recently but few researchers turn the issue into a question of discrimination. The aim of the study was to analyse the impact of health in young age for social position in adult age and to discuss health selection in terms of discrimination from a gender-theoretical perspective. A prospective cohort study was conducted, in which all pupils (N = 1083) in the last year of compulsory school in a middle-sized municipality in northern Sweden were followed for 14 years. The response rate was high, with 96.6% still participating after 14 years. The data were collected through repeated comprehensive self-administered questionnaires as well as through teacher interviews and register data. Health selection was analysed in a multiple logistic regression model, with working-class position at age 30 as a dependent variable and different measures of health/health behaviour at age 16 and 21 as independent variables. Overall, the impact of early health/health behaviour on future socioeconomic position was small or non-existent. However, even after correction for possible mediating and moderating mechanisms, being overweight at age 16 and at age 21 was related to future working-class position among women only. Possible mediating mechanisms were feeling looked down upon, not being active in associations and not reading cultural/political events in daily newspapers. Early menarche together with early motherhood and low education could not explain the correlations. Our results indicate that overweight girls and young women are exposed to gendered discrimination which probably occurs in many arenas, based on the societal norms for female bodies in our society. There is a need to redirect research on health selection into gender research in order to further explore the subject as well as the possible mechanisms of gendered discrimination.

Adolescent↗
PubMed2001

Adding aging and gender to the women's health agenda.

The complex interaction of medical, social, and economic factors that affect women's wellness as they age requires a new paradigm that bridges the gap between those who are concerned about aging issues and those concerned about women's health. In this article, we begin this endeavor by advancing three interrelated themes: (1) there is a gendered relationship between socioeconomic structures and health over time; (2) there are gender-specific implications of health care financing and policy; and (3) there are health consequences to the gendered nature of caregiving.

Aged↗
PubMed2004

Attitudes and use of pornography in the Norwegian population 2002.

The purpose of this study was to describe and analyze use of pornographic material in a representative sample of adult Norwegians. The data collection was carried out by means of a standardized questionnaire administered via personal telephone interviews. Among the 90% of participants who reported ever having examined pornography, 76% reported examining a pornographic magazine, 67% had watched a pornographic film, and 24% had examined pornography on the Internet. Significant gender differences emerged in the reporting. The percentage of men and women who reported frequent use of pornography was small. We identified three dimensions of attitudes toward pornography: pornography as a means of sexual enhancement, pornography as a moral issue, and social climate. These attitude dimensions were included in path models as intermediating variables between demographic variables (age, gender, and level of education) and frequency of reading or watching pornographic materials. These models explained 36% of the variance in frequency of watching pornographic films, 35% of the variance in frequency of reading pornographic magazines, and 21% of the variance in frequency of watching pornography on the Internet.

Adolescent↗
PubMed1996

Notification of a family history of breast cancer: issues of privacy and confidentiality.

Little information is available about notifying individuals with a family history of cancer about their risk of cancer. With the recent identification of BRCA1, an important predisposition gene for breast and ovarian cancer, genetic testing is becoming available to high-risk women and their families. Some of these individuals, may not be aware of their family history and may be notified of their family history by medical personnel or biomedical investigators. This disclosure could be detrimental to the individual by changing their perception of risk, sense of privacy, or psychosocial well-being. Members of 544 breast cancer families are currently being contacted as part of an epidemiologic follow-up study at the University of Minnesota. Some family members were unaware of their relative's diagnosis and therefore, notification occurred when they were contacted by study personnel. To determine the impact of risk notification in this context, 376 male and female relatives of 160 breast cancer probands were surveyed to assess their prior knowledge of their family history of cancer, issues relating to study participation, and their concerns regarding the possibility of developing cancer. Following a telephone interview about family history, family members were administered a short, open-ended questionnaire. The majority of individuals (82%) were blood relatives of the proband and 71% were either first- or second-degree relatives. A proportion of blood relatives (24%) were not aware of their family history of breast cancer. More blood relatives (76%) than nonblood relatives (62%, P < 0.01) were aware of their family history. 43 respondents (12%) expressed specific concerns about participating in the large genetic follow-up study and 16 comments concerned privacy issues. Neither the reasons for participation nor an individual's concern about developing cancer was associated with gender of the respondent, relationship to the proband, or awareness of breast cancer in the family. Interestingly, individuals who were notified about their family history through the large follow-up study were no more likely than other family members to be more concerned about developing cancer. Understanding the privacy and psychosocial issues of family members who are informed about a family history of breast cancer may aid in developing appropriate guidelines for notification. Risk notification in this setting does not appear to have a significant impact on these family members.

Breast Neoplasms↗
PubMed2004

Gender and sexual health in clinical practice in Lebanon.

This study examines the readiness of obstetricians/gynecologists (Ob/Gyns) in Lebanon to provide sexual consultation, their degree of comfort when discussing issues of sexual health, and their attitudes regarding assessment, treatment, and referral. Data on these concepts were collected through face-to-face interviews with 286 randomly selected Ob/Gyns. Most Ob/Gyns reported feeling comfortable discussing sexuality during consultations, which they attributed much more to professional experience than to training. Most Ob/Gyns reported giving proper time for management of sexual health issues and follow-up, as these issues are brought up frequently by their women clients. However, results suggest that only one-third (31%) of Lebanese Ob/Gyns nearly always take the initiative in asking patients about their sexual health. Moreover, almost 45% of participating Ob/Gyns did not recognize a strong relationship between reproductive health and sexual functioning. Gender was not found to be an important predictor for any of the indicators measured in the present study. Ob/Gyns in Lebanon are significant consultants on various sexual issues, and they need better postgraduate training, continuing medical education, and access to medical congress resources on the topic of sexuality and its relationship to reproductive health.

Attitude of Health Personnel↗
PubMed2006

Age, gender, quality of life and psychological distress in patients hospitalized with psoriasis.

BACKGROUND: Psoriasis has a great impact on the quality of life of patients, and the ageing population is an important public health issue. OBJECTIVES: To investigate whether older patients with psoriasis have a different impairment in quality of life compared with younger patients, considering level of severity, duration of disease, gender and psychological distress. METHODS: The study was performed between February 2000 and February 2002 at the inpatient wards of the Dermatological Institute IDI-IRCCS, Rome, Italy, in the framework of a large project on clinical, epidemiological, emotional and quality of life aspects of psoriasis (IMPROVE study). This is a hospital-based cross-sectional study, with measures of quality of life (Skindex-29, Dermatology Life Quality Index and Psoriasis Disability Index) and of psychological distress, generic (12-item General Health Questionnaire) and psoriasis-related (Psoriasis Life Stress Inventory), all self-assessed by patients. We compared the mean scores of each quality of life instrument in patients aged < 65 years and >/= 65 years, in subsets of patients based on clinical and sociodemographic characteristics. RESULTS: We analysed 936 patients hospitalized at IDI-IRCCS with a diagnosis of psoriasis. Quality of life was significantly more impaired in the older group for all the Skindex-29 scales, and psychological distress was higher in older patients. In particular, older women suffering from anxiety or depression had the greatest impairment in quality of life. The results were somewhat different using the other quality of life instruments. CONCLUSIONS: These results should alert dermatologists that similar levels of clinical severity in psoriasis may be associated with different levels of quality of life and psychological distress of patients. Particular attention should be devoted to older patients, and especially to older women.

Adolescent↗
PubMed1995

Gender-related differences in the amount and functional state of rat liver UDP-glucuronosyltransferase.

The basis for gender-dependent differences in rates of glucuronidation of xenobiotics is uncertain. To clarify this issue, the glucuronidation of p-nitrophenol was compared in liver microsomes from adult male and female rats. The activity of native UDP-glucuronosyltransferase was 47% higher in microsomes from male than from female rats. Immunoblotting of microsomal protein with anti-UDP-glucuronosyltransferase antiserum revealed 66% more immunoreactive protein in male microsomes. A kinetic method for measuring glucuronidating enzyme content confirmed the result of the immunoblot. Responses of UDP-glucuronosyltransferase to activation by palmitoyllysophosphatidylcholine or high pressure indicated that the activity of the enzyme was more latent in male than in female microsomes. Differences in enzyme latency could be due to differences in membrane structure. A comparison of microsomal fatty acid composition revealed significantly higher levels of oleic and linoleic acids and lower levels of stearic and docosahexaenoic acids in male than in female microsomes. The phospholipid composition, ratio of cholesterol:phospholipid, and membrane fluidity were similar in male and female microsomes. These results indicate that gender-dependent differences in UDP-glucuronosyltransferase activity are due to differences in both the amount and functional state of the enzyme.

Animals↗