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Transition from residency training to academia.

Anxious and depressive reactions during transitions from psychiatry residency to career settings have been reported. The authors describe difficulties encountered in their transition from psychiatry residency to academic psychiatry within the same program. Four stages of transition are described: Termination--a time of separation and grief over losses; Adjustment--a time of ambivalence and uncertainty; Identity Formation--a time of increased productivity and comfort; Consolidation--a time of accomplishment and compatibility of life goals. Women may additionally encounter gender-specific problems in entering a predominantly male profession. The development of supportive relationships within and outside work settings are viewed as the best methods of coping with transitional stress.

Adaptation, Psychological↗

Diabetes mellitus--a priority health care issue for women.

Diabetes occurs in more than 13 million persons in the United States, and approximately 60% of the new cases are diagnosed in women. This review examines health issues related to women with diabetes mellitus. The following issues are discussed in the review. The prevalence of diabetes is higher in Native-American, black, and Hispanic women than in white women. Women with upper-body obesity are at risk for developing non-insulin-dependent diabetes mellitus (NIDDM) and women with diabetes are at risk for developing heart disease. Diabetes, obesity, and heart disease are all modifiable by nutrition. White women with diabetes derive approximately 40% of energy from fat, which is 10% greater than the national goal. Women with a history of gestational diabetes are at risk for developing NIDDM. Women with insulin-dependent diabetes mellitus (IDDM) are at high risk of developing complications in pregnancy, and pregnancy outcomes improve with preconceptual counseling. Women with IDDM are at risk for developing eating disorders, although not to a greater extent than the nondiabetic population. Women with diabetes are at risk for developing endometrial cancer. Both IDDM and NIDDM prevention clinical trials are in progress, although none target women specifically. Dietetics practitioners are encouraged to use local and national diabetes resources.

Diabetes Mellitus, Type 1↗

Weight goals in a college-age population.

OBJECTIVE: Although a growing body of literature has found unrealistic weight loss goals to be common among older, primarily female, subjects, little is known about weight loss goals of younger adults. RESEARCH METHODS AND PROCEDURES: Three hundred seventy-nine college students had their height and weight taken and reported their "goal," "dream," "happy," "acceptable," and "disappointed" weights. A series of 2 (gender) x 2 (nonoverweight vs. overweight) ANOVAs were conducted with both absolute weight goals and percentage of weight loss needed to obtain those goals as dependent variables. RESULTS: When examined in terms of absolute weight goals, women generally had lower body mass index (BMI) goals than men, and nonoverweight participants had lower BMI goals than overweight participants. Surprisingly, most overweight participants would accept a weight loss that would still place them in the overweight BMI range. When examined in terms of percentage loss needed to reach those goals, only overweight women chose goal and dream weights that would require a loss greater than can be expected from nonsurgical weight-loss treatments, and all overweight participants chose happy and acceptable weights within 15% of current weight. DISCUSSION: Participants in this study had generally reasonable weight-loss goals, and even the most extreme weight loss goals were much more moderate than those found in previous studies. These results are surprising given the extreme social pressures for thinness facing young adults. Future studies should examine the variables that influence selection of goal weights and how goal weights affect actual dieting behavior.

Adolescent↗

Longitudinal predictors of proactive goals and activity participation at age 80.

This study investigated longitudinal predictors of proactive goals and activity participation at age 80 among members of the Terman Study of the Gifted. The participants were 242 individuals between the ages of 75 and 84 (M = 79.53) who responded to questionnaires in 1992, 1972, and 1950. Proactive goals included goals for involvement and achievement. Activity participation included intellectual, cultural, and social service activities. LISREL 8 was used to test an integrative longitudinal latent variable model of the associations among the variables. The results showed that purposiveness at age 40 predicted proactive goals at age 80 indirectly through satisfaction with cultural life and service to society measured at age 60. Satisfaction with culture and service at age 60 was related to activity participation at age 80 through proactive goals. Women rated proactive goals as more important to them and indicated greater participation in the activities in this study than did men, but the structural equation model was invariant across the two groups. The results are discussed in terms of contemporary research and theory concerning the self-concept and life span development.

Activities of Daily Living↗

Maternal feelings after cessation of breastfeeding: influence of factors related to employment and duration.

The purpose of this study was to measure feelings following weaning in women planning employment within 1 year postpartum and to examine the effects of factors related to duration and employment on these feelings. No significant differences in feelings of sadness, anger, guilt, and relief were reported by women who weaned due to mother-led reasons or baby-led reasons or in women who did or did not meet their breastfeeding goal. Women who did not feed their babies as planned when employed, however, felt significantly more sadness/depression and guilt compared to women who achieved their planned method of feeding.

Adult↗

Who wins in the status games? Violence, sexual violence, and an emerging single standard among adolescent women.

Throughout U.S. history, women have changed their sexual behaviors in response to, or as actors affecting, economic, political, and legal imperatives; to preserve health; to promote new relationship, identity or career paths; to assert a set of values; as a result of new reproductive technologies; or to gain status. In adjusting to pressures or goals, women have not always acted, or been able to act, in the interests of their own health, identity, or status. As this article will demonstrate, women, in the short or long run, may attempt to preserve status at the cost of other values such as health. This may occur through conscious and critical choice or through less conscious processes in reaction to relatively larger forces whose impact has not been critically analyzed. With the awareness in the 1980s in the United States of an emergent and incurable sexually transmissible infection, HIV, it would have been anticipated that a new sexual caution may have appeared. Yet, across several research projects in the late 1990s and into the 21st century, as our research team interviewed youth in a high HIV seroprevalence neighborhood in New York City about HIV prevention, we began to hear that a substantial minority of young women and men were participating in social settings for sexual behavior that (1) put youth at risk for HIV; (2) appeared to be motivated by acquisition of status ("props," "points"); and (3) offered few ways for women to win in these status games. We estimate from one random dwelling unit sample that about one in eight youth have been present in these settings and half of them have participated in risky sexual behavior in such settings. The settings are often characterized by men's publicly offhand attitudes toward sexual encounters, are organized around men's status maintenance, and evidence peer pressures that are poorly understood by both young men and women participants. To regain status, some women participants have adopted attitudes more characteristic of men.

Adolescent↗

Planned condom use among women undergoing tubal sterilization.

BACKGROUND AND OBJECTIVES: Women who are undergoing tubal sterilization are at risk for various sexually transmitted diseases (STDs) if they do not use a barrier method of contraception. There is a paucity of data concerning dual use of condoms among sterilized women. GOAL: Planned use of condoms for protection against STDs was examined among 2,782 women undergoing surgical sterilization from 1991 to 1996. STUDY DESIGN: Cross-sectional survey. RESULTS: Planned condom use increased significantly over the 6-year study period. Of women who were using condoms before sterilization (n = 646), nearly half indicated no plans to do so after becoming sterilized. Thus, 11% of the total sample experienced an increased risk for exposure to human immunodeficiency virus or other STDs. Condom abandonment was significantly higher among Hispanic and married women. Multiple regression analysis was used to examine the association between condom use and various characteristics. Factors associated with future condom use were younger age, black ethnicity, being unmarried, previous STD, not having a steady partner, higher number of previous sexual partners, having used condoms for disease prevention in the past, and lack of partner involvement in the decision to undergo sterilization. CONCLUSIONS: Use of condoms among sterilized women appears to be on the rise, women at higher risk for disease are more likely than others to be using condoms, and only a small group of women experience an increased risk for exposure to disease as a result of selecting this permanent method of contraception.

Adult↗