Gender-specific Definition Research Articles

Dealing with rape cases in Ghana: The law, the victim and the offender

Rape is a criminal offence in all countries of the world. However, what constitutes rape in the legal sense differs from country to country, with many common law countries sharing some similarities in their definition of rape. This paper conducts a critical review of the crime of rape in Ghana by discussing what constitutes rape under Ghanaian law, its key elements which a prosecution has to prove to succeed on a charge of rape, and the challenges of adjudicating rape cases in Ghana, paying particular attention to the victim. Furthermore, the manuscript offers some useful recommendations on improving current practice. Among the challenges identified as militating against the successful prosecution of rape cases in Ghana are the high poverty level resulting in the lack of money to pay for the costs of forensic medical examination by the victim, stigmatisation and ridicule of rape victims, lack of social and psychological support for the victims of rape, the unduly long period adjudication of rape cases take, the gender-specific definition of rape, and the general inadequate or lack of reformative services for rape prisoners. The paper recommends that the state of Ghana should take steps to tackle these challenges in order to promote justice for rape victims, while effectively dealing with the perpetrators of such crimes. These steps could include, the State covering the costs of forensic medical examination for rape victims through the National Health Insurance Scheme, intensifying public education on rape and its consequences, especially on the victim, and amending the definition of rape to make it gender-neutral instead of gender-specific. This paper will be useful to legal, psychological, and sociological researchers in Ghana and the world over.

The Relevance of Women’s Economic Marginalization to Recidivism

This study examines whether changes over time in women’s criminogenic needs, particularly their financial needs, predict recidivism. In a 9-year longitudinal study, 304 women were interviewed repeatedly during 4.5 years after probation/parole began. Women provided data on both their gender-specific and gender-neutral criminogenic needs. Women’s average standing on each need and an index of their change in the need over time were computed and used to predict subsequent recidivism over the 3.4 years after the final interview. Women whose financial needs decreased were less likely to be rearrested and convicted relative to other women. The findings highlight the importance of considering a multifaceted and gender-specific definition of economic marginalization in both theory and practice. At the policy level, there is a need to reduce justice-involved women’s financial needs. In addition, further longitudinal research should be conducted to understand how different type of changes in women’s lives impact recidivism.

Prevalence of High Body Mass Index in Children with Sickle Cell Disease and Its Correlation of Disease Severity

▪BackgroundChildren with sickle cell disease (SCD), particularly those with the homozygous form designated HbSS, have frequently been reported to suffer from impaired growth, delayed onset of puberty and poor nutritional status (1). However, improvement in healthcare of children with SCD in more economically developed countries, along with increased use of SCD-directed therapies such as hydroxyurea and chronic transfusions along with the recent rise in childhood obesity rates may have influenced growth of children with SCD. Two recent reports in the US found that 19-22% of children with SCD were overweight or obese (2, 3) . It is not known whether high body mass index (BMI) in children with SCD results in a worse clinical phenotype. Known association of childhood obesity with obstructive sleep apnoea (OSA) raises the potential of worsening clinical phenotype of SCD by increasing the incidence of nocturnal hypoxaemia which in turn may give rise to increased vaso-occlusive episodes (4). This study aimed to determine the prevalence of high body mass index (BMI) in an urban population of children in the UK with SCD and assess if there is correlation between BMI and disease severity.MethodsA retrospective chart review was performed on all patients aged 2-18 years with SCD who attended an outpatient clinic at Kings College Hospital, London between April 2015 and April 2017. Acute sickle cell-related emergency department (ED) attendances and hospital admissions in this period were recorded. BMI percentile, demographic information and laboratory markers of disease were recorded from the most recent clinic visit. Age and gender specific definitions of BMI percentiles were used, based on the British 1990 growth reference charts. Patients were assigned to 1 of 3 groups based on their BMI percentile: low, normal and high BMI. A high BMI was defined as >85th percentile for age and gender, whilst underweight was defined as <5th percentile.ResultsData was collected on 385 children with SCD in a single tertiary Paediatric Haemoglobinopathy centre in London. 16.6% children with SCD were overweight or obese and 5.2% were underweight. In contrast, government figures indicate that in the South London Borough of Southwark, up to 28% children aged 10-11 years were overweight or obese and 0.9% children were underweight in 2016-2017 (data.london.gov.uk). A high BMI among our SCD patients was associated with HbSC genotype (P= 0.006) and females (P=< 0.001). HbSS patients taking hydroxycarbamide had a significantly higher mean BMI compared to those not taking it (P=0.006). No association was found between BMI group and the number of acute sickle cell-related A&E attendances or hospital admissions for HbSS patients (P=0.450 and 0.780 respectively) or HbSC patients (P=0.838 and P=0.750 respectively). Patients with HbSS SCD in the high BMI group had a significantly higher haemoglobin (Hb) and fetal Hb (HbF) than those in the normal BMI group (P=<0.001 and P=0.010 respectively). HbSS patients in the high BMI group had a significantly lower absolute reticulocyte count (ARC) than those in the normal BMI group (P=0.022), see Table 1. These results suggest that HbSS patients with a high BMI may have a less severe disease than those with a normal BMI. These associations were not demonstrated in patients with HbSC disease.ConclusionsNearly one-sixth of children and adolescents with SCD in this urban population were overweight or obese. The association of hydroxycarbamide therapy and higher BMI in children with HbSS has been demonstrated in this study for the first time. There was no association between BMI group and the number of acute sickle cell-related A&E attendances or hospital admissions. In patients with HbSS disease, laboratory markers of disease severity, including Hb, HbF and ARC, suggest than patients with a high BMI may have a less severe disease than those with a normal BMI. Longitudinal studies monitoring BMI of children over time and markers of severity in SCD would produce greater evidence of the impact of a high BMI on disease severity. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Looking Backward to Move Forward: Revisiting Some Past Feminist Contributions to the Study of Violence Against Women

Although empirical, theoretical, and policy work on violence against women in adult intimate relationships has advanced significantly in the past 40 years, feminist scholars, practitioners, and activists in the field continue to face many challenges, especially those generated by a growing legion of people fundamentally opposed to gendered social scientific analyses. The main objective of this article is to suggest means of effectively dealing with attempts to marginalize feminist scholarship. The approaches suggested include revisiting some major contributions from the past, including using broad and gender-specific definitions, local community surveys, and multiple methods.

Effect of a New Gender-Specific Definition for Heavy Drinking on Prevalence and Risk Estimates for Male and Female Marine Corps Personnel

This study assessed the impact of a definition change on the prevalence estimates and the odds of heavy drinking among a large sample of male and female Marine Corps personnel using data from the 2008 and 2011 Department of Defense Health Related Behaviors surveys. It appears that, based on the new gender-specific definition, female Marines' risk for heavy drinking is comparable to that of males. This finding highlights the need to address gender-specific risks in alcohol prevention efforts in the U.S. Marine Corps. These results provide valuable baseline estimates by which to compare future heavy-drinking rates in military personnel.

The diagnosis and management of non-alcoholic fatty liver disease: Practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association

These recommendations are based on the following: (1) a formal review and analysis of the recently published world literature on the topic [Medline search up to June 2011]; (2) the American College of Physicians’ Manual for Assessing Health Practices and Designing Practice Guidelines; (3) guideline policies of the three societies approving this document; and (4) the experience of the authors and independent reviewers with regards to NAFLD. Intended for use by physicians and allied health professionals, these recommendations suggest preferred approaches to the diagnostic, therapeutic and preventive aspects of care. They are intended to be flexible and adjustable for individual patients. Specific recommendations are evidence-based wherever possible, and when such evidence is not available or inconsistent, recommendations are made based on the consensus opinion of the authors. To best characterize the evidence cited in support of the recommendations, the AASLD Practice Guidelines Committee has adopted the classification used by the Grading of Recommendation Assessment, Development, and Evaluation (GRADE) workgroup with minor modifications (Table 1). The strength of recommendations in the GRADE system is classified as strong (1) or weak (2). The quality of evidence supporting strong or weak recommendations is designated by one of three levels: high (A), moderate (B) or low-quality (C). This is a practice guideline for clinicians rather than a review article and interested readers can refer to several comprehensive reviews published recently.

Impact of a New Gender-Specific Definition for Binge Drinking on Prevalence Estimates for Women

Binge drinking accounts for more than half of the 79,000 deaths due to excessive drinking in the U.S. each year. In 2006, the Behavioral Risk Factor Surveillance System (BRFSS) lowered the threshold for defining binge drinking among women from ≥5 drinks to ≥4 drinks per occasion, in accordance with national recommendations. To assess changes in binge-drinking prevalence among women. The relative and absolute change in binge drinking among U.S. adult women was assessed using pooled BRFSS data from the 2 years before (2004-2005) and after (2006-2007) the implementation of the new gender-specific definition. Analyses were conducted in 2008-2009. Binge-drinking prevalence among women increased 2.6 percentage points (from 7.3% in 2004-2005 to 9.9% in 2006-2007), a 35.6% relative increase. The percentage of women who reported consuming exactly 4 drinks in 2006 (3.6%) was similar to the increase in the prevalence of binge drinking among women that was observed from 2005 to 2006 (absolute change=2.9 percentage points). The new gender-specific definition of binge drinking significantly increased the identification of women drinking at dangerous levels. The change in prevalence among women was primarily due to the change in the definition and not to actual changes in drinking behavior. The new gender-specific definition of binge drinking can increase the usefulness of this measure for public health surveillance and support the planning and implementation of effective prevention strategies (e.g., increasing alcohol excise taxes).

The Utility of a Gender-Specific Definition of Binge Drinking on the AUDIT

Objective: Although binge drinking is commonly defined as the consumption of at least 5 drinks in 1 sitting for men and 4 for women, the Alcohol Use Disorders Identification Test (AUDIT) defines binge drinking as the consumption of 6 or more drinks in 1 sitting for both men and women. This study examined the effect of using gender-specific binge drinking definitions on overall AUDIT scores. Participants: Participants were 331 college men and 1224 college women. Methods: Participants completed a self-report questionnaire, which included the AUDIT. Results: Findings showed that defining binge drinking as 4 or more drinks for women, rather than 6 or more, does impact their AUDIT scores and could affect the percentage of women classified as hazardous users. Among men, AUDIT scores were unaffected by the use of a gender-specific definition of binge drinking. Conclusions: Results suggest that the AUDIT might be underidentifying hazardous users among college women.

Prognostic importance of hemoglobin in hypertensive patients with electrocardiographic left ventricular hypertrophy: The Losartan Intervention For End point reduction in hypertension (LIFE) study

The prognostic importance of hemoglobin is controversial. We investigated the prognostic importance of baseline and in-treatment hemoglobin in the LIFE study. Eight thousand one hundred ninety-four LIFE patients with hypertension and left ventricular hypertrophy with available baseline hemoglobin measurements were randomized to losartan- or atenolol-based treatment and followed for 4.8 years for end points of all-cause mortality and composite of cardiovascular death, nonfatal stroke, or nonfatal myocardial infarction. U-shaped relations were observed between deciles of baseline hemoglobin and all-cause mortality and the composite end point. In univariate Cox models, baseline hemoglobin in the lowest gender-specific decile (women/men: <12.5/13.4 g/dL) was associated with all-cause mortality (hazard ratio [HR] 2.01, 95% CI 1.64-2.64) and the composite end point (HR 1.53, 95% CI 1.27-1.85, both P < .001), whereas hemoglobin in the highest gender-specific decile (women/men: > or =15.0/16.2 g/dL) was not. The decrease in hemoglobin was higher (P < .001) in patients allocated to losartan- (14.3-13.8 g/dL) versus atenolol-based treatment (14.3-14.0 g/dL). In Cox models with the same gender-specific definitions for high and low hemoglobin as time-varying covariates with adjustment for treatment allocation and established risk factors and diseases, hemoglobin in the lowest decile was associated with higher rates of all-cause mortality (HR 3.03, 95% CI 1.89-4.85, P < .001) and the composite end point (HR 1.36, 95% CI 1.08-1.71, P < .01), whereas hemoglobin in the highest decile was not. After adjusting for other risk factors, relatively low, but not high, hemoglobin during antihypertensive treatment was associated with higher incidence of all-cause mortality and the composite end point.

Puberty as a Risk Factor for Less Favorable Visual Outcome in Idiopathic Intracranial Hypertension

To test the hypothesis that puberty is a risk factor for poorer visual outcome in idiopathic intracranial hypertension (IIH). Retrospective chart review case series. Tertiary referral center, neuro-ophthalmology unit. Ninety-six patients with IIH followed for a minimum of one year. Age (grouped into prepubertal, pubertal, teenage, or adult), obesity, initial intracranial pressure (ICP), measurements and presence of hypertension, anemia, or renal failure were correlated with final visual outcome using chi(2), stepwise logistic regression, and model-selection log linear analyses. Visual outcome was graded into "excellent" -- no evidence of an optic neuropathy or any permanent visual field defect in either eye, "moderate"-- evidence of an optic neuropathy and/or a mild (nasal constriction) visual field defect, or "poor outcome" (peripheral constriction) -- permanent visual field defect. Outcome data were complete for 96 patients. Moderate to poor visual outcome, as opposed to excellent, was significantly associated with puberty (P = .007 using the gender-specific definition of puberty, .0002 using the broad definition). Moderate-poor visual outcome occurred in none of seven IIH patients of prepubertal age (<9 years), in 15 of 26 patients presenting between nine to 16 years, in two of six patients aged 17 to 22 years, and in seven of 57 adult patients over the age of 23 years. In this series of 96 patients with IIH, visual outcome was less favorable in pubertal patients than in prepubertal, teenage, and adult patients. We recommend that clinicians maintain a high index of awareness when caring for pubescent children with IIH.

Gender differences in psychopathy in a swedish offender sample

In this study we examined gender differences in the PCL:SV employing a variety of statistical methods with two subsets of psychopathic individuals drawn from larger samples of 129 female and 499 male Swedish offenders. The larger samples included forensic psychiatric patients, forensic psychiatric evaluees and criminal offenders. We found gender differences in antisocial behavior, as defined in factor 2 of the PCL:SV, with female psychopaths (PCL:SV>or=18) displaying significantly more lying, deceitfulness and lack of control, while male psychopaths were more antisocial as measured by the PCL:SV. We conclude that it might be meaningful to use gender specific definitions in the assessment of psychopathy or, alternatively, slightly revise the diagnostic tools. Our results support the use of the three-factor model of the PCL-R and PCL:SV introduced by Cooke and Michie (2001) in female populations.

Prevalence and Correlates of Alcohol-Induced Blackouts Among College Students: Results of an E-Mail Survey

The authors conducted an e-mail survey of 772 college students to learn more about their experiences with blackouts. Approximately half (51%) of those who had ever consumed alcohol reported they had experienced a blackout at some point in their lives, and 40% had experienced 1 in the year before the survey. Among those who drank in the 2 weeks before the survey, nearly 1 in 10 (9.4%) had experienced a blackout during that period. Many later learned that, during the blackout, they had vandalized property, driven an automobile, had sexual intercourse, or engaged in other risky behaviors. Experiencing 3 or more blackouts was associated with a variety of other experiences, including heavier drinking, lower grades, an earlier age of drinking onset, and having others express concerns about their drinking. The female students who reported blackouts during the 2 weeks before the survey drank far less than male students did during this time period, supporting the use of gender-specific definitions of risky drinking.

Estimated blood alcohol levels reached by "binge" and "nonbinge" drinkers: A survey of young adults in Montana.

The authors examined estimated blood alcohol concentrations (BACs) reached by so-called "binge drinkers" and "nonbinge drinkers" using a survey of young adults (age 18-24 years) in Montana. One third of drinkers were classified as "binge drinkers" the last time they consumed alcohol, using a gender-specific definition commonly applied to young adults: for men, having 5 or more drinks in a row, and for women, having 4 or more drinks. BAC levels were estimated on the basis of length of drinking episode, gender, weight, and typical alcohol consumption level. Among "binge drinkers," 63% did not reach .10% BAC or higher, 48% did not reach .08% BAC or higher, and 30% did not reach .06% BAC or higher. Of the "nonbinge drinkers," 7% reached .06% BAC or higher and 4% reached .08% BAC or higher. These findings underscore the potential problem of using binge drinking as a description and shorthand measure of drinking to intoxication.

Drinking habits among older persons: findings from the NHANES I Epidemiologic Followup Study (1982-84). National Health and Nutrition Examination Survey.

To describe alcohol use and its sociodemographic correlates among persons aged 65 years and older in a US probability sample. Cross-sectional analysis of a national probability sample-based cohort study. Multiple sites throughout the United States. A total of 3448 persons aged 65 and older who participated in the first wave of the NHANES I Epidemiologic Followup Study (1982-84). We describe the alcohol use behaviors and demographic characteristics of 3448 persons aged 65 and older. Least squares regression models were used to assess associations between older persons' sociodemographic characteristics and alcohol use. Sixty percent of the sample reported having 12 or more drinks of alcohol in at least 1 year of their lives. Seventy-nine percent of these older drinkers were currently drinking. Twenty-five percent of all drinkers drank daily (31% men, 19% women). Using gender-specific definitions (men >2 drinks/day; women >1 drink/day), 16% of men drinking alcohol and 15% of women drinking alcohol were heavy drinkers. Younger age, male gender, and higher income were associated with greater alcohol use. Most older persons who ever drank alcohol in their lifetimes were currently drinking. In addition, a substantial number of older persons were drinking currently at levels that may place them at risk of adverse health consequences.