Gender-specific Issues Research Articles

A perspective from drug user organisations on 'ECDC and EMCDDA guidance: prevention and control of infectious diseases among people who inject drugs'.

A perspective from drug user organisations on 'ECDC and EMCDDA guidance: prevention and control of infectious diseases among people who inject drugs'.

Gender differences in depression

Depression is one of the most prevalent and debilitating diseases. In recent years there has been increased awareness of sex- and gender-specific issues in depression. This narrative review presents and discusses differences in prevalence, symptom profile, age at onset and course, comorbidity, biological and psychosocial factors, the impact of sexual stereotyping, help-seeking, emotion regulation and doctor-patient communication. Typically, women are diagnosed with depression twice as often as men, and their disease follows a more chronic course. Comorbid anxiety is more prevalent in women, whereas comorbid alcohol abuse is a major concern in men. Sucide rates for men are between three and five times higher compared with women. Although there are different symptom profiles in men and women, it is difficult to define a gender-specific symptom profile. Socially mediated gender roles have a significant impact on psychosocial factors associated with risk, sickness behavior and coping strategies. In general, too little attention has been paid to the definition and handling of depression and the gender-related requirements it makes on the healthcare system.

Perception of firefighters’ turnout ensemble and level of satisfaction by body movement

This study investigates firefighters’ perception of the protective turnout ensemble, more specifically, the level of satisfaction for a set of commonly performed body movements. Five hundred sixteen male and female firefighters completed our online survey. The current study identifies (1) the level of satisfaction with the fit of the turnout ensemble, (2) perceived reasons for discomfort and movement restriction in areas with low satisfaction, and (3) gender-specific fit issues. Female firefighters showed significantly lower satisfaction with the fit and functionality of the turnout ensemble in multiple areas than males. Common fit issues such as a stiff or oversized neckline and inappropriate location of knee pads, tightness in the lower pant leg, and inaccessibility of pockets that affect male and female firefighters are addressed. This study offers important implications to industry and academia involved in the study of protective clothing to increase the mobility, safety, and comfort of today's firefighters.

Impact of Gender on Reactions to Military Sexual Assault and Harassment

Research has shown that experiences ofmilitary sexual assault and harassment can have a negative impact on veterans' health and functioning, even years or decades later, thus clearly identifying this as an important area of concern for social workers. In addition to understanding the scope and general impact of military sexual assault and harassment, social workers also must thoroughly understand how different cultural factors may intersect with veterans' experiences. To this end, this article reviews the current knowledge base on how veterans' life experiences related to gender can affect their experience of and recovery from military sexual assault and harassment, highlights common gender-specific issues, and discusses implications for practice.

A Gendered Perspective on Military Deployment

Military deployment, especially in combat or dangerous areas, can have a strong influence on subsequent mental health. This effect may be intensified as a result of the potential stigma that admission of mental health problems indicates weakness. Additional mental health issues exist for female soldiers from the National Guard who are pulled from non-military environments to work under dangerous conditions far from home and traditional social support. Minimal documentation is available about the day-to-day, gendered experiences of deployment for this group of female soldiers. To provide background for appropriate training and support, the aim of this study was to understand better the experiences of military deployment for women in the National Guard. We used content analysis to analyze individual, semi-structured interviews with a sample of 42 women from 7 U.S. National Guard units who were deployed in combat areas. Four general themes emerged about deployment experience: the general environment of stress, heterogeneous job responsibilities, home comes with you, and gendered stress. Military efforts are needed to address gender-specific issues associated with deployment and to develop resilience training that will optimize the mental health of female soldiers.

The Need to Be Superman: The Psychosocial Support Challenges of Young Men Affected by Cancer

To investigate how gender-specific issues shape the experiences of young adult men with cancer and what they report to be problematic. A qualitative, descriptive approach. Website, focus group in the southwestern United States, and phone interviews throughout the United States. Text from an online forum (N=3,000 posts), focus group of six men, and separate interviews with four men. Data analysis took place over two months through constant comparison of online text as well as a focus group and interview transcripts. Men face challenges being both a receiver and provider of support in relationships with their peers, romantic partners, and children. Cultural expectations to "be strong" drive their support-seeking beliefs and behaviors. Men report conflict between desires to show strength and to be honest that present a barrier to support, as well as contribute to inadequate relationships with male peers and greater difficulty in exchanging support with romantic partners. The authors identified attitudes about and barriers to men's experiences with social support, which healthcare providers, such as nurses, should be sensitive to when developing and providing support.

Student perceptions of high-achieving classmates

The reported study investigated students’ perceptions of their high-performing classmates in terms of intelligence, social skills, and conscientiousness in different school subjects. The school subjects for study were examined with regard to cognitive, physical, and gender-specific issues. The results show that high academic achievements in particular school subjects lead to negative reactions in the peer group whereas high achievements in other school subjects result in positive peer reactions. In contrast, the respondents’ gender and the gender of the successful classmates had little influence on student perceptions of high achievers. The results are discussed in regard to their implications for gifted education.

Adolescent and Young Adult Male Health: A Review

Adolescent and young adult male health receives little attention, despite the potential for positive effects on adult quality and length of life and reduction of health disparities and social inequalities. Pediatric providers, as the medical home for adolescents, are well positioned to address young men's health needs. This review has 2 primary objectives. The first is to review the literature on young men's health, focusing on morbidity and mortality in key areas of health and well-being. The second is to provide a clinically relevant review of the best practices in young men's health. This review covers male health issues related to health care access and the Centers for Disease Control and Prevention's Healthy 2020 objectives for adolescents and young adults, focusing on the objectives for chronic illness, mortality, unintentional injury and violence, mental health and substance use, and reproductive and sexual health. We focus, in particular, on gender-specific issues, particularly in reproductive and sexual health. The review provides recommendations for the overall care of adolescent and young adult males.

Exploring Gender Dimensions of Treatment Programmes for Neglected Tropical Diseases in Uganda

BackgroundGender remains a recognized but relatively unexamined aspect of the potential challenges for treatment programmes for Neglected Tropical Diseases (NTDs). We sought to explore the role of gender in access to treatment in the Uganda National Neglected Tropical Disease Control Programme.Methodology/Principal FindingsQuantitative and qualitative data was collected in eight villages in Buyende and Kamuli districts, Eastern Uganda. Quantitative data on the number of persons treated by age and gender was identified from treatment registers in each village. Qualitative data was collected through semi-structured interviews with sub-county supervisors, participant observation and from focus group discussions with community leaders, community medicine distributors (CMDs), men, women who were pregnant or breastfeeding at the time of mass-treatment, and adolescent males and females. Findings include the following: (i) treatment registers are often incomplete making it difficult to obtain accurate estimates of the number of persons treated; (ii) males face more barriers to accessing treatment than women due to occupational roles which keep them away from households or villages for long periods, and males may be more distrustful of treatment; (iii) CMDs may be unaware of which medicines are safe for pregnant and breastfeeding women, resulting in women missing beneficial treatments.Conclusions/SignificanceFindings highlight the need to improve community-level training in drug distribution which should include gender-specific issues and guidelines for treating pregnant and breastfeeding women. Accurate age and sex disaggregated measures of the number of community members who swallow the medicines are also needed to ensure proper monitoring and evaluation of treatment programmes.

A Qualitative Study of Treatment Needs Among Pregnant and Postpartum Women with Substance Use and Depression

Little is known about treatment for pregnant and postpartum women with cooccurring substance use and depression. Funded by the National Institute of Drug Abuse, we conducted three focus groups with 18 pregnant and postpartum women in 2011 at an urban substance use treatment clinic. A semi-structured discussion guide probed for factors impacting treatment outcomes and needs. Data were analyzed using grounded theory. Women identified motivational, family, friend, romantic, and agency characteristics as facilitative or challenging to their recoveries, and desired structure (group treatment, a safe environment, and transportation) and content (attention to mental health, family, and gender-specific issues) of treatment.

Hiv-Infected Women in Europe: Gender-Specific Needs and Challenges

In collaboration with the Strong, HIV positive, Empowered Women (SHE) programme, an industry-funded initiative aimed at improving the quality of life of HIV-positive women, Antiviral Therapy has taken the excellent step to dedicate a Supplement Issue addressing the needs and challenges related to the care of women living in Europe. Included articles present the multiple facets of gender-specific issues and research gaps, ranging from HIV testing strategies to antiretroviral combination therapy, including long-term challenges associated with chronic HIV infection.

An Empirical Study on the Satisfaction Level of Women Lawyers towards Their Work Life Balance

Legal profession is one of the growing and lucrative professions all over the world. It is one of the most adventurous as well as exciting career. Lawyers are held in high esteem in our society, and there remains the faith that when all else fails, one can still take recourse to the legal system. In such a valued profession women doesn't occupy a valuable space. Though participation of Women in legal profession has grown in the recent years, women were not given equivalent power and opportunities. Less frequently given the opportunity to move onto the occupational fast track, women face subtle but often self-perpetuating cycles of gender bias that limit their career choices. Although women qualify in equal proportions to men at the entry point of professional courses, there is a progressive decline in the number of women as one move up the hierarchy. Our legal structure should be modified wherein women are encouraged to get into legal profession and gender specific issues are to be eliminated in order to reduce the attrition rate of women lawyers.

Effective therapeutic milieus in secure services for women: The service user perspective

Background: Women in secure setting represent a group for whom gender sensitive treatments are only emergent. Service users are viewed as participants in treatment developments. However, the opinions of forensic patients have, in contrast to other service users, been under researched.Aims: To identify service users' views of the constituents of an effective therapeutic milieu for women in secure settings and to help identify the extent to which services need to be specifically tailored for women.Method: A qualitative service user-led participatory research approach was used. Two focus groups with service users from low and medium secure settings discussed the ingredients of an effective therapeutic milieu based on their experience of gender-specific treatment. Group transcripts were subjected to thematic analysis.Results: Themes identified covered interpersonal relationships; treatment programming; service user empowerment; the ward as a place of safety; and hope for the future. Participants did not highlight gender-specific issues despite this being implicit in focus group questions.Conclusions: Findings echo themes from other psychiatric settings and provide a much needed consensus between service providers and users on which to base healthcare planning. The elucidation of gender-specific factors in effective therapeutic milieus requires more focussed research.

Transition von Jugendlichen mit Blasenekstrophie-Epispadie Komplex in die Erwachsenenmedizin: Implikationen des Langzeitverlaufes für das Management

Today, young individuals with rare congenital anomalies as the Exstrophy-Epispadias-Complex (EEC) are mostly monitored interdisciplinary with a high standard of care and enthusiasm during childhood. However, when growing up through adolescence to adulthood adequate care-givers are not available at the moment in adult medicine in Germany and a concrete transition process has yet not been established. Over the past years, we put much effort in systematic evaluation of long-term outcome after reconstruction of the EEC in the newborn period to further improve outcome results. Beside predictive parameters for continence and long-term bladder function, genital function and fertility, as well as postoperative pelvic floor morphology and gynecological outcome, orthopedic results and psychosexual and psychosocial development in EEC were of major interest. As a consequence we currently develop a German-wide follow-up concept in EEC patients regarding age- and gender specific outcome issues. Long-term observations of the EEC outcome however, underline the unrestricted importance of careful long-term follow-up of all EEC patients, as well as the necessity of close cooperation of pediatric urologist, pediatric surgeons, urologists, orthopedic surgeons, gynecologists, andrologists, psychologists and urotherapists from early childhood and the need of knowledge transfer and hopefully a successful transition of the EEC individuals to general medicine.

Management of Pericarditis in Women

The risk of developing pericarditis is similar in men and women. However, systemic autoimmune diseases are more common in women and may determine an increased risk of recurrences and complications. Specific management issues for women with pericarditis include pregnancy and lactation. Relatively few data have been published on pericardial involvement during pregnancy, and major concerns of clinicians are related to management issues, especially medical treatment. Nowadays, the general outcomes of these pregnancies can be similar to that expected in the general population when carefully followed by dedicated multidisciplinary teams. The aim of this article is to review the management of pericarditis with a focus on gender-specific issues.

Being men with eating disorders: Perspectives of male eating disorder service-users

This study aimed to explore experiences of men currently using eating disorder services. Eight men from two eating disorder services were interviewed about their experiences of seeking and receiving treatment. Two superordinate themes emerged from Interpretative Phenomenological Analysis: (1) difficulty seeing self as having an eating disorder; and (2) experiences of treatment: how important is gender? The underlying themes varied in their specificity to men, with some echoing findings from the female eating disorder literature. Difficulty admitting the eating disorder may link with eating disorder psychopathology as well as gender-specific issues. Implications for clinical practice and future research are discussed.

Identifying Gender Differences among Romanian Non-smoking Junior High School Students

The purpose of this study was to assess gender differences regarding perceptions of smoking between Romanian non-smoking boys and girls, to facilitate the development of effective smoking prevention programmes. Cross-sectional data were obtained in 2006 by means of written questionnaires among 981 non-smoking school students aged 13-14 years from Cluj-Napoca, Romania. The results reveal that girls were more convinced than boys that smoking would result in several positive outcomes such as helping them getting more attention and becoming easier part of the crowd. Moreover, girls declared lower self-efficacy in refraining from smoking when friends smoke or offer them a cigarette. Parental norms regarding smoking seem to be less restrictive for boys than for girls. The gender differences found in our study do not warrant specific smoking prevention programmes for boys and girls, but it is advisable to include gender-specific issues in prevention activities targeting Romanian adolescents aged 13-14 years.

Psychosocial stress and cardiovascular risk - current opinion

Cardiovascular disease (CVD) is a major cause of morbidity and mortality worldwide. Epidemiologic research of the last half-century has clearly shown that psychosocial factors related to the social environment, personality characteristics, and negative affect increase the risk of incident CVD and also impact prognosis of cardiac patients. Several mechanisms may explain this link, including a genetic predisposition, poor lifestyle choices, low adherence to health recommendations, and direct pathophysiologic perturbations. The latter include alteration of the hypothalamic-pituitary adrenal axis and autonomic dysfunction resulting in endothelial dysfunction, inflammation, and a prothrombotic state further downstream. Screening for psychosocial factors seems appropriate as part of the standard history and based on the clinician's knowledge of the patient and the purpose of the visit. Psychological interventions generally alleviate distress in cardiac patients, but whether they reduce the risk of hard cardiovascular endpoints and all-cause mortality is less evident. Cardiac patients with more severe depression may particularly profit from antidepressant medications. Due to their pharmacologic properties, selective serotonin reuptake inhibitors were shown to improve cardiovascular outcome. The most effective psychosocial treatment is multicomponent therapy that combines elements of cognitive behaviour therapy ("stress management") and changes in health behaviours, including the adoption of a regular exercise regimen. Gender-specific issues should probably be considered. The field of behavioural cardiology has accumulated a wealth of epidemiological, mechanistic and clinical knowledge that undoubtedly has furthered our understanding about the important role of psychosocial risk factors in patients with a heart disease.

Peak oxygen consumption and prognosis in heart failure: 14 mL/kg/min is not a “gender-neutral” reference

BackgroundPeak oxygen consumption (VO2) predictive authority in heart failure (HF) has been established from male cohorts. We evaluated the gender impact on the prognostic meaning of low peak VO2. MethodsWe followed 529 HF patients (116 female), with peak VO2 ≤14mL/kg/min, until cardiovascular death (CVD) and urgent heart transplantation. ResultsDuring follow up, 156 (29%) patients had cardiac events. Female gender, age, left ventricular ejection fraction, peak VO2, peak systolic blood pressure, and beta-blocker treatment all contributed to increase the risk ability of the hierarchical multivariate model. Two-year survival was higher in women: 85 vs 66%; χ2=15.7, p<0.0001. Peculiarly, outcome results were similar when only CVD was considered. Females showed a multivariate adjusted hazard ratio (HR) of 0.46. Since a 1-mL/kg/min increment in peak VO2 was equated with a 12% improvement in prognosis, the same gender adjusted HR was achieved when mean peak VO2 was reduced by 5 units in women: thus, a HF woman with peak VO2 of 9mL/kg/min has the same 2-year outcome as a HF man with peak VO2 of 14mL/kg/min. ConclusionsAlthough HF women have a comparatively lower peak VO2 than men, they live longer. We discovered that the traditional cut point value for peak VO2, i.e. ≤14mL/kg/min is not a “gender-neutral” reference since lumping HF men and women together with the same VO2 value is unlikely to describe the true risk. These preliminary findings do underline the need to assimilate gender-specific issues into clinical practice in HF, when appropriate.

A critical review on physical factors and functional characteristics that may explain a sex/gender difference in work-related neck/shoulder disorders

The objective of this paper is to critically review recent literature on physical and functional sex/gender (s/g) differences, with focus on physical determinants associated with neck/shoulder musculoskeletal injuries. It is well known that there are s/g differences in anthropometrical and functional body characteristics (e.g. size and strength). However, s/g differences may be wrongly attributed if data analysis does not include appropriate corrections (e.g. by strength for endurance). Recent literature on motor control shows that there may indeed be s/g differences in muscle coordination and movement strategies during upper limb tasks that are not currently explained by methodological inadequacies. Moreover, recent studies have shown differences between men and women in sensory hypersensitivity characteristics associated with neck/shoulder injuries. Taken together, the literature points to the importance of accounting for possible s/g differences at all levels of the biopsychosocial system in order to better understand sex- and gender-specific issues relevant to workplace health. Practitioner Summary: This article critically reviews recent literature and a conceptual model highlighting s/g differences in physical and functional characteristics related to neck/shoulder musculoskeletal disorders (NSMSD). Findings have implications on understanding how personal factors may affect NSMSD risk. With better understanding, practitioners can make more appropriate decisions to prevent work-related NSMSD.