Reduction In Women Research Articles

Abstract P3-10-07: Uptake of risk reducing measures in healthy BRCA 1-2 mutation carriers from Northern Italy: Outcomes of 9 years of close-surveillance. Experience of the hereditary cancer clinic in the region of Veneto, Italy

Abstract Background: There are several options for cancer reduction in women with a BRCA 1-2 mutation, including prophylactic surgery, chemo-prevention and close surveillance. Each of these measures offers varying levels of effectiveness with prophylactic mastectomy (PM) and oophorectomy (PO) providing the greatest risk reduction for the development of breast and ovarian cancer. The uptake of preventive procedures, however, differs according to country, not only in relation to access to care, but also cultural preferences. Here we present data on the experience of the Hereditary Cancer Center at the Istituto Oncologico Veneto, which is one of the few centers in Northern Italy to offer not only genetic testing, but also long-term follow-up to healthy carriers of the BRCA 1-2 genes. Methods: 106 healthy women were identified within a cohort of BRCA positive individuals followed since 2008. Upon learning of their BRCA mutation carrier status, they all agreed to enroll in a long-term protocol of close-surveillance. All women were also informed about risk-reducing surgery such as PO and PM. Results: The age in this sample ranged between 20 and 77 years with a median of 41.5. The average follow-up time was 4.3 +/-2.4 years. We observed that PO was more commonly accepted (41% 44/106) than PM (11% 12/106). The mean age at the time of PO was 47.3. In the PM group, half of the women decided to undergo such procedure only after being diagnosed with breast cancer. The mean age at the time of PM in the healthy subjects was 41.8 years. Over the follow-up period, 9.4% of the patients (10/106) developed BRCA related malignancies, of which 9 breast and 1 ovarian cancer. Of the 9 breast events, 2 were diagnosed at stage 0, 2 at stage I, 3 at stage II, and 2 at stage III. All cancer cells were aggressive (grade 3). Of the 2 stage III breast tumors, 1 was diagnosed on the very 1st breast MRI screening, and the other after an interval of 3 years due to the patient being pregnant and then breastfeeding. The 3 cases of stage II breast cancer, despite being 1 cm or less in size, already had node involvement. Both stage III breast tumors were triple negative in BRCA 1 carriers. The other breast cancers were ER+ and none was Her2+. Of the ER+ breast events 4 occurred in BRCA2 and 2 in BRCA1 carriers. Except for the 2 Stage 0 tumors, which arose in women who had a previous oophorectomy, all the other breast malignancies developed in carriers who still had their ovaries and were premenopausal. The one serous ovarian cancer was diagnosed at Stage II in a 77 years-old BRCA1+ woman. Conclusions: In this sample of healthy northern Italian women carriers of BRCA mutations, close to 10% developed a tumor within 5 years of follow-up with an aggressive cell phenotype. The more accepted method of risk-reduction in this group of women was PO as compared to PM. A protocol of close-surveillance allows for an early stage diagnosis in about half of the women who develop a breast tumor. Citation Format: Rastelli A, Azzolin F, Tognazzo S, Alducci E, Zovato S. Uptake of risk reducing measures in healthy BRCA 1-2 mutation carriers from Northern Italy: Outcomes of 9 years of close-surveillance. Experience of the hereditary cancer clinic in the region of Veneto, Italy [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P3-10-07.

Individualised gonadotropin dose selection using markers of ovarian reserve for women undergoing in vitro fertilisation plus intracytoplasmic sperm injection (IVF/ICSI).

Individualised gonadotropin dose selection using markers of ovarian reserve for women undergoing in vitro fertilisation plus intracytoplasmic sperm injection (IVF/ICSI).

Effect of body mass index on diabetogenesis factors at a fixed fasting plasma glucose level.

AimThe present study evaluated the relative influence of body mass index (BMI) on insulin resistance (IR), first-phase insulin secretion (FPIS), second-phase insulin secretion (SPIS), and glucose effectiveness (GE) at a fixed fasting plasma glucose level in an older ethnic Chinese population.MethodsIn total, 265 individuals aged 60 years with a fasting plasma glucose level of 5.56 mmol/L were enrolled. Participants had BMIs of 20.0–34.2 kg/m2. IR, FPIS, SPIS, and GE were estimated using our previously developed equations. Pearson correlation analysis was conducted to assess the correlations between the four diabetogenesis factors and BMI. A general linear model was used to determine the differences in the percentage of change among the four factor slopes against BMI.ResultsSignificant correlations were observed between BMI and FPIS, SPIS, IR, and GE in both women and men, which were higher than those reported previously. In men, BMI had the most profound effect on SPIS, followed by IR, FPIS, and GE, whereas in women, the order was slightly different: IR, followed by FPIS, SPIS, and GE. Significant differences were observed among all these slopes, except for the slopes between FPIS and SPIS in women (p = 0.856) and IR and FPIS in men (p = 0.258).ConclusionsThe contribution of obesity to all diabetes factors, except GE, was higher than that reported previously. BMI had the most profound effect on insulin secretion in men and on IR in women in this 60-year-old cohort, suggesting that lifestyle modifications for obesity reduction in women remain the most important method for improving glucose metabolism and preventing future type 2 diabetes mellitus.

Carnets de l'incarnation: Textes choisis 2002–2015 by Nancy Huston

Reviewed by: Carnets de l'incarnation: Textes choisis 2002–2015 by Nancy Huston Polly Galis Nancy Huston, Carnets de l'incarnation: Textes choisis 2002–2015. Arles: Actes Sud, 2016. Huston's corpus is commonly characterised by its transnational and multi-generic format, and Carnets de l'incarnation is no exception. Huston draws inspiration from multiple contexts including a research trip to Israel, a gallery in Beijing, a New York book-club, and the Parisian Hebdo polemic surrounding the 2015 terrorist attacks. She also incorporates both public pieces (newspaper articles, critical prefaces, conference proceedings) and personal fragments (diary entries, poetry, and prose), playing with narrative style and shifting from the comic to the tragic. Huston pays homage to a wide spectrum of philosophers, artists, and writers, including Diane Arbus, Anaïs Nin, Nelly Arcan, Kate Chopin, Simone de Beauvoir, as well as Annie Leclerc and Romain Gary, on whom she has written extensively in two eponymous publications. As with her previous amalgamated textes choisis, Désirs et Réalités (1995) and Âmes et corps (2004), Huston brings together a decade's worth of foundational essays centred on an overarching theme: in the case of Carnets de l'incarnation, a gendered mind-body dichotomy. Huston begins by acknowledging problems experienced primarily by women: prostitution and pornography; the Madonna-whore complex; and the reduction of women's identity to their bodily form (be they de- or hyper-sexualised). Huston then addresses male-orientated issues, [End Page 141] namely, men's coercion into violent and dominant social positions, and their implication in paedophilia, crime, and war. Huston situates these analyses at the intersection of biological determinism and social constructionism. On the one hand, Huston claims men have a naturally higher libido than women, and that women are predetermined to solicit the male gaze. On the other, Huston considers instincts to be dangerously distorted by social phenomena such as the sex industry, which exploits men's sexual drives and women's bodies to finance a neo-liberal market. Huston thus highlights the hypocrisy of our contemporary epoch which both denies sexual difference and profits from it. Where women are encouraged to define themselves according to their bodies, moreover, men are paradoxically taught to deny theirs. Huston insists that we should not overlook but learn from sexual difference, to harness its positive potential instead. What could be interpreted as a contradiction thus constitutes an invitation to overcome binaries. The same is true for other dualisms in this collection, as with love-intellect, nihilism-idealism, corporeality-spirituality. As Huston confirms in her introduction, she seeks not coherence but polyphony, and invites us to embrace our material corporeality—men and women alike—to access a mode of spirituality fitting for our modern times. How this spiritual state is to be achieved in practical terms, however, is left unanswered, and the book ends with a fictional tale of disempowerment: the narrator espies an approaching army and is unable to forfend its advance. In true Huston style, this collection refuses neat categorisation and simple solutions. If any conclusive messages do stand out, it is that we can problematize cultural, racial, and gender divides by imagining the position of the Other, and that we must re-evaluate the causes and consequences of gendered bodily experience before it is too late. [End Page 142] Polly Galis University of Leeds Copyright © 2018 L'Esprit Créateur

Clinical management and risk reduction in women with low-grade squamous intraepithelial lesion cytology: A population-based cohort study.

We analyzed the management and risk of subsequent cervical intraepithelial neoplasm 3 (CIN3) and invasive cervical cancer in women with low-grade squamous intraepithelial lesion (LSIL) cytology. A total of 53,293 women with a new diagnosis of cytologic LSIL were identified in Taiwan’s national cervical screening registration database. Based on the retrieved clinical management data, the incidence of subsequent CIN3+ lesions was determined, and the hazard ratios (HRs) were estimated using a Cox proportional hazards model. The average follow-up was 5.02 years. A total of 988 women developed CIN3+ lesions during this period, with an overall incidence of 369.3 women per 100,000 person-years. Cryotherapy and conization/loop electrosurgical excision procedure (LEEP) decreased the subsequent risk of CIN3+ lesions in women younger than 50 years (HR 0.49, 95% confidence interval [CI] 0.37–0.64, p<0.0001 for cryotherapy; HR 0.39, 95% CI 0.27–0.55, p<0.0001 for LEEP). Cryotherapy and conization/LEEP were two significant protective factors for developing CIN3+ lesions, especially in women with biopsy-proven CIN1 (HR 0.55, 95% CI 0.37–0.82, p = 0.003 for cryotherapy; HR 0.43, 95% CI 0.24–0.77, p = 0.005 for LEEP). These results suggest that when women are first screened LSIL and lack prior abnormal cervical cytology, cryotherapy should be one of the treatment options. Younger women with a histological biopsy diagnosis of CIN1 were most likely to benefit from cryotherapy.

Renal function and urological complications after radical hysterectomy with postoperative radiotherapy and platinum-based chemotherapy for cervical cancer.

We aimed to clarify renal functional changes long term and serious urological complications in women with cervical cancer who undergo radical hysterectomy followed by pelvic radiotherapy and/or platinum-based chemotherapy to treat the initial disease. Data on 380 women who underwent radical hysterectomy at the National Kyushu Cancer Center from January 1997 to December 2013 were reviewed. Main outcome measures were the estimated glomerular filtration rate (eGFR) and monitored abnormal urological findings. Postoperative eGFR was significantly lower than preoperative eGFR in 179 women with surgery alone and in 201 women with additional pelvic radiotherapy and/or chemotherapy (both P < 0.01). Two types of univariate analyses for eGFR reduction in women after treatment showed that older age, advanced stage, pelvic radiotherapy, and platinum-based chemotherapy were significant variables on both analyses. Two types of multivariate analyses showed that platinum-based chemotherapy or pelvic radiotherapy were associated with impaired renal function (odds ratio 1.96, 95% confidence interval 1.08-3.54 and odds ratio 2.85, 95% confidence interval 1.12-7.24, for the respective analyses). There was a higher rate of bladder wall thickening in women with pelvic radiotherapy had than those without it (17.4% vs. 2.7%, P < 0.01). One serious urological complication (intraperitoneal rupture of the bladder) occurred among women who underwent pelvic radiotherapy (0.6% vs. 0%). Surgeons should be aware that eGFR is reduced after platinum-based chemotherapy and/or postoperative pelvic radiotherapy. Serious and life-threatening urological complications are rare, but surgeons should be aware of the possibility during the long follow-up.

Gliptin therapy reduces hepatic and myocardial fat in type 2 diabetic patients.

Increased hepatic fat and cardiac fat are common in patients with type 2 diabetes mellitus (T2DM) and are associated with a greater risk of liver fibrosis and cardiovascular (CV) events. Sex-specific differences of dipeptidyl peptidase-four (DPP-4) inhibitor effects on hepatic (HCL) and myocardial fat content (MYCL) have not yet been evaluated. Forty-one T2DM patients (20 male, 21 female) received a gliptin add-on therapy if HbA1c goals were not reached under metformin monotherapy. They underwent cardiac and liver magnetic resonance tomography and spectroscopy before and 6months after therapy initiation. Plasma samples were analysed for the growth differentiation factor 15 (GDF-15), a novel marker for cardiovascular risk. Thirty-eight patients on gliptin therapy completed the study. We observed a positive correlation between MYCL and HCL before therapy (R=0·41, P=0·05). After 6months of therapy, we noticed a significant weight reduction in women only (P=0·02) whereas waist circumference decreased similarly in both sexes. HbA1c sunk significantly in both sexes (P=0·002). HCL decreased significantly (P=0·0004), with women featuring higher basal HCL (P<0·05). MYCL decreased in women only (P=0·01) and GDF-15 comparably in both sexes (P<0·05). 6months of DPP-4-therapy led to a significant overall decrease in HCL and body weight such as a reduction of MYCL only in women. This preliminary data set could implicate that gliptin may be a feasible therapy option in fatty liver patients with diabetes potentially including positive effects on cardiovascular function particularly in women.

The MC4R genotype is associated with postpartum weight reduction and glycemic changes among women with prior gestational diabetes: longitudinal analysis

The genetic variants near the Melanocortin-4 receptor gene (MC4R), a key protein regulating energy balance and adiposity, have been related to obesity and glucose metabolism. We aimed to assess whether the MC4R genotype affected longitudinal changes in body weight and glucose metabolism biomarkers among women with prior gestational diabetes mellitus (GDM). The MC4R genotype, postpartum weight reduction, and glycemic changes between after delivery and pregnancy were assessed in a cohort of 1208 Chinese women who had experienced GDM. The adiposity-increasing allele (C) of the MC4R variant rs6567160 was associated with greater postpartum increase of HbA1c (β = 0.08%; P = 0.03) and 2-hour OGTT glucose concentrations (β = 0.25 mmol/L; P = 0.02). In addition, we found an interaction between the MC4R genotype and postpartum weight reduction on changes in fasting plasma glucose (P-interaction = 0.03). We found that the MC4R genotype was associated with postpartum glycemic changes; and the association with fasting glucose were significantly modified by postpartum weight reduction in women who had experienced GDM.

Why did life expectancy decline in the United States in 2015? A gender-specific analysis

In 2015, age-adjusted mortality rates increased for 8 of the 10 leading causes of death in the United States. As a result, life expectancy declined by 0.17 years for both women and men. The decline could be just an anomaly, or it could represent the start of a new trend of stagnation or decline in life expectancy, as some scholars have warned. The first step is to determine the sources of the decline. In this study we analyze the contribution of specific causes of death to the decline in men's versus women's life expectancy, as well as the mechanisms that generated the decline. With regard to mechanisms, we examine whether the decline in life expectancy resulted from reductions in the average age at death for most causes of death, or from a greater risk of dying of causes that disproportionately affect the young and middle-aged. Using CDC mortality data, we construct life tables for men and women separately, based on 20 different underlying causes of death. We find that men's reduction in life expectancy was attributable primarily to changes in midlife mortality, with a greater risk of dying of causes such as accidental poisoning or homicide. The reduction in women's life expectancy, on the other hand, was attributable primarily to changes in old-age mortality, where the mean age at death for most causes (such as heart disease and mental illnesses) was lower in 2015 than it was in 2014. These gender-specific mechanisms that contributed to the decline in life expectancy are common to the major racial/ethnic groups, but the magnitude of the decline differs greatly across racial/ethnic groups. Future research can use the tools provided here to investigate in more detail how the gender-specific mechanisms of the 2015 decline differ by race.

Mindfulness-Based Stress Reduction in Women with Overweight or Obesity: A Randomized Clinical Trial.

ObjectiveTo evaluate the feasibility and cardiometabolic effects of mindfulness‐based stress reduction (MBSR) in women with overweight or obesity.MethodsEighty‐six women with BMI ≥ 25 kg/m2 were randomized to 8 weeks of MBSR or health education and followed for 16 weeks. The primary outcome was the Toronto Mindfulness Scale. Secondary outcomes included the Perceived Stress Scale‐10, fasting glucose, and blood pressure.ResultsCompared to health education, the MBSR group demonstrated significantly improved mindfulness at 8 weeks (mean change from baseline, 4.5 vs. −1.0; P = 0.03) and significantly decreased perceived stress at 16 weeks (−3.6 vs. −1.3, P = 0.01). In the MBSR group, there were significant reductions in fasting glucose at 8 weeks (−8.9 mg/dL, P = 0.02) and at 16 weeks (−9.3 mg/dL, P = 0.02) compared to baseline. Fasting glucose did not significantly improve in the health education group. There were no significant changes in blood pressure, weight, or insulin resistance in the MBSR group.ConclusionsIn women with overweight or obesity, MBSR significantly reduces stress and may have beneficial effects on glucose. Future studies demonstrating long‐term cardiometabolic benefits of MBSR will be key for establishing MBSR as an effective tool in the management of obesity.

Incident rate and risk factors for tuberculosis among patients with type 2 diabetes: retrospective cohort study in Shanghai, China.

To examine the incident rate of tuberculosis (TB) and its associates among adults with type 2 diabetes in Shanghai, China. We conducted a retrospective cohort study among 170 399 patients with type 2 diabetes aged ≥18 years who were registered in Shanghai community-based diabetes management system between 2004 and 2009. Their TB status was tracked until 31 December 2014. Cox regression was performed to identify the risk factors for TB. We documented 785 new TB cases during 654 977 person-years of follow-up. The incident rate of TB was 224.20 (206.69, 243.16) per 100 000 person-years among men and 51.34 (44.75, 58.92) per 100 000 person-years among women. A 1-unit increase of BMI was associated with a risk reduction in 16% (P < 0.01) for men and a 14% (P < 0.01) reduction for women. TB cases were more likely to be insulin-dependent [men: hazard ratio = 2.13 (1.29, 3.53); women: 3.28 (1.28, 8.39)] and had a poor glucose level initially [men: 1.21 (1.15, 1.27); women: 1.27 (1.18, 1.37)]. The risk factor for TB specific to men was a young age at diagnosis of diabetes, and the protective factor specific to women was actively engaging in physical activity. TB incident rate among patients with type 2 diabetes was substantially higher among men than among women. The risk of TB was reversely associated with initial BMI. The severity of poor glucose control among patients with diabetes was also linearly associated with the risk of TB.

The relationship between women's paid employment and women's stated son preference in India

Objective: We explore whether women’s paid employment is associated with reductions in women’s stated son preference in India and whether these results vary by employment sector (agriculture, manufacturing, services, professional-technical) and skill level (education and literacy). Methods: We conduct a logistic regression analysis of the relationship between women’s paid employment and women’s stated son preference among a sample of never-pregnant Indian women. We use the 2005 India National Family Health Survey (NFHS). Results: Women’s paid employment in the service and manufacturing sectors is associated with significant reductions in the stated son preference of low-skilled women (i.e., low education and literacy). However, this negative association goes away for women at higher skill levels. In fact, paid employment in manufacturing is associated with significantly higher stated son preference among university-educated women. However, women’s paid employment in agriculture and the professional-technical sectors is not significantly associated with women’s stated son preference. Finally, the association between women’s paid employment and stated son preference is significantly larger for women living in north India than for women living in south and east India. Conclusions: We hypothesize that significant negative associations between women’s paid employment and women’s stated son preference occur only in cases where paid employment changes the economic status of women within the family. Contribution: Our analysis demonstrates that there are important linkages between women’s paid employment and stated son preference, and draws attention to how the context of employment (e.g., sector and skill level) is differentially associated with demographic outcomes.

Influence of Protein Intake, Race, and Age on Responses to a Weight-Reduction Intervention in Obese Women

BackgroundWomen have higher rates of obesity than men and develop more pronounced functional deficits as a result. Yet, little is known about how obesity reduction affects their functional status, including whether their responses differ when protein intake is enhanced. ObjectiveThe aim of this study was to confirm the feasibility of delivery of a higher-protein (balanced at each meal) calorie-restricted diet in obese women and determine its efficacy for influencing function and retention of lean mass. MethodObese community-dwelling women [n = 80; body mass index (in kg/m2), in means ± SDs: 37.8 ± 5.9; aged 45–78 y; 58.8% white] were enrolled in a weight-loss (−500 kcal/d) study and randomly assigned to either a Control–Weight-Loss (C-WL; 0.8 g protein/kg body weight) group or a High-Protein–Weight-Loss (HP-WL; 1.2 g protein/kg body weight; 30 g protein 3 times/d) group in a 1:2 allocation. Primary outcomes were function by 6-min walk test (6MWT) and lean mass by using the BodPod (Life Measurement, Inc.) at 0, 4, and 6 mo. ResultsBoth groups reduced calorie intakes and body weights (P < 0.001), and the feasibility of the HP-WL intervention was confirmed. The 6MWT results improved (P < 0.01) at 4 mo in the HP-WL group and at 6 mo in both groups (P < 0.001). Both groups improved function by several other measures while slightly decreasing (P < 0.01) lean mass (−1.0 kg, C-WL; −0.6 kg, HP-WL). Weight loss was greater in white than in black women at both 4 mo (6.0 ± 3.6 compared with 3.7 ± 3.4 kg; P < 0.02) and 6 mo (7.2 ± 4.8 compared with 4.0 ± 4.7 kg; P < 0.04) and tended to be positively related to age (P < 0.06). ConclusionsA clinically important functional benefit of obesity reduction was confirmed in both study groups, with no significant group effect. Our findings of racial differences in response to the intervention and a potential influence of participant age lend support for further studies sufficiently powered to explore the interaction of race and age with functional responses to obesity reduction in women. This trial was registered at clinicaltrials.gov as NCT02033655.

E-cigarettes for immediate smoking substitution in women diagnosed with cervical dysplasia and associated disorders

Smoking is a known risk factor for cervical cancer. This American study aimed to examine the impact of nicotine replacement therapy and e-cigarettes on smoking cessation or reduction in women diagnosed with, or at risk of, cervical dysplasia.

Musculoskeletal disorders as underlying cause of death in 58 countries, 1986\u20132011: trend analysis of WHO mortality database

BackgroundDue to low mortality rate of musculoskeletal disorders (MSK) less attention has been paid to MSK as underlying cause of death in the general population. The aim was to examine trend in MSK as underlying cause of death in 58 countries across globe during 1986–2011.MethodsData on mortality were collected from the WHO mortality database and population data were obtained from the United Nations. Annual sex-specific age-standardized mortality rates (ASMR) were calculated by means of direct standardization using the WHO world standard population. We applied joinpoint regression analysis for trend analysis. Between-country disparities were examined using between-country variance and Gini coefficient. The changes in number of MSK deaths between 1986 and 2011 were decomposed using two counterfactual scenarios.ResultsThe number of MSK deaths increased by 67% between 1986 and 2011 mainly due to population aging. The mean ASMR changed from 17.2 and 26.6 per million in 1986 to 18.1 and 25.1 in 2011 among men and women, respectively (median: 7.3% increase in men and 9.0% reduction in women). Declines in ASMR of 25% or more were observed for men (women) in 13 (19) countries, while corresponding increases were seen for men (women) in 25 (14) countries. In both sexes, ASMR declined during 1986–1997, then increased during 1997–2001 and again declined over 2001–2011. Despite decline over time, there were substantial between-country disparities in MSK mortality and its temporal trend.ConclusionsWe found substantial variations in MSK mortality and its trends between countries, regions and also between sex and age groups. Promoted awareness and better management of MSK might partly explain reduction in MSK mortality, but variations across countries warrant further investigations.

Igualdad de género en las enseñanzas no universitarias en España: Un estudio descriptivo (1999-2013)

Desde mediados del siglo XIX, la enseñanza ha sido el sector que la mujer ha utilizado para entrar en el mercado de trabajo, produciéndose, a partir de entonces, una feminización de la profesión docente en España. Numerosos procesos políticos, socioeconómicos y culturales han permitido el acceso masivo de la mujer a la enseñanza superior y una paulatina expansión de profesoras desde la enseñanza primaria a todos los niveles del profesorado. Sin embargo, pese a los altos índices de feminización de la profesión, aún existen diferencias de género que se evidencian en la disminución de su presencia a medida que aumenta el nivel educativo y en los cargos de poder de las instituciones educativas, entre otras. Este trabajo pone el énfasis en el análisis descriptivo de la composición del profesorado según el género y su relación con los niveles y enseñanzas impartidas, la titularidad del centro, los equipos directivos, la edad, la dedicación horaria y otras variables referidas al desempeño de la profesión como la motivación o la satisfacción laboral. Se concluye que, para las Enseñanzas de Régimen General No Universitarias en el periodo 1999-2013 para el que existen datos disponibles, se encuentran diferencias por sexo significativas que permiten concretar algunas iniciativas para reducir las desigualdades de género, incrementar el número de varones en la profesión y avanzar hacia la equiparación de oportunidades en la participación femenina en los puestos de dirección. Por último, este estudio se propone como punto de partida para un trabajo empírico posterior acerca del efecto de la composición del profesorado atendiendo al género sobre los resultados académicos del alumnado.

Reducing female admissions to custody: Exploring the options at sentencing

Although women represent a small minority of the prison population in all nations, it has long been a concern that custody is overused with respect to female offenders. Reducing the number of women in prison has therefore emerged as a policy priority in many western nations, including the United Kingdom. This article evaluates a range of sentencing strategies to reduce the number of women in prison, on the grounds that their experience of the sanction is disproportionately severe. The challenge is to achieve a reduction in women’s imprisonment without compromising the fundamental sentencing principles of equity and proportionality. Although no jurisdiction has launched a sentencing initiative with this specific aim, the international sentencing literature offers insight into the most effective methods by which reductions may be achieved. Informed by the principle of equal impact, which underpins gender-specific sentencing, we explore policy options in two principal domains: (1) statutory provisions to eliminate or restrict judicial discretion to imprison female offenders; and (2) sentencing guidelines to structure judicial discretion in gender-sensitive ways. We conclude by considering the likelihood of implementing the options.

Impact of a Stress Management Intervention Program on Sexual Functioning and Stress Reduction in Women with Breast Cancer

Breast cancer as the most common cancer among women endangers various aspects of their sexual lives and is a major culprit regarding health impairment and low life quality. The aim of this study was to examine the effect of a stress management intervention program on sexual functioning and stress reduction in women with breast cancer. This study employed a quasi-experimental pre-test, post-test design which included follow-up checks and a control group. To this end, 104 women with breast cancer referring to Hamadan’s Mahdiyeh MRI Center at the time of data collection were conventionally selected in 2015. Using permuted blocks, they were randomly divided into experimental and control groups (n= 52), only the former receiving stress management counseling for 18 hours. Data were collected through a demographic questionnaire, the Female Sexual Function Index (FSFI) questionnaire, and Harry’s stress questionnaire, filled out by patients before and after the intervention. To analyze the data, descriptive statistics and two-way ANOVA were used. The results showed that cognitive - behavioral stress management group therapy improved total sexual functioning and its subscales. After the treatment, there was a significant difference in mean scores between the groups (p=0.01). Moreover, significant differences were observed in the mean scores for stress with improvement in the experimental group in post-test results. Cognitive - behavioral group therapy for stress management was thuis found to improve total sexual functioning and its subscales and reduce the level of stress in the experimental group after the intervention and follow-up period with an interval of two weeks. Therefore, this method can be used as a complementary therapy along with medical treatment in oncology centers.

Improved Farm Technology Adoption and its Role in Doubling Farmers’ Income: A Case of Dry Zones in Karnataka

The study has estimated the adoption of improved dry farming technologies, identified the factors governing their adoption and assessed the socio-economic impact owing to their adoption, including enhancement in farm incomes. The study is largely based on the primary data collected from a sample of 500 farm households spread across 50 villages chosen from 25 talukas in all the five dry zones of Karnataka. Technology Adoption Index (TAI), multiple regression model and descriptive statistics were used to analyse the data. The TAI was found highest in the Improved Livestock Management Practices (ILMP), followed by Improved Crop Production Technologies (ICPT), Improved Energy Management Systems (IEMS) and Improved Soil and Water Conservation Technologies (ISWCT), and was least in Improved Land Use Systems (ILUS). Due to adoption of improved dry land technologies, across all dry zones, the average increase was 21.37 per cent in resource-use efficiency, 22.75 per cent in profitability, 14.96 per cent in standard of living, 13.50 per cent in women's participation and 8.19 per cent in reduction of women's drudgery. Given the technology adoption levels much below the desired levels, the extension gap (Yield Gap-II) needs to be more focussed than research gap (Yield Gap-I) in the next 4–5 years. To achieve “doubling of farmers’ income by 2022, a multi-pronged approach needs to be adopted by all concerned in a consistent and planned manner, since the contributions to double the farm incomes come not only from technological innovations, but also significantly from institutional support, infrastructural facilitation and policy intervention.

When Agreements Blur Disputes: Do Common Assumptions Regarding General Implications of Intimate Physical Partner Violence Mediate or Intensify the Controversy?

A common assumption is that gender can be studied through the differences between men and women living in intimate partner violent (IPV) relationships. Mainly, that general gender behavior can be studied through IPV. This approach is examined and an alternative possibility for a broad agreement is suggested. Accordingly, gender motives reflecting status enhancement for men and risk reduction for women can be dominant in daily conduct and implemented in intimate relationships. The suggestions made in this article can be seen as an alternative agreed starting point for the study of IPV free of a priori premises and conventions. Theoretical and practical implications are suggested which can mediate between the approaches regarding gender and IPV and perhaps clarify the controversy so that different psychological interventions may be applied.