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1.
J Adolesc ; 79: 91-102, 2020 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-31926450

RESUMO

INTRODUCTION: Adolescents spend an increasing amount of time using digital media, but gender differences in their use and in associations with psychological well-being are unclear. METHOD: We drew from three large, representative surveys of 13- to 18-year-old adolescents in the U.S. and UK (total N = 221,096) examining digital media use in hours per day and several measures of psychological well-being separately in each of the three datasets. RESULTS: Adolescent girls spent more time on smartphones, social media, texting, general computer use, and online, and boys spent more time gaming and on electronic devices in general. Associations between moderate or heavy digital media use and low psychological well-being/mental health issues were generally larger for girls than for boys. Light users of digital media were slightly higher in well-being than non-users, with larger differences among boys. Among both genders, heavy users of digital media were often twice as likely as low users to be low in well-being or have mental health issues, including risk factors for suicide. CONCLUSIONS: Associations between heavy digital media use and low psychological well-being are larger for adolescent girls than boys.

2.
Artigo em Inglês | MEDLINE | ID: mdl-31914788

RESUMO

INTRODUCTION: Transgender women are 49 times more likely to become HIV positive than all adults worldwide. Data were unavailable for trans women's sexual and mental health in the Middle East and North Africa (MENA) until 2015-2016, when HIV prevalence (10%) and suicide attempt (46%) rates were established in Lebanon. Because of the lack of evidence-based interventions for this marginalized group, the purpose of this study was to pilot-test an adapted intervention, "Baynetna," to assess preliminary impact on mental and sexual health. METHODS: Using the Gender Affirmation model and community connectedness and social cohesion constructs, we pilot-tested Baynetna among sixteen trans women, who attended six weekly 3-hour trans-facilitated group-delivered sessions in Beirut with post-test assessments at 1-, 3-, and 6-months. Each participant acted as her own control; we used paired t-tests to assess changes at follow-up to evaluate potential differences in outcomes. RESULTS: Positive directionality in intervention impact on gender affirmation satisfaction, community connectedness, and social cohesion was demonstrated. An increase in HIV testing proportion between six months before and after enrollment was achieved. Higher social cohesion was associated with less suicidal thoughts (p=0.05). There was a significant (p=0.019) relationship between more community connectedness and lower depression scores. War event exposure was associated with higher anxiety (p=0.02; p=0.004). Those who reported never having had an STI had higher gender affirmation satisfaction scores (7.5, 95% CI: 1.4-13.6) (p=0.019). CONCLUSIONS: Increases in community connectedness, social cohesion, and gender affirmation satisfaction scores confirm Baynetna's proposed mechanisms of impact. Proportional HIV testing increases demonstrate prevention objectives progress. The significant results contribute to confidence in Baynetna's mechanisms of action and support the hypothesis that the Gender Affirmation model is applicable to the Lebanese context. We have shown for the first time that the adapted intervention, and its constructs, are applicable in this context outside the U.S.

3.
Support Care Cancer ; 2020 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-31916007

RESUMO

PURPOSE: Cancer has long-term financial consequences. Adolescent and young adult (AYA) and middle-aged cancer survivors may experience more financial toxicity than older adults. This study examined age differences in financial distress in hematopoietic cell transplant survivors and whether these differences result from measurement bias, more financial barriers to care, or an overall higher level of distress. METHODS: Hematologic malignancy survivors (n = 1135, 2-10 years post-transplant) completed the Cancer and Treatment Distress Scale (CTXD) and demographics as part of the baseline assessment for a randomized clinical trial. The CTXD has seven subscales, but for this study, we examined the financial distress subscale and the overall score. Item response theory analyses tested for bias by age and gender. Multivariate linear regression tested the association of age and gender with the CTXD scores while controlling for financial barriers to care. RESULTS: No bias was found on the CTXD. AYA (p < 0.01) and middle-aged adults (p < 0.001) reported more financial and overall distress than older (age 65+) adults. The same association of age and financial distress was observed in women (p < 0.01). However, only middle-aged men (p < 0.01) reported more financial and overall distress than older men; AYA men did not (p > 0.18). Financial barriers to care were not associated with financial or overall distress. CONCLUSIONS: Part of the increase in financial distress with younger age may be due to a higher risk of general distress. Policy initiatives to control cancer costs should consider life stage and the unique financial challenges at different ages for men and women.

4.
Health Promot Int ; 35(1): 27-41, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-31916577

RESUMO

This systematic review sought to evaluate the impact of gender equality on the health of both women and men in high-income countries. A range of health outcomes arose across the 48 studies included. Gender equality was measured in various ways, including employment characteristics, political representation, access to services, and with standard indicators (such as the Global Gender Gap Index and the Gender Empowerment Measure). The effects of gender equality varied depending on the health outcome examined, and the context in which gender equality was examined (i.e. employment or domestic domain). Overall, evidence suggests that greater gender equality has a mostly positive effect on the health of males and females. We found utility in the convergence model, which postulates that gender equality will be associated with a convergence in the health outcomes of men and women, but unless there is encouragement and support for men to assume more non-traditional roles, further health gains will be stymied.

5.
Artigo em Inglês | MEDLINE | ID: mdl-31917883

RESUMO

Research has identified discrimination and a lack of knowledgeable providers as major barriers for transgender and gender diverse (TGD) individuals seeking care, which contributes to greater stress and significant health disparities affecting this population. However, research involving TGD youth is limited. The aim of this study, therefore, was to describe TGD adolescents' experiences, concerns and needs in healthcare settings, including their feedback on themes previously identified by healthcare providers (i.e. discomfort with gender-related topics, reasons for not asking patients about gender and previous training regarding gender diversity). The authors conducted semi-structured interviews with 12 TGD-identified adolescents aged 14-17, living in Minnesota, USA in 2017-2018. Inductive thematic analysis was used to summarise participant comments into themes and subthemes. Two main themes were directly relevant to concerns and needs of TGD youth in healthcare settings and their views on healthcare providers' concerns: (a) asking about gender and pronouns and (b) training for healthcare providers. Findings suggest the need for revisions to clinic materials, infrastructure and protocols. Adding training to all general medical and nursing education to increase knowledge, comfort and competence around gender identity would further improve care and ultimately reduce healthcare disparities affecting TGD youth.

6.
J Sleep Res ; : e12971, 2020 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-31919946

RESUMO

The negative consequences of deteriorated sleep have been widely acknowledged. Therefore, research on the determinants of poor sleep is crucial. A factor potentially contributing to poor sleep is the use of a smartphone. This study aims to measure the association between overall daily smartphone use and both sleep quality and sleep duration. To this end, we exploit data on 1,889 first-year university students. Compared with previous research we control for a large set of observed confounding factors. Higher overall smartphone use is associated with lower odds of experiencing a good sleep. In addition, we explore heterogeneous differences by socioeconomic factors not yet investigated. We find that the negative association between smartphone use and sleep quality is mainly driven by female participants.

7.
Medicine (Baltimore) ; 99(1): e18470, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31895779

RESUMO

The appropriate approach to dental patients, developed during the course of dentists' training, is a prerequisite for the holistic treatment of patients. Empathy is an important component of such an approach. This study aimed to determine the levels of empathy among students of dentistry at different stages in their training.The Jefferson Scale of Empathy - Health Profession Students Version was used to conduct the research, and 100 dental students (66 female and 34 male) ranging from first to fifth year participated in the survey. The scale contained 20 questions, with a possible score interval between 20 and 140. A higher score indicates increased ability to express empathy.The level of empathy among dentistry students increased from the first and second to fourth years, where it reached its maximum. During the fifth year, a decrease in levels of empathy was observed.The increase in empathy during the dental course may be correlated with the growth of clinical practice during the subsequent years of study. A slight decrease in empathy in the fifth-year students may be due to the curricular focus on performing procedures, with students having to meet a set target in order to finish the course.


Assuntos
Atitude do Pessoal de Saúde , Empatia , Estudantes de Odontologia/psicologia , Adulto , Educação em Odontologia , Feminino , Humanos , Masculino , Assistência Centrada no Paciente/métodos , Polônia , Distribuição por Sexo , Inquéritos e Questionários
8.
BMC Psychiatry ; 20(1): 17, 2020 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-31924182

RESUMO

BACKGROUND: The wars in the Democratic Republic of Congo have left indelible marks on the mental health and functioning of the Congolese civilians that sought refuge in Uganda. Even though it is clear that civilians who are exposed to potentially traumatizing events in war and conflict areas develop trauma-related mental health problems, scholarly information on gender differences on exposure to different war-related traumatic events, their conditional risks to developing PTSD and whether the cumulative exposure to traumatic events affects men and women differently is still scanty. METHODS: In total, 325 (n = 143 males, n = 182 females) Congolese refugees who lived in Nakivale, a refugee settlement in the Southwestern part of Uganda were interviewed within a year after their arrival. Assessment included exposure to war-related traumatic events, and DSM-IV PTSD symptom severity. RESULTS: Our main findings were that refugees were highly exposed to war-related traumatic events with experiencing dangerous flight as the most common event for both men (97%) and women (97%). The overall high prevalence of PTSD differed among women (94%) and men (84%). The highest conditional prevalence of PTSD in women was associated with experiencing rape. The dose-response effect differed significantly between men and women with women showing higher PTSD symptom severity when experiencing low and moderate levels of potentially traumatizing event types. CONCLUSION: In conflict areas, civilians are highly exposed to different types of war-related traumatic events that expose them to high levels of PTSD symptoms, particularly women. Interventions focused at reducing mental health problems resulting from war should take the context of gender into consideration.

9.
Int J Behav Med ; 2020 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-31925674

RESUMO

BACKGROUND: Sexual and gender minority (SGM) adolescents are more likely than their heterosexual and cisgender peers to smoke cigarettes. Family rejection has been associated with adverse health outcomes; however, few studies have examined whether SGM-specific family rejection is associated with cigarette smoking among SGM adolescents. METHOD: A non-probability sample of 11,005 SGM adolescents (M = 15.58, SD = 1.27) completed an online cross-sectional survey. Bivariate and multivariable analyses were conducted to examine associations between SGM-specific family rejection, sociodemographic variables, and smoking. RESULTS: Approximately 7% of the sample currently smoked cigarettes. Pansexual, asexual, trans boys, and non-binary assigned female at birth adolescents had the highest SGM family rejection scores. In multivariable regression analyses, SGM-specific family rejection was independently associated with smoking after adjusting for covariates (AOR = 1.15, 95% CI 1.04, 1.28). Family support (AOR = 0.80, 95% CI 0.73, 0.88) and experiencing violence (AOR = 1.64, 95% CI 1.49, 1.82) were also associated with smoking in multivariable models. Adolescents who identified as bisexual versus gay/lesbian (AOR = 1.50, 95% CI 1.21, 1.85) and trans boys versus cisgender girls (AOR = 2.05, 95% CI 1.13, 3.71) had an increased odds of smoking. Those who disclosed their sexual orientation identity to most (AOR = 1.95, 95% CI 1.45, 2.63) and all (AOR = 1.60, 95% CI 1.21, 2.11) of their family/parents had increased odds of smoking. CONCLUSION: Our findings underscore the importance of attending to the role of SGM-specific family rejection and distinctions with SGM adolescents in tobacco prevention and smoking cessation efforts.

11.
J Ethn Subst Abuse ; : 1-19, 2020 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-31900065

RESUMO

To determine gender difference in the nature of the association between alcohol consumption and depressive symptoms in the elderly aged 60 and above in a rural community sample. A cross-sectional face-to-face survey conducted for community residents 60 years of age and older (n = 1,819). Alcohol consumption problems were measured by self-report of the Korean version of Alcohol Use Disorders Identification Test (AUDIT-K) scale. Depressive symptom was measured using the Korean Beck Depression Inventory (K-BDI) scale. Potential explanatory variables included MCS, PCS, and health-related behavior, socio-economics status, and democratic variables. Two gender-specific multivariate regression models were applied for the analysis. A U-shaped relationship between alcohol consumption and depressive symptoms was found, and the relationship did not differ by gender. Non-problem drinkers and hazardous and harmful drinkers were related to an increased risk of depressive symptoms for both men and women. Several correlates for the association were found. No gender difference was found in a U-shaped curvilinear relationship between alcohol consumption and depression found among the elderly aged 60 and above in rural communities in South Korea. The findings of this study suggest the need for further investigation of subgroup differences in the association by using samples of various age groups in rural and urban areas, and samples drawn from different cultural contexts than the studies conducted in Western countries.

12.
Psychiatr Q ; 2020 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-31900820

RESUMO

Child abuse among adolescents in China has been documented and can lead to a whole range of psychological and behavioural problems. This study examined whether male and female adolescents would differ in level of child abuse, emotional processing difficulties, alexithymia, psychological symptoms and behavioural problems, and whether the pattern of association between these variables would vary depending on gender. Eight hundred adolescents were recruited from China and completed the Childhood Trauma Questionnaire, Emotional Processing Scale, Toronto Alexithymia Scale, General Health Questionnaire, and Prediction Test of Problem Children. Male adolescents reported significantly higher levels of emotional and physical neglect, and external oriented thinking style than female adolescents. Females reported significantly more anxiety symptoms and problems with learning than males. For males, child abuse was associated with emotional processing difficulties which were associated with alexithymia. In turn, alexithymia was associated with both psychological and behavioural problems. For females, the same association was established for predicting behavioural problems but not psychological symptoms. Male and female adolescents differed in level of child abuse, alexithymia, psychological symptoms and behavioural problems. These psychological constructs were connected in a specific pattern to trigger psychological and behavioural problems for male adolescents whereas for females, different patterns were involved.

13.
J Sex Res ; : 1-20, 2020 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-31902238

RESUMO

Gender-based violence (GBV) against women and girls is pervasive and has negative consequences for sexual and reproductive health (SRH). In this systematic review of reviews, we aimed to synthesize research about the SRH outcomes of GBV for adolescent girls and young women in low- and middle-income countries (LMICs). GBV exposures were child abuse, female genital mutilation/cutting, child marriage, intimate partner violence (IPV), and non-partner sexual violence. PsycINFO, PubMed, and Scopus searches were supplemented with expert consultations, reference-list searches, and targeted organizational website searches. Reviews had to contain samples of girls and young women ages 10-24, although inclusion criteria were expanded post-hoc to capture adolescent-adult combined samples. Twenty-seven reviews were quality-rated. Study-level data were extracted from the 10 highest quality reviews (62 unique studies, 100 samples). Reviews were mostly from Africa and Asia and published between 2011 and 2015. We found consistent associations between GBV and number of sexual partners, gynecological conditions (e.g., sexually transmitted infections [STIs]), unwanted/unplanned pregnancy, and abortion. Some types of IPV also were associated with greater use of contraception/STI prevention. Addressing GBV is essential to improve SRH for girls and women in LMICs.

14.
J Nurs Res ; 2020 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-31904736

RESUMO

BACKGROUND: Compared with older adults, young adults exhibit poor treatment and control of hypertension. However, little is known about the factors affecting the treatment and control of hypertension in young adults. PURPOSE: This study was aimed to identify the factors affecting the treatment and control of hypertension in early adulthood by gender in South Korea. METHODS: This secondary data analysis study used a data set from the Korean National Health and Nutrition Examination Survey. The inclusion criteria were as follows: (a) 19-44 years old and (b) having an indicator of hypertension (systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg, or taking antihypertensive drugs). Seven hundred eighty participants were included in this study. The odds ratios and 95% confidence intervals were derived using composite-sample multiple logistic regression. RESULTS: In men, age, marital status, family history of hypertension, treatment of hyperlipidemia, abdominal obesity, high-sodium diet, cholesterol, and aerobic exercise were found to be associated with hypertension treatment and control. In women, age, employment status, cardiovascular risk factors, body mass index, high-sodium diet, and drinking were found to be associated with hypertension treatment and control. CONCLUSIONS: The factors affecting the treatment and control of hypertension differed between the two genders. Therefore, healthcare providers should consider the differences in the factors between the two genders in early adulthood. To improve the treatment and control of hypertension, the guidelines for treatment interventions and management should be gender-specific from early adulthood. Nurses should actively suggest health-related behavioral modifications such as performing aerobic exercise for young adult men and reducing alcohol consumption for women.

15.
Arch Sex Behav ; 2020 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-31897832

RESUMO

Sexual and gender identity have frequently been assessed in public health research as static states. However, a substantial and growing body of evidence indicates that both identities may have greater potential for change over time than once supposed. Despite this evidence, research into adult identity change remains relatively limited. Using longitudinal data from 1553 Black men who have sex with men (BMSM) aged 18-68 years and recruited from study locations in six major cities across the country, we examined changes in sexual and gender identities over a period of 12 months. The results showed that sexual and gender identity did indeed change among adult BMSM. Additionally, we explored internalized homophobia (IH) as a potential driver of identity change and found that IH significantly impacts the degree and direction of change, with individuals who reported higher baseline IH more likely to demonstrate a shift toward a heterosexual/straight identity at 6 and 12 months. The results are discussed in light of what is known and unknown regarding identity change, and potential avenues for future research are explored.

16.
Int J Aging Hum Dev ; : 91415019896225, 2020 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-31910644

RESUMO

This study investigated whether there are gender-based differences in the process wherein family functions influence stress through various health behaviors in midlife adults. A cross-sectional study was done using a convenience sample of 250 middle-aged Koreans. Data on the family APGAR index, four health behaviors (i.e., seeking health information, physical activity, healthy diet, and social interaction), and stress were collected by a self-administered survey and analyzed using hierarchical multiple linear regression analyses and a PROCESS macro for SPSS. The study results showed that an indirect effect of family function on stress through health behaviors was significant in women, whereas such a relationship was not shown in men. This study found that the process wherein family function is linked with stress through health behaviors differs by gender. Developing gender-specific interventions is essential to decrease stress in midlife adults.

17.
AIDS Behav ; 2020 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-31912274

RESUMO

We present findings from qualitative interviews (N = 67) with 36 staff and 31 participants of nine distinct individual and/or group level interventions to engage transgender women of color (TWOC) in HIV care in the U.S. We examine the commonalities amongst the intervention services (addressing unmet basic needs, facilitating engagement in HIV care, health system navigation, improving health literacy, emotional support), and the relationships formed during implementation of the interventions (between interventionists and participants, among participants in intervention groups, between participants and peers in the community). Interventionists, often TWOC themselves, who provided these services developed caring relationships, promoted personal empowerment, and became role models for participants and the community. Intervention groups engaged participants to reinforce the importance of health and HIV care and provided mutual support. Gender affirming services and caring relationships may be two key characteristics of interventions that address individual and structural-level barriers to engage TWOC in HIV care.

18.
Br J Sociol ; 2020 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-31912495

RESUMO

This paper explores temporal constituents of the female self in terms of their role in underpinning ongoing gender inequality. Drawing on the work of Simone de Beauvoir and Iris Marion Young, together with sociological approaches to ambivalence, I suggest that these temporal subjectivities are embodied, arise from the split subjectivity associated with woman as simultaneously subject and object, and counterpose the neoliberal emphasis on "choice" and agency with a more traditional gendered "expectation," or "waiting" style. The dialectic between both temporalities, in which neither is hegemonic, results in a chronic state of ambivalence which impedes women's ability to fully project themselves into the future, a skill significant to planning and career ambition and the absence of which suspends women instead in an extended present. The paper aims to do two things in particular. In conceptual terms it aims to explore aspects of the configuration of the gendered self that underlie the stalling and slowing down of the gender revolution and which can be seen to provide a "missing link" between structures, institutions, and micro-cultures. In empirical terms, it suggests a future research agenda, of which this paper constitutes a beginning, through which such gendered temporalities can be explored in greater detail via ethnographies of women's lived experience of time throughout the life course.

19.
PLoS One ; 15(1): e0227190, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31917784

RESUMO

STUDY OBJECTIVES: Insomnia is the most common sleep disorder with significant psychiatric/physical comorbidities in the general population. The aim of this study is to investigate whether socioeconomic and demographic factors are associated with gender differences in insomnia and subtypes in Korean population. METHOD: The present study used data from the nationwide, cross-sectional study on sleep among all Koreans aged 19 to 69 years. The Insomnia Severity Index (ISI) was used to classify insomnia symptoms and their subtypes (cutoff value: 9.5). The Pittsburgh Sleep Quality Index (PSQI), Goldberg Anxiety Scale (GAS) and Patient Health Questionnaire-9 (PHQ-9) were used to measure sleep quality, anxiety and depression. RESULTS: A total of 2695 participants completed the survey. The overall prevalence of insomnia symptoms was 10.7%, including difficulty in initiating sleep (DIS) (6.8%), difficulty in maintaining sleep (DMS) (6.5%) and early morning awakening (EMA) (6.5%), and these symptoms were more prevalent in women than in men. Multivariate analysis showed that female gender, shorter sleep time and psychiatric complications were found to be independent predictors for insomnia symptoms and subtypes. After adjusting for covariates among these factors, female gender remained a significant risk factor for insomnia symptoms and their subtypes. As for men, low income was related to insomnia. CONCLUSION: Approximately one-tenth of the sample from the Korean general population had insomnia symptoms. The prevalence of insomnia symptom and the subtypes were more prevalent in women than men. Gender is an independent factor for insomnia symptoms.

20.
Lancet ; 395(10217): 1, 2020 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-31908270
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