Medicine and Health Sciences Commons^™

Gender Differences And Factors Associated With The Receipt Of Thrombolytic Therapy In Patients With Acute Myocardial Infarction: A Community-Wide Perspective, Jorge Yarzebski, Nananda Col, Paul Pagley, Judith Savageau, Joel Gore, Robert Goldberg

Jorge L. Yarzebski

In spite of national interest in gender differences in the presentation and management of chronic disease, limited information is available about possible gender differences in the receipt of thrombolytic therapy after acute myocardial infarction (AMI). As part of an ongoing community-based study of AMI, we examined gender differences in the receipt of thrombolytic therapy among 2885 patients with confirmed AMI. The study sample consisted of 1680 males and 1205 females with validated AMI who were admitted to 16 hospitals in the Worcester, Massachusetts, metropolitan area in four study periods between 1986 and 1991. During the years under study, 24.4% of …

Testing Self-Efficacy As A Pathway That Supports Self Care Among Family Caregivers In A Psychoeducational Intervention, Marie Savundranayagam, M. Brintnall-Peterson

Marie Y Savundranayagam

This study investigated the extent to which a psychoeducational intervention supports family-centered care by influencing health risk and self-care behaviors of caregivers of individuals with Alzheimer's disease (N = 325). Moreover, this study investigated the extent to which changes in self-efficacy explained changes in health risk and self-care behaviors. Data were analyzed using repeated measures and multivariate analysis of variance and multiple regression. Qualitative written accounts of the impact of the intervention augmented the quantitative findings. The study's findings revealed that family caregivers experienced reductions in health risk behaviors and improvements in exercise, stress management, and relaxation activities as a …

Impact Of Role Discrepancies On Caregiver Burden Among Spouses, Marie Savundranayagam, R. Montgomery

Marie Y Savundranayagam

Using caregiver identity theory, the authors investigated whether role discrepancies mediated the relationships between illness-related stressors (activities of daily living [ADLs] limitations and problem behaviors) and burden (stress, relationship, and objective burden) for spouse caregivers. Participants completed measures of identity standards for spouse and caregiver roles and behaviors, burden, assistance with ADLs, and problem behaviors. Structural equation modeling analyses revealed that role discrepancies completely mediated the relationships between ADLs and stress and relationship burden. Although role discrepancies mediated the relationships between problem behaviors and all forms of burden, there were direct relationships between problem behaviors and burden. Finally, participants who …

Factors Behind Hiv Testing Practices Among Canadian Aboriginal Peoples Living Off-Reserve, Treena Orchard, C. Mcinnes, K. Fernandes, M. Clement, M. Gilbert, V. Lima, J. Montaner, R. Hogg

Dr. Treena Orchard

The objective of this study was to examine factors associated with HIV testing among Aboriginal peoples in Canada who live off-reserve. Data were drawn for individuals aged 15–44 from the Aboriginal Peoples Survey (2001), which represents a weighed sample of 520,493 Aboriginal men and women living off-reserve. Bivariable analysis and logistic regression were used to identify factors associated with individuals who had received an HIV test within the past year. In adjusted multivariable analysis, female gender, younger age, unemployment, contact with a family doctor or traditional healer within the past year, and “good” or “fair/poor” self-rated health increased the odds …

Insert Discourse: Rectal Douching Among Young Hiv-Positive And Hiv-Negative Gay Men In Vancouver, Canada, A. Schilder, Treena Orchard, C. Buchner, S. Strathdee, R. Hogg

Dr. Treena Orchard

Douching is a common practice among certain groups of women and MSM, and it is conducted for the purpose of cleanliness as part of bodily hygiene maintenance. Although there has been considerable research about female vaginal douching, understandings of rectal douching (RD) for MSM are limited. In the epidemiological and medical literature, RD is presented as a behaviour that removes beneficial bacteria and the surface epithelium layer of the colon, which can, potentially, increase the risk of HIV transmission in MSM. The paucity of research on male douching practices is curious given the primacy of anal sex in HIV prevention …

The Irrational Woman: Informed Consent And Abortion Decision-Making, Maya Manian

Maya Manian

In Gonzales v. Carhart, the Supreme Court upheld a federal ban on a type of second-trimester abortion that many physicians believe is safer for their patients. Carhart presented a watershed moment in abortion law, because it marks the Supreme Court’s first use of the anti-abortion movement’s “woman-protective” rationale to uphold a ban on abortion and the first time since Roe v. Wade that the Court denied women a health exception to an abortion restriction. The woman-protective rationale asserts that banning abortion promotes women’s mental health. According to Carhart, the State should make the final decisions about pregnant women’s healthcare, because …

Social Psychological Aspects Of Communication And Aging, Marie Savundranayagam, E. Ryan

Marie Y Savundranayagam

Language plays an important role in defining identities in older adulthood. Both self-perception and others' perceptions of older adults are reflected through language used by older and younger adults (see recent texts: de Bot & Makoni, 2005; Harwood, 2007; Hummert & Nussbaum, 2001; Nussbaum & Coupland, 2004). In this review, we outline key theoretical perspectives on the study of communication with older adults and provide evidence supporting these perspectives within the context of age stereotypes, intergenerational communication, cross-cultural communication, and health care encounters. Given that communication is an interactive process, we discuss how older adults use language and communication to …

South Florida's Immigrant Youth And Civic Engagement: Major Engagement: Minor Differences, Alex Stepick, Carol Dutton Stepick, Yves P. Labissiere

Yves Labissiere

Best Practices In Intercultural Health; Five Case Studies In Latin America, J. Mignone, J. Bartlett, J. O'Nwil, Treena Orchard

Dr. Treena Orchard

The practice of integrating western and traditional indigenous medicine is fast becoming an accepted and more widely used approach in health care systems throughout the world. However, debates about intercultural health approaches have raised significant concerns. This paper reports findings of five case studies on intercultural health in Chile, Colombia, Ecuador, Guatemala, and Suriname. It presents summary information on each case study, comparatively analyzes the initiatives following four main analytical themes, and examines the case studies against a series of the best practice criteria.

In This Life: The Impact Of Gender And Tradition On Sexuality And Relationships For Devadasi Sex Workers In Rural India, Treena Orchard

Dr. Treena Orchard

In the popular imagination and certain academic fields, sex workers' experiences of sexuality and intimate relationships are often "naturalized," to the point where they are assumed to be deviant or completely different than those of women in mainstream society. Researchers and sex worker organizations are challenging these reified constructions by examining more diverse and representative models of sexuality and relationships. However, the experiences of women selling sex in the "third world" are consistently portrayed as violent, non-pleasurable, and oppressive, characteristics often applied universally to "third world women". Using data from ethnographic fieldwork with girls and women who belong to the …

Girl, Woman, Lover, Mother: Towards A New Understanding Of Child Prostitution Among Young Devadasi Sex Workers In Rural Karnataka, India, Treena Orchard

Dr. Treena Orchard

The emotive issue of child prostitution is at the heart of international debates over ‘trafficking’ in women and girls, the “new slave trade”, and how these phenomena are linked with globalization, sex tourism, and expanding transnational economies. However, young sex workers, particularly those in the ‘third world’, are often represented through tropes of victimization, poverty, and “backwards” cultural traditions, constructions that rarely capture the complexity of the girls’ experiences and the role that prostitution plays in their lives. Based on ethnographic fieldwork with girls and young women who are part of the Devadasi (servant/slave of the God) system of sex …

Dhandha, Dharma And Disease: Traditional Sex Work And Hiv/Aids In Rural India, J. O'Neil, Treena Orchard, J. Swarankar, J. Blanchard, K. Gurav, B. Barlaya, R. Patil, C. Hussain Khan, S. Moses

Dr. Treena Orchard

This paper discusses the results of two ethnographic studies with female sex workers in rural areas of Karnataka and Rajasthan, India. In particular, we focus on women whose socio-economic status, and religious and occupational practices, are part of sex work systems that have historical precedents such that they can be termed “traditional” sex workers. The approach taken in the ethnographic work was informed by current critical approaches in medical anthropology and public health. The paper argues that in the context of an expanding HIV/AIDS epidemic in rural areas of India, understanding the historical and structural factors that operate to perpetuate …

Relationship Of Family Structure To Adolescent Drug Use, Peer Affiliation, And Perception Of Peer Acceptance Of Drug Use, Jeanne Jenkins, Sabina Zunguze

Jeanne E. Jenkins

The sample consisted of 2,229 high school students who were administered a self-report instrument containing items measuring drug use and psychosocial variables. Dependent variables included frequency of use of five gateway drugs [cigarettes, marijuana, beer, wine coolers, and liquor], degree of affiliation with drug- using peers, and perceptions of peer acceptance of drugs. Comparison groups included single-parent [both mother- and father-headed], step-parent, and intact families. Analysis conducted separately by grade level revealed significant differences between groups on drug use variables in grades 8 and 10, with adolescents from intact families reporting less frequent drug use, fewer drug-using friends, and perceptions …