Objective: Analyze the issues of genderand race involved in seeking for health care among black contributors from a university. Method: this is a qualitative study conducted by means of semi-structured interviews, whose subjects were 10 employees and outsourced workers from a university located in Feira de Santana, Bahia, Brazil. Results: in general, men do not seek health care the same way as women. Fears with regard to bringing his masculinity into question, due to undergoing exams, and to the risk of job loss, due to time off from work, suggest to a man that seeking for health care implies a conjuncture of unemployment, economic deprivation, and powerlessness to provide his family with a living. Conclusion: we identified influence of the categories race andgenderand interference of social constructs related to them in seeking for health care among black men who are active in the labor market. Descriptors: Genderandhealth, Men’s health, Public health, Health services.
In general, these results show the existence of relationships between genderandhealth in the nursing profession like those identified in other social and occupational contexts (Cuéllar-Flores & Dresch, 2012; Cuéllar-Flores & Sánchez- López, 2011; Mahalik et al., 2003, 2007). However, some of these relationships enable us to identify differential health behaviors for men and for women and highlights specific relationship mechanisms between genderandhealth for men and women in atypical occupational contexts. This has already been demonstrated in some qualitative studies (Simpson, 2009), which describe how a gender imbalance may give rise in the minority to so much pressure and restraint, such as greater visibility and status symbolism. In the case of nursing these mechanisms are related, for women, with practice of a traditionally female activity but in a professional context where they are no longer the center of attention. In the case of the men, it would be related to practicing a traditionally feminine role in an occupational context where women dominate. Here, being in a minority would give rise to pressures to develop role norms related to stereotypes of male gender roles and fear of becoming feminized or stigmatized (Lupton, 2000). Nonetheless, it also appears to endow them with greater insight and possibility of promotion than their female counterparts (Simpson, 2009). This advantage could also partially explain the better health found in male nurses both in comparison with women and compared to men in general, as discovered in other studies (Limiñana-Gras et al., 2013).
Our research findings can contribute to the theoretical debate on at least three points. First, people seem to rate their own health in a heuristic manner, as proposed by Huisman and Deeg , because the study participants in every subgroup exhibited an excess risk for mortality which could not be completely explained by a set of diagnosed illnesses and socio-demographic factors. Second, the percentages of explainable excessive risk varied according to socio-demographic factors and depression symptoms, and moreover, the set of explanatory factors differed for each subgroup. This suggests that people in different subgroups may be differentially utilizing information in order to rate their health. Third, when we focus on the sex/gender difference, the percentage of unexplainable excessive risk was greater among women (76%) than men (48.6%), implying that Japanese women are more heuristic than Japanese men in the process of assessing their own health (assuming that added control variables constitute the available information for assessing their own health). Overall, our findings support the argument that a framework of psychological factors should be added to Jylha’s theoretical framework, as Huisman and Deeg suggest [3,28].
continually to the desires and demands of others (especially the partner, but also the children), an orientation toward alterity that will lead her to erase herself and to be a person truly unknown to herself, putting her in a state of “melancholic affect,” cloaked in a romantic and normative discourse of gender (traditional model interacting with a transitional model). This trajectory will continue until the present, when a very profound person crisis and the desire to get out of it, along with the question of “why?”, give rise to the beginning of a personal reflexivity that will allow her to find specific help and to realize that her subjective andgender positioning lead her inevitably to the opposite of what she seeks, thus continuing to be erased, abused, mistreated, and unhappy. The secret and central element that safeguards the fragile line separating emotional and physical or somatic ill health – the generalized pain of FM – which began at around 7 years of age according to her memory, was her grandfather, the only figure from whom she received a certain subjective understanding and esteem. He died when she was 7 years old, and his death represents to her the end of the only care and recognition she had received, just as she was “abandoned to the world.” This made a generalized pain explode in her body, which intermittently remained over the years as a continual hazy subjective position. Pain must remain invisible to the family of origin and to herself in order not to make an already bad situation much worse for those around her (given that caretakers cannot be an object of care without the patriarchal codes and sex/gender system in a traditional mode or transitional model). This pain has remained a secret and intermittent burden until she was fifty, and it has not been until recent years that she stopped being intimate and secrete for others and became a clinical (and political) FM diagnosis, which presupposes a certain recognition. History and life position in the family of origin made her flee the family with her partner (an artist, she says) at 17, and which was a mirroring and stereotype constructed as an image of freedom and liberation from her father’s imprisonment of her, without knowing that it would, in reality, become the opposite – a continuation in her life as an adult woman. The life and relationship with her partner have been
Support was provided by the United Nations Population Fund, the U.S. Agency for International Development ( under the MEASURE Communication project) , the Ford and Rocke- feller Foundations ( under the Mainstreaming Gender Equity in Health Sector Reform project) , and the governments of Norway and Sweden ( under the Reducing Gender Inequity in Health in Central America project) .
The causes of gender-based violence point to the need for multi-pronged approaches, including action at the community level to change cultural norms, decrease the acceptability of violence against women and girls, and improve the linkages between the health system and the legal system. Changing such norms calls for political, civil, and social leadership to change institutional prac- tice and to debunk underlying ideologies. A common indicator of improved governance is the increase in women’s participation at all levels of decision-making, including at the household and community levels and in national legislative bodies. However, wider transforma- tions are needed to strengthen institutional functioning to address gender equity. Such transformations rely on the development of institutional capacity and governance based on robust evidence and examples of effective good practice. This includes advocacy for health information systems disaggregated by genderand by other important factors that shape vulnerability and resilience to ill-health (poverty, age, literacy, disability).
The association between functional disability, genderand age group verified in this study is shown as an important guide for health actions that must be addressed mainly to elderly women and the oldest old, who are potentially more likely to develop disabilities. Moreover, it is necessary to identify the fac- tors associated with these groups in order to provide elements for building measures aiming to improve, maintain or restore the functional capacity of the elderly as long as possible.
OBJECTIVES: To describe the indications for and visual outcomes of intrastromal corneal ring segment implantation. METHODS: A large retrospective case-series chart-review study was conducted using Sorocaba Ophthalmological Hospital medical records. This study included 1222 eyes (1196 patients) that were surgically treated between November 2009 and December 2012. The following preoperative data were collected: age, gender, type of medical care and funding source, surgical technique, best-corrected visual acuity, manifest sphere and cylinder refractive error, maximum and minimum central keratometry, and pachymetry measurements of the cornea at the thinnest point and at the ring channel. The postoperative best-corrected visual acuity and patient satisfaction were also determined. The cases were classified into six groups: four keratoconus groups (severe, advanced, moderate and mild), a pellucid marginal degeneration group and a post-graft irregular astigmatism group. This study was approved by the Brazilian Registry of Clinical Trials (UTN number 1111-1182-6181, TRIAL RBR-6S72RF). RESULTS: The age (mean±standard deviation) of the patients was 31.0±10.0 years. The most prevalent pathol- ogy was keratoconus (1147 eyes, 93.8%). A correlation was found between ectasia severity and medical assis- tance (po0.001), and the most serious cases was treated by the Brazilian public health system. No complications were found in a total of 1155 surgeries, and after surgery, 959 patients were satisfied. Among the 164 dis- satisfied patients, the majority failed to show improved best-corrected visual acuity.
This paper builds on four recent contributions to the literature. First, in the sociology of space literature, Gieryn (2000) wrote an article pleading for giving more attention to place, understood not only as a container of social actions, but also as an actor influencing and being influenced by social interactions. The article was so influential that inspired more than 1300 studies. Similarly, Gans (2002) pointed to the need for more sociological studies of space oriented towards spatial practices from the private sphere. Second, as an important contribution to gender studies, the article introducing the concept of doing gender (West & Zimmerman, 1987) became one of the most influential sociological papers in the last decades (Healy, 2014; Caren, 2012), receiving more than 8000 citations. It gave rise to a follow-up conceptualization of undoing gender (Deutsch, 2007) that was also noteworthy, receiving more than 500 citations. Third, in the sociology of home field the critical review of the literature performed by Mallett (2004) is one of the most cited articles in home studies, being referenced in more than 600 papers. The author highlights the importance of gender in analyzing the meaning of home, concluding general debate about genderand the meaning of home remains problematic, if not simplistic (ibidem, p. 77). More exactly, earlier studies have focused on the feminist interpretation of how gender differences are reinforced by domestic space, legitimizing masculine hegemony, but they ignored women s positive interpretations of home and the intersection between genderand other identities. Fourth, because of the growing body of qualitative research results, scholars recommend using particular methods of qualitative research synthesis, different from the conventional ones (meta-analysis, systematic review, literature review). Inside these methods, the interpretive synthesis technique is gaining more and more acceptance (Campbell et al., 2011; Barnett-Page, 2009; Weed, 2008, 2005; Jensen & Allen, 1996), especially in the fields of education, health, community development, and organizations (Major & Savin-Baden, 2011). We think it might contribute to integrating qualitative results from the fields of gender studies and spatial studies.
Objective: To know the prevalence and factors associated to low cognitive performance in a representative sample of the adult population in a society aging progressively. Method: Cross-sectional population-based study carried out in a three-stage sampling: 81 census tracts (primary sampling unity) were randomly selected, followed by 1,672 households and 2,471 participants (weighted sample) corresponding to the second and third stages, respectively. The outcome prevalence was calculated according sociodemographic, behavioral andhealth related variables. Crude and adjusted prevalence ratios were estimated using Poisson regression. Results: The prevalence of low cognitive performance was high, mainly among females, and indicated linear trends into categories of age, schooling, income, plasma fibrinogen and self-reported health status. In multivariate models, gender, diabetes, fibrinogen and self-reported health status presented positive associations, while schooling, employment and sitting time presented negative associations with the outcome. Conclusion: Interventions related to diabetes and fibrinogen levels control as well as improvement in health care might delay low cognitive performance in societies aging progressively as such the study population.
Mounting criticisms have resulted in the addition of several innovative gender equity indices in the last few years. These measures diverge from the existing composite indices and are therefore presented separately in Table 2. The European Union Gender Equality Index (EU-GEI), developed by Plantenga et al. (2009) is unique in the sense that it is based upon the universal caregiver model of Fraser (1997). It consists of four dimensions of equal sharing of: paid work, money, decision-making power and time. In contrast to the indices discussed to this point, it not only includes inequality in employment, wages, occupations and the political arena, but also the gender gap in caring time for children and leisure time, the latter of which are unique. It does not include health dimensions, which as discussed previously, are not as relevant within the European context. A shortcoming is that since it is only available for countries within the European Union (EU), it is limited to a few countries and misses some relevant countries in Europe (e.g., Norway, Switzerland) that have not joined the EU.
One of the researchers met with these nurses to explain the objectives and how to collect the data, followed by a written roadmap to assist in completing the data collection instruments. Data were collected through a sociodemographic andhealth information questionnaire (age, gender, nationality, education, occupation, marital status, dialysis sessions length, presence of hypertension, and diabetes), the subjective happiness scale (SHS) [19–21], the satisfaction with life in general (SWLG), the personal wellbeing index (PWI) [22, 23], the Portuguese ver- sion of positive and negative affect schedule (PANAS) [24–26], and the 12-item short form health survey (SF-12) [27, 28].
frequency: 84.2% of the study subjects reported that they brushed their teeth twice a day or more, and this was reported more frequently by women and by subjects with > 12 years of education (p = 0.043). There were no age group differences in brushing frequency (p = 0.629). Porto Alegre subjects reported that they brush twice a day or even more frequently (p < 0.001). Interdental cleaning frequency: Of the total study subject population, 66% reported that they do not clean interdentally, and only 17.7% clean daily. No difference was found between men and women (p = 0.287), but a significant association was found with age (p = 0.001) and level of education (p < 0.001). Study subjects < 30 years of age, and subjects with < 12 years of education reported a lower frequency of interdental cleaning. Interdental cleaning was significantly (p < 0.001) more frequent for Porto Alegre study subjects. Use of dental floss was more frequently reported (28.6%) than toothpicks (2.4%) and interdental brushes (2.4%). Frequency of dental visits: The great majority of study subjects reported that they visit a dental clinic only in emergencies, and a higher percentage of study subjects with > 12 years of education reported dental visits every 3 to 6 months (p < 0.001). No difference was found among gender or age group. A significant difference was found among the cities. Preventive dental visits made at least once a year were more frequent in subjects from Tucumán.
The Director said that, by strengthening the focal points’ ability to provide gender training, the Organization was endeavoring to create “waves” or generate a multiplier effect at the national level, so that eventually the gender approach would permeate all aspects of health sector activity in the countries. He emphasized that the facilitator‘s manual constituted a solid basis for gender training, although it would of course be adapted and refined over time, incorporating the experience gained in conducting the workshops. He also pointed out that one of main reasons that the gender training workshops in the countries had been so successful was that the Program had been able to convince the participants of the usefulness of the gender approach for their work, which was essential, since people were not likely to accept new approaches if they could see no practical applications for them. Finally, he reiterated the Organization’s commitment to gender sensitization for staff at all levels and to the incorporation of the gender perspective in all aspects of PAHO technical cooperation.
Education was the most frequently studied determinant of healthand for which most evidence exists of health in- equalities. Evidence of educational inequalities in obesity was particularly common, especially for women, as the two studies that stratified the analysis by gender found only women showed significant inequalities [43, 44]. This suggests educational inequalities in overweight/obesity are found mostly or exclusively in women. This is not unique for Portugal: Roskam et al. (2010) found that other southern European countries also show high education inequalities in overweight and obesity only for women . In this analysis, Portugal had the highest educational inequalities in overweight and obesity among women in all the countries analysed. This can be a conse- quence of various factors, such as inequalities in physical activity, dietary patterns or parity. However, both men and women seem to show the same extent of educational in- equalities in physical activity and diet in Portugal [58, 59], which makes them unlikely factors in explaining inequal- ities in obesity seen mostly in women. On the other hand, women with lower education in Portugal have a higher fertility index , and since higher parity is strongly associated with obesity , this might be the most suitable explanation for the high educational inequalities in overweight and obesity seen for women in Portugal.
Three articles approach important aspects pertaining to reproductive health care. Heil- born et al. study perceptions concerning contraception among female users of the Unified National Health System (SUS). Marinho et al. investigate factors associated with the use of contraceptives during sexual initiation, in three Brazilian State capitals. Nagahama de- velops and applies an instrument for evaluating the implementation of contraceptive care. Contributing to the basis for research, Schraiber et al. discuss the interrelationship be- tween theoretical, methodological, and ethical aspects in the study of gender violence. Likewise, Menezes & Aquino provide a recent overview of collective health studies on abor- tion, seeking to identify gaps and challenges for research on the theme.
Objective: To investigate the association between the syndrome of physical frailty and sociodemographic and clinical cha- racteristics of elderly users of the basic health care. Methods: Cross-sectional quantitative study. The sample was calculated based on the estimated population proportion and consisted of 203 elderly users of the Basic Health Unit. Tests were applied for screening of cognitive impairment, assessment of physical frailty and sociodemographic and clinical questionnaire. Results: The age and education variables appeared as signiicant for the group of frail elderlies. The gender, health problems, loneliness, falls and urinary incontinence variables were statistically signiicant for the non-frail ones. Conclusion: Frailty was related to the sociodemographic variables age and education and non-frailty was related to genderand clinical variables, such as health problems, loneliness, falls and urine incontinence. The identiication of the variables associated with frailty allows the development of interventions and speciic care for the management of frailty.
The guides facilitate the inclusion of the gen- der perspective in Health Plans. This inclusion is necessary since according to the “Guide to facil- itate the inclusion of the gender perspective in Comprehensive Health Plans” produced by the Ministry of Health of the Government of Anda- lusia, there is a predominant and false perception among the various groups of health professionals that technical, healthand managerial work, the adjustment of resources, training opportunities, etc., are gender-neutral. Among the conditions mentioned in the guide for inclusion of the gen- der perspective in healthcare is an explicit com- mitment to ensuring its implementation in the political and organizational sphere, availability of the resources and means to carry it out, and awareness of the need for its implementation and training to do so 36 .