GENDER AND HEALTH
GENDER AND HEALTH SYD 3805
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Date Created: 09/18/15
Review Questions and Key Term s for Women s Health A Question for all readings I How is health defined or measured 0 Absence of diseasenormative functioning Fitness Wellbeing Ability to fully participate in normative activities and roles Multidimensional 0 Physical o Mentalcognitiveemotional o Relationalsexual o Spiritual 2 How is sexgender defined or measured 0 ex Male female hermaphrodite 0 Gender ideology roles and norms sexual orientation identity 3 The authors sounds most like basic scientist OR health practitioner OR social scientists o NIH social scientis 0 Health practitionersocial scientist NIH ORWH What is the mission of the ORWH The mission of the Of ce of Research on Women s Health ORWH is to stimulate and encourage meritorious research on women s health including the role of sex and gender in health and disease List the 4 themes important for women s health research 1 Li espan 2 SexGender Determinants 3 Health DisparitiesDifferences and Diversity 4 Interdisciplinary Research List the 5 areas of research interest Diseases and conditions that affect women Basic and clinical research methodology 3 Quality of life 4 Research collaborations and partnerships 5 Career development and advancement of girls and women in science Auerbach amp Figert How did women s health movements lead to federal policy on women s health research 0 Increased action by WHAM women s health action mobilization and WAC women s action coalition have raised awareness about lack of funding for women s diseases and the need to change the definition of AIDS to be more inclusive for women 0 Wearing pink ribbons for breast cancer awareness What report is the symbolic policy origins o The report by the Public Health Service Task Force on Women s Health Issues in 1985 How did the NIH respond to the report 0 NIH issued a new policy in 198687 encouraging the inclusion of women in clinical scientific trials List the 4 key issues associated with a lack of scientific data on women s health ack of inclusion of women in major clinical studies 2 Inadequate attention to gender differences and gender analysis in medical research 3 Inadequate attention to diseases and conditions specific to women or for which there are more risk factors or interventions for women than men 4 Dearth of women researchers in senior positions in science and medicine For What reasons were women excluded from clinical scientific trials 0 Fear of teratogenicity and general liability problems it might pose 0 Too much variability among women because of menstruation pregnancy and menopause o Assumption that there are no significant gender differences that would influence treatment 0 Budget constraints What is the scientific consequence of excluding women Makes assessment of any potential gender differences in outcomes impossible 0 Highlights central gender paradox in medical research What is the Women s Health Initiative WHI o The major longitudinal study of women s health 0 Designed to assess the risk benefit ratio of hormone replacement therapy vitamin and calcium supplements and exercise and lowfat diet on cardiovascular disease osteoporosis and cancer among midlife women What is the woman question in science 0 Why aren t there more women in science How is it related to women s health research policy ocus on women in science 0 NIH supporting it What is the science question in feminism How gender affects the scientific enterprise and its products Review Questions and Key Term s for Men s Health Kraemer The fragile male Describe gender differences in a survival from conception to birth e male than female embryos b male fetus is at greater risk of death b medical conditions in childhood a specific reading delay b hyperactivity c autism d Tour c Medical conditions in adulthood a Circulatory disorders b Diabetes c Alcoholism d Duodenal ulcer e Lung cancer Which differences are primarily biological primarily social or both 0 Biological sex brain size 0 Social girls more pampered addiction in males Whose health is identified as generally more vulnerable 0 males What are the implications for parental care giving and physicians care arental caregiving difficult babies need more care but often don t get it o Physicians males may hold back their concerns Courtenav 2004 Best practices colleqe men List the health outcomes Courtenay uses as evidence of men s greater vulnerability 0 Smoking drinking driving without a seatbelt all cause problems Does he argue that observed differences are biological social or both Explain your answer 0 ocial behaviors and actions Describe the SixPoint HEALTH Plan 0 manize validates or normalizes patients health problems and concerns 0 Educate Health education interventions are an essential aspect of disease and injury prevention and can reduce risks improve compliance facilitate change and promote health Assume the Worst Locate supports don t value independence if you need help from outside source Tailor a plan devise a health maintenance plan Highlight strengths foster motivation and compliance Why is it called a sixpoint plan c There are 6points List the types of interventions in the plan 0 What is the most common and enduring stereotypes about men and health Men are independent selfreliant strong robust and tough What should a college man s ideal comprehensive maintenance plan include o periodic physicals screenings selfexaminations preventive behaviors selfcare techniques and vitamin and medicine schedules Patriarchy a form of social organization in which the father is the supreme authority in the family clan or tribe and descent is reckoned in the male line with the children belonging to the father39s clan or tribe Hegemonic masculinity macho man syndrome got to be the one in charge Lohan Integrating Critical studies Define CSM and describe its central principles 0 CSM critical studies of men 0 M is the study ofthe gendered nature of men s lives which emerges primarily from within feminism and also gay and queer studies Describe the theory of inequalities in health 0 List and define the 3 explanatory pathways by which inequality influences health A u in I I n e 0 Men work riskier jobs higher workrelated disability 0 Women have less access to health insurance and pensions Culturalbehavioral gender identity 0 M culine deny health needs aggression o Women passivity dependence low self esteem increases risk of disorders and depression 0 Psychosocial gender roles 0 Women are caregivers stress from home 0 Men breadwinners stress from work Write 12 sentences that explain how each of these pathways work Blah blah blah Critical period model suggests that diseases which make a greater contribution to the socioeconomic gradient in health have their origins in critical periods of velopment Pathway model focuses on how early quot 39 39 439 394 39 39 39 39 39 have implications for health for example how childhood disadvantage may 39 39 Fr quot 39 mayinturn quot 39 quot39 and heal 39 later life Accumulation model or 39 quot 4 39 39 r quot or duration of r L39 39 439 Hquot r L v r cumulative or chain adverse effect on health SEXGENDER Henrich amp Viscoli Med Schools What are the 3 indicators of women s inclusion in medical school curricula l o 2 o 3 What conclusions about these indicators did the authors reach from their analyses of medical school curricula ew schools offer 39 39 39 39 y women s health 39 or include genderspecific information in their curricula A designated women s health program may increase this content in schools curricula most were elective or selective clinical rotations that as a result of limited enrollments bene ted a small number of students Mark Venusx Mars and Beyond Why is NASA interested in sexgender differences and similarities in health I we need to leam how to keep our astronauts healthy because it may take 6 months to reach Mars 12 months to explore the surface and another 6 months for the return trip These issues will become extremely important because we cannot just send our astronauts back to Earth if there is a health problem Describe 1 difference and l similarity in human adaptation to space travel 0 What and why is the ideal gender composition of flight crews to Mars 0 Mixed groups of both sexes work the best no one sex is isolated Krieger Gendersx Sexesx and Health Which are the 2 cases in Which only sexlinked biology plays a causal role 0 Case 3 Greater prevalence of short stature and gonadal dysgenesis among women with Turner s syndrome compared with unaffected women 0 Case 4 Both similar and different adverse health outcomes among women and men due to ubiquitous exposure to cooking oil contaminated by polychlorinated biphenyls PCB Yusho disease Which are the 2 cases in Which only gender relations play a causal role 0 Case 1 Greater prevalence of HIVAIDS due to needlestick injury among female compared with male health care workers providing patient care 0 Case 2 Greater prevalence of contact lens microbial keratitis among male compared with female contact lens wearers l4 Which is the only case unaffected by either gender relations or sexlinked biology 0 Case 5 Higher risk of stroke among both women and men in the US stroke belt in several Southern states compared with women and men in other regions of the US as distinct from differences in risk for women and men within a given region Of the remaining 7 cases which 2 show a double sexlinked biological effect ase 8 Earier age of human immunodeficiency virus infection among women compared with heterosexual men US 0 Case 12Greater rate of mortality among women com pared with men due to intimate partner violence Gender a social construct regarding culturebound conventions roles and behaviors for as well as relations between and among women and men and boys an 39 Sex a biological construct premised upon biological characteristics enabling sexual reproduction Sexuality culturebound conventions roles and behaviors involving expressions of sexual desire power and diverse emotions mediated by gender and other aspects of social position Chronic Conditions SWHR Diabetes Describe sex gender differences in prevalence and incidence of diabetes Of people aged 20 years or older in the United States approximately 93 million women and 87 million men have diabetes I What proportion of the diabetic population is estimated to be undiagnosed Over 18 million people more than 6 of the populations in the United States have diabetes 3 Over 5 million of these diabetics are undiagnosed Name sex gender differences in these diabetic complications and comorbidities Amputation rates are 14 27 times higher in men than women with diabetes Stroke stroke risk is higher in women than in men especially women aged 55 64 years myocardial infarction the risk is greater in women than in men the mortality risk for women was higher than for men Peripheral vascular disease PVD is more common in men than in women Diabetic women are almost 8 times more likely to suffer PVD than non diabetic women Key terms Type 1 diabetes an autoimmune disorder which is characterized by the immune system attack on pancreatic insulin producing cells resulting in loss of blood glucose regulation3 Type 1 diabetes accounts for 5 10 of diabetes cases Approximately equal numbers of boys and girls are affected and often additional autoimmune phenomena occur In diabetic children older than 10 years girls have much higher levels of antibodies directed against their own thyroids than boys Type 2 diabetes which accounts for 90 95 of diabetes cases is not an autoimmune disorder but results from the body s inability to respond to or produce enough insulin Obesity is a major contributing factor to the development of type 2 but not type 1 diabetes SWHR CVD Describe sex gender differences in coronary heart disease for Age at onset Men have a greater risk of suffering from an M1 and at earlier ages than women Women are more likely to suffer from MIs at older ages than men The average age of first MI is 658 and 704 in men and women respectively Lifetime prevalence the lifetime risk of developing CHD after age 40 is 49 and 32 in men and women respectively trends in death rates While CHD deaths have decreased in men studies indicate that CHD deaths in women have remained stable or even have increased Describe sex gender differences in hypertension among both middle aged and older adults Before the age of 55 a higher percentage of men than women have hypertension however this relationship switches after age 55 Hypertension affects 74 of women ages 65 to 74 In 2002 59 of the deaths from hypertension were in women Compare and contrast men s and women s symptoms of a myocardial infarction Symptoms in men chest discomfort discomfort in the arms back neck jaw or stomach shortness of breath and other symptoms such as cold sweat nausea or lig ht headedness Chest pain is the most common symptom of M1 for men Symptoms in women minor chest pains and subtle symptoms of MI such as nausea vomiting fatigue shortness of breath dizziness abdominal or mid back pain and indigestion Describe women s and physician s awareness of CVD risk in women Key terms know what these abbreviations are CHD Coronary Heart Disease CVD Cardiovascular Disease MI Myocardial Infarction Redberg Cardiac Care List the 3 gender disparities in cardiac care 1 Women are diagnosed later than men and receive fewer therapies 2 Women receive fewer coronary angiog raphy and revascularization procedures 3 women have higher complication and mortality rates after revascularization Describe the framework for categorizing variation in health care Framework for categorizing variations in care into three tiers differences disparities and biases Variations in care can be considered disparities if 0 The difference in health care reflects shortfalls in appropriate care that cannot be explained by other patient factors 0 There are associated adverse health consequences Bias would apply to disparities that cannot be explained by health system factors provider characteristics The CURE and Anand et al studies provide evidence for which tier of the framework Differences Define outcome and process measures of cardiac care outcome measures how well or how long patients actually live process measures measures of procedures or treatments as indirect indicators of health and outcomes How are process measures associated with outcome measures Processes such as therapies or procedures are valuable only if they lead to improved quality andor quantity of life Most quality indicators in cardiology studies are process measures such as the administration of drugs eg acetylsalicylic acid beta blockers angiotensinconverting enzyme inhibitors or measurement of ejection fraction in patients admitted for heart failure These process measures are presumed to lead to improved outcomes such as a decrease in rates of myocardial infarction and death and indeed many studies show these treatments are associated with improved outcomes Why are data necessary to evaluate the association between process and outcome measures missing Data to support the association of process measures and outcomes are more limited for women and minority populations as the result of lower enrollment in clinical trials These missing data are crucial For example although initial trials showed benefit of glycoprotein IIbIIIa inhibitors in men with ACS a meta analysis of six ACS studies found no benefit of glycoprotein IIbIIIa inhibitors in women and more alarmingly a 15 increased risk of MI and death Key terms Health care disparities Health care bias Williams Diabetes amp Asthma What is Williams research objective This paper explores the interaction of gender with the management of chronic illness during adolescence focusing on the ways in which the social constructions of femininities and masculinities affect how young people live with asthma or diabetes Why does Williams focus on diabetes and asthma during adolescence In terms of the control of both asthma and diabetes it appears that the mid teens is a critical time when control worsens particularly for young women Gregg 1983 Pond et al 1996 which ts in with the overall pattern of a gradual emergence of excess morbidity in females during adolescence Compare and contrast how teenage boys and girls incorporate their chronic illness into their personal and social identities Although all of the young people were aware of their reduced life expectancy the young men dealt with this by putting it to one side39 and by generally being less willing than the girls to incorporate cystic fibrosis into their social identities The young men were also found to maintain a more positive attitude in their everyday experiences of living with cystic fibrosis expressing a greater sense of control over their health and lives than did the girls Women with a chronic illness generally showed a greater adaptability than men and that women rarely persisted in tying their futures to recapturing their past selves when they defined physical changes as permanentquot How do these identities produce sex gender differences in use of diet and exercise to manage chronic disease However Miller et al found that the teenage girls in their study were less likely than the boys to experience a sense of positiveness in relation to their everyday experience of living with cystic fibrosis which they felt was due to the social practice of femininity This led to passivity feelings of powerlessness and an emphasis on attractiveness which in turn led to a decline in health status with the lack of physical activity and the need to be attractive rather than active having a powerful adverse effect on morbidity Disability Devlieger et al Disability Culture What is the authors research question Describe the study sample We ask if disability culture exists outside mainstream white society and if it is monolithic within and across subgroups of the larger disabled population Can disability culture take shape in an African American group and if so what are the conditions that enable the development of such a culture Young African American men with violently acquired spinal cord injuries VASCIs Disability activists and scholars agree that there is a disability culture based in a common disability life and set of experiences Define the oppositional model of disability culture According to oppositional models the building of an activist community and empowerment of disabled people is the effective response to oppression How is it associated with political activism Describe how the identities and social relations of the men changed shock of alienation The social relations of violently disabled men become organized around the category of disability The disability experience for these men housed for a considerable time in a rehabilitation facility removed from their old neighborhoods offers them a transition and opportunities that they would not have had under other circumstances VASCI men quickly learn that their former gang brothers are not there to support them They maintain some fond memories from their previous world but realize that now they are pretty much on their own What are the two common elements in developing a common worldview Alive not dead grateful for life even if it s with a disability Giving back after living in the drug world urge to give back List the three general conditions under which disability culture emerged among African American men 1 experience of a disabling violent event and the perception of alienation from family friends and gangs sets the stage for forming new identities and participation in a disability culture created in the context of new reference groups 2 forced removal from a violent and drug centered culture into a safe and supportive physical and social environment Inner City Rehab creates conditions where basic needs are met security is assured and disability meanings are produced reinforced and passed on across generations 3 the time and freedom within this environment to develop personal narratives and metaphors that give coherence to VASCI experiences anchor behavior changes and help to reconcile value conflicts and plan for the future What do the authors conclude about disability culture Hint answer to basic research question in 1 The emergence of disability culture is ultimately about shared meanings represented through signs symbols ceremonies and language The worldview of disability culture is expressed through statements about life such as not being dead giving back and rejecting drugs disability culture among violently disabled young African American men emerges because of three general conditions 0 1 distancing from gangs family friends and community of residence which contribute to a sense of social alienation o 2 immersion in a new safe supportive physical and social environment where basic needs are met and meanings are produced reinforced and passed on across generations 0 3 The development of personal narratives and metaphors that give meaning to their newly acquired disabilities anchor behavioral changes and help reconcile value conflicts The development of disability culture is represented and reinforced through signs symbols and ceremonies Key terms Martin amp BatChava DeafHearing Mainstreaming deaf kids has inspired research on the social dimension of the educational experience What is the primary barrier to deaf child ren s relationships with hearing peers Communication difficulties Define coping strategies and name the two types responses that counter the impact of stressful situations on individuals 0 problem focused outer directed o emotion focused inner directed Why is each type relevant to the research study Problem focused coping refers to strategies that employ planful assertive behavior directed at the stressor emotion focused coping regulates the emotional consequences of the stressor for example by reappraising the situation What is the authors research objective Hint best stated in the beginning of the discussion section Describe the study sample 35 deaf children attending full or partial mainstream school settings Identify the four categories or types of coping strategies observed among these children using personal resources including family members to solve problems using diversion and emotional responses to lessen the impact of the stressor using a combination of personal and diversion emotional responses comfort from maintaining contact with other deaf peers and using family members for support How are coping strategies similar between deaf boys and girls How are they different women use emotion coping strategies more frequently than men more directive behaviours for men and more cooperative behaviors for women Men typically use an interaction style described as constricting ie aimed at shaping the behavior of others In contrast women s interaction style is described as enabling ie aimed at pleasing others and facilitating cooperation Key terms mainstream schools coping strategies Gerschick Theory List the 4 research questions of this study 1 How does disability affect the gendering process 2 How does it affect the experience of the gender 3 How does having a disability affect women s and men s abilities to enact gender 4 In what ways are the experiences of women and men with disabilities similar and different About what proportion of the US population has some level of disability Over 206 of the population 54 million people How does disability affect the enactment of gender Hint paragraph that begins To have a disability is not and the next paragraph In order to enact gender people with disabilities must be recognized by others as appropriately masculine or feminine Successful enactment bestows status and acceptance Failure invites embarrassment and humiliation The bodies of people with disabilities make them vulnerable to being denied recognition as being women and men How does disability affect the gendering process Hint paragraph that begins Disability affects the gendering process and the next paragraph For people with disabilities gendering is conditional Mental illness can vary individuals gender enactment Describe the differences and similarities among men with disabilities Hint paragraph that begins Although women and men with and the 3 paragraphs Masculine gender privilege collides with the stigmatized status of having a disability causes status inconsistency Separate them into material economic and nonmaterial consequences Key terms Stigma Temporally able bodied Sexism without the pedestal Status inconsistency Physical Functioning Jette ICF Compare and contrast the medical social and biopsychosocial models of disability according to a cause of problem and b solutions to problem What is the purpose of the ICF Attempted to provide a coherent biopsychosocial view of health states from a biological personal and social perspective Like Verbrugge and Jette s elaboration of Nagi s framework the ICF portrays human function and decreases in functioning as the product of a dynamic interaction between various health conditions and contextual factors Name and define each of the 3 domains in the ICF model 1 Body functions and structure a Body functions are the physiological functions of body systems including psychological functions b Body structures are anatomical parts of the body such as organs limbs and their components c Impairments are problems in body function or structure as a significant deviation or loss Impairments within the ICF include deviations from generally accepted population standards in the biomedical status of the body and its function and can be temporary or permanent 2 Activity a Activity is the execution of a task or action by an individual b Activity limitations are defined as difficulties an individual may have in executing activities 3 Participation Participation is involvement in a life situation while participation restrictions are problems an individual may experience in involvement in life situations Define disability for each of these domains Describe what Jette means by downward spiraling consequences including examples These consequences of a given disabling condition called secondary conditions 37 which may involve pathology impairments further limitations in function or disability Key Terms ICF International Classification of Functioning Disability and Health Health Conditions diseases disorders and injuries Body Function physiological functions of body systems Body Structures anatomical parts of the body Impairments problems in body functions or structure Activity the execution of a task or action by an individual Activity Limitation difficulties an individual may have in executing activities Participation involvement in a life situation Participation Restriction problems an individual may experience in involvement in life situations Review Questions and Key Term s for Mortality Austad Sex Di eren ces in Lon gevim In the introduction Austad identifies 3 goals of his research review essay What are they I lihow robust the differences are between the sexes I Zihow we might elucidate the differences using comparative biology I 3iexam ine possible mechanistic hypotheses and then outline what we are starting to learn and why we don t know more Who is Jeanne Calment I She was a Supercentenarian and the oldest person we know of with a valid birth record that lived to be 122 years old In which country and why do men live longer than women I Bangladesh Austad describes sex differences in longevity as robust What does he mean I Substantial significant He also describes women as being more robust than men at every age What does he mean I Women are more durable healthwise and can handle health situations better than men Do women and men age physically deteriorate at the same rate I Basically yes Name and define the 5 mechanistic hypotheses for sex differentials in longevity l Heterogametic sex hypothesisi the lack of a second X chromosome in the male will tend to lead to shorter life spans 2 Animals that have a reduction in the activity of growth hormone and the insulinlike growth factor 1 signaling cascade are longer lived and tend to be smaller than animals that have greater activity 3 Oxidative stress hypothesisi oxygen radicals produced as an inevitable consequence of metabolism along with various defenses against oxidative damage will ultimately in uence aging and a wide variety of diseases 4 Females live longer because they have a more active immune systemilongevity is principally determined by immune function and therefore females would be predicted to live longer 5 estrogen somehow protects female animals at a cellular level so that femaleswhether they are rats or mice or whales or bats or humanswill be generally longer lived What types of data are used as evidence to assess the hypotheses What can we conclude from comparative biology about sex differences in longevity in the animal world I Females tend to live longer than males Which hypothesis is best supported by comparative biology I Heterogametic sex hypothesis What scientific process is expected to permit serious progress in understanding sex differences in longevity I Genome sequencing Key terms Centenariansipeople that live to be 100 Supercentenarianipeople that live to be at least 110 years old Heterogametic sexithe sex possessing the 39 will be 1 n r i d May I mmunigg May contends that comparative biology shows sex differences in the lifespan but the most popular explanatory theories are incomplete To improve understanding May proposes that combining these theories into 3 factors differences in behavior infection and cellular aging Describe how differential behavior affects gender and longevity risk behaviors and parental investment I In many species particularly mammals male animals engage in complex courtship rituals displays of dominance malei male conflict and other sexspecific activities If such behavior leads to an increased risk of death as would clearly be the case with displays of aggression then males would on average be expected to die earlier I One might expect average male lifespan in most species to be shorter since parents would neglect male offspring during resourcepoor seasons leading to higher mortality in male infants Describe how differential infection affects gender and longevity immunity sexual size dimorphism infectious disease I Similar sexdependent differences are observed for bacterial and viral infections27 suggesting that males may in general show lowered disease resistance I This theory of parasitemediated sexual selection suggests that animals select mates with higher disease resistance an invisible but highly desirable trait by assessing honest signals of health such as coloration Ten years later Folstad and Karter combined the HamiltonZuk hypothesis with the wealth of data showing higher disease burdens in males relative to fem ales thereby developing the influential immunocompetence handicap hypothesis29 This hypothesis proposes a tradeoff between secondary sex characters and immunity The trade off results from the dual role of the sex hormone testosterone which positively regulates secondary sexual characters e g bill coloration in birds303l but simultaneously suppresses immunity I Moore and Wilson have instead proposed that body size rather than testosterone level may account for sexbiased parasitism in mammals3 In this model the larger sex presents a larger target for parasitic infection and a lar er resource to support heavier infestations A powerful argument in favor of this hypothesis is the finding that species with reversed sexual dimorphism ie females larger than males16 also show a reversal in parasitism ie females are more heavily parasitised3 thus arguing against a role for testosterone I An important aspect of the sexual size dimorphism argument is that sexdependent differences in disease burden may not result from differences in size per se but also from the consequences of size differences I The Soay sheep In comparison with female sheep male Soays are larger more heavily infected with intestinal parasites42 and are shorter lived43 lmportantly when parasite burdens were experimentally reduced in both male and female sheep the sex difference in mortality was ost Describe how differential cellular aging MAY affect gender and longevity oxidative dam age Note May proposes how a master regulator gene may help explain sex differences at the molecularcellular level Women may have evolved through natura selection a genetic mutation insulinlGFl that coordinates increased immunity detoxification and tolerance of oxidative damage I However sexdependent differences in lifespan remain even in the absence of infection and risky behavior primarily because of sexdependent differences in cellular ageing processes such as the accumulation of oxidative damage In the final part of this review I propose that insulinlGFl mediated stress responses may underlie this third facet of sex dependent ageing thereby linking gender and longevity at the molecular level Key terms parental investment theory immunocompetence handicap hypothesis sexual size dimorphism Bateman s Principlethe mostefficient way for males to increase their fitness is by mating with more partners whereas female fitness is most efficiently enhanced by living longer gerontogenes genes whose activity directly regulates longevity Pampel Cigarette Use SKIP or SKIM these sections Estimating tobaccoattributed mortality 8286 See my summary of this section below Differences across countries 8790 Testing the cigarette diffusion explanation 9296 What is the genderequality thesis How does it explain the reversal in the trend in sex differences in mortality I Harmful consequences of improvements in women s status for the sex differential in mortality I Movement toward social and economic equality between men and women will tend to equalize their mortality p78 Describe its 3 critiques Fails to consider the changes in male behaviors and roles that affect along with changes in female behaviors and roles the sex differential 2 Even women with high education highprestige occupations and high incom eithose who benefit most from women s improved opportunities maintain a substantial longevity advantage over men 3 Analyses of mortality from external causes have not found strong links between changes in mortality and women s status What does Pampel propose as an important explanation in sex differences in mortality I Sex differences in the timing of cigarette smoking adoption and cessation can explain both the widening of the gap in previous decades and narrowing of the gap in more recent decades but have little to do with movement toward gender equality How does he link his explanation to the genderequality thesis His theory I Addressing changes in both male and female smokingrelated mortality I Attributing no special harm to fem ale employment I Proving consistent with the literature on sex differentials in external causes of death Compare the sexgender differences in smoking and longevity in the US in the past century List his 4 hypotheses 1 Deaths related to tobacco use should become more similar over time among men and women 2 Deaths unrelated to tobacco should show no such convergence 3 Countries having experienced the largest narrowing of the sex differential in mortality overall should also experience the largest narrowing of the sex differential in tobaccorelated mortality 4 The narrowing of the sex differential in mortality overall should have little relationship to the sex differential for deaths unrelated to smoking Summary Data used as evidence are sexspecific smoking and nonsmoking death rates and the logged ratio of maletofemale rates A higher ratio means a larger female advantage He compares male and female death rates and the ratio across time He also makes comparisons within 3 different age groups because deaths due to smoking usually occur years after the age when smoking begins The data are presented in Table l and the data and findings are described in the text In the youngest age group does the sex differential widen narrow or stay the same In the middle age group does the sex differential widen narrow or stay the same Compare the trend in the sex differential smoking and nonsmoking causes of death What is concluded about smoking and the fem ale mortality advantage over time I The female longevity advantage has fallen because of adoption of smoking Describe how smoking diffuses from only a small group of smokers to become a common habit among many people How does smoking diffusion help explain sex differentials in mortality How does Pampel connect the diffusion of smoking habits to gender inequality In the concluding section Pampel notes that the sex differential in nonsmoking mortality continues to widen Why How are sex differences in mortality expected to change in the future Thompson et al thsical Abuse 1 What are the study s 2 objectives a Effects of physical abuse in childhood on health problem Assessing gender differences in these associations 2 Why has there been a lack of research on gender differences in the longterm consequences of childhood physical abuse a Most studies on the consequences of child maltreatment have focused on females b Studies have not been focused on physical abuse just maltreatment 3 What kinds of experiences were measured as physical abuse a Having something thrown at the person b Being pushed grabbed or shoved c Having hair pulled d Being slapped or hit e Being kicked or bitten f Being choked or experienced attempted drowning g Being hit with an object h Being beaten i Being threatened with a gun j Being threatened with a weapon other than a gun k Having a gun used on them Having a weapon other than a gun used on them 4 What health domains are studied a Health problems in adulthood b Physical injury c Chronic physical health condition d Chronic mental health condition e Alcohol use f Drug use g Current perceptions of unfavorable physical health h Demographics and other violence experienced 5 According to Table 1 do women or men have a higher prevalence of physical abuse in childhood a MEN 6 Describe gender differences in adult health In adulthoodiMen more likely than women to have sustained an injury used alcohol daily and used illegal drugs within the last month b Women more likely to have acquired a mental or physical health condition or used tranquilizers or antidepressants within the past month in adulthood 7 The data show that childhood physical abuse was significantly associated with all of the assessed health problems in adulthood For which health problems were the effects of childhood abuse largest a Mental health problems b Tranquilizer use c Antidepressant use d Illegal drug use 8 Which 2 health problems are higher among women who experienced abuse than men who experienced abuse Mental health conditions b Perception of ill health 9 In the discussion section sexgender differences in other childhood experiences selfblame stress response and magnitude of abuse are proposed as reasons for gender differences in adult mental health outcomes Describe each potential mechanism I Selfblame women more likely to partake than menileads to increased risk of mental illness I Stress response females internalize stress symptomsdepression and males externalize stress symptoms aggression I Magnitude of abuse males experience more forms of physical abuse in childhood than females do Halpern et a Teen Partner Violence What are the study s 2 objectives a Prevalence of psychological and minor physical violence victimization in a nationally representative sample of adolescents b Associations between sociodemographic factors and victimization 2 Why are adolescents a crucial group for studies and interventions of intimate partner violence a Patterns of con ict that precipitate domestic violence in the adult years may start in adolescent dating experiences 3 What are the 2 violence measures 4 Are they measures of perpetrators victims or both 5 Using Table 1 describe the gender and age characteristics ofthe data M nirvana females than males interviewed had participated in relationships More people age 1517 had held relationships More whites than any other race interviewed held relationships The majority ofthe parents of the people interviewed had a high school diploma or a college diploma Religion seemed pretty important to the interviewees Most of the people interviewed attended a large school Most people interviewed only held one relationship 6 Using Table 2 describe the sexspecific prevalence for each violent act and for patterns of violence 7 a More females than males experienced psychological violence More females than males experienced physical violence Most violent behaviors were psychological with swearing being most common Twelve percent reported being the victim of physical violence Approximately 10 of respondents reported having been pushed and 3 reported that something was thrown at them The patterns of victimization indicate that about 1 in 5 adolescents reported only psychological violence and about 1 in 10 reported physical violence usually accompanied by psychological violence For most measures victimization prevalence figures were virtually identical for males and females the exception is being insulted or treated disrespectfully in front of friends which was more frequently reported by females In the discussion section the authors compare their data Add Health Survey with data from young adults How does the prevalence of partner violence change between adolescence and young adulthood a b almost 3 of every 10 adolescents aged 12 to 21 who were involved in heterosexual romantic relationships in an 18month period experienced some type of violence victimization within those relationships One in 10 was the victim of minor physical violence the prevalence of partner violence victimization may increase by a factor of 2 to 5 between adolescence and young adulthood 8 The authors observe gender differences in the sociodemographic correlates of partner violence Which correlates isare associated with women s greater vulnerability to physical abuse ower grades and more relationships were significant predictors of physical or both types of victimization suggesting that females who are doing less well in school or have multiple relationships may be especially vulnerable to physical victimization Yonas et al Gender amp Violence 1 2 3 5 What is a Descri b a Descri b a the objective of the study how young boys and girls living in low income urban neighborhoods defined and described reasons associated with youth violence e the gender differences in youth violence that are presented in the introduction section Several common reasons for violence were found among both boys and girls romantic relationships respect idle time gangscliques and witnessing violence Reasons for violence unique to boys include fighting about issues related to money and illicit drugs Gossip was identified as a reason specific to why girls engage in violence e the sex raceethnicity and age ofthe participants in the discussion sessions Twenty nine youth participated in the study with the average age of the participants being 11 years of age39 one third were boys and the rest girls All of the participants were African American How was the privacy ofthe participants protected a List the b C d e young participants adopted nick names and were encouraged to not share personal experiences or specific details regarding events in their neighborhood Informed consent was obtained from each participant s parent or guardian At the beginning of each focus group discussion the consent forms were collected and the assent form was reviewed to obtain assent from each partici ant 4 thematic categories used to organize the results of the data analysis Definitions of youth violence Similarities between boys and girls reasons for violence Boyspecific reasons for violence Girlspecific reasons for violence 6 List the 5 common reasons for youth violence omantic relationships b Idle time c Res ect d Gangscliques e Witnessing violence 7 List the 2 boyspecific and 1 girlspecific reasons a Boyspecific Fighting about money and illicit drugs b Girlspecific Gossip Hu et al Midlife Suicide 1 What are the 2 classes of risk factors of suicide Give 2 examples of each 1 distal such as a previous suicide attempt mental or physical illness a history of sexual assault or abuse a family history of suicide or mental illness access to lethal methods 2 proximal such as stressful life events 39 39 39 violence 39 v39 39 39 39 media presentations of suicide or a firearm in the home N What are the 3 time trends in the overall suicide rate a Prior to 1999 the overall suicide rate increased annually by 08 between 1981 and 1986 b declined annually by 12 between 1986 and 1999 c From 1999 to 2005 an annual 07 increase in the overall suicide rate occurred 00 Why are the analyses in Tables 1 and 2 and Figures 3 and 4 ONLY of white suicides Of the four major racial groups only whites showed a significant increase in suicide rates during 19997 2005 with an annual 11 increase Suicideprevention efforts have focused most heavily on the groups considered to be most at risk 4 In which age group have suicide rates recently risen Older people 0 Is there a sexgender difference If so describe it Men more likely to suicide than women What constitutes the majority of suicide deaths How has the method of suicide changed since 1999 Men use firearms or hanging Women try to poison themselves 8 If there is a sexgender difference then describe it 9 Which groups have received most of the suicideprevention efforts 10 What are the 2 explanations offered for the observed increase in rates at midlife 11 What are the 2 most promising interventions to reduce suicide rates gt10 Key words suicide WISQARS Webbased injury statistics query and reporting system Hader et al HIVin Women 1 What are the authors study objectives a To perform a comprehensive review of epidemiologic clinical psychosocial and behavioral information about HIV in women and to recommend an agenda for future activities 2 What do they find about sex differences in HIV prevalence and incidence a Women account for an increasing percentage of all acquired immunodeficiency syndrome AIDS cases from 67 181927140 cases in 1986 to 18 119810724656 cases in 1999 By the end of 1998 of all newly reported AIDS cases among women proportionally more were in the South 41 among black women 61 and from heterosexual transmission 38 3 Describe the epidemiological shift in the HIV epidemic among women according to region of the country raceethnicity and mode oftransmission a The surveillance data underscore an epidemiologic shift of an increasing proportion of AIDS cases occurring in women in the South 41 in women with heterosexual risk 38 and in black women61 FIGURE While the HIV epidemic is also increasingly affecting men in the South and black men the overall trends for women are distinct The HIV epidemic in women initially centered on injection drugusing women in the urban Northeast 1 0 but now centers on women with heterosexual risk in the Southll traditionally a region with some of the highest sexually transmitted disease rates in the country AIDS trends in Texas and Florida which report almost half of the AIDS cases in the South are similar to those for the South overall ll Women in rural areas are increasingly affected For example rural counties in Alabama have the highest AIDS incidence in the state with women infected primarily through heterosexual sex Black and Hispanic women have been disproportionately affected by HIV Figure and now account for almost three quarters of HIV infections reported among women between the ages of 13 and 24 years ll Black women are more likely than white women to have acquired HIV heterosexually or with no identified or reported risk 4 What role does age play in women s incidence rates a Younger women are disproportionally at risk re ected by estimates that 26 to 50 of all persons who acquire HIV heterosexually do so when they are teenagers or in their early 20s Young women are at risk for infection at an earlier age than are heterosexual men likely due to infection by older sex partners 5 Describe sexgender differences in a survival and disease progression b HIVassociated illnesses and c guidelines for use of and adherence to HAART S 0 Key terms Survival and Disease Progression Although 1 study estimated a l6fold increased risk for progression for women at a given viral load others have indicated no differences in rate of progression or death Thus guidelines uptodate have not recommended sexspecific thresholds for initiation of antiretroviral treatment HIVAssociated Illnessesirates of HIVassociated illnesses are similar in women and men with Pneumacys s carinii pneumonia esophageal candidiasis mycobacterial infections bacterial pneumonias and nonHodgkin A being common 39 39 of 39 A A 39 and appearing roughly equal in both sexes Guidelines for use of and adherence to HAARTilike men only about three quarters of women receiving therapy report taking medications as or almost as directed Comm on reasons for nonadherence in women and men are forgetting to take pills and drug adverse effects but many other reasons such as not understanding how to take medications forgetting refills depressed mood lifestress anxiety and pain also pertain and may vary by sex HAARTihighly active antiretroviral therapy HERS HIV Epidemiology Research Study WIHS Women s lnteragency HIV Study Rath berger amp Vlassoff Tropical Disease 1 List the 5 problems with the tradition biomedical research on sexgender and tropical disease F 39gtW 2 Describe the 3 focal spheres in their framework for gendersensitive research For each sphere describe 1 example that shows sexgender differences in the risk or impact of tropical disease 1 2 3 Review Questions and Key Terms for Cognition Powell the Teenage Brain Key Terms Myelin Myelination Synaptic pruningithe process of eliminating overabundant unnecessary nerve cell connections 1 What have neuroscientists who study the teenage brain found 0 Neuroscientists probing the teen brain have found that it undergoes a major remodeling that may be responsible for the teenager s propensity to take risks seek out new experiences and fail to restrain inappropriate responses 2 Describe changes in grey matter during adolescence in terms of a when it starts and stops I grey matter thickens in childhood but then thins in a wave that begins at the back of the brain and reaches the front by early adulthood b sex differences I The process completes itself sooner in girls than in boys c how sex differences correspond to conventional wisdom This corresponds to a longheld assumption that adolescence sees the prefrontal cortex regions that handle executive functions waking up39 and to the conventional wisdom that girls mature faster in this respect 3 How does myelination help connect different parts of the brain 0 Myelination follows an inverted 39U39 shape over our lifetimes peaking at around age 50 The teen years are on the early stages of the steep upward curve of myelination 4 What requires maximum myelination o Wisdom 5 What is the onset of adulthood according to studies that use functional MRI to track blood ow across the regions of the brain 0 Luna associates the onset of adulthood with an integration of the frontal regions with other areas of the braini a move from localarea networks to widearea networks in computer terms Myelination is probably part of the process but not all of it if it were peak brain efficiency would not be seen until late middle age 6 What is the role of the reward center 0 In adolescents given a medium or large reward a centre in the brain called the nucleus accumbens reacted more strongly than in children or adults That looks like an exaggeratedly positive reaction When given the small reward the teenage accumbens response decreased below that of children and adults 7 as if the small reward represented no reward at all in the teen39s view 7 What is a likely impact of discovering that increased risktaking is wired into the adolescent brain 0 Halpern amp LaMay Smarter Sex Key Terms episodic memory memory for events in one39s own life semantic memory general memory for facts psychobiosocial model The psychobiosocial model is based on the idea that some variables are both biological and social and therefore cannot be classi ed into one of these two dichotomous categories 1 Why do the authors use the term sex instead of gender 0 using sex to refer to biologically mediated differences and gender to refer to socially mediated differences In accord with the psychobiosocial model presented we believe that biological and social in uences o en are not separable therefore we use the more generic term sex to refer to differences between women and men regardless of their origin 2 Intelligence tests used in educational settings are based on what idea 0 the idea that intelligence is related to success in a traditional academic curriculum 3 List the tests used to assess academic success 0 Wechsler Adult Intelligence Scale WAIS o the Wechsler Intelligence Scale for Children WISC now in its third revision 0 the StandfordBinet Intelligence Test 0 Raven39s Progressive Matrices a nonverbal test 4 List the tests used to predict performance in college and graduate school 0 Scholastic Assessment Tests SAT 0 Graduate Record Examination GRE 5 Do these tests measure uid or crystallized intelligence 0 Fluid 6 How have intelligence tests been constructed with regard to gender 0 Female and male scores are equalized by eliminating questions that show a large advantage for either females or males or by balancing questions that a greater proportion of females39 answers correctly with questions that an equally greater proportion of males39 answers correctly 7 What does gendered test construction mean for assessing true sex differences 0 There is no evidence that either sex is the more intelligent This conclusion that there are no overall sex differences in intelligence has been supported by analysis of scores on the Achievement Tests and Advanced Placement Tests taken by collegebound high school seniors 0 As noted earlier these tests are not classi ed as quotintelligence testsquot but they are used to make decisions about academic ability and presumably re ect intelligence at least in part Stumpf and Stanley found sex differences on individual tests but overall the sex differences on these tests canceled each other 8 Are biasfree measures of intelligence possible No 9 To what is the psychobiosocial model an alternative 0 The naturenurture dichotomy 10 Describe the 3 examples of how biological and social cannot be separated a learning experiences b sex hormones c beliefs about group differences 11 Why is a psychobiosocial model argued to be preferable o it allows for multiple processes to operate simultaneously with environmental inputs altering the biological bases for cognition which in turn changes the nature of what the individual selects from the environment which further changes biology attitudes and the way individuals make choices 12 What is the takehome message about the smarter sex 0 the data reported here are based on group averages and that no individual is average Gerstorf et 211 Old Age 1 The research objectives are a To see if there are sex differentials in the level of cognitive performance and b If the rate of cognitive decline is the same AKA slope List factors that may in uence the level and rate of cognitive decline I It seems that the major biological and psychological changes associated with aging do not modify or affect sex differences in cognition 2 The data come from a sample of older adults who are tested 5 different times over 13 years Longitudinal sample attrition means that not all of the adults who began the study stayed in the study all 13 years Sample attrition is primarily due to what 0 Mortality 3 It is difficult to draw conclusions in longitudinal studies when the people who stayed in all the years are different from those who did not How are the longitudinal participants different from those who attrited 0 Longitudinal participants had a higher education level and as to be expected they were younger at T1 4 List the 4 intellectual abilities AKA cognitive domains that were tested Digit Letter and Identical Pictures tests to assess perceptual speed Paired Associates and Memory for Text tests to assess episodic memory Categories and Word Beginnings tests to assess uency Vocabulary and Spot a Word tests to assess knowledge 5 Once sex differences in education are taken into account what are the sex differences in the 4 cognitive domains and who has the cognitive advantage hint see notes for Figure l 0 At the zeroorder level there were sex differences in intercepts of cognitive functioning favoring women on the Paired Associates and Memory for Text tests and those favoring men on the Vocabulary test Once we took sex differences in education into account the advantage for men vanished and women outperformed men on ve out of the eight cognitive tests Digit Letter Paired Associates Memory for Text Word Beginnings and Spot a Word For example women outperformed men on the Paired Associates test by 4 Tscore units Although both show linear decline amounting to approximately 3 Tscore units per decade sex differences remain constant during advanced old age 6 Do these sex differences change as people age hint lst and last paragraphs of discussion section 0 It seems that the major biological and psychological changes associated with aging do not modify or affect sex differences in cognition Review Questions and Key Terms for Mental and Emotional Health Lundberg Stress 1 List the 3 stress hormones o Epinephrine norepinephrine and Cortisol 2 Which hormone is sensitive to physical demands 0 Norepinephrine 3 Which is sensitive to mental demands 0 Epinephrine 4 Which is sensitive to fear and anxiety 0 Cortisol 5 Describe sexgender differences in stress when women and men have similar occupations o In subsequent studies men and women at the same occupational level were found to respond similarly to stress at work 6 Describe sexgender differences in stress outside the workplace 0 Women s stress levels tend to remain elevated also after work whereas men seem to unwind and relax rapidly at the end of the working day 7 What is the role of each stress hormone in the development of chronic disease 0 With regard to cortisol overactivity of the HPA axis andor disturbance to the regulation of this system has been associated with increased risk of several health problems such as cardiovascular disease Type 2 diabetes reduced immune function and cognitive impairment 8 There is the assumption that responses to stress exposure were health promoting early in human evolutionary history Because the primary utility for health promotion is lost with evolution it is converted to health damage Describe the Allostatic Load Model in terms of activation and shutoff Which is speculated to be a greater health problem than absolute stress on and off the job in modern society 0 Allostasis refers to the ability of various physiological systems to adapt to the environmental demands imposed by change According to this model rapid activation of the allostatic systems is necessary for successful coping with a stressor However rapid shutoff of any such response is important for rest and recovery As a consequence repeated activation of responses without time for rest and recovery as well as sustained activation will cause overexposure to stress hormones high blood pressure and high levels of blood lipids thereby increasing the risk of various health problems Also lack of an adequate responseias a result for example of exhaustion of any one systemimay cause health problems due to an imbalance between different systems or compensatory overactivation of a particular system Gorman Depression Key terms seasonal affective disorder SAD receptor dysregulation theory 1 What is the objective of this review 2 Describe crossnational lifetime prevalence levels and sex differences in major depression 3 List the 6 psychiatric and medical consequences of depression 4 Describe the diagnostic criteria for major depression hint table 5 Do women and men respond equally well to antidepressant medication 6 Describe sexgender similarities and differences in early life stress and psychopathology Keogh Pain Key terms 1 Who appears to have greater pain prevalence according to experimental and epidemiological studies 0 women 2 What do pain intervention studies conclude about sexgender differences 0 Better postop analgesia in women than in men 0 Women actually use fewer analgesics than men 3 Name the 2 types of explanations or mechanisms to account for sexgender differences in pain and list the 3 mechanisms described for each type of explanation 0 Biological factors I Genetics I Sex hormones I Brain imaging studies 0 Psychosocial factors I Negative emotions I Coping strategies I Social in uences 5 According to each mechanism how are women and men similar or different 0 6 What conclusions are drawn about sexspeci c pain treatment 0 Fischer et al Emotion Key terms cross cultural study GEM l The authors begin by reporting that research studies on gender and emotion in Western societies nd a gender speci c pattern Describe sexgender differences in emotional responding 0 Women generally report more sadness fear shame and guilt whereas men report experiencing and expressing more anger and other hostile emotions although this latter nding shows less consistent evidence a How are these differences linked to gender role socialization a social explanation How are gender roles linked to power and status I Traditionally in Western industrial societies women are more likely than men to have domestic and nurturing roles in which taking emotional care of others is their main task Men however are more likely than women to provide the material resources and assume a role in the paid economy I Female roles are seen to have less power and status than male roles b Give an example of a potential biological explanation of gender differences in emotion I hormonal in uences would explain the more frequent crying behavior of women c What crosscultural pattern should be observed if gender differences in emotion are biological in origin What pattern should be observed if differences are social in nature Indeed their crosscultural analysis supports the idea that gender differences stem from an interaction between physical attributes and social arrangements in society Applying this perspective to gender differences in emotion emotions should vary as a result of the crosscultural variability in gender roles if they are primarily determined by the social roles men and women occupy However if emotional reactions eg crying are primarily determined by biological in uences a more uniform pattern across countries would emerge 2 What is the GEM index intended to measure 0 Re ects the extent to which women actively participate in economic and political life 3 What types of information are used in the GEM index 0 percentage of seats in parliament held by women 0 percentage of administrators and managers who are women 0 percentage of professional and technical workers who are women 0 women s share of earned income in the country in question 4 What does a higher score on the index mean 0 The higher the GEM the more status and power women have in a speci c society 5 The authors test 1 hypothesis about emotional intensity and 2 hypotheses about emotional expression antagonism and crying Which hypothesis or hypotheses represents a biological explanation of gender differences in emotion o Hypothesis 3 about crying o Hypothesis 1 about emotional intensity 6 What are the study s conclusions about intensity p 92 0 With respect to the reported intensity of emotions no gender differences for powerful emotions were found 0 However in the case of the powerless emotions men s scores but not those of women signi cantly interacted with the GEM 0 Men from highGEM countries rated their powerless emotions as less intense than did men from lowGEM countries 7 What male pattern of emotionality do the ndings support 0 Powerlessness and vulnerability correspond less with the male role in many Western countries than with the male role in nonWestem countries supporting the idea that the male pattern of restrictive emotionality is a typical Western phenomenon 8 What are the study s conclusions about patterns and explanations for antagonism p 92 o Antagonism however seems more affected by social roles as indicated by the fact that women in highGEM countries report more anger expressions than women in lowGEM countries Whereas the GEM does not affect men s reports on antagonism o This nding suggests that the reported expression of anger by women is an indication of their general position and status in a society 9 What are the study s conclusions about patterns and explanations for crying 0 There is a uniform pattern for crying across countries 0 crying is more strongly determined by biological factors than by social roles
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