Influence of gender and life stressors on longitudinal depression treatment outcomes among older primary care patients

Purpose: Depression in older females is a significant and growing problem. Females who experience life stressors across the life span are at higher risk for developing problems with depression than their male counterparts. The primary aim of this study was (a) to examine gender-specific differences in the correlates of depression in older primary care patients based on baseline and longitudinal analyses; and (b) to examine the longitudinal effect of biopsychosocial risk factors on depression treatment outcomes in different models of behavioral healthcare (i.e., integrated care and enhanced referral). Method: This study used a quantitative secondary data analysis with longitudinal data from the Primary Care Research in Substance Abuse and Mental Health for Elderly (PRISM-E) study. A linear mixed model approach to hierarchical linear modeling was used for analysis using baseline assessment, and follow-up from three-month and six-month. Results: For participants diagnosed with major depressive disorder female gender was associated with increased depression severity at six-month compared to males at six-month. Further, the interaction between gender and life stressors found that females who reported loss of family and friends, family issues, money issues, medical illness was related to higher depression severity compared to males whereas lack of activities was related to lower depression severity among females compared to males. Conclusion: These findings suggest that gender moderated the relationship between specific life stressors and depression severity similar to how a protective factor can impact a person's response to a problem and reduce the negative impact of a risk factor on a problem outcome. Therefore, life stressors may be a reliable predictor of depression for both females and males in either behavioral health treatment model. This study concluded that life stressors influence males basic comfort, stability, and survival whereas life stressors influence females' development, personal growth, and happiness; therefore, life stressors may be a useful component to include in gender-based screening and assessment tools for depression. ^

A Case-Only Genome-wide Association Study of Gender- and Age-specific Risk Markers for Childhood Leukemia

Males and age group 1 to 5 years show a much higher risk for childhood acute lymphoblastic leukemia (ALL). We performed a case-only genome-wide association study (GWAS), using the Illumina Infinium HumanCoreExome Chip, to unmask gender- and age-specific risk variants in 240 non-Hispanic white children with ALL recruited at Texas Children’s Cancer Center, Houston, Texas. Besides statistically most significant results, we also considered results that yielded the highest effect sizes. Existing experimental data and bioinformatic predictions were used to complement results, and to examine the biological significance of statistical results. Our study identified novel risk variants for childhood ALL. The SNP, rs4813720 (RASSF2), showed the statistically most significant gender-specific associations (P < 2 x 10-6). Likewise, rs10505918 (SOX5) yielded the lowest P value (P < 1 x 10-5) for age-specific associations, and also showed the statistically most significant association with age-at-onset (P < 1 x 10-4). Two SNPs, rs12722042 and 12722039, from the HLA-DQA1 region yielded the highest effect sizes (odds ratio (OR) = 15.7; P = 0.002) for gender-specific results, and the SNP, rs17109582 (OR = 12.5; P = 0.006), showed the highest effect size for age-specific results. Sex chromosome variants did not appear to be involved in gender-specific associations. The HLA-DQA1 SNPs belong to DQA1*01:07and confirmed previously reported male-specific association with DQA1*01:07. Twenty one of the SNPs identified as risk markers for gender- or age-specific associations were located in the transcription factor binding sites and 56 SNPs were non-synonymous variants, likely to alter protein function. Although bioinformatic analysis did not implicate a particular mechanism for gender- and age-specific associations, RASSF2 has an estrogen receptor-alpha binding site in its promoter. The unknown mechanisms may be due to lack of interest in gender- and age-specificity in associations. These results provide a foundation for further studies to examine the gender- and age-differential in childhood ALL risk. Following replication and mechanistic studies, risk factors for one gender or age group may have a potential to be used as biomarkers for targeted intervention for prevention and maybe also for treatment.

Through the Prisms of Gender and Power: Agency in International Courtship between Colombian Women and American Men

Since 1999 Colombia has experienced dramatic increases in emigration, particularly the emigration of women towards the U.S. as fiancées of U.S. citizens or residents. Parallel to this trend is the increased number of websites facilitating these Colombian-American matches. This dissertation investigates the agency of Colombian women and American men who pursue romantic courtship through the services of International Marriage Brokers (IMBs) from the “Gendered Geographies of Power” (GGP) framework of analysis. It examines how both groups’ social locations, their positioning in multiple axes of differentiation including gender, nationality and social class, affects how and why they exert their agency across and within different geographic scales. Most importantly, it investigates the role the imagination plays (imagination work) in both men and women’s agency, an aspect of the GGP framework that has been under-researched and theorized to date. The research also finds that this imagination work is promoted and cultivated in deeply gendered ways by IMBs seeking to profit off this transnational courtship. Employing data collected via interviews and content analysis of IMBs’ websites, the dissertation analyzes comparatively the expectations each group (women, men and IMBs) bring to their imagination work and experiences of the courtship marketplace. A central question posed and answered in the dissertation is “What do women and men courting each other in cyberspace seek and do they find it?” The dissertation finds that the men seek “traditional” women and the women seek “liberated” less “macho” men. Ironically, the men find Colombian women who are among the most “liberated” women in their homeland but who downplay this aspect of themselves in order to strategically find a more modern man and migrate abroad where they expect to find greater personal and professional opportunities.

Adaptation of Trailing Spouses: Does Gender Matter?

The adaptation to a new country is a complex and stressful process that is compounded when changes in status and identity have to be made. This exploratory study examined the adaptation of international company transferee spouses when they decide to follow the transferee on overseas assignments. Research to date indicates that the spouses’ dissatisfaction with life abroad is the leading cause of transferees breaking contract and prematurely returning home. The causes of this dissatisfaction are still not clear and this study sought greater clarification, particularly examining the experiences of male as well as female trailing spouses. The study, thus, takes gender as a main variable to consider. It explores how gendered expectations inherent in the structures of society inflect and inform the decisions, attitudes, and behaviors that affect the adaptations of trailing spouses living in a foreign habitus. The study is based on eight months of ethnographic research in two culturally different locations, Kuala Lumpur, Malaysia and Brussels, Belgium. Forty-two American international company transferee spouses were recruited (seven males and thirty-five females). The data analysis revolved around five main themes: (1) the comparison of male with female trailing spouses’ experiences, (2) the effect of location on spouses’ adaptation, (3) the communities that spouses integrate into, (4) variations in personal work and family histories, and (5) conditions of exit. The analysis engaged multiple theories regarding gender, sociological adaptation, and psychological adaptation. Results indicate that both socio-cultural and psychological factors affect adaptation and that gender matters very significantly, particularly along two axes: (1) gendered structures in our society create different reasons why males and females become trailing spouses, (2) the gendered social constructions of role expectations make the experience of being a trailing husband different from being a trailing wife. In addition spouses’ status as parents (or not) and their “readiness for change” were found to be important predictors of positive spousal adaptation. In contrast, significant ties with families in the home country and strong professional identity with career projections were important predictors of negative spousal adaptation.

Analysis and comparison of the moral development of students required to graduate with an ethics course

Accounting students become practitioners facing ethical decision-making challenges that can be subject to various interpretations; hence, the profession is concerned with the appropriateness of their decisions. Moral development of these students has implications for a profession under legal challenges, negative publicity, and government scrutiny. Accounting students moral development has been studied by examining their responses to moral questions in Rest's Defining Issues Test (DIT), their professional attitudes on Hall's Professionalism Scale Dimensions, and their ethical orientation-based professional commitment and ethical sensitivity. This study extended research in accounting ethics and moral development by examining students in a college where an ethics course is a requirement for graduation. Knowledge of differences in the moral development of accounting students may alert practitioners and educators to potential problems resulting from a lack of ethical understanding as measured by moral development levels. If student moral development levels differ by major, and accounting majors have lower levels than other students, the conclusion may be that this difference is a causative factor for the alleged acts of malfeasance in the profession that may result in malpractice suits. The current study compared 205 accounting, business, and nonbusiness students from a private university. In addition to academic major and completion of an ethics course, the other independent variable was academic level. Gender and age were tested as control variables and Rest's DIT score was the dependent variable. The primary analysis was a 2x3x3 ANOVA with post hoc tests for results with significant p-value of less than 0.05. The results of this study reveal that students who take an ethics course appear to have a higher level of moral development (p=0.013), as measured by the (DIT), than students at the same academic level who have not taken an ethics course. In addition, a statistically significant difference (p=0.034) exists between freshmen who took an ethics class and juniors who did not take an ethics class. For every analysis except one, the lower class year with an ethics class had a higher level of moral development than the higher class year without an ethics class. These results appear to show that ethics education in particular has a greater effect on the level of moral development than education in general. Findings based on the gender specific analyses appear to show that males and females respond differently to the effects of taking an ethics class. The male students do not appear to increase their moral development level after taking an ethics course (p=0.693) but male levels of moral development differ significantly (p=0.003) by major. Female levels of moral development appear to increase after taking an ethics course (p=0.002). However, they do not differ according to major (p=0.0 97). These findings indicate that accounting students should be required to have a class in ethics as part of their college curriculum. Students with an ethics class have a significantly higher level of moral development. The challenges facing the profession at the current time indicate that public confidence in the reports of client corporations has eroded and one way to restore this confidence could be to require ethics training of future accountants.

An analysis of the impact of the Islamic revolution in Iran on Iranian women

This study compares the status of women under the secular government of the Pahlavi Dynasty with the Islamic Republic of Iran. It relies on Hisham Sharabi's theory of neopatriarchal society and Fatima Mernissi's psychological analysis of the dynamics of gender relations in Islam. Both the Pahlavi dynasty and the Islamic regime promoted a perception of women's rights which were conducive to the ideologies of secularism and Islamism. Both regimes, however, worked within the framework of a patriarchal society by instituting policies that were misogynous in nature. This study found that the majority of Iran's female population was not greatly affected by the overthrow of the Pahlavi dynasty and the subsequent implementation of the Islamic regime. The basis of this argument lies in the fact that despite the contrasting ideologies of both governments, where women's issues are concerned, the patriarchal social structure remained virtually intact.

Injustice Everywhere: Hemingway's Struggle with Race, Gender, and Aesthetics

The purpose of this study was to critically evaluate the aesthetic decisions and theoretical complexity of three of Ernest Hemingway’s most experimental texts: IN OUR TIME, TO HAVE AND HAVE NOT, and THE GARDEN OF EDEN, and to show that the usually maligned Hemingway was an author invested in the avant-garde and in analyzing and dissecting rigid societal rules, not championing them. Through critical analysis this study examined how Hemingway makes specific aesthetic decisions in order to more clearly examine the disparity between whites and both women and racial minorities in America. The problems that Hemingway makes clear through his art are meant to have a profound effect upon the reader and encourage re-evaluation of societal rules, their purpose, and their fairness to those who are not white, male, and typically in a position of power. The findings demonstrate that Hemingway’s entire oeuvre is open to re-interpretation on the basis of a progressive view of the author.

The State of our Toolbox: A Meta-analysis of Reliability Measurement Precision

My study investigated internal consistency estimates of psychometric surveys as an operationalization of the state of measurement precision of constructs in industrial and organizational (I/O) psychology. Analyses were conducted of samples used in research articles published in the Journal of Applied Psychology between 1975 and 2010 in five year intervals (K = 934) from 480 articles yielding 1427 coefficients. Articles and their respective samples were coded for test-taker characteristics (e.g., age, gender, and ethnicity), research settings (e.g., lab and field studies), and actual tests (e.g., number of items and scale anchor points). A reliability and inter-item correlations depository was developed for I/O variables and construct groups. Personality measures had significantly lower inter-item correlations than other construct groups. Also, internal consistency estimates and reporting practices were evaluated over time, demonstrating an improvement in measurement precision and missing data.

Gender Differences in the Influence of Protective Factors, Risk Factors, and Health Risk Behaviors on HIV Risk Behaviors Among Youth in South Florida

Adolescents engage in a range of risk behaviors during their transition from childhood to adulthood. Identifying and understanding interpersonal and socio-environmental factors that may influence risk-taking is imperative in order to meet the Healthy People 2020 goals of reducing the incidence of unintended pregnancies, HIV, and other sexually transmitted infections among youth. The purpose of this study was to investigate gender differences in the predictors of HIV risk behaviors among South Florida youth. More specifically, this study examined how protective factors, risk factors, and health risk behaviors, derived from a guiding framework using the Theory of Problem Behavior and Theory of Gender and Power, were associated with HIV risk behavior. A secondary analysis of 2009 Youth Risk Behavior Survey data sets from Miami-Dade, Broward, and Palm Beach school districts tested hypotheses for factors associated with HIV risk behaviors. The sample consisted of 5,869 high school students (mean age 16.1 years), with 69% identifying as Black or Hispanic. Logistic regression analyses revealed gender differences in the predictors of HIV risk behavior. An increase in the health risk behaviors was related to an increase in the odds that a student would engage in HIV risk behavior. An increase in risk factors was also found to significantly predict an increase in the odds of HIV risk behavior, but only in females. Also, the probability of participation in HIV risk behavior increased with grade level. Post-hoc analyses identified recent sexual activity (past 3 months) as the strongest predictor of condom nonuse and having four or more sexual partners for both genders. The strongest predictors of having sex under the influence of drugs/alcohol were alcohol use in both genders, marijuana use in females, and physical fighting in males. Gender differences in the predictors of unprotected sex, multiple sexual partners, and having sex under the influence were also found. Additional studies are warranted to understand the gender differences in predictors of HIV risk behavior among youth in order to better inform prevention programming and policy, as well as meet the national Healthy People 2020 goals.

A case-only genome-wide association study of gender- and age-specific risk markers for childhood leukemia

Males and age group 1 to 5 years show a much higher risk for childhood acute lymphoblastic leukemia (ALL). We performed a case-only genome-wide association study (GWAS), using the Illumina Infinium HumanCoreExome Chip, to unmask gender- and age-specific risk variants in 240 non-Hispanic white children with ALL recruited at Texas Children’s Cancer Center, Houston, Texas. Besides statistically most significant results, we also considered results that yielded the highest effect sizes. Existing experimental data and bioinformatic predictions were used to complement results, and to examine the biological significance of statistical results. ^ Our study identified novel risk variants for childhood ALL. The SNP, rs4813720 (RASSF2), showed the statistically most significant gender-specific associations (P < 2 x 10-6). Likewise, rs10505918 (SOX5) yielded the lowest P value (P < 1 x 10-5 ) for age-specific associations, and also showed the statistically most significant association with age-at-onset (P < 1 x 10-4). Two SNPs, rs12722042 and 12722039, from the HLA-DQA1 region yielded the highest effect sizes (odds ratio (OR) = 15.7; P = 0.002) for gender-specific results, and the SNP, rs17109582 (OR = 12.5; P = 0.006), showed the highest effect size for age-specific results. Sex chromosome variants did not appear to be involved in gender-specific associations. ^ The HLA-DQA1 SNPs belong to DQA1*01:07and confirmed previously reported male-specific association with DQA1*01:07. Twenty one of the SNPs identified as risk markers for gender- or age-specific associations were located in the transcription factor binding sites and 56 SNPs were non-synonymous variants, likely to alter protein function. Although bioinformatic analysis did not implicate a particular mechanism for gender- and age-specific associations, RASSF2 has an estrogen receptor-alpha binding site in its promoter. The unknown mechanisms may be due to lack of interest in gender- and age-specificity in associations. These results provide a foundation for further studies to examine the gender- and age-differential in childhood ALL risk. Following replication and mechanistic studies, risk factors for one gender or age group may have a potential to be used as biomarkers for targeted intervention for prevention and maybe also for treatment.^

The Influence of Gender on Perceived Treatment Need among a Community Sample of Substance Users

Purpose: Most individuals do not perceive a need for substance use treatment despite meeting diagnostic criteria for substance use disorders and they are least likely to pursue treatment voluntarily. There are also those who perceive a need for treatment and yet do not pursue it. This study aimed to understand which factors increase the likelihood of perceiving a need for treatment for individuals who meet diagnostic criteria for substance use disorders in the hopes to better assist with more targeted efforts for gender-specific treatment recruitment and retention. Using Andersen and Newman’s (1973/2005) model of individual determinants of healthcare utilization, the central hypothesis of the study was that gender moderates the relationship between substance use problem severity and perceived treatment need, so that women with increasing problems due to their use of substances are more likely than men to perceive a need for treatment. Additional predisposing and enabling factors from Andersen and Newman’s (1973/2005) model were included in the study to understand their impact on perceived need. Method: The study was a secondary data analysis of the 2010 National Survey on Drug Use and Health (NSDUH) using logistic regression. The weighted sample consisted of a total 20,077,235 American household residents (The unweighted sample was 5,484 participants). Results of the logistic regression were verified using Relogit software for rare events logistic regression due to the rare event of perceived treatment need (King & Zeng, 2001a; 2001b). Results: The moderating effect of female gender was not found. Conversely, men were significantly more likely than women to perceive a need for treatment as substance use problem severity increased. The study also found that a number of factors such as race, ethnicity, socioeconomic status, age, marital status, education, co-occurring mental health disorders, and prior treatment history differently impacted the likelihood of perceiving a need for treatment among men and women. Conclusion: Perceived treatment need among individuals who meet criteria for substance use disorders is rare, but identifying factors associated with an increased likelihood of perceiving need for treatment can help the development of gender-appropriate outreach and recruitment for social work treatment, and public health messages.