Evaluation of the causal pathways through which subjective norms influence mammography intention and stage of change in a national sample of women veterans

Few studies have investigated causal pathways linking psychosocial factors to each other and to screening mammography. Conflicting hypotheses exist in the theoretic literature regarding the role and importance of subjective norms, a person's perceived social pressure to perform the behavior and his/her motivation to comply. The Theory of Reasoned Action (TRA) hypothesizes that subjective norms directly affect intention; while the Transtheoretical Model (TTM) hypothesizes that attitudes mediate the influence of subjective norms on stage of change. No one has examined which hypothesis best predicts the effect of subjective norms on mammography intention and stage of change. Two statistical methods are available for testing mediation, sequential regression analysis (SRA) and latent variable structural equation modeling (LVSEM); however, software to apply LVSEM to dichotomous variables like intention has only recently become available. No one has compared the methods to determine whether or not they yield similar results for dichotomous variables. ^ Study objectives were to: (1) determine whether the effect of subjective norms on mammography intention and stage of change are mediated by pros and cons; and (2) compare mediation results from the SRA and LVSEM approaches when the outcome is dichotomous. We conducted a secondary analysis of data from a national sample of women veterans enrolled in Project H.O.M.E. (H&barbelow;ealthy O&barbelow;utlook on the M&barbelow;ammography E&barbelow;xperience), a behavioral intervention trial. ^ Results showed that the TTM model described the causal pathways better than the TRA one; however, we found support for only one of the TTM causal mechanisms. Cons was the sole mediator. The mediated effect of subjective norms on intention and stage of change by cons was very small. These findings suggest that interventionists focus their efforts on reducing negative attitudes toward mammography when resources are limited. ^ Both the SRA and LVSEM methods provided evidence for complete mediation, and the direction, magnitude, and standard errors of the parameter estimates were very similar. Because SRA parameter estimates were not biased toward the null, we can probably assume negligible measurement error in the independent and mediator variables. Simulation studies are needed to further our understanding of how these two methods perform under different data conditions. ^

The association between uterus shape and development of chronic conditions in a retrospective corhort of diethylstilbestrol-exposed women in Minnesota and Texas

Diethylstilbestrol (DES) exposed women are well known to be at increased risk of gynecologic cancers and infertility. Infertility may result from DES associated abnormalities in the shape of women's uteri, yet little research has addressed the effect of uterine abnormalities on risk of infertility and reproductive tract infection. Changes in uterine shape may also influence the risk of autoimmune disease and women's subsequent mental health. A sample of consenting women exposed in utero to hormone who were recruited into the DESAD project, underwent hysterosalpingogram (HSG) from 1978 to 1984. These women also completed a comprehensive health questionnaire in 1994 which included women's self-reports of chronic conditions. HSG data were used to categorize uterine shape abnormalities as arcuate shape, hypoplastic, wide lower segment, and constricted. Women were recruited from two of the four DESAD study sites in Houston (Baylor) and Minnesota (Mayo). All women were DES-exposed. Adjusted relative risk estimates were calculated comparing the range of abnormal uterine shaped to women with normal shaped uteri for each of the four outcomes: infertility, reproductive tract infection, autoimmune disease and depressive symptoms. Only the arcuate shape (n=80) was associated with a higher risk of infertility (relative risk [RR]= 1.53, 95% CI = 1.09, 2.15) as well as reproductive tract infection (RR= 1.74, 95% CI = 1.11, 2.73). In conclusion, DES-associated arcuate shaped uteri appeared to be associated with the higher risk of a reproductive tract infection and infertility while no other abnormal uterine shapes were associated with these two outcomes.^

HIV disclosure decisions and social support among African-American women in Houston, Texas

African Americans make up 12.3% of the population but account for over half of the new HIV cases and 39% of the AIDS cases in 2003 (Centers for Disease Control and Prevention [CDC], 2003). African American women in particular accounted for 64% of these cases of HIV and 60% of the AIDS cases (Leigh & Huff, 2003). This study contributed to the knowledge about the disclosure process of women living with HIV/AIDS by documenting the relationship between social support and the disclosure process in the African American HIV/AIDS population.^ The study aims were to: (1) discuss the participants' self concept of support; (2) describe the common characteristics of the disclosure process; and (3) evaluate the common characteristics of support sought in a potential disclosure source. The ethnographic qualitative methodology was utilized to elicit participant narratives of HIV disclosure and social support. The researcher utilized a key informant interview methodology building on existing social and organizational relationships (Krueger, 1994) to gain access to the population. ^ Semi-structured interviews are a widely used and accepted qualitative research method for use with hard to reach populations and sensitive topics. Ten participants completed a 45 to 60 minute, one on one semi-structured interview covering social support and disclosure variables. Inclusion and exclusion criteria included: (1) self identified as a person living with HIV/AIDS; (2) African American); (3) female; (4) age 18-64 years old, (5) residence in Houston or surrounding counties.^ Themes generated from the interviews were (1) nondisclosure, (2) experiences with disclosure, (3) timing, (4) disclosure sources, and (5) coping. The themes suggest African American women living with HIV/AIDS come from different lifestyles but share similar experiences. Women utilize different strategies such as deciphering whom to trust and determining how much information to divulge in order to protect themselves or others.^ Although the sample group was small for this study, the results inform us about the various experiences each woman goes through as it relates to social support and disclosure and that each woman has to customize her response to the type of support she is receiving and her personal attitude about her disease.^

Health status of Saudi women, the case of Yanbu al-Sinaiya

Detailed data on the health status of Saudi women are lacking. This cross sectional study attempts to provide a comprehensive description of the health status of Saudi females between the ages of 15-45 residing in Yanbu Al-Siniyah. The purpose is to assess women's needs for health services. The health status indicators are chronic tracer conditions, reported symptoms and multidimensional functioning levels. The generic functioning instrument of the Medical Outcome Study was used to estimate physical, social, and role functioning; degree of pain and health perceptions. The information was obtained by interviewing subjects and abstracting facts from their medical records. The results show functioning scores are in the "well health" range for physical, social, role and pain. Crowding and education have an equal or stronger effect of reducing functioning levels than the diagnosed tracer conditions. The highest prevalence conditions having a definite functional impact and diagnosed adequately in primary care are anemia, urinary tract infection, hemorrhoids, rheumatoid arthritis, caries and gingivitis. Reported symptoms strongly reducing function levels in this study are dyspnea, heart pain, incontinence, eye and skin problems, and joint ache. The impact of the reliability and validity of the measures used and other limitations of the results are discussed. Finally, some policy implications and suggestions for future study are presented. ^

SOCIAL, ATTITUDINAL AND BEHAVIORAL CORRELATES OF WEIGHT CHANGE AMONG MEXICAN AMERICAN WOMEN (OBESITY, DIET, TEXAS)

In industrialized countries the prevalence of obesity among women decreases with increasing socioeconomic status. While this relation has been amply documented, its explanation and implications for other causal factors of obesity has received much less attention. Differences in childbearing patterns, norms and attitudes about fatness, dietary behaviors and physical activity are some of the factors that have been proposed to explain the inverse relation.^ The objectives of this investigation were to (1) examine the associations among social characteristics and weight-related attitudes and behaviors, and (2) examine the relations of these factors to weight change and obesity. Information on social characteristics, weight-related attitudes, dietary behaviors, physical activity and childbearing were collected from 304 Mexican American women aged 19 to 50 living in Starr County, Texas, who were at high risk for developing diabetes. Their weights were recorded both at an initial physical examination and at a follow-up interview one to two and one-half years later, permitting the computation of current Body Mass Index (weight/height('2)) and weight change during the interval for each subject. Path analysis was used to examine direct and indirect relations among the variables.^ The major findings were: (1) After controlling for age, childbearing was not an independent predictor of weight change or Body Mass Index. (2) Neither planned exercise nor total daily physical activity were independent predictors of weight change. (3) Women with higher social characteristics scores reported less frequent meals and less use of calorically dense foods, factors associated with lower risk for weight gain. (4) Dietary intake measures were not significantly related to Body Mass Index. However, dietary behaviors (frequency of meals and snacks, use of high and low caloric density foods, eating restraint and disinhibition of restraint) did explain a significant portion (17.4 percent) of the variance in weight change, indicating the importance of using dynamic measures of weight status in studies of the development of obesity. This study highlights factors amenable to intervention to reverse or to prevent weight gain in this population, and thereby reduce the prevalence of diabetes and its sequelae. ^

Social integration, health behaviors and health status among Mexican-American women in the *southwestern United States

Using the Hispanic Health and Nutrition Examination Survey (HHANES), this research examined several health behaviors and the health status of Mexican American women. This study focused on determining the relative impact of social contextual factors: age, socioeconomic status, quality of life indicators, and urban/rural residence on (a) health behaviors (smoking, obesity and alcohol use) and (b) health status (physician's assessment of health status, subject's assessment of health status and blood pressure levels). In addition, social integration was analyzed. The social integration indicators relate to an individual's degree of integration within his/her social group: marital status, level of acculturation (a continuum of traditional Mexican ways to dominant U.S. cultural ways), status congruency, and employment status. Lastly, the social contextual factors and social integration indicators were examined to identify those factors that contribute most to understanding health behaviors and health status among Mexican American women.^ The study found that the social contextual factors and social integration indicators proved to be important concepts in understanding the health behaviors. Social integration, however, did not predict health status except in the case of the subject's assessment of health status. Age and obesity were the strongest predictors of blood pressure. The social contextual factors and obesity were significant predictors of the physician's assessment of health status while acculturation, education, alcohol use and obesity were significant predictors of the subject's assessment of health status. ^

Intersecciones : Política social e inserción laboral : Un estudio de caso sobre la informalidad de subsistencia en un barrio del Conurbano Bonaerense

La política social y el mercado de trabajo son dimensiones del sistema social mutuamente implicadas en las sociedades industriales capitalistas. Sin embargo, una interpretación apresurada sobre el mundo social podría opacar los procesos que hacen que en un grupo de la población se yuxtapongan: una inserción laboral precaria dentro del mercado de trabajo informal junto con la (re) construcción de ese grupo como sujeto-objeto de políticas sociales. El artículo tiene por propósito problematizar las representaciones dominantes sobre el trabajo y su relación con las prácticas de organización de los hogares, considerando que en su interior la dimensión laboral se articula con otros recursos (provenientes de las políticas sociales). De modo más específico, el objetivo se orienta a la descripción y análisis de prácticas y representaciones sobre la situaci162n ocupacional de jefas/es y cónyuges que realizan actividades laborales en la informalidad de subsistencia. Se plantea como hipótesis exploratoria que en el período actual las condiciones de trabajo y representaciones de los trabajadores ocupados en ese tipo de actividades expresarían la existencia de un tipo de informalidad fuertemente segregada respecto de las actividades productivas, un en un contexto de crecimiento del empleo. También se sostiene que las formas bajo las cuales estas inserciones laborales se articulan con los planes sociales (como un nivel específico de política social) evidenciarían el carácter de la contribución estatal a la reproducción de las condiciones de vida de los trabajadores insertos en este tipo de informalidad. Los hallazgos presentados constituyen un avance de investigación sobre la reproducción de la marginalidad urbana en el Conurbano Bonaerense. Parte del trabajo de campo se realizó durante el año 2008, en un barrio del Partido de Almirante Brown. Se organizaron dos grupos de discusión: uno con mujeres perceptoras de planes y otro con hombres que realizaban changas como actividad principal. Con el objeto de aportar datos acerca de las condiciones materiales de los hogares, se aplicó un cuestionario a los participantes. Junto con esta información, se analizaron registros de campo tomados en observaciones realizadas en diversos espacios del barrio

Intersecciones : Política social e inserción laboral : Un estudio de caso sobre la informalidad de subsistencia en un barrio del Conurbano Bonaerense

La política social y el mercado de trabajo son dimensiones del sistema social mutuamente implicadas en las sociedades industriales capitalistas. Sin embargo, una interpretación apresurada sobre el mundo social podría opacar los procesos que hacen que en un grupo de la población se yuxtapongan: una inserción laboral precaria dentro del mercado de trabajo informal junto con la (re) construcción de ese grupo como sujeto-objeto de políticas sociales. El artículo tiene por propósito problematizar las representaciones dominantes sobre el trabajo y su relación con las prácticas de organización de los hogares, considerando que en su interior la dimensión laboral se articula con otros recursos (provenientes de las políticas sociales). De modo más específico, el objetivo se orienta a la descripción y análisis de prácticas y representaciones sobre la situaci162n ocupacional de jefas/es y cónyuges que realizan actividades laborales en la informalidad de subsistencia. Se plantea como hipótesis exploratoria que en el período actual las condiciones de trabajo y representaciones de los trabajadores ocupados en ese tipo de actividades expresarían la existencia de un tipo de informalidad fuertemente segregada respecto de las actividades productivas, un en un contexto de crecimiento del empleo. También se sostiene que las formas bajo las cuales estas inserciones laborales se articulan con los planes sociales (como un nivel específico de política social) evidenciarían el carácter de la contribución estatal a la reproducción de las condiciones de vida de los trabajadores insertos en este tipo de informalidad. Los hallazgos presentados constituyen un avance de investigación sobre la reproducción de la marginalidad urbana en el Conurbano Bonaerense. Parte del trabajo de campo se realizó durante el año 2008, en un barrio del Partido de Almirante Brown. Se organizaron dos grupos de discusión: uno con mujeres perceptoras de planes y otro con hombres que realizaban changas como actividad principal. Con el objeto de aportar datos acerca de las condiciones materiales de los hogares, se aplicó un cuestionario a los participantes. Junto con esta información, se analizaron registros de campo tomados en observaciones realizadas en diversos espacios del barrio

Intersecciones : Política social e inserción laboral : Un estudio de caso sobre la informalidad de subsistencia en un barrio del Conurbano Bonaerense

La política social y el mercado de trabajo son dimensiones del sistema social mutuamente implicadas en las sociedades industriales capitalistas. Sin embargo, una interpretación apresurada sobre el mundo social podría opacar los procesos que hacen que en un grupo de la población se yuxtapongan: una inserción laboral precaria dentro del mercado de trabajo informal junto con la (re) construcción de ese grupo como sujeto-objeto de políticas sociales. El artículo tiene por propósito problematizar las representaciones dominantes sobre el trabajo y su relación con las prácticas de organización de los hogares, considerando que en su interior la dimensión laboral se articula con otros recursos (provenientes de las políticas sociales). De modo más específico, el objetivo se orienta a la descripción y análisis de prácticas y representaciones sobre la situaci162n ocupacional de jefas/es y cónyuges que realizan actividades laborales en la informalidad de subsistencia. Se plantea como hipótesis exploratoria que en el período actual las condiciones de trabajo y representaciones de los trabajadores ocupados en ese tipo de actividades expresarían la existencia de un tipo de informalidad fuertemente segregada respecto de las actividades productivas, un en un contexto de crecimiento del empleo. También se sostiene que las formas bajo las cuales estas inserciones laborales se articulan con los planes sociales (como un nivel específico de política social) evidenciarían el carácter de la contribución estatal a la reproducción de las condiciones de vida de los trabajadores insertos en este tipo de informalidad. Los hallazgos presentados constituyen un avance de investigación sobre la reproducción de la marginalidad urbana en el Conurbano Bonaerense. Parte del trabajo de campo se realizó durante el año 2008, en un barrio del Partido de Almirante Brown. Se organizaron dos grupos de discusión: uno con mujeres perceptoras de planes y otro con hombres que realizaban changas como actividad principal. Con el objeto de aportar datos acerca de las condiciones materiales de los hogares, se aplicó un cuestionario a los participantes. Junto con esta información, se analizaron registros de campo tomados en observaciones realizadas en diversos espacios del barrio

Social capacity building in rural Aymara women organizations in Puno, Peru.

Social capacity building has been considered in the last decades an important element of rural development projects, as it helps organizations and communities to better use their resources, design and manage projects locally and improve their living standards. Social capacity building has been related to the development of certain skills and to the concept of leadership development. Social capacity building and leadership development under a social learning approach have guided a rural development project with an Aymara women organization in Puno, Peru, where around 400 women artisans are trying to develop a business organization to improve their lives and their communities. Qualitative and quantitative methodologies have been applied to assess improvements in capacities and leadership. Results show that the technical aspects are the first to be developed but that group process skills and contextual skills take longer and are crucial to the success of the projects.

O PODER DE ZEFERINA NO QUILOMBO DO URUBU UMA RECONSTRUÇÃO HISTÓRICA POLÍTICO-SOCIAL

Os ideais de liberdade exigiram do povo negro diferenciadas práticas para romper com o sistema escravista. Eram as rebeliões em navios, os atos de infanticídio, os justiçamentos dos feitores, as revoltas, além de participações em movimentos libertários e formações de quilombos. Dentre estas formas de organização, o quilombo foi fenômeno essencial nos mais de 300 anos de escravismo no Brasil. Em cada região existiam quilombos, pois para a população negra, cativa ou não, esse era o melhor meio de alcançar a liberdade, um meio coletivo para enfrentar o sistema. O Quilombo do Urubu representou a insistência em garantir a condição humana que o regime escravista negava, sobretudo às mulheres, aos homens e às crianças negras. Essa era uma força que saía de suas entranhas como grito de liberdade, configurada nas fugas em busca de um lugar que lhes assegurasse aproximação de uma vida digna e que pudessem orgulhar-sedo seu porte físico e da sua cultura. Todo esse desprendimento, além de uma força física, exigia um completo conhecimento histórico e espiritual, resguardado pela religiosidade que fortalecia seus espíritos para lutar contra toda negação de humanidade do século XIX no subúrbio da capital baiana. A líder Zeferina, inconformada com a exclusão social de seu povo negro, e entusiasmada pelo poder de herança de ancestralidade, pelo conhecimento de raiz da cultura matrilinear angolana, pelo profundo conhecimento histórico de resistência da rainha Nzinga Mbandi e pela tradição de quilombolas e guerreiras, viveu e lutou pelo sonho de liberdade. Hoje, a chama desse poder é mantida acesa na caminhada de celebração do 20 de novembro pela comunidade de Pirajá e arredores, enquanto referencial de resistência negra na luta contra as exclusões sociais vigentes.(AU)

Economic crisis, immigrant women and changing availability of intimate partner violence services: a qualitative study of professionals' perceptions in Spain

Introduction: Since 2008, Spain has been in the throes of an economic crisis. This recession particularly affects the living conditions of vulnerable populations, and has also led to a reversal in social policies and a reduction in resources. In this context, the aim of this study was to explore intimate partner violence (IPV) service providers’ perceptions of the impact of the current economic crisis on these resources in Spain and on their capacity to respond to immigrant women’s needs experiencing IPV. Methods: A qualitative study was performed based on 43 semi-structured in-depth interviews to social workers, psychologists, intercultural mediators, judges, lawyers, police officers and health professionals from different services dealing with IPV (both, public and NGO’s) and cities in Spain (Barcelona, Madrid, Valencia and Alicante) in 2011. Transcripts were imported into qualitative analysis software (Atlas.ti), and analysed using qualitative content analysis. Results: We identified four categories related to the perceived impact of the current economic crisis: a) “Immigrant women have it harder now”, b) “IPV and immigration resources are the first in line for cuts”, c) “ Fewer staff means a less effective service” and d) “Equality and IPV policies are no longer a government priority”. A cross-cutting theme emerged from these categories: immigrant women are triply affected; by IPV, by the crisis, and by structural violence. Conclusion: The professionals interviewed felt that present resources in Spain are insufficient to meet the needs of immigrant women, and that the situation might worsen in the future.

Italian women in industry: a study of conditions in New York City

by Louise C. Odencrantz.