Construction and validation of an instrument that breaks the silence: the impact of domestic and/or sexual violence on women's health, as shown during climacterium

Objective: The aim of this study was to construct and to validate a measure of the consequences of domestic violence on women's health during climacterium. Methods: A questionnaire was administered at the Outpatient Climacterium Clinic to 124 women aged 40 to 65 years who were the victims of domestic and/or sexual violence (experimental group). They were divided into three groups: (1) those who were victims of violence exclusively during childhood/adolescence, (2) those who were victims of violence exclusively during adulthood, and (3) those who were victims of violence throughout their lives. The instrument included 34 items evaluating the beginning, frequency, and type of violence; the search for health assistance and reporting of the violence; the violence and the number of comorbidities; and violence and the Kupperman Menopausal Index. We also included a control group composed of perimenopausal and postmenopausal women who did not experience any violence (n = 120). Results: The instrument presented a Cronbach alpha = 0.82, good reliability among the examiners (+0.80), and a good possibility of reproducibility. The mean age of menopause was 45.4 years, and the mean age in the control group was 48.1 years. Group 1 showed a mean of 5.1 comorbidities, Group 2 had 4.6, and Group 3 had 4.4. Sexual violence (43.5%) and other types of violence both presented average comorbidities (4.60) but represented a significant impairment in the victim's sexual life. There were significant associations in group 3 and a high Kupperman Menopausal Index score. In the experimental group, 80.6% did not seek health services for the violence they experienced. Conclusions: The questionnaire presented good internal consistency and a validated construction. It can be easily reproduced and is indicated to evaluate the consequences of domestic and/or sexual violence on women's health during climacterium.

Hydatidiform mole resulting from sexual violence

Abstract Background Hydatidiform mole (HM) is characterized by abnormal proliferation of human trophoblast with producers functioning tissues of human chorionic gonadotropin. It can evolve with ovarian cysts tecaluteínicos, hypertension of pregnancy or hyperthyroidism. The incidence of HM is variable and its etiology poorly known, associated with nutritional factors, environmental, age, parity, history of HM, oral contraceptives, smoking, consanguinity or defects in germ cells. There is no reference in literature on HM resulting from sexual violence, objective of this report. Method Description of two cases of HM among 1146 patients with pregnancy resulting from sexual violence treated at Hospital Pérola Byington, São Paulo, from July 1994 to August 2011. Results The cases affected young, white, unmarried, low educated and low parity women. Sexual violence was perpetrated by known offenders unrelated to the victims, under death threat. Ultrasound and CT of the pelvis showed bulky uterus compatible with HM without myometrial invasion. One case was associated with theca lutein cysts. The two cases were diagnosed in the second trimester of pregnancy and evolved with hyperthyroidism. There was no hypertension, disease recurrence, metastasis or sexually transmitted infection. Conclusion The incidence of HM was 1:573 pregnancies resulting from rape, within the range estimated for Latin American countries. Trophoblastic material can be preserved to identify the violence perpetrator, considering only the paternal HM chromosomes. History of sexual violence should be investigated in cases of HM in the first half of adolescence and women in a vulnerable condition.

Lifetime Prevalence, age and gender distribution and age-of-onset of psychiatric disorders in the São Paulo Metropolitan Area, Brazil: results from the São Paulo Megacity Mental Health Survey

OBJECTIVES: To estimate prevalence, age-of-onset, gender distribution and identify correlates of lifetime psychiatric disorders in the São Paulo Metropolitan Area (SPMA). METHODS: The São Paulo Megacity Mental Health Survey assessed psychiatric disorders on a probabilistic sample of 5,037 adult residents in the SPMA, using the World Mental Health Survey Version of the Composite International Diagnostic Interview. Response rate was 81.3%. RESULTS: Lifetime prevalence for any disorder was 44.8%; estimated risk at age 75 was 57.7%; comorbidity was frequent. Major depression, specific phobias and alcohol abuse were the most prevalent across disorders; anxiety disorders were the most frequent class. Early age-of-onset for phobic and impulse-control disorders and later age-of-onset for mood disorders were observed. Women were more likely to have anxiety and mood disorders, whereas men, substance use disorders. Apart from conduct disorders, more frequent in men, there were no gender differences in impulse-control disorders. There was a consistent trend of higher prevalence in the youngest cohorts. Low education level was associated to substance use disorders. CONCLUSIONS: Psychiatric disorders are highly prevalent among the general adult population in the SPMA, with frequent comorbidity, early age-of-onset for most disorders, and younger cohorts presenting higher rates of morbidity. Such scenario calls for vigorous public health action.

Police Interviews with Victims and Suspects of Violent and Sexual Crimes : Interviewee's experiences and interview outcomes

The police interview is one of the most important investigative tools that law enforcement has close at hand, and police interview methods have changed during the twentieth century. A good police interview is conducted in the frame of the law, is governed by the interview goal, and is influenced by facilitating factors that may affect the elicited report. The present doctoral dissertation focuses on police interviews in cases of very serious crimes of violence and sexual offences. Results reveal crime victims’ and perpetrators’ experiences of being interviewed and police officers’ attitudes towards conducting interviews related to traumatizing crimes. Study 1 revealed that when police officers interviewed murderers and sexual offenders, the interviewees perceived attitudes characterized by either dominance or humanity. Police interviews marked by dominance and suspects’ responses of anxiety were mainly associated with a higher proportion of denials, whereas an approach marked by humanity, and responses of being respected were significantly associated with admissions. In line with Study 1, the victims of rape and aggravated assault in Study 2 also revealed the experience of two police interview styles, where an interviewing style marked by dominance and responses of anxiety was significantly associated with crime victims’ omissions of information. Moreover, a humanitarian interviewing style, and crime victims’ feelings of being respected and co-operative, was significantly related to crime victims providing all information from painful events. Special squad police officers’ attitudes towards interviewing crime victims, in Study 3, also showed a humanitarian approach and two dominant approaches, one affective and the other refusing. The attitude towards interviewing suspects of crimes in focus revealed humanitarian and dominant interviewing attitudes, and an approach marked by kindness. The present thesis shows that, during their entire career, an overwhelming majority of the special squad police officers have experienced stressful events during patrol as well as investigative duty. Results show that symptoms from stressful event exposures and coping mechanisms are associated with negative attitudes towards interviewing suspects and supportive attitudes towards crime victim interviews. Thus, experiences from stressful exposures may automatically activate ego-defensive functions that automatically generate dominant attitudes. Moreover, it is important to offer police officers who have been exposed to stressful events the opportunity to work through their experiences, for example, through debriefing procedures. After debriefings, police officers are better prepared to meet crime victims and suspects and, through conscious closed-loop processes, to conduct police interviews without awaking ego-defensive functions.

Exercising the self : On the Role of Exercise, Gender and Culture in Physical Self-Perceptions

In modern society, individuals constantly pass judgments on their own body and physical competence as well as that of other people. All too often, the verdict is less favourable. For the person, these physical self-perceptions (PSP) may negatively affect global self-esteem, identity, and general mental well being. The overall aim of this thesis is to examine primarily the role that exercise, but also the roles that gender and culture, play in the formation of PSP. In Study I, using confirmatory factor analyses, strong support for the validity of a first-order, and a second-order hierarchical and multidimensional model of the Physical Self-Perception Profile (PSPP: Fox & Corbin, 1989) was found across three national samples (Great Britain, Sweden and Turkey) of university students. Cross-cultural differences were detected, with the British sample demonstrating higher latent means on all PSPP subdomains except for the physical condition subdomain (Condition), than the Swedish and Turkish samples. In Study II, a higher self-reported exercise frequency was associated with more positive PSP (in particular for Condition) and more importance attributed to PSP in Swedish university students. Males demonstrated higher overall PSPP-scores than females. In Study III, a true-experimental design with randomisation into an intervention and a control group was adopted. Strong support for the effects of an empowerment-based exercise intervention programme on PSP and social physique anxiety (SPA) over six months for adolescent girls was found. The relations of exercise, gender and culture with PSP, SPA and self-esteem are discussed from the standpoints of a variety of theoretical models (the EXSEM-model), and frameworks (self-presentation and objectification theory). The two theories of self-enhancement and skill-development are examined with regard to the direction of the exercise-physical self relationship and motivation for exercise. Arguments for the relevance of exercise and PSP for practitioners in promoting general mental well-being and preventing modern-day diseases are outlined.

Learning to recognize gender using experince

[EN]Automatic facial analysis abilities are commonly integrated in a system by a previous off-line learning stage. In this paper we argue that a facial analysis system would improve its facial analysis capabilities based on its own experience similarly to the way a biological system, i.e. the human system, does throughout the years. The approach described, focused on gender classification, updates its knowledge according to the classification results. The presented gender experiments suggestthatthisapproachispromising,evenwhenjustashort simulationofwhatforhumanswouldtakeyearsofacquisition experience was performed.

An analysis of automatic gender classification

[EN]Different researches suggest that inner facial features are not the only discriminative features for tasks such as person identification or gender classification. Indeed, they have shown an influence of features which are part of the local face context, such as hair, on these tasks. However, object-centered approaches which ignore local context dominate the research in computational vision based facial analysis. In this paper, we performed an analysis to study which areas and which resolutions are diagnostic for the gender classification problem. We first demonstrate the importance of contextual features in human observers for gender classification using a psychophysical ”bubbles” technique.

Gender and identity classification for a naive and evolving system

[EN]This paper does not propose a new technique for face representationorclassification. Insteadtheworkdescribed here investigates the evolution of an automatic system which, based on a currently common framework, and starting from an empty memory, modifies its classifiers according to experience. In the experiments we reproduce up to a certain extent the process of successive meetings. The results achieved, even when the number of different individuals is still reduced compared to off-line classifiers, are promising.

Percorsi di gender performance: fotografia tra arte e moda dagli anni Novanta ad oggi

My project explores and compares different forms of gender performance in contemporary art and visual culture according to a perspective centered on photography. Thanks to its attesting power this medium can work as a ready-made. In fact during the 20th century it played a key role in the cultural emancipation of the body which (using a Michel Foucault’s expression) has now become «the zero point of the world». Through performance the body proves to be a living material of expression and communication while photography ensures the recording of any ephemeral event that happens in time and space. My questioning approach considers the gender constructed imagery from the 1990s to the present in order to investigate how photography’s strong aura of realism promotes and allows fantasies of transformation. The contemporary fascination with gender (especially for art and fashion) represents a crucial issue in the global context of postmodernity and is manifested in a variety of visual media, from photography to video and film. Moreover the internet along with its digital transmission of images has deeply affected our world (from culture to everyday life) leading to a postmodern preference for performativity over the more traditional and linear forms of narrativity. As a consequence individual borders get redefined by the skin itself which (dissected through instant vision) turns into a ductile material of mutation and hybridation in the service of identity. My critical assumptions are taken from the most relevant changes occurred in philosophy during the last two decades as a result of the contributions by Jacques Lacan, Michel Foucault, Jacques Derrida, Gilles Deleuze who developed a cross-disciplinary and comparative approach to interpret the crisis of modernity. They have profoundly influenced feminist studies so that the category of gender has been reassessed in contrast with sex (as a biological connotation) and in relation to history, culture, society. The ideal starting point of my research is the year 1990. I chose it as the approximate historical moment when the intersection of race, class and gender were placed at the forefront of international artistic production concerned with identity, diversity and globalization. Such issues had been explored throughout the 1970s but it was only from the mid-1980s onward that they began to be articulated more consistently. Published in 1990, the book "Gender trouble: feminism and the subversion of identity" by Judith Butler marked an important breakthrough by linking gender to performance as well as investigating the intricate connections between theory and practice, embodiment and representation. It inspired subsequent research in a variety of disciplines, art history included. In the same year Teresa de Lauretis launched the definition of queer theory to challenge the academic perspective in gay and lesbian studies. In the meantime the rise of Third Wave Feminism in the US introduced a racially and sexually inclusive vision over the global situation in order to reflect on subjectivity, new technologies and popular culture in connection with gender representation. These conceptual tools have enabled prolific readings of contemporary cultural production whether fine arts or mass media. After discussing the appropriate framework of my project and taking into account the postmodern globalization of the visual, I have turned to photography to map gender representation both in art and in fashion. Therefore I have been creating an archive of images around specific topics. I decided to include fashion photography because in the 1990s this genre moved away from the paradigm of an idealized and classical beauty toward a new vernacular allied with lifestyles, art practices, pop and youth culture; as one might expect the dominant narrative modes in fashion photography are now mainly influenced by cinema and snapshot. These strategies originate story lines and interrupted narratives using models’ performance to convey a particular imagery where identity issues emerge as an essential part of fashion spectacle. Focusing on the intersections of gender identities with socially and culturally produced identities, my approach intends to underline how the fashion world has turned to current trends in art photography and in some case turned to the artists themselves. The growing fluidity of the categories that distinguish art from fashion photography represents a particularly fruitful moment of visual exchange. Varying over time the dialogue between these two fields has always been vital; nowadays it can be studied as a result of this close relationship between contemporary art world and consumer culture. Due to the saturation of postmodern imagery the feedback between art and fashion has become much more immediate and then increasingly significant for anyone who wants to investigate the construction of gender identity through performance. In addition to that a lot of magazines founded in the 1990s bridged the worlds of art and fashion because some of their designers and even editors were art-school graduates encouraging innovation. The inclusion of art within such magazines aimed at validating them as a form of art in themselves supporting a dynamic intersection for music, fashion, design and youth culture: an intersection that also contributed to create and spread different gender stereotypes. This general interest in fashion produced many exhibitions of and about fashion itself at major international venues such as the Victoria and Albert Museum in London, the Metropolitan Museum of Art and the Solomon R. Guggenheim Museum in New York. Since then this celebrated success of fashion has been regarded as a typical element of postmodern culture. Owing to that I have also based my analysis on some important exhibitions dealing with gender performance like "Féminin-Masculin" at the Centre Pompidou of Paris (1995), "Rrose is a Rrose is a Rrose. Gender performance in photography" at the Solomon R. Guggenheim Museum of New York (1997), "Global Feminisms" at the Brooklyn Museum (2007), "Female Trouble" at the Pinakothek der Moderne in München together with the workshops dedicated to "Performance: gender and identity" in June 2005 at the Tate Modern of London. Since 2003 in Italy we have had Gender Bender - an international festival held annually in Bologna - to explore the gender imagery stemming from contemporary culture. In few days this festival offers a series of events ranging from visual arts, performance, cinema, literature to conferences and music. Being aware that any method of research is neither race nor gender neutral I have traced these critical paths to question gender identity in a multicultural perspective taking account of the political implications too. In fact, if visibility may be equated with exposure, we can also read these images as points of intersection of visibility with social power. Since gender assignations rely so heavily on the visual, the postmodern dismantling of gender certainty through performance has wide-ranging effects that need to be analyzed. In some sense this practice can even contest the dominance of visual within postmodernism. My visual map in contemporary art and fashion photography includes artists like Nan Goldin, Cindy Sherman, Hellen van Meene, Rineke Dijkstra, Ed Templeton, Ryan McGinley, Anne Daems, Miwa Yanagi, Tracey Moffat, Catherine Opie, Tomoko Sawada, Vanessa Beecroft, Yasumasa Morimura, Collier Schorr among others.

Understanding Recent Developments in the Turkish Labor Market: Empirical Essays with a Gender Focus

This dissertation comprises three essays on the Turkish labor market. The first essay characterizes the distinctive characteristics of the Turkish labor market with the aim of understanding the factors lying behind its long-standing poor performance relative to its European counterparts. The analysis is based on a cross-country comparison among selected European Union countries. Among all the indicators of labor market flexibility, non-wage cost rigidities are regarded as one of the most important factors in slowing down employment creation in Turkey. The second essay focuses on an employment subsidy policy which introduces a reduction in non-wage costs through social security premium incentives granted to women and young men. Exploiting a difference-in-difference-in differences strategy, I evaluate the effectiveness of this policy in creating employment for the target group. The results, net of the recent crisis effect, suggest that the policy accounts for a 1.4% to 1.6% increase in the probability of being hired for women aged 30 to 34 above men of the same age group in the periods shortly after the announcement of the policy. In the third essay of the dissertation, I analyze the labor supply response of married women to their husbands' job losses (AWE). I empirically test the hypothesis of added worker effect for the global economic crisis of 2008 by relying on the Turkey context. Identification is achieved by exploiting the exogenous variation in the output of male-dominated sectors hard-hit by the crisis and the gender-segmentation that characterizes the Turkish labor market. Findings based on the instrumental variable approach suggest that the added worker effect explains up to 64% of the observed increase in female labor force participation in Turkey. The size of the effect depends on how long it takes for wives to adjust their labor supply to their husbands' job losses.

Building Peace and/or Gender Equality. Changing Attitudes around Peace, Development and Security in International Cooperation in Rwanda.

The times following international or civil conflicts but also violent revolutions often come with unequal share of the peace dividend for men and women. Delusions for women who gained freedom of movement and of roles during conflict but had to step back during reconstruction and peace have been recorded in all regions of the world. The emergence of peacebuilding as a modality for the international community to ensure peace and security has slowly incorporated gender sensitivity at the level of legal and policy instruments. Focusing on Rwanda, a country that has obtained significant gender advancement in the years after the genocide while also obtaining to not relapse into conflict, this research explores to what extent the international community has contributed to this transformation. From a review of evaluations, findings are that many of the interventions did not purse gender equality, and overall the majority understood gender and designed actions is a quite superficial way which would hardly account for the significative advancement in combating gender discrimination that the Government, for its inner political will, is conducting. Then, after a critique from a feminist standpoint to the concept of human security, departing from the assumption (sustained by the Governemnt of Rwanda as well) that domestic violence is a variable influencing level of security relevant at the national level, a review of available secondary data on GBV is conducted an trends over the years analysed. The emerging trends signal a steep increase in prevalence of GBV and in domestic violence in particular. Although no conclusive interpretation can be formulated on these data, there are elements suggesting the increase might be due to augmented reporting. The research concludes outlining possible further research pathways to better understand the link in Rwanda between the changing gender norms and the GBV.

Gender und Genre in melodramatischen Literaturverfilmungen der Gegenwart - Far From Heaven, The Hours, A Single Man

Die Dissertation Gender und Genre in melodramatischen Literaturverfilmungen der Gegenwart untersucht das Medium Film anhand von Todd Haynes’ Far from Heaven (2002), Stephen Daldrys The Hours (2002) und Tom Fords A Single Man (2009) als Quelle des Wissens über gesellschaftlich-normierte Geschlechterrollen und sozialkonstruierte Genderkonzepte. Die Arbeit versteht sich als eine nachhaltige Schnittstellenforschung zwischen Gender-, Literatur-, Film- und Medienwissenschaften und zeigt die Öffnung der Germanistik für den medial geprägten Kulturwandel, welcher den deutschen bzw. den deutschsprachigen Kulturraum betrifft. Gender und Geschlecht destabilisieren die Gesellschaft und die „heterosexuelle Matrix“ durch das individuelle Suchen, Finden, Konstruieren und Anerkennen einer eigenen, individuellen Genderidentität. Dieser Prozess kann unter Zuhilfenahme des Erzählens von Geschlecht im Film verdeutlicht werden, denn die audiovisuelle Fiktion modelliert Wirklichkeitsvorstellungen und das Wirklichkeitsverständnis der Rezipienten. Wobei offen bleibt, ob die Fiktion die Realität oder die Realität die Fiktion imitiert. Denn es gibt nicht nur eine Wahrheit, sondern mehrere, vielleicht unzählige Bedeutungszuschreibungen. Die drei paradigmatischen Literaturverfilmungen wurden jeweils in Bezug zu ihren Literaturvorlagen von Virginia Woolf, Michael Cunningham und Christopher Isherwood gesetzt. Sie können als Beispiele für ein wissendes, postmodernes Pastiche des Themen-Clusters Diskriminierung/Homophobie/Homosexualität/„Rasse“ gelten. Alle drei Filme verhandeln durch gemeinsame, melodramatische Motive (Spiegel, Telefon, Krieg, Familie) die Darstellbarkeit von Emotionen, Begehren, Sehnsüchten, Einsamkeit und dem Verlust der Liebe. Durch Verbindungslinien zu den Melodramen von Douglas Sirk und mittels den Theorien von u.a. Judith Butler, Stanley Cavell, Carolin Emcke, Thomas Elsaesser, Sigmund Freud, Hermann Kappelhoff und Laura Mulvey wurde das Begriffspaar Genre und Gender her-ausgestellt und im zeitgenössischen Geschlechter-Diskurs verortet. Das im Verlauf der Arbeit erarbeitete Wissen zu Gender, Sexualität, Körper und Geschlecht wurde als ein Gender-Genre-Hybrid verstanden und im Genre des queeren bzw. homosexuellen Melodrams (gay melodrama) neu verortet. Die drei Filme sind als ein Wiederbelebungsversuch bzw. ein Erweiterungsversuch des melodramatischen Genres unter dem Genderaspekt anzusehen. Die Analyse und Dekonstruktion feststehender Begriffe im Kontext der Gender- und Gay Studies und dem Queer Cinema lösen produktive Krisen und damit emanzipierte Verfahren aus. Diese müssen immer wieder neu beschrieben werden, damit sie wahrgenommen und verstanden werden. Daher sind die drei melodramatischen Literaturverfilmungen ein fiktionales Dokumentationsmodell gesellschaftlicher Konflikte, welches anhand individueller Schicksale verdeutlicht wird.

Primary tumors of the submandibular glands: a retrospective study based on 41 cases

We report our experience on the diagnostic approach, treatment, and follow-up of primary submandibular gland tumors. Retrospective review. Tertiary referral center. Forty-one adult patients, 22 male and 19 female, with primary submandibular gland tumors, 20 benign and 21 malignant. Age, gender, clinical findings, cyto- and histopathology, treatment and outcome were analyzed. Most tumors presented as a painless submandibular mass. Thirty three patients underwent a fine needle aspiration, the sensitivity, specificity and accuracy of which--in detecting malignant tumors--were 79%, 100% and 88%, respectively. Preoperative radiological imaging was performed in 30 cases. Patients with benign tumors were treated with surgery. Most malignant tumors were treated with a combined modality, including neck dissection and radiation therapy. Five patients developed a postoperative complication. Recurrent disease was encountered in 5 malignant tumors. The 2, 5 and 10 year disease-specific survival of patients with malignancy were 84%, 75% and 41%, respectively. The preoperative assessment of the nature of submandibular gland tumors remains challenging. Aggressive treatment of patients with malignant disease may help to avoid poor prognosis.

A multifactorial analysis of obesity as CVD risk factor: use of neural network based methods in a nutrigenetics context

Obesity is a multifactorial trait, which comprises an independent risk factor for cardiovascular disease (CVD). The aim of the current work is to study the complex etiology beneath obesity and identify genetic variations and/or factors related to nutrition that contribute to its variability. To this end, a set of more than 2300 white subjects who participated in a nutrigenetics study was used. For each subject a total of 63 factors describing genetic variants related to CVD (24 in total), gender, and nutrition (38 in total), e.g. average daily intake in calories and cholesterol, were measured. Each subject was categorized according to body mass index (BMI) as normal (BMI ≤ 25) or overweight (BMI > 25). Two artificial neural network (ANN) based methods were designed and used towards the analysis of the available data. These corresponded to i) a multi-layer feed-forward ANN combined with a parameter decreasing method (PDM-ANN), and ii) a multi-layer feed-forward ANN trained by a hybrid method (GA-ANN) which combines genetic algorithms and the popular back-propagation training algorithm.

Gender Differences in Emotional Responses to Hooking Up

The present research looked to explore the relationship between the emotional responses of college students to different hooking up behaviors. Seven hundred and nine undergraduates participated in a web-based survey that included a demographic questionnaire, SDS, PANAS, AUDIT, and a measure of hooking up. This measure examined the frequency with which they participated in eight different types of hooking up varying by degree of familiarity to their hook partner and whether or not the hook up was coital or non-coital, as well as their emotional responses to the behavior and their perception of the emotional responses of their partner. Results showed that both menand women experienced more positive emotional responses to hooking up behaviors than negative emotional responses. Men experienced significantly more positive emotional responses to hook up behaviors than did women. Women experienced significantly more negative emotional responses for hook ups that were coital with strangers than did men, while men experienced more positive emotional responses for hook ups that were coital with strangers, coital with acquaintances, and coital with partners that were previous romantic partners than did women. Men also experienced more positive emotional responses for hook ups that were non-coital with strangers and non-coital withacquaintances. Men tended to rate their partner’s positive emotional responses higher than what women reported experiencing, particularly for hook ups with less familiar partners. Women’s ratings of their partner’s negative emotional responses were lower than what men actually reported experiencing. The data collected provide several opportunities for future analyses to be conducted and this research will add to the relatively small body of literature on hooking up.