Sex-role traits and the comorbidity of symptoms of disordered eating and problem drinking

The symptoms of problem drinking and disordered eating were studied independently in relation to sex-role traits and also for evidence of comorbidity in a student sample of 217 women. The participants completed surveys that assessed positive and negative sex-role traits, reported drinking levels, alcohol dependence, problem drinking, bulimic symptoms, dietary restraint, and drive for thinness. Eating symptoms were related to both the negative and positive traits of Femininity, but self-descriptions involving negative traits (passivity, dependence, unassertiveness, etc.) showed the strongest relationship. High scores on identification with the traits typically labelled as Masculinity were related to drinking but there was an important difference between drinking per se (which was related to Positive Masculinity) and drinking found to be associated with drinking problems, which was related to Negative Masculinity (aggression, showing-off, rudeness, etc.). Feminine traits were also related to drinking. Low identification with the traits of Negative Femininity was associated with non-problem drinking, whereas low identification with the traits of Positive Femininity were associated with problem-related drinking. Young women who displayed comorbid symptoms described themselves by a high identification with the traits of both Negative Masculinity and Negative Femininity. It was argued that comorbidity reveals a more extreme form of the sex-role conflict previously described in relation to disordered control over both eating and drinking when considered independently.

Is the link between nutrients and foods understood? The case of fibre and folate

Objectives: To assess and contrast awareness of the link between dietary fibre and folate and their major food sources (fruit, vegetables, bread and cereals).

Design and setting: Mailed questionnaire investigating changes made to dietary intake of fibre, folate, fruit, vegetables, bread and cereals in the previous six months.

Setting: The survey was conducted between June and November 1998 in the Australian Capital Territory.

Subjects: One thousand one hundred and twenty-six adults randomly selected from the electoral roll.

Results: More women than men in both older (50 + years) and younger (18–49 years) age groups reported increasing their consumption of folate, fibre, fruit and vegetables in the prior six months. In contrast, more men than women reported increased consumption of bread, cereals, rice and pasta in the previous six months. For food categories and fibre, less than 4% of respondents were unsure about changes in these food habits. However, 26% of men and women were ‘not sure’ about changes to folate intake. Similar proportions of men and women (about 33%) reported consuming more fruit, vegetables or cereal-based foods over the prior six months, yet only 6% of these men and 14% of these women reported consuming more folate. In contrast, 44% of men and 51% of women who reported consuming more plant foods also reported consuming more dietary fibre.

Conclusions: The results suggested that subjects, particularly the younger age group, had a poor understanding of the relationship between folate intake and its major food sources. The understanding of the relationship between fibre intake and its food sources appeared substantial, but confusion about specific food sources was still evident. These outcomes question the effectiveness of nutrition education used to date, particularly for the current priority of increasing folate intake in younger women in the new, ‘health claims’ environment.

A cross-sectional study of weight-and shape-related beliefs, behaviours and concerns of north Queensland adolescents

The purpose of this study was to examine differences in weight- and shape-related beliefs, behaviours and concerns across a high school population. Data were collected by questionnaire from 902 high school students from private schools in Townsville. Concerns about weight and shape were more apparent in students from the higher school years. More girls in higher than lower school years were dissatisfied with their bodies, concerned that many parts of their bodies were too fat and more of them attempted weight loss. More boys in higher than lower school years were satisfied with their bodies but they wanted to 'bulk up'. Societal expectations of weight and shape may adversely affect both males and females but in different ways. Thus, interventions aiming to promote the maintenance of a healthy body weight may need to account for the desire of the majority of young women to be thinner, while the majority of young men would like to be larger.

Change in women's body mass index and waist circumference, 1997 to 2002: the Nepean study

Objective: To investigate character istics associated with body mass index (BMI) and waist circumference stability over a five-year period in women with school-age children.

Methods: Women with 7–8 year-old children from western Sydney, Australia, had anthropometric measures taken in 1996/97 (n====436) and five years later (n=327). Socio-demographic characteristics examined at baseline included age, socioeconomic status, smoking, and number of children.

Results: Over five years, less than half of the women maintained a stable BMI (38.8%) or waist circumference (31.5%), with the majority gaining in both indicators of adiposity. BMI and socio-demographic characteristics were not predictive of BMI or waist circumference stability or decrease.

Conclusions and Implications: Total and abdominal adiposity increased in these Australian women who have children. The results support the need to develop effective weight gain prevention initiatives.

Working parents of children with chronic illness/disability: narratives of concern

This paper reports some initial findings of an exploratory, qualitative study of the life and work of people who are, concurrently, parents of a child with chronic illness/disability and working full time. The respondents of this study happen to be all women. Two emerging themes of interest are explored here. The first is a revisit of traditional notions of the abusive workplace, which seems to be of special interest when considering the plight of these women. Secondly, the numerous work and home demands on the working mother, especially the working mother of a child with chronic illness or disability. [twas unsurprising that these women reported extensive and multiple physical and emotional demands while trying to manage full time work with significant home and caring responsibilities. What is surprising is that these narratives of concern have not previously been explored, and should be.

Feminism's marginal problem: Women in management

Contemporary feminism has, from its inception, been ambivalent in its responses to the issue of women in management. On the one hand, feminists have recognised as a problem the limited numbers of women in management and the barriers that they encounter. They have promoted the development of programs such as affirmative action with, arguably, greater, or lesser success. At the same time, there has been a reluctance by some feminists to attach too much importance to the issue, given the manifestly more severe forms of discrimination encountered by other groups of women. According to this view, the problems of a privileged elite are a lesser priority, that is, marginal to more pressing feminist concerns.

This paper is based on research into career success predictors. It draws on work on culture and models of change in higher education to show that while interventions such as legislation granting maternity leave are significant initiatives to be strongly supported, the impact of such policies is mediated by the social rules of the organisation. These rules are a corollary of enduring value structures which are embedded in organisational cultures.

Research findings showed that the value systems, and especially the social rules which operate within organisations impact on men and women's career success differently. This research provides valuable insights into the mechanisms operating at several levels (at the organisational level as well as at the level of individual women) which tend to construct women as marginal in management.

Seeking to understand the marginality experienced by women in management has benefits that extend well beyond improving the lot of individual women managers. This is because better conceptualisations of marginality and, concomitantly, power in organisations can provide leverage for more far reaching changes for women generally.

Learning from the margins : young women, social exclusion and education

This collection of ground-breaking international essays address the educational, social, work and biographical experiences of young women who are routinely constructed as ‘at risk’ and on the margins. Drawing on research from an international range of scholars, this book brings together important new perspectives on the gendered dimensions of social exclusion and educational marginalisation.

The mother-daughter guilt dynamic : effects of type 1 diabetes during life transitions

Aim. The aim of the study was to explore and describe the strategies young women with type 1 diabetes used to manage life transitions. The paper describes one aspect of how guilt dynamic often operates between mothers and daughters and how the women managed the guilt dynamic to create stability in their lives.
Background. When a child is diagnosed with diabetes, major transitional changes occur in the relationships between the mother and her child. The changes affect the psychological and social aspects of their lives and have a major impact on how young women manage their diabetes. A guilt dynamic between mothers and young women with diabetes emerged as a major theme in a larger study that investigated how young women with diabetes managed life transitions. Although the literature indicates that mothers of chronically ill children experience guilt feelings towards their children, little research was identified that addressed the emotional dynamics between mothers and daughters with diabetes.
Design. Using grounded theory method, interviews were conducted with 20 women with type 1 diabetes and five mothers during 2002 and 2003. Constant comparative analysis was used to analyse the data and develop an in-depth understanding of the experience of living with diabetes during life transitions.
Findings. The findings revealed that guilt feelings created a two-way dependency between mothers and their daughters with diabetes. The two-way dependency involved feelings of being a burden to each other, difficulty balancing responsibilities for diabetes management, difficulty relinquishing emotional and social dependency especially during life transitions. In addition, these issues were rarely discussed openly with each other or with health professionals. The findings provide additional information about the human experience of the mother–daughter relationship and the effect on coping with diabetes in the context of life transitions.
Conclusions. Understanding the impact diabetes has on the emotional and social well being of both women with type 1 diabetes and their mothers is critical in planning appropriate support for both groups. Most importantly, it is critical to understand the guilt dynamic that operates during young women with diabetes' life transitions when the daughters' dependency on their mother's control and responsibility for diabetes management undergo changes resulting in emotional responses, especially guilt feelings.
Relevance to clinical practice. Health professionals need to understand the emotional and social impact of the guilt dynamics between young women with type 1 diabetes and their mothers. Adequate and appropriate support can minimize the guilt feelings and enhance stability and quality of life for both mothers and their daughters, especially during major life transitions, such as motherhood.

The effect of training in reduced energy density eating and food self-monitoring accuracy on weight loss maintenance

Background:
Failure to maintain weight losses in lifestyle change programs continues to be a major problem and warrants investigation of innovative approaches to weight control.
Objective:
The goal of this study was to compare two novel group interventions, both aimed at improving weight loss maintenance, with a control group.
Methods and Procedures:
A total of 103 women lost weight on a meal replacement–supplemented diet and were then randomized to one of three conditions for the 14-week maintenance phase: cognitive-behavioral treatment (CBT); CBT with an enhanced food monitoring accuracy (EFMA) program; or these two interventions plus a reduced energy density eating (REDE) program. Assessments were conducted periodically through an 18-month postintervention. Outcome measures included weight and self-reported dietary intake. Data were analyzed using completers only as well as baseline-carried-forward imputation.
Results:
Participants lost an average of 7.6 plusminus 2.6 kg during the weight loss phase and 1.8 plusminus 2.3 kg during the maintenance phase. Results do not suggest that the EFMA intervention was successful in improving food monitoring accuracy. The REDE group decreased the energy density (ED) of their diets more so than the other two groups. However, neither the REDE nor the EFMA condition showed any advantage in weight loss maintenance. All groups regained weight between 6- and 18-month follow-ups.
Discussion:
Although no incremental weight maintenance benefit was observed in the EFMA or EFMA + REDE groups, the improvement in the ED of the REDE group's diet, if shown to be sustainable in future studies, could have weight maintenance benefits.

Predictors of hysterectomy as a treatment for menstrual symptoms

Background: Hysterectomy is a common procedure in Australia; approximately 1 in 5 Australian women undergoing a hysterectomy by the age of 50 for indications such as fibroids, disorders of menstruation (including excessive or irregular menstrual bleeding), and endometriosis. However, little is known about the characteristics of women who have had the procedure or the predictors of hysterectomy as a treatment for menstrual problems. This study of 687 middle-aged Australian women suffering from menstrual symptoms aimed to identify the common health and demographic characteristics that were likely to lead to hysterectomy for the treatment of these problems.

Methods: A cross-sectional and a prospective cohort study were undertaken as a substudy of the Australian Longitudinal Study on Women's Health (Women's Health Australia). Women from the mid-aged cohort of the Women's Health Australia study who identified having menstrual problems (n = 715) in the 1996 and 1998 surveys or who had undergone a hysterectomy (n = 218) during that time were recruited. A self-administered instrument was mailed to the 933 women in 2000. Data were analyzed using backward logistic regression to identify the characteristics that increased the likelihood of women undergoing hysterectomy for the treatment of menstrual problems.

Results: Factors that increased the likelihood of hysterectomy as a treatment for menstrual problems were varied. They included the number of menstrual symptoms experienced (odds ratio [OR], 1.63; p < .005) or conditions diagnosed (such as fibroids or excessive menstrual bleeding; OR, 2.5; p < .0005), a perception that information was available about menstrual problems (OR, 1.16; p < .001), being influenced in the decision making process to elect a treatment option (OR, 1.25; p < .025), and dissatisfaction with the other treatments tried before hysterectomy (OR, 0.63; p < .0005).

Conclusions: Hysterectomy seem to be the treatment of choice for women experiencing a number of menstrual problems and less than satisfactory outcomes with other treatment options. Importantly, women appear to be making decisions based on the perception of sufficient information available about their menstrual problems, regardless of whether or not this was actually the case. Women are being influenced in their decision-making process to undergo a hysterectomy by health professionals, such as general practitioners and gynecologists.

Voices from the margins? Women at the footy.

Based on focus group and single person interviews with women Australian rules football (AFL) supporters this paper explores the issue of how women articulate their support of a male dominated sport. We demonstrate that women supporters (widely overlooked in studies of sports) express their support of AFL with as much power and passion as is credited to male supporters. Moreover, women have formed about a half of AFL at-ground spectators for over a century with the historical record suggesting that the passion of their support was no less then than now. Yet to what extent have women supporters emerged from the metaphorical margins of AFL to appropriate distinctive spaces in their consumption of this sport? Using their voices and accounts of their at-ground actions, we argue that women fans perform an appropriation of supporting practice that is clearly gendered - in being a feminine discourse of support constructed by women - while giving the appearance of being genderless through their appropriation of discursive frames to legitimate their support of a male dominated sport. We conclude that in consuming football women fans perform doxic actions that reproduce, in leisure spaces, wider processes of gender inequality while, in a contradictory manner, contesting them through the appropriation of their own places in these spaces.

Habitual fish consumption does not prevent a decrease in LCPUFA status in pregnant women (the Seychelles Child Development Nutrition Study)

Information on the status of long-chain polyunsaturated fatty acids (LCPUFAs) in pregnancy and breast milk in very high fish-eating populations is limited. The aim of this study was to examine dietary intake and changes in fatty acid status in a population of pregnant women in the Republic of Seychelles. Serum docosahexaenoic acid (DHA) decreased significantly between 28-week gestation and delivery (n=196). DHA status did not correlate significantly with length of gestation and was not associated with self-reported fish intake, which was high at 527 g/week. In breast milk, the ratio of DHA to arachidonic acid (AA) was consistent with those observed in other high fish-eating populations. Overall the data suggest that high exposure to LCPUFAs from habitual fish consumption does not prevent the documented decrease in LCPUFA status in pregnancy that occurs as a result of foetal accretion in the third trimester of pregnancy.

MOSAIC (MOthers' Advocates In the Community): protocol and sample description of a cluster randomised trial of mentor mother support to reduce intimate partner violence among pregnant or recent mothers

Background : Intimate partner violence (IPV) is prevalent globally, experienced by a significant minority of women in the early childbearing years and is harmful to the mental and physical health of women and children. There are very few studies with rigorous designs which have tested the effectiveness of IPV interventions to improve the health and wellbeing of abused women. Evidence for the separate benefit to victims of social support, advocacy and non-professional mentoring suggested that a combined model may reduce the levels of violence, the associated mental health damage and may increase a woman's health, safety and connection with her children. This paper describes the development, design and implementation of a trial of mentor mother support set in primary care, including baseline characteristics of participating women.

Methods/Design : MOSAIC (MOtherS' Advocates In the Community) was a cluster randomised trial embedded in general practice and maternal and child health (MCH) nursing services in disadvantaged suburbs of Melbourne, Australia. Women who were pregnant or with infants, identified as abused or symptomatic of abuse, were referred by IPV-trained GPs and MCH nurses from 24 general practices and eight nurse teams from January 2006 to December 2007. Women in the intervention arm received up to 12 months support from trained and supported non-professional mentor mothers. Vietnamese health professionals also referred Vietnamese women to bilingual mentors in a sub-study. Baseline and follow-up surveys at 12 months measured IPV (CAS), depression (EPDS), general health (SF-36), social support (MOS-SF) and attachment to children (PSI-SF). Significant development and piloting occurred prior to trial commencement. Implementation interviews with MCH nurses, GPs and mentors assisted further refinement of the intervention. In-depth interviews with participants and mentors, and follow-up surveys of MCH nurses and GPs at trial conclusion will shed further light on MOSAIC's impact.

Discussion : Despite significant challenges, MOSAIC will make an important contribution to the need for evidence of effective partner violence interventions, the role of non-professional mentors in partner violence support services and the need for more evaluation of effective health professional training and support in caring for abused women and children among their populations.

Low-sodium dietary approaches to stop hypertension-type diet including lean red meat lowers blood pressure in postmenopausal women

Low-sodium Dietary Approaches to Stop Hypertension (DASH) diets are base producing but restrict red meat without clear justification. We hypothesized that a vitality diet (VD), a low-sodium DASH-type diet with a low dietary acid load containing 6 servings of 100 g cooked lean red meat per week, would be more effective in reducing blood pressure (BP) compared with a higher acid load reference healthy diet (RHD) based on general dietary guidelines to reduce fat intake and increase intake of breads and cereals. A randomized, parallel dietary intervention study was conducted to compare the BP-lowering effect of these 2 diets in postmenopausal women with high/normal BP. Women were randomly assigned to follow either VD or RHD for 14 weeks. Home BP was measured daily with an automated BP monitor under standard conditions. Of 111 women commencing the study, 95 completed (46 VD, 49 RHD). Systolic BP (SBP) throughout the intervention was lower in the VD group compared to the RHD group (repeated-measures analysis of variance time by diet, P = .04), such that at the end of the study, the VD had a fall of SBP by 5.6 ± 1.3 mm Hg (mean ± SEM) compared with a fall of 2.7 ± 1.0 mm Hg in the RHD (group difference, P = .08). When only those taking antihypertensive medications were assessed, the VD (n = 17) had a significant fall of 6.5 ± 2.5 mm Hg SBP (P = .02) and 4.6 ± 1.4 mm Hg diastolic BP (P = .005) after 14 weeks, and their BP was lower than that of the RHD group (n = 18) throughout the study (P < .05). We concluded that a low-sodium DASH diet with a low dietary acid load, which also included lean red meat on most days of the week, was effective in reducing BP in older women, particularly in those taking antihypertensive medications.

Sexual desire in women presenting for anti-androgen therapy

Women presenting with hirsuties/polycystic ovary syndrome have increased production of androgens. Clinical lore suggests that these women may have increased sexual desire. Treatment of hirsuties commonly involves antiandrogen therapy, a form of therapy with a potential for reducing sexual desire. The present study investigated sexual desire in 29 hirsute women aged 19 to 43 years presenting for therapy. We conducted a questionnaire appraisal of the women's sexual desire, body and self-esteem, and affect at baseline, 3 months, and 12 months and compared the data with a control group of 30 nonhirsute women of similar mean age. Those in the treatment group also had their Ferriman and Gallwey scores and body mass indices calculated at baseline and end of study for those in the treatment group. We determined hormone levels for those in the treatment group with baseline blood tests. Our hypotheses were that the hirsute women would experience different levels of sexual desire than the control group prior to therapy and that therapy would have a demonstrable effect on the self-reported sexual desire of these women. The study demonstrated that women with hirsuties had mean levels of sexual desire and body esteem that were significantly lower than the control group women. During the year-long course of therapy, the sexual desire levels of the hirsute women decreased progressively, while their self-esteem increased. The women's Ferriman and Gallwey scores fell, indicating diminishing hirsutism. These findings provide empirical data upon which clinicians can base advice to patients seeking therapy.