Validity of alcohol screening instruments in general population gender studies: an analytical review

The present study is an analytical review of the methodology used in studies of efficacy of screening instruments to detect harmful use/ alcohol dependence according to the gender in population surveys. Systematic review of bibliography was done, using data from Web of Science, Pubmed and PsycInfo. Population studies were included without date range, in English, Spanish or Portuguese languages, with sample of adults, evaluating psychometric characteristics of any alcohol screening instrument, whereas studies in special population or under treatment as well as prevalence of alcohol consumption were excluded. Thirteen studies were selected to be included in the present review. According to the studies, the instruments that presented a better performance among men were AUDIT and its derivatives (6 studies) and CAGE (2 studies), whereas among women, AUDIT and its derivatives (7 studies), followed by CAGE (3 studies). The increase of consumption and problems related to alcohol use and its implications for public health indicate the need and urgency for adequacy of screening instruments to differences of gender in general population. The population surveys in the area are scarce. Furthermore, the found studies present heterogeneous methodology which makes accurate comparisons difficult.

Fertility and infertility : studies in reproductive epidemiology in Australia

Worldwide, there are few large-scale epidemiological studies on infertility. In Australia, population-based research on infertility is limited to a few small-scale studies. Therefore, the prevalence of infertility and unmet need for specialist medical advice and treatment cannot be estimated reliably. Women who have used assisted reproductive technologies (ART) are recorded in treatment registries. However, there are many infertile women who are excluded from these clinical populations because they neither seek advice nor use treatment. The thesis was based on a biopsychosocial model of health and used the methods of reproductive epidemiology to address the lack of national data on the prevalence of infertility in Australia. Firstly, numbers of births and pregnancy losses were investigated in two generations of women participating in the Australian Longitudinal Study on Women’s Health (ALSWH). The ALSWH is a broad-ranging, longitudinal examination of biological, psychological and social factors that impact on women’s health and wellbeing. Women from three age cohorts were randomly sampled from the population using the universal public health insurance (i.e., Medicare) database and ALSWH participants were representative of the female population. However, the studies in the thesis only involved data from two cohorts. The younger cohort were born in 1973-78 and completed up to four mailed surveys between 1996 (when they were aged 18-23 years, n=14247) and 2006 (28-33 years, n=9145). The mid-aged cohort were born in 1946-51 and completed four mailed surveys between 1996 (when they were aged 45-50 years n=13715) and 2004 (53-58 years, n=10905). Compared to other studies that focus on outcomes of single pregnancies, these studies included all pregnancy outcomes by developing comprehensive reproductive histories for each woman. Pregnancy outcomes included birth, miscarriage, stillbirth, termination and ectopic pregnancy. Women in the youngest cohort (born in 1973-78) were only just reaching their peak childbearing years and many (44%) had yet to report their first pregnancy outcome. Women from the mid-aged cohort (born 1946-51) had completed their reproductive lives and 92% were able to report on their lifetime pregnancy outcomes. Pregnancy losses, especially miscarriage, were common for both generations of women. Secondly, the prevalence of infertility, seeking medical advice and using treatment was identified for these two generations of women. For the older generation, the lifetime prevalence of infertility and demand for treatment was investigated in the context of the specialist medical services which became available circa 1980. By this time, however, most of these older women had already been pregnant and completed their families. For women who experienced infertility (11%), their options for advice and treatment were limited and less than half (42%) had used any treatment. More recently for the younger generation of women, who were aged 28-33 years in 2006, specialist advice and treatment were extensively available. Among women who had tried to conceive or had been pregnant (n=5936), 17% had experienced infertility and the majority (72%) were able to access medical advice. However, after seeking advice only half of these infertile women had used treatment with fertility hormones or in vitro fertilisation (IVF). Overall for infertile women aged up to 33 years, only one-third had used these treatments. Thirdly, the barriers to accessing medical advice and using treatment for infertility were identified for women aged less than 34 years. Among a community sample of infertile women aged 28-33 years (ALSWH participants), self-reported depression was found to be a barrier to accessing medical advice. The characteristics of these infertile women in the community who had (n=121) or had not (n=110) used treatment were compared to infertile women aged 27-33 years (n=59) attending four fertility clinics. Compared to infertile women in the community, living in major cities and having private health insurance were associated with early use of treatment for infertility at specialist clinics by women aged <34 years. In contrast to most clinical studies of IVF, the final study reported in the thesis took into account repeated IVF cycles and the impact of women’s individual histories on IVF outcomes. Among 121 infertile women (aged 27-46 years) who had 286 IVF cycles, older age and prolonged use of the oral contraceptive pill were associated with fewer eggs collected. Further, women in particular occupations had lower proportions of eggs fertilised normally than women in other occupational groups. These studies form the first large-scale epidemiological examination of infertility in Australia. The finding that two-thirds of women with infertility had not used treatment indicates that there is an unmet need for specialist treatment in women aged less than 34 years. However, barriers to accessing treatment prevent women using ART at a younger age when there is a higher chance of pregnancy.

E-Government Collaboration in the Swedish Public Sector : Multiple Studies on Collaboration Facilitators and Collaboration Modes

Collaboration in the public sector is imperative to achieve e-government objectives such as improved efficiency and effectiveness of public administration and improved quality of public services. Collaboration across organizational and institutional boundaries requires public organizations to share e-government systems and services through for instance, interoperable information technology and processes. Demands on public organizations to become more open also require that public organizations adopt new collaborative approaches for inviting and engaging citizens in governmental activities. E-government related collaboration in the public sector is challenging, however, and collaboration initiatives often fail. Public organizations need to learn how to collaborate since forms of e-government collaboration and expected outcomes are mostly unknown. How public organizations can collaborate and the expected outcomes are thus investigated in this thesis by studying multiple collaboration cases on the acquisition and implementation of a particular e-government investment (digital archive). This thesis also investigates how e-government collaboration can be facilitated through artifacts. It is done through a case study, where objects that cross boundaries between collaborating communities in the public sector are studied, and by designing a configurable process model integrating several processes for social services. By using design science, this thesis also investigates how an m-government solution that facilitates collaboration between citizens and public organizations can be designed. The thesis contributes to literature through describing five different modes of interorganizational collaboration in the public sector and the expected benefits from each mode. It also contributes with an instantiation of a configurable process model supporting three open social e-services and with evidence of how it can facilitate collaboration. This thesis further describes how boundary objects facilitate collaboration between different communities in an open government design initiative. It contributes with a designed mobile government solution, thereby providing proof of concept and initial design implications for enabling collaboration with citizens through citizen sourcing (outsourcing a governmental activity to citizens through an open call). This thesis also identifies research streams within e-government collaboration research through a literature review and the thesis contributions are related to the identified research streams. This thesis gives directions for future research by suggesting that future research should focus further on understanding e-government collaboration and how information and communication technology can facilitate collaboration in the public sector. It is suggested that further research should investigate m-government solutions to form design theories. Future research should also examine how value can be co-created in e-government collaboration.

Gender studies : Intersex by Catherine Harper

Intersex is the condition whereby an individual is born with biological features that are simultaneously perceived as male and female. Ranging from the ambiguous genitalia of the true 'hermaphrodite' to the 'mildly or internally intersexed', the condition may be as common as cleft palate. Like cleft palate, it is hidden and surgically altered, but for very different reasons. Intersex draws heavily on the personal testimony of intersexed individuals, their loved ones and medical carers. The impact of early sex-assignment surgery on an individual's later life is examined within the context of ethical and clinical questions. Harper challenges the conventional and radical 'treatment' of intersexuality through non-consensual infant sex-assignment surgery. In doing so, she exposes powerful myths, taboos and constructions of gender - the perfect phallus, a bi-polar model of gender and the infallibility of medical decisions. Handling sensitive material with care, this book deepens our understanding of a condition that has itself only been medically understood in recent years.

Społeczna interpretacja wybranych wczesnośredniowiecznych cmentarzysk rzędowych w perspektywie gender studies i lifecycle analysis

Wydział Historyczny: Instytut Prahistorii

Gender Studies – Die Niedersächsische Forschungsevaluation und ihre offenen Fragen

Der Anglizismus „Gender Studies“ bezeichnet in Deutschland faktisch Frauenforschung, also Forschung von Frauen über Frauen für Frauen. Es gibt sie seit mehr als drei Jahrzehnten. Die Zahl der Gender - Professuren beträgt mittlerweile ca. 250. Sie binden finanzielle Ressourcen in entsprechender Höhe. Das ist nicht der einzige, aber doch ein Grund, nach dem wissenschaftlichen Output dieser Forschungen zu fragen. In Niedersachsen ist 2013 eine Forschungsevaluation zum Thema Gender Studies durchgeführt worden. Möglicherweise handelt es dabei um die erste und einzige Untersuchung ihrer Art. Der Ergebnisbericht dieser Evaluation wird hier dargestellt und kritisch kommentiert. Das Ergebnis der Kritik lautet, dass gar keine Evaluation des Forschungs-Outputs vorgenommen worden ist, sondern dass es der beauftragten Kommission nur darum ging, die Input-Strukturen zu stärken, indem mehr Stellen, mehr finanzielle Mittel und noch weniger Kontrollen gefordert wurden.