When physician-expressed uncertainty leads to patient dissatisfaction: a gender study.

CONTEXT: Communication guidelines often advise physicians to disclose to their patients medical uncertainty regarding the diagnosis, origin of the problem, and treatment. However, the effect of the expression of such uncertainty on patient outcomes (e.g. satisfaction) has produced conflicting results in the literature that indicate either no effect or a negative effect. The differences in the results of past studies may be explained by the fact that potential gender effects on the link between physician-expressed uncertainty and patient outcomes have not been investigated systematically. OBJECTIVES: On the basis of previous research documenting indications that patients may judge female physicians by more severe criteria than they do male physicians, and that men are more prejudiced than women towards women, we predicted that physician-expressed uncertainty would have more of a negative impact on patient satisfaction when the physician in question was female rather than male, and especially when the patient was a man. METHODS: We conducted two studies with complementary designs. Study 1 was a randomised controlled trial conducted in a simulated setting (120 analogue patients Analogue patients are healthy participants asked to put themselves in the shoes of real medical patients by imagining being the patients of physicians shown on videos); Study 2 was a field study conducted in real medical interviews (36 physicians, 69 patients). In Study 1, participants were presented with vignettes that varied in terms of the physician's gender and physician-expressed uncertainty (high versus low). In Study 2, physicians were filmed during real medical consultations and the level of uncertainty they expressed was coded by an independent rater according to the videos. In both studies, patient satisfaction was assessed using a questionnaire. RESULTS: The results confirmed that expressed uncertainty was negatively related to patient satisfaction only when the physician was a woman (Studies 1 and 2) and when the patient was a man (Study 2). CONCLUSIONS: We believe that patients have the right to be fully informed of any medical uncertainties. If our results are confirmed in further research, the question of import will refer not to whether female physicians should communicate uncertainty, but to how they should communicate it. For instance, if it proves true that uncertainty negatively impacts on (male) patients' satisfaction, female physicians might want to counterbalance this impact by emphasizing other communication skills.

A gender study investigating physics self-efficacy

The underrepresentation of women in physics has been well documented and a source of concern for both policy makers and educators. My dissertation focuses on understanding the role self-efficacy plays in retaining students, particularly women, in introductory physics. I use an explanatory mixed methods approach to first investigate quantitatively the influence of self-efficacy in predicting success and then to qualitatively explore the development of self-efficacy. In the initial quantitative studies, I explore the utility of self-efficacy in predicting the success of introductory physics students, both women and men. Results indicate that self-efficacy is a significant predictor of success for all students. I then disaggregate the data to examine how self-efficacy develops differently for women and men in the introductory physics course. Results show women rely on different sources of self-efficacy than do men, and that a particular instructional environment, Modeling Instruction, has a positive impact on these sources of self-efficacy. In the qualitative phase of the project, this dissertation focuses on the development of self-efficacy. Using the qualitative tool of microanalysis, I introduce a methodology for understanding how self-efficacy develops moment-by-moment using the lens of self-efficacy opportunities. I then use the characterizations of self-efficacy opportunities to focus on a particular course environment and to identify and describe a mechanism by which Modeling Instruction impacts student self-efficacy. Results indicate that the emphasizing the development and deployment of models affords opportunities to impact self-efficacy. The findings of this dissertation indicate that introducing key elements into the classroom, such as cooperative group work, model development and deployment, and interaction with the instructor, create a mechanism by which instructors can impact the self-efficacy of their students. Results from this study indicate that creating a model to impact the retention rates of women in physics should include attending to self-efficacy and designing activities in the classroom that create self-efficacy opportunities.

Evaluation of children nasal geometry, employing accoustic rhinometry

The area above the nasal cavity plays a role in respiratory physiology. Aim: To analyze, during a period of growth, a possible change in the minimum cross sectional area (MCA) and nasal volume of the anterior nasal cavity. Materials and Methods: We evaluated 29 children (14 boys and 15 girls) with a mean age of 7.81 years at first examination (M1) and 11.27 years in the second examination (M2), without symptoms of nasal obstruction. The interval between examinations was 36-48 months. Children were subjected to the examination of acoustic rhinometry in which we recorded the minimum cross-sectional areas, volumes and their correlations with gender. Study design: Cohort. Results: The mean cross-sectional area of the nasal cavity of MCA for girls was 0.30 +/- 0.09 cm2 (M1) and 0.30 +/- 0.14 cm2 (M2), while for boys was 0.24 +/- 0.12 cm2 (M1) and 0.32 +/- 0.10 cm2 (M2). The mean values of the total volumes found for the whole sample were 2.17 +/- 0.23 cm3 (MCA1-M1), 2.56 +/- 0.27 cm3 (MCA1-M2), 4.24 +/- 1.17 cm3 (MCA2-M2) and 4.63 +/- 1.10 cm3 (MCA2-M2). Conclusion: There was no significant change in the minimum cross sectional area of the anterior nasal cavity. There was no significant difference between genders for both MCA and for the volume. There was a significant increase in MCA1.

Health inequalities among the elderly in western Europe

Background: This paper analyses gender inequalities in health status and in social determinants of health among the elderly in Western Europe. Methods: Data came from the first wave of the “Survey of Health, Ageing and Retirement in Europe” (SHARE, 2004). For the purposes of this study a subsample of community-residing people aged 65-85 years with no paid work was selected (4218 men and 5007 women). Multiple logistic regression models separated by sex and adjusted for age and country were fitted. Results: Women were more likely to report poor health status, limitations in mobility and poor mental health. Whereas in both sexes educational attainment was associated with the three health indicators, household income was only related to poor self-rated health among women. The relationship between living arrangements and health differed by gender and was primarily associated with poor mental health. In both sexes, not living with the partner but living with other people and being the household head was related to poor mental health status (aOR=2.14; 95% CI=1.11-4.14 for men and aOR=1.75; 95% CI=1.12-2.72 for women). Additionally, women living with their partner and other(s) and those living alone were more likely to report poor mental health status (aOR=1.67; 95% CI=1.17-2.41 and aOR=1.58; 95% CI=1.26-1.97, respectively). Conclusions: Health inequalities persist among the elderly. Women have poorer health status than men and in both sexes the risk of poor health status increases among those with low educational attainment. Living arrangements are primarily associated with poor mental health status with patterns that differ by gender.

Abnormal eating behaviors among medical students at a university in southern Santa Catarina, Brazil

OBJECTIVES: Disturbances in eating behavior significantly affect young adults. This study aimed to estimate the prevalence of abnormal eating behaviors, according to the Eating Attitudes Test - 26 (EAT-26) in medical students at a university in southern Santa Catarina State, Brazil. METHODS: Self-reported questionnaire, based on the EAT-26 scale, was administered to medical students. Additional questions about age, gender, study period of the course, weight and height were asked. A total of 391 medical students were assessed, amounting to 93.3 percent of the 419 students enrolled. RESULTS: Ten percent of the surveyed subjects had positive EAT-26 scores. This outcome measure was positive associated with females (PR 6.5), body mass index (BMI) ≤ 25 kg/m² (PR 4.5), age ≤ 20 years (PR 1.3) and being student from 1st to 5th semester of the course (PR 1.7). A higher proportion of women gave positive responses to behaviors related to control of food intake or weight loss than men. CONCLUSION: The significant prevalence of behaviors related to eating disorders, predominantly among women, suggests the implementation of preventive measures targeting this population.

Factores comportamentales hacia la fotoprotección

Introducción: la fotoprotección constituye las actividades preventivas que minimizan los efectos deletéreos de la exposición solar; estos comportamientos de salud pueden estar relacionados con actitudes y conocimientos adquiridos. Objetivo: Identificar estas asociaciones en Estudiantes de Medicina de la Escuela de Medicina y Ciencias de la Salud de la Universidad del Rosario, quienes se encargarán de transmitir educación y ejemplo de comportamiento en su contexto personal y profesional. Metodología: estudio de corte transversal. Se implementó una encuesta voluntaria por correo institucional y físicamente entre estudiantes de 1-8 semestre matriculados en el segundo semestre de 2009; n= 122 estudiantes, la mayoría menores de 20 años y de género femenino; factores de estudio analizados: biológico – demográficos, informador, actitudes, conocimientos, personas modelo y comportamiento, expresados en frecuencias, analizados con pruebas y fuerzas de asociación con intervalo de confianza del 95%. Resultados: factores asociados a fotoprotección: ser de 1-4 semestre (p=0,008), ser =19 años (p=0,028), reconocer como consecuencias las alteraciones en los ojos y la visión (p=0,043) y las alteraciones producidas en el sistema inmune (p=0,021), uso de la pareja de ropa protectora (p=0,019), permanencia de un amigo a la sombra (p=0,055), conocimiento de la posibilidad de quemadura independiente al clima (p=0,001) y conocimiento de la posibilidad de quemadura sin sentir los rayos calientes del sol (p=0,049). Conclusiones: es posible reforzar comportamientos preventivos, favorecer el seguimiento de modelos positivos afines a los jóvenes, incrementar el conocimiento en salud y afirmar la educación primaria en salud desde la Medicina General y mejorar así la fotoprotección.

(In)visibilidade da violência doméstica no atendimento do Sistema Público de Saúde: nos bairros das Quintas e de Felipe Camarão

It analyses the approach given by health professionals (social workers, nurses and doctors) against woman violence at the Medical Unities of Felipe Camarão and Quintas of the City of Natal and searches to identify if the domestic violence is (in)visible at the Public Health Assistance System attendance. and It refers to the grandiosity of this violence and its consequences to the women health, recognizing it as a public health problem. To the comprehension of the relationship between violent acts against women and their health serious damages, exposes the battle history of the feminist movements and the brazilian women, demonstrating the visibility acquired by theses conquests of the questions related to the women and how the gender study becomes the central category to (re) think the social relations involving women and men, specially, the violent relationships between them. It analyses, mainly, those practiced by the husbands, partners, boyfriends or lovers. It refers, at the end, about the public politics of violence combat adopted at police stations at health centers, showing the difficulties to establish the legislation that exists to combat the violence suffered by the women that look for assistance at the health unities. It intends, with this way, to give more visibility to the domestic questions at the marital relations and ask attention from the public power and health professionals between them, the social worker to the (in) visibility of this problems at the attendances practiced

A identidade feminina em The Magic Toyshop: estudos de gênero no texto e na tela

Besides producing a vast literary work, Angela Carter (1940-1992) participated of the screenplay’s production for two movies based on her books, The Company of Wolves and The Magic Toyshop. Either through the influence that cinema had in her life or through the very own style of her writing, the relation of the British author with the seventh art is visible. Considering the importance of significations in literary works, this paper proposes a comparative study between Angela Carter’s The Magic Toyshop (1967) and the film of the same title, based on Carter’s novel, directed by David Wheatley and produced by Granada Television, in 1987. Based on Tania Carvalhal’s conception about intertextuality and film theories, the focus of this paper is the gender study, since its ideology is subscribed, represented and reproduced in every cultural practice, including literature and cinema. The characters construction in both cases, especially the female characters, is filled with symbols which are going to bring the film closer to the literary work and contribute to express the critics suggested in the work’s leading: the complaint to the patriarchal system. However, given the different nature of each work, it is necessary to stress that this present comparison doesn’t intend to establish a total identification between novel and film, but to set a dialogue between both, observing the approximation and distance of these two instances.

Atención plena, inteligencia emocional, género, área de estudio y reporte de ejercicio en estudiantes universitarios costarricenses

[ES] El propósito del estudio fue conocer la relación entre atención plena (mindfulness), inteligencia emocional, género, área de estudio y reporte de ejercicio en estudiantes universitarios costarricenses.

La educación virtual antidoping como estrategia para desarrollar la cultura del juego limpio en el deporte mexicano : Un estudio de género

El propósito del estudio fue analizar el nivel de conocimiento y dominio sobre el doping que tienen las deportistas élite en México, para emprender acciones que permitan educar a los deportistas y su equipo de entrenamiento en el juego limpio, a través de acciones psicopedagógicas que faciliten un aprendizaje significativo, evitando que las deportistas usen de manera voluntaria o involuntaria sustancias y métodos prohibidos. Las pregunta principal que orientó la investigación fue la siguiente: ¿Qué nivel de conocimiento y dominio sobre el doping tienen las deportistas élite en México?. Para la investigación de campo, se elaboró un cuestionario de 22 preguntas para explorar el nivel de conocimiento y dominio que tenían los deportistas considerados élite por pertenecer a la selección estatal o nacional de los deportes de gimnasia olímpica, tiro con arco y hockey sobre pasto. Las respuestas encontradas demuestran que en algunos aspectos existe desconocimiento en materia de dopaje, y se devela la necesidad de profundizar en el programa de educación antidoping. Se manifiesta que la ignorancia que existe en diferentes aspectos, pone en riesgo a los deportistas en el uso inconsciente de sustancias y métodos prohibidos en el deporte

La educación virtual antidoping como estrategia para desarrollar la cultura del juego limpio en el deporte mexicano : Un estudio de género

El propósito del estudio fue analizar el nivel de conocimiento y dominio sobre el doping que tienen las deportistas élite en México, para emprender acciones que permitan educar a los deportistas y su equipo de entrenamiento en el juego limpio, a través de acciones psicopedagógicas que faciliten un aprendizaje significativo, evitando que las deportistas usen de manera voluntaria o involuntaria sustancias y métodos prohibidos. Las pregunta principal que orientó la investigación fue la siguiente: ¿Qué nivel de conocimiento y dominio sobre el doping tienen las deportistas élite en México?. Para la investigación de campo, se elaboró un cuestionario de 22 preguntas para explorar el nivel de conocimiento y dominio que tenían los deportistas considerados élite por pertenecer a la selección estatal o nacional de los deportes de gimnasia olímpica, tiro con arco y hockey sobre pasto. Las respuestas encontradas demuestran que en algunos aspectos existe desconocimiento en materia de dopaje, y se devela la necesidad de profundizar en el programa de educación antidoping. Se manifiesta que la ignorancia que existe en diferentes aspectos, pone en riesgo a los deportistas en el uso inconsciente de sustancias y métodos prohibidos en el deporte

La educación virtual antidoping como estrategia para desarrollar la cultura del juego limpio en el deporte mexicano : Un estudio de género

El propósito del estudio fue analizar el nivel de conocimiento y dominio sobre el doping que tienen las deportistas élite en México, para emprender acciones que permitan educar a los deportistas y su equipo de entrenamiento en el juego limpio, a través de acciones psicopedagógicas que faciliten un aprendizaje significativo, evitando que las deportistas usen de manera voluntaria o involuntaria sustancias y métodos prohibidos. Las pregunta principal que orientó la investigación fue la siguiente: ¿Qué nivel de conocimiento y dominio sobre el doping tienen las deportistas élite en México?. Para la investigación de campo, se elaboró un cuestionario de 22 preguntas para explorar el nivel de conocimiento y dominio que tenían los deportistas considerados élite por pertenecer a la selección estatal o nacional de los deportes de gimnasia olímpica, tiro con arco y hockey sobre pasto. Las respuestas encontradas demuestran que en algunos aspectos existe desconocimiento en materia de dopaje, y se devela la necesidad de profundizar en el programa de educación antidoping. Se manifiesta que la ignorancia que existe en diferentes aspectos, pone en riesgo a los deportistas en el uso inconsciente de sustancias y métodos prohibidos en el deporte