Et si on parlait des hommes?

Cet article se veut un questionnement sur quelques-uns des effets pervers du discours sur l'association sexe/santé dans notre contexte socio-culturel. Ce discours dénonce haut et fort les problèmes psychosociaux des femmes, mais tend à passer sous silence la vulnérabilité des hommes, pourtant inscrite en noir sur blanc dans nos statistiques officielles sur le suicide, la dépendance à l'alcool et autres drogues, la violence et l'itinérance.This article raises questions about some of the perverse effects of the reasoning behind correlations betweeen sex and health in our socio-cultural context. Such a reasoning strongly denounces the psychosocial problems of women, but tends to forget the vulnerability of men which is nonetheless clearly evident in official statistics on suicide, dépendance on alcohol and other drugs, violence and itinerancy

Role stress, role resources, and mental health outcomes among recreational runners

Research on the impact of multiple role management on mental health outcomes has yet to consider the implications of a recreational athlete role. Role Conflict theory predicts that incorporating this additional role would increase potential for stress manifested as a mental health problem. Role Expansion theory predicts the social qualities of this additional role can be helpful in buffering against stress. In an exploratory study, a sample of recreational runners from New England were recruited by email to complete an online survey that evaluated role resources, role stress, depression, and alcohol problems. Results show no significant relationships between role stress, role resources, and mental health outcomes. Gender differences in mental health outcomes are absent among this sample. This study is unable to support or contradict the Role Conflict Theory and Role Expansion Theory. Implications for future research are discussed

The Influence of Patient-Centeredness on Minority and Socioeconomically-Disadvantaged Patients’ Trust in their Physicians: An Evidence-Based Structural Equation Modeling Investigation

The purpose of this investigation was to determine the effect of physician patient-centeredness on patient trust across randomly selected groups of patients from an inner city medical practice serving a preponderance of minority and socioeconomically-disadvantaged patients. METHODS: A two-factor multigroup structural equation modeling design was employed, with randomly selected test (N = 300) and cross-validation (N = 300) samples of medical practice patients. Equality constraints were established to test the invariance of effects across groups. The model was compared to its unconstrained counterpart to further test its trustworthiness. An additional 5,000 nonparametric bootstrapped samples for each group were generated to further cross-validate and assess the stability of effect estimates. RESULTS: The model fit well. Physician patient-centeredness significantly influenced patient trust, explaining 82 percent of its variability. When physician patient-centeredness increased by one unit, the predicted value for patient trust increased by 1.043 units (.903 standardized). Patient-centered physician behaviors increased patients’ confidence in and likelihood to recommend their physician. This pattern of effects held across the test and cross-validation groups. The hypothesized model was sustained when compared to its competing counterpart. CONCLUSIONS: Evidence supported the factor and structural validity of the model. This study offers a plausible two-factor model for the measurement and improvement of patient-centeredness, and concomitantly, patient trust in an inner city medical clinic serving minority and socioeconomically-disadvantaged patients. In addition to quality improvement and outcome measurement, the results have implications for improving patient-centeredness, patient trust, the patient–provider relationship, medical education, and reducing health care disparities

Questões acerca da avaliação do comportamento sexual

O comportamento sexual é uma das principais causas das doenças de transmissão sexual (DTS) que se tornaram fonte de preocupação crescente para os profissionais de saúde, políticos e população em geral, quer pelas suas consequências directas, nalguns casos de vida ou de morte, quer pelas suas consequências indirectas como sejam os custos sociais e económicos. A opinião pública tende a dar especial atenção A prevenção secundária e terciária enquanto, sem dúvidas, a prevenção primária é a intervenção mais importante. A maneira de avaliar os comportamentos sexuais das populações de modo a organizar programas de prevenção primária passa, normalmente, por questionários estruturados do tipo dos utilizados em epidemiologia da saúde. Ora a investigação tem demonstrado que uma percentagem elevada de indivíduos não responde a questões sobre temática sexual, reduzindo a validade interna e externa das investigações epidemiológicas, enviesando as conclusões e prejudicando, por isso, a intervenção do psicólogo clínico da saúde que, ao organizar programas de intervenção em prevenção primária se baseará em dados incorrectos. O objectivo da investigação aqui apresentada pretende identificar as características de um grupo de risco (jovens) quanto ao comportamento sexual, que não respondem a perguntas de temática sexual, com o objectivo, por um lado, de julgar se se devem considerar os dados disponíveis benévolos ou, pelo contrário, se os dados disponíveis deverão ser considerados mais graves e, por outro lado, de discutir como se pode melhorar a comunicação em investigação epidemiológica de modo a recolher dados fidedignos.ABSTRACT: The sexual behaviour is one main cause on transmission sexual diseases (TSD) which become a source of growing concern among health specialists, politicians and general population, either by their direct consequences - in some cases of life and death - as by, their indirect consequences, such as social and eco - nomic costs. The public opinion pay special attention to secondary and tertiary prevention while, in fact, the primary prevention is the most important intervention. The methodology to assess the population’s sexual behaviour in order to organise primary prevention programs is usually supported by structured surveys alike those questionnaires used on health epidemiology. Nevertheless, research has showed that an important percentage of subjects do not answer to questions on sexual thematic, which mean a narrowing of epidemiological research interna1 and externa1 validity, producing a bias on conclusions, prejudicing, therefore, the health clinical psychologist intervention, basing the organisation of their intervention programs on inaccurate data. The main goal of this research report is to identify the characteristics of a risk group (teenagers) regarding their sexual behaviour, whom did not answer to sexual thematic questions, aiming, in one hand, to establish if we should consider the available data as benevolent or, on contrary, if the available data should be taken as more serious and, in the other hand, to discuss how we can improve the communication in epidemiological research in order to obtain more reliable data

Risikoverhalten und präventives Verhalten im Geschlechtervergleich: Ein Überblick

In diesem Beitrag wird ein Überblick über gesundheitsrelevantes Risikoverhalten und präventives Verhalten im Geschlechtervergleich gegeben. Bei Männern kommt Risikoverhalten häufiger vor, Frauen verhalten sich etwas gesundheitsbewußter und nehmen deutlich häufiger Angebote zur Gesundheitsförderung und prävention wahr. Geschlechtsunterschiede in gesundheitsrelevantem Verhalten werden am besten durch gesellschaftliche Geschlechtsrollenerwartungen erklärt. Einhergehend mit Veränderungen in diesen Erwartungen haben bereits Verhaltensänderungen stattgefunden, beispielsweise rauchen inzwischen Mädchen genauso häufig wie Jungen. Um zu erklären, wie Geschlechtsrollen das individuelle Verhalten beeinflussen, wird das GeschlechtsrollenSelbstkonzept als vermittelnde psychologische Variable postuliert; dazu werden einige exemplarische Untersuchungen vorgestellt

Experimental cultivation of the Mediterranean calanoid copepods

A pilot re-circulating system was used for the cultivation of two Mediterranean calanoid copepods: Temora stylifera and Centropages typicus. The system automatically concentrated the naupliar and copepodite stages. Temora stylifera was fed the flagellate Rhodomonas baltica or Prorocentrum minimum, whereas C. typicus was fed with a mixture of R. baltica or P. minimum and Tetraselmis suecica. Both copepods also received Isochrysis galbana. After 21 days, the T. stylifera population increased 26-fold, reaching a density of 38 000 individuals, mostly represented by nauplii (88%). The maximum density recorded was 380 ind. L−1, with a production of 370 nauplii L−1. On average, the egg hatching success for this copepod during the rearing period was 54%, with the highest viability in April and May (>75%). The C. typicus population increased more than 10-fold after 7 weeks of rearing, reaching a density of 123 000 individuals, mainly represented by nauplii (>90%). The highest naupliar production was 100 ind. L−1, with a mean egg hatching success of 68%. This system may be useful to produce nauplii and copepodite stages to be used as live, alternative or complementary food for fish larvae or to provide a ready source of organisms for physiological and bioassay studies

The acceptability of healthcare: from satisfaction to trust

The assessment of healthcare quality increasingly emphasises lay acceptability, as evidenced by the emergence of patient satisfaction and patient-centred care in the literature and in policy. In this paper we aim to provide a conceptual overview of acceptability and propose ways to enhance its assessment. Firstly, we map how acceptability’s importance in quality assessments has increased and how the term acceptability has been used as synonymous with patient satisfaction, despite it being a broader concept. We then critique the concept of patient satisfaction and its measurement and challenge its use as an indicator of acceptability and quality. By drawing on our research and those of others, the second half of the paper describes how trust in clinicians and health services has emerged as a related concept, including a theoretical discussion of trust in healthcare outlining how it can be built, undermined and abused. We propose trust as an alternative indicator of acceptability in healthcare quality and review its measurement. Finally, we consider how healthcare policy may impact on trust and make recommendations for future research

The Relationship between Treatment-Seeking and Characteristics of Depression among African Americans

Objective: Depression is a common psychiatric condition, and despite the availability of effective treatments, this condition is largely under-recognized and undertreated, particularly among African Americans. One reason for this discrepancy may be that depressive symptoms often co-occur with physical health conditions, which can influence both the reporting of depressive symptomology, willingness to seek care, and the type of healthcare provider sought. The purpose of this study was to explore the relationship between treatment-seeking characteristics and diagnostic attributions of depression among community-dwelling African American adults. Methods: Data come from the National Survey of American Life, a nationally representative sample of African Americans, Caribbean blacks and non-Hispanic whites. Analysis is limited to African Americans (N = 3,432), of whom 64% were women. Lifetime history of Major Depressive Disorder (MDD) was assessed using the Composite International Diagnostic Inventory (CIDI). Participants were categorized into four diagnostic groups: Never MDD, MDD never attributed to physical health problems (e.g., typical depression), MDD sometimes attributed to physical health problems (e.g., complicated depression), and MDD always attributed to physical health problems (e.g., physical depression). Whether or not care was sought for depression, and the type of healthcare provider seen, was assessed by self-report. Multinomial logistic regression was used to assess the cross-sectional relationship between treatment-seeking characteristics and diagnostic type of depression. Models were adjusted for age, sex, insurance status, health behaviors, and comorbid health conditions. Results: 441 (12.8%) of the sample met CIDI criteria for MDD, and of these 66.7% were classified as typical depression, 18.1% were complicated depression, and 15.2% were physical depression. In fully-adjusted models, seeking treatment from a mental health professional was significantly associated with diagnosis of complicated depression (Odds ratio (OR): 5.53; 95% Confidence Interval (CI): 2.27 – 13.43) as opposed to typical depression. In adjusted analysis treatment-seeking from a family doctor was significantly associated with diagnosis of physical depression (OR: 2.94; 95% CI: 1.20 – 7.19) as opposed to typical depression. Seeking care from three or more different types of healthcare providers was significantly associated with diagnosis of complicated depression (OR: 2.10; 95% CI: 1.13 – 3.92) relative to typical depression. There was no significant relationship between seeing multiple providers and physical depression. Conclusions: Type of healthcare provider sought for care for depressive symptoms is significantly related to how those depressive symptoms are diagnosed. These findings are consistent with the hypothesis that healthcare providers influence whether depressive symptomology is attributed to physical health problems. However, this study cannot definitively differentiate the role of personal choice in seeking particular types of care providers from differences in assessment and attribution of depressive symptomology by types of providers. Future research is necessary to determine the factors related to both choosing a care provider when experiencing psychiatric symptoms and how different types of providers assess depressive symptoms and confer diagnosis

The difference between expected and experienced utility

_Turkish_ Daniel Kahneman faydanın iki formu olduğunu söyleyerek faydayı beklenen fayda ve deneyimlenen fayda olmak üzere ikiye ayırır. Kahneman’a göre deneyimlenen fayda hem insanlar tarafından ölçülebilir hem de deneyimlenen faydanın deneysel olarak beklenen faydadan farklılıkları bulunmaktadır. Beklenen fayda insanların mutlulukları üzerine bir tercihinin gelecekteki onlara sağlayacağı etkileri hakkındaki inançlarıdır. Faydanın deneyimlenen fayda ve beklenen fayda olarak adlandırılan bu iki çeşidi bu noktada birbirinden ayrılır. Bu makalenin temel amacı da çocuk sahibi olma üzerine beklenen fayda ve deneyimlenen fayda arasındaki farkı açıklamaktır. İnsanlar beklenen faydalarına göre daha mutlu olmayı bekler iken, aslında deneyimlenen faydada böyle olmaz. Özellikle çocuksuz çiftler ve kadınlar çocuk sahibi olmanın onlara mutluluk getireceğine inanır. Erkeklerin ise kadınların mutluluk beklentilerine kıyasla çocuk sahibi olmanın daha az mutluluk getireceği inancı vardır. Kadınların ve erkeklerin çocuk sahibi olma beklentisinin onların mutluluğunu artıracağı yönündeki bu inanışa yönelik sonuç Kahneman’ın belirttiği beklenen faydayı ortaya çıkarmaktadır. Peki, kadınlar ve erkekler çocuk sahibi olduktan sonra gerçekten mutlu olurlar mı? Kadın ve erkeklerin bu konudaki cevaplarına bakıldığında beklenen ve deneyimlenen fayda aynı seviyede midir? Çocuğun doğumu öncesinde ve doğum sonrasında kadınların ve erkeklerin mutluluk seviyesi farklıdır