CHANGES IN THE COMOVEMENT OF EUROPEAN EQUITY MARKETS

This paper investigates the impact that the removal of exchange controls within major European economies has had on the interdependence of European equity markets. For five years prior to the removal of exchange controls and five years following their removal, we use impulse responses and variance decompositions from vector autoregressions to illustrate that European equity markets have become substantially more integrated after the removal of exchange controls. We undertake further tests that demonstrate that, even if we allow for parallel macroeconomic harmonization, the removal of exchange controls has been a major cause of increased equity market integration within Europe. ( JEL F33, F36, G15)     

Prevention of osteoporosis: one step forward, two steps back

For many years, hormone replacement therapy (HRT) was the mainstay for osteoporosis prevention in postmenopausal women until a large randomized clinical trial raised serious safety concerns. This resulted in a big drop in HRT use and its demotion by regulatory authorities to second-line treatment. Many clinicians now feel that HRT is not safe to use, and recommend various alternatives for the treatment of osteoporosis. But how effective are these alternative therapies, are they any safer than HRT, and how do their costs compare? This review questions the validity of the safety concerns about HRT, and highlights the safety concerns about alternative therapies. It concludes that HRT is as safe as the other treatment options, and its efficacy and low cost demand that it be restored as a first-line treatment for the prevention of postmenopausal osteoporosis. Other therapies are available for use in osteoporosis, and the bisphosphonates are particularly effective for the treatment of the established disease. However, they must be used selectively and with caution, and are best restricted to those patients who are elderly or have severe disease. New treatments are emerging, but again caution must be taken until any long-term adverse effects have been identified.     

Enhanced rate of resting energy expenditure in women using hormone-replacement therapy: preliminary results

Hormone-replacement therapy (HRT) attenuates the menopause-associated alterations in body composition. It is not known, however, whether this effect is a result of a concomitant increase in energy expenditure. The authors examined whether women submitted to a long-term HRT treatment presented greater energy expenditure than women who had never used HRT. We compared 13 postmenopausal women using HRT (>1 yr) with 13 age- (+/-2 yr) and body-mass-index-matched (BMI; +/-1.5 kg/m2) postmenopausal women not using HRT. Resting energy expenditure (REE; indirect calorimetry), body composition, and daily (DEE) and physical activity (PAEE) energy expenditure (accelerometry) were obtained. Although BMI, fat mass, fat-free mass, DEE, and PAEE were similar between groups, the HRT group displayed a significantly greater REE than the no-HRT group (Delta +222 kcal/day). In conclusion, the authors observed that a long-term treatment with HRT is associated with a greater REE in postmenopausal women. These results need to be confirmed.     

National Osteoporosis Society's Position statement on hormone replacement therapy in the prevention and treatment of osteoporosis

Hormone replacement therapy (HRT) has been shown to increase bone density, reduce the risk of fracture and can successfully relieve menopausal symptoms. From a time when HRT was the major therapeutic option for the management of osteoporosis, women and their clinicians now have a range of treatments available. Following the publication of the Women's Health Initiative (WHI) and the Million Women Study highlighting potential side-effects, such as breast cancer, heart disease and stroke, many doctors and women are now reluctant to use HRT. The National Osteoporosis Society felt that the role of HRT in the management of osteoporosis needed to be clarified. Using the Charity's expert clinical and scientific advisers, and through public consultation with members and key stakeholders, a Position Statement has been published. We conclude that HRT has a role to play in the management of osteoporosis in postmenopausal women below the age of 60 years. The key recommendations of the Position Statement are presented in this paper.     

Harnessing hormonal signaling for cardioprotection

Cardiovascular disease is the leading cause of death in women in the Western world and is predominant among the elderly. A large body of evidence suggests that hormonal signaling plays a critical role in the regulation of cardioprotective mechanisms, as premenopausal women are at significantly lower risk of heart disease compared with men, but the risk greatly increases with the onset of menopause. This association indicates that estrogen may protect the heart from cardiovascular disease. Whereas a number of analyses of the effects of hormone replacement therapy (HRT) on postmenopausal women supported the idea that estrogen is a cardioprotective factor, the findings of the more recent Women's Health Initiative (WHI) study suggested that HRT may actually increase the risk of cardiovascular events. These conflicting reports have left both patients and clinicians reluctant to continue using current HRT regimes. The WHI findings do not, however, negate the epidemiological link between menopause and increased cardiovascular risk. Hence, the identification of the specific actions of estrogen that promote cardioprotective pathways without enhancing deleterious vascular mechanisms may provide novel estrogen-based alternatives to current HRT strategies. In this Review, we outline the known actions of estrogen on the cardiovascular system, focusing on cardioprotective mechanisms that may be targeted for the development of new therapeutic approaches.     

Physical activity and hormone-replacement therapy: interactive effects on cognition?

The purpose of this study was to examine the interactive effects of hormone-replacement therapy (HRT) and physical activity (PA) on the cognitive performance of older women. Postmenopausal women (n = 101) were recruited to complete a PA questionnaire, provide demographic information, and perform the digit-symbol substitution task (DSST) and the trail-making tests (TMT). Regression analyses were conducted for participants with complete data for each cognitive test (DSST n = 62; TMT n = 69). For both tasks, results indicated that PA and education were positively related and age was negatively related to cognitive performance. The interaction of HRT with PA did not add to the predicted variance of either measure of cognitive performance. This was true even after limiting the HRT users to women using unopposed estrogen. It is concluded that the beneficial relationship between PA and these two measures of cognitive performance in postmenopausal women exists irrespective of HRT use.     

Gender,interaction and intonational variation: The discourse functions of High Rising Terminals in London

In this paper, I examine the different conversational and interactional functions that High Rising Terminals (HRT) fulfil among young, White, middle‐class speakers of London English. Data are drawn from sixteen small‐group interviews with forty‐two individuals (28 women and 14 men) aged 18–25. From this corpus, 7351 declarative Intonation Phrases were extracted, and auditorily coded for the presence/absence of HRT as well as for a variety of social, interactional and pragmatic factors. I combine quantitative and qualitative methods to demonstrate that while all of the speakers investigated use HRT to accomplish relational work in conversation, the specific interactional strategies that the feature is recruited to perform differ markedly across genders. I consider the ramifications of this finding for our understanding of ‘politeness’ as a gendered practice, and illustrate the importance of examining a variable like HRT in its discourse‐functional context.     

Systemic lupus erythematosus and hormone replacement therapy

The indications for hormone replacement therapy (HRT) in postmenopausal women is the treatment of climacteric symptoms and the prevention of osteoporosis. Women with systemic lupus erythematosus (SLE) are more likely to have a premature menopause, osteoporosis and cardiovascular disease. HRT can induce SLE flares and cardiovascular or venous thromboembolic events. Therefore it should not be used in women with active disease or those with antiphospholipid (aPL) antibodies. In general, it should be used only for patients without active disease, a history of thrombosis or aPL antibodies. Non-oral administration of estrogen is recommended because of its lesser effect on coagulation. With regard to the progestogen, progesterone or pregnane derivatives are preferred. Otherwise, non-estrogen-based strategies should be used.     

Sexual Functioning Following Elective Hysterectomy: The Role of Surgical and Psychosocial Variables

In this article, two studies were conducted to investigate the surgical and psychosocial correlates of women's post-hysterectomy sexual functioning. In Study 1, sexual functioning was measured in an online convenience sample of 65 women who had undergone elective hysterectomy. Results suggested that most women experienced improved sexual functioning after their hysterectomy. Women who underwent hysterectomy to treat endometriosis reported less improvement in sexual functioning as compared to women who had hysterectomies for other indications, and women who had abdominal hysterectomies reported less improvement in sexual functioning as compared to women who had vaginal hysterectomies. Sexual functioning post-hysterectomy was associated with psychosocial variables, particularly body esteem and relationship quality. In Study 2, sexual functioning was investigated at two time points three to five months apart in a sample of 14 women who reported developing sexual problems following their elective hysterectomies. Results suggested that, among women suffering from post-hysterectomy sexual dysfunction, sexual pain and difficulty with orgasm increased over time.     

Sexual assault while in the military: violence as a predictor of cardiac risk?

The purpose of this article is to determine whether known cardiac risk factors are more prevalent among women veterans who report having sustained sexual assault while in the military. We surveyed a random sample of 3,632 women veterans using Veterans Administration (VA) ambulatory care nationally. Obesity, smoking, problem alcohol use, sedentary lifestyle, and hysterectomy before age 40 were found to be more common in women reporting a history of sexual assault while in the military than in women without such history. An association between myocardial infarction and prior sexual assault history may be mediated in part by known cardiac risk factors.     

A study of new referrals to a menopause clinic and their initial outcomes: how can we improve the service we provide?

This retrospective case-note study was performed to examine the ways in which an already established menopause clinic could improve service to its patients. The management of 151 patients was examined. Most were referred by their general practitioner and the most common reason for referral was to seek an alternative to hormone replacement therapy (HRT). The consultant saw 17% of the patients, and with the trainee was most likely to discharge the patient. Better information on alternatives to HRT, more consultant input and better use of telephone consultation for follow-up would enhance the service provided by the menopause clinic.     

Comments

Blood volume pulse (BVP) recordings were obtained from a 47‐year‐old hysterectomized woman prior to, during, and following a hot flash (HP). She displayed a relatively smaller BVP 120 seconds prior to the HF, as compared to a marked BVP increase during the HF. The woman's report of subjective “warmth” and observed perspiration 120 seconds prior to the HF appeared to correspond to a period of peripheral vasoconstriction. It was theorized that HF is associated with sympathetically mediated peripheral constriction in anticipation of the HF and may be exacerbated by the person's anticipatory fear that a HF is soon to occur. Learning principles may be relevant for considering both the development and partial relief of intense and frequent HF in hysterectomized women.     

Taking guns from batterers: public support and policy implications

Federal law prohibits the purchase or possession of a firearm by persons convicted of misdemeanor domestic violence and those under certain domestic violence restraining orders. The purpose of this investigation is to examine public sentiment about the removal of firearms in the absence of a restraining order or misdemeanor conviction following domestic violence. An experimental vignette design was used in a telephone survey of a cross-sectional statewide sample of 522 community-residing adults in California. Study design and population weights were applied; the findings, thus, are a reasonable approximation for the population of California. In more than 3,500 vignettes, the abusive behavior was judged to be wrong, illegal, or should be illegal (98.7%, 73.1%, and 77.7%, respectively). Although only about one half (56.5%) of the scenarios were thought to merit the issuance of a restraining order, three fourths (77.4%) were thought to merit the removal of firearms. Multivariate analyses indicated greater support for firearms removal when the abuse involved sexual or physical abuse (adjusted odds ratio [AOR] ranged from 2.65 to 5.64) or a gun (AOR = 6.54). Men were the sole population group with significantly lower support for firearm removal following domestic violence (AOR = 0.39). The men who wanted firearms to remain did not differ from other men on any of the measured variables. In sum, there is substantial support, especially when a gun is displayed in a domestic violence incident, for policies requiring the removal of firearms from abusers.     

Identifying the needs of parents with learning disabilities: A review

Despite the success of some programmes in raising the parental competency of parents who have learning disabilities, many services are still providing only minimal support to such families, often following crisis intervention. Recent legislative changes within the UK have meant that statutory services are now required to adopt a preventative approach to children and families in need. A review of the literature reveals that children of learning-disabled parents are particularly vulnerable to abuse/neglect and removal from their natural family. This article addresses the difficulties that many clinicians currently experience in the early identification of parents who have learning disabilities. It also emphasizes the need for a systematic approach in the assessment of these parents prior to the implementation of parental teaching programmes.     

Predictors of reentry into the foster care system: Comparison of children with and without previous removal experience

Foster care reunification is the most common permanency plan for children in care, but it can be a challenging and stressful process for both the child and birth family. In some cases, the family reunification is unsuccessful and requires removal of the child from the home and reentry into care. The current study focuses on two groups: children who have had no previous removal-foster care experience and those who have had previous removal experience. The aims of the present study are to: (1) examine the rate of reentry for children who have no previous removal-foster care experience versus those who have previous removal experience prior to the current episode; (2) measure the period between the time of the reunification and the time of reentry to care for both groups; and (3) identify risk and protective factors correlated with reentry for both groups. The study analyzes secondary data through survival analysis. The sample includes 4642 children exiting from care to reunification between 2010 and 2013, who are followed for 18 months. The rate of reentry for children with previous removal experience was much higher (25% vs. 16%), and the time of highest risk for future reentry was shorter (4 vs. 6 months, after reunification) compared to children without removal experience. Several common risk factors were found for both groups. Child behavior, reunification against agency recommendation, and siblings in care increased the odds of reentry. However, visitation of the family by a case worker post-reunification decreased the risk for reentry. Child welfare administrators and caseworkers should continue to work toward providing care and ensuring that the child and family are fully prepared for reunification. Programs and post reunification services must be targeted and provided to children with previous removal experience.