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.     

The future of hormone replacement therapy in the aging male

This paper is based on a presentation given at the 2nd World Congress on the Aging Male, Geneva, Switzerland, February 2000     

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.     

Women's perceptions of power and control in sexual abuse counseling

Fifty women who were sexually abused as children were interviewed regarding their perceptions of helpful and hindering counseling behaviors. The critical incident technique was the methodology used. One major category that emerged from the data was Approach to Power and Control. This category comprised eight subcategories: (1) flexibility with agenda; (2) willingness to offer choices; (3) response to criticism; (4) response to client as an equal or with honor; (5) sexual interest; (6) approach to client's suggestions; (7) expectations regarding forgiveness; and (8) consultation with alter identities. Implications for counseling practice, research, and counselor education are discussed.     

Social density: Its effects on behaviors and perceptions of preschoolers

The effects of social density on the behaviors and perceptions of 5-year-old children in four- and eight-person groups were investigated. In addition, differential effects of density for sex and for preferred personal space were examined. From a factor analysis of observed behaviors and self-reported perceptions, five factors emerged:Activity-Aggression-Anger, Positive Interactions, Distress-and-Nonplay, Feeling Bad, andAvoidance. A multivariate analysis of variance was performed; significant main effects were found for density and for sex. A univariate analysis of variance for each factor demonstrated that in the crowded condition there was significantly moreActivity-Aggression-Anger, moreDistress-and-Nonplay and fewerPostive Interactions than in the uncrowded condition. In the high density condition the frequency ofActivity-Aggression-Anger for boys increased significantly more than it did for girls. No effects for density on Avoidance were found, and there were no differential effects for density on preferred personal space. Several indications of developmental differences in crowding effects were found when the present findings are compared with those of other studies.     

The effects of interruption,gender, and status on interpersonal perceptions

This study examined: (1) how violations in turn-taking, ie., interruption, are perceived, (2) whether attributions toward an interrupter vary according to gender and status, and (3) how individuals who adopt cross-sex interruptive styles are seen. Subjects listened to a four-minute audiotape of a conversation and rated conversants on masculinity, femininity, competence, sociability, attractiveness, and traditionality. Sex of interrupter, style of interruption (statement, question, no interruption), and status were varied. Results suggest that interruption leads to negative personality attributions. Interrupters were seen as less sociable and more assertive than individuals who did not interrupt. They were also perceived as more masculine and less feminine than those who did not interrupt. Few sex differences emerged, indicating that women who interrupt are not penalized relative to men.We would like to thank Emory Cowen for his helpful comments and suggestions on earlier version of this article. We extend special thanks to Anne Bogat for her assistance and support at Michigan State University, and to Sharon Benson, Erica Colwell, Scott Fischer, Maureen Goldman, Jason Korosec, Michael Lynch and Ann Skoczenski for their assistance and patience in the development of the materials.     

An exploration of the effects of victim visuals on perceptions and reactions to crisis events

How news media and organizations use visual images in reports of crisis events remains relatively unexplored in spite of possible effects on perceptions of crisis responsibility and reputation. This study assessed the impact of visual condition (no visual, neutral visual, and victim visual) in two product harm crisis scenarios. Results revealed minimal effects for victim visuals. Implications for future research on visual elements and crisis communication are presented.     

Cultural issues and the menopause

Culture is a rather amorphous concept yet has a huge impact on our attitudes to diet, lifestyle, religion, sexuality and, via its influence on society, attitudes to education and health care. The midlife is a time of emotional and hormonal upheaval for any woman so defining the effects on culture on her response is challenging. Much depends on the value she places on her fertility and sexuality together with her own goals and aspirations, yet these are also influenced by culture. Very few traditional cultures survive in isolation for comparison. Shifting populations mean counter influences and transitional societies can be ambivalent. Emigrants and refugees transplanted into a different environment may struggle with the concept of acculturation. In time, all cultures evolve regardless. Finally, there may be biological and hormonal differences between races. This article seeks to place these different forces into context.     

Metabolic syndrome and the menopause

The metabolic syndrome consists of a combination of risk factors that include abdominal obesity, atherogenic dyslipidaemia, hypertension and insulin resistance. It increases the risk of cardiovascular disease and type 2 diabetes. The increased risk of cardiovascular disease is higher in women than in men. The first manifestation of metabolic syndrome may occur in pregnancy presenting as gestational diabetes or preeclampsia. Both conditions are associated with increased insulin resistance. Also metabolic syndrome is more common in polycystic ovarian syndrome. It has been suggested that there is a metabolic syndrome resulting from the menopause due to estrogen deficiency, as many of the risk factors are more prevalent in postmenopausal women. Also estrogen replacement improves insulin sensitivity and reduces the risk of diabetes. The key elements in managing the metabolic syndrome are weight reduction, increasing physical activity and diet modification. If blood pressure, lipid and glycaemic control are not achieved through these interventions then pharmacological therapy will be required.     

Employee perceptions of the effects of a two-tier wage structure

This exploratory study examines three research questions related to employees’ perceptions concerning the effects and purposes of a permanent two-tier wage structure in their employment setting. Although much of the popular literature on employee dissatisfaction with tiers has focused on low-wage tier employees, the results of this study indicate overall dissatisfaction with the effects of tiers amongboth high- and low-wage tier employees. Financial support for this study was provided by the W.E. Upjohn Institute for Employment Research in Kalamazoo, Michigan, and the Master of Arts in Industrial Relations Program at Wayne State University.     

The effects of gender and type of romantic touch on perceptions of relational commitment

This study investigated the relationship between intimate touching behaviors and corresponding cognitions of relational commitment as a function of gender. One hundred fifty-two subjects were surveyed regarding perceptions of commitment for seven intimate touches. The 2-way ANOVA revealed significant effects for gender, type of touch, and the touch by gender interaction. Progressively intimate touches were associated with greater commitment. Females associated significantly higher levels of commitment than males, particularly for the more intimate touches. The discrepancy in the level of commitment inferred by gender increases as the touching behavior grows more intimate, resulting in a greater potential for miscommunication across the more intimate channels of haptic communication.     

School discipline and disruptive classroom behavior: the moderating effects of student perceptions

This study examines the relationship between school discipline and student classroom behavior. A traditional deterrence framework predicts that more severe discipline will reduce misbehavior. In contrast, normative perspectives suggest that compliance depends upon commitment to rules and authority, including perceptions of fairness and legitimacy. Using school and individual-level data from the National Education Longitudinal Study of 1988 and multilevel regression modeling, the author finds support for the normative perspective. Students who perceive school authority as legitimate and teacher–student relations as positive are rated as less disruptive. While perceptions of fairness also predict lower disruptions, the effects are mediated by positive teacher–student relations. Contrary to the deterrence framework, more school rules and higher perceived strictness predicts more, not less, disruptive behavior. In addition, a significant interaction effect suggests that attending schools with more severe punishments may have the unintended consequence of generating defiance among certain youth.     

Review of the effects of Five Factor Model personality traits on network structures and perceptions of structure

We review recent research on Five Factor Model personality and social network analysis to assess how structures develop and are perceived. Extraversion and agreeableness relate consistently to personal but not workplace networks. Extraverts are more likely to seek connections, whereas agreeable individuals receive connections from others. Openness predicts network diversity and is marginally related to position when groups pursue collective goals. Conscientiousness is associated with maintaining certain personal relationships, but is strongly related to central positions in workplace networks. Neuroticism has no consistent relationship with network size or composition, and is differentially related to network positions, depending on the context.     

Mental health around and after the menopause

The menopause is a time in a woman's life when it is recognized that biological and social changes can impact upon mental wellbeing. Several studies have investigated the relationship between menopause and psychological symptoms, especially depression, with mixed results. In part, this is due to a considerable overlap between depressive symptoms and those due to declining estrogen levels, causing challenges in assessment. However it appears that vulnerable women are at a higher risk of succumbing to depression during menopausal transition. Antidepressants remain the mainstay of treating depressive symptoms, with little conclusive evidence for hormone replacement therapy. Memory problems during menopause are a common complaint, but there is no demonstrated link to subsequent dementia. This paper also reviews considerations of diagnosis and treatment of postmenopausal depression.