Gay Abuse Screening Protocol (GASP): screening for abuse in gay male relationships

Thirty-two male patients in gay relationships and eight family physicians were recruited from a family practice in order to determine comfort with an eight-question Gay Abuse Screening Protocol (GASP). The GASP was administered during a typical clinical encounter. After the encounter, physicians and patients each completed a 5-point Likert Scale questionnaire to assess their comfort levels with each of the 8 GASP questions (Likert Scale: 1 = not at all comfortable to 5 = very comfortable). The mean comfort score was high (Likert >4) for both patients (4.16 +/- 0.18) and physicians (4.71 +/- 0.18). However, mean comfort scores were significantly lower for abused patients (3.26 +/- 0.75) than nonabused patients (4.57 +/- 0.26). Patients were comfortable (Likert >3) with 76.2% of GASP items while physicians were comfortable with all GASP items.     

Testing the Personal Wellbeing Index on 12–16?Year-Old Adolescents in 3 Different Countries with 2 New Items

The 7-item adult version of the Personal Wellbeing scale (Cummins et al. Social Indic Res 64:159?C190, 2003) was administered to two samples of adolescents aged 12?C16 in Brazil (N?=?1,588) and Spain (N?=?2,900), and to a sample of adolescents aged 14?C16 in Chile (N?=?843). The results obtained were analyzed to determine its psychometric characteristics when used with adolescents in the three different countries and to check whether two additional items would improve its qualities. Results reveal that the new PWI-9 version worked well with the adolescents in the three countries, improving some of the qualities of the PWI-7. One of the added items, satisfaction with oneself, appears to be a major contributor to unique explained variance when regressed on the single-item of overall life satisfaction (OLS). The model we present using structural equations shows good fit statistics for the factor structure, with both 7 and 9 items. Separate in-country analyses demonstrate that cultural context has a strong influence on correlations and saturations between the studied variables and also on the explained variance. Probably related to this fact, the Model fit structure is good in Brazil (with a low PWI variance accounted for by its predictors) and Spain (medium), but rather modest in Chile, where data show a high proportion of the PWI variance accounted for by its predictors. However, a multi-group factor analysis among the three countries restricting saturations to 1 in each country in order to make data comparable across countries still show a good fit of the proposed model for both PWI-7 and PWI-9.     

What Makes Koreans Happy?: Exploration on the Structure of Happy Life among Korean Adults

The current study explored the perceptions of Korean people about what can make them happy and constructed a comprehensive measurement of happiness of Korean. A total of 61 Korean adults participated in Focused Group Interview (FGI), where they were asked three questions (e.g., What makes you happy? What could make you happier than now? In general, who is a happy person?). Participants’ responses were reviewed by the present investigators independently and 152 statements of happy life with 18 categories were derived from content-analysis. The list of 152 statements of happy life was administered to 517 Korean adults to assess the importance of each item for Koreans’ happy life through the objective rating scale (6-point Likert scale). Confirmatory factor analysis showed that most factors were unidimensional. The items with low reliability were deleted and some new items were added, resulting in the experimental form of the Happy Life Inventory with 156 items and 18 categories including a new category of religion. The preliminary form of the Happy Life Inventory and the Psychological Well-being scale were administered to a nationwide sample of 1503 Korean adults in order to assess their happiness through 6-point Likert scale. The responses from 877 participants were submitted to exploratory factor analysis. The items with low factor loadings were excluded and 98 items with 16 factors were included in the final version of the Happy Life Inventory. Confirmatory factor analysis of the responses from 611 subjects confirmed that the 16 factor model was appropriate and most categories had one underlying dimension with moderate to high reliabilities. Correlations between the Happy Life Inventory and the psychological well-being scale supported construct validity of the Happy Life Inventory. Suggestions for further research were discussed.     

Internalized Homophobia,Coping, and Quality of Life Among Nigerian Gay and Bisexual Men

ABSTRACT

Despite high levels of homophobia in Nigeria, no studies have investigated the quality of life (QOL) of Nigerian gay and bisexual (GB) men. The associations between QOL and minority stress may differ from those reported in developed countries and may indicate alternative interventions. This study investigated internalized homophobia (IH) and coping strategies among gay and bisexual men in Nigeria and the relationships with overall QOL. Eighty-nine GB men were recruited with a snowball sampling technique. QOL (outcome), IH (predictor) and coping strategies (covariates) were assessed using standardized questionnaires. Relationships were investigated using linear regression analyses. Participants used adaptive more frequently than maladaptive coping strategies. The relationship between IH and QOL was nonlinear (β = ?0.27, 95% CI = ?0.48, ?0.06), and the positive component was attenuated by adaptive coping strategies. Adaptive strategies can be reinforced as a therapeutic intervention to improve wellbeing among gay and bisexual men in Nigeria.     

The Relationship Between Homosexuality,Internalized Homo-Negativity,and Mental Health in Men Who Have Sex with Men

ABSTRACT

Whether homosexuality or internalized homo-negativity is the critical variable affecting the mental health of men who have sex with men has long been debated. As part of a larger study, 422 Midwestern homosexual men completed questionnaires examining degree of homosexuality, internalized homo-negativity, and depression. Logistic regression modeling identified internalized homo-negativity, but not degree of homosexuality, as significantly associated with greater adjustment depression (OR?=?1.5), major depression (OR?=?2.6), dysthymia (OR?=?1.5), and likelihood of being in therapy (OR?=?1.4). Internalized homo-negativity was also negatively associated with overall sexual health, psychosexual maturation, comfort with sexual orientation, “outness,” and peer socialization. Internalized homo-negativity, not homosexuality, appears associated with negative health outcomes. Providers should promote sexual health and avoid interventions that reinforce internalized homo-negativity.     

Impact of having a high-risk pregnancy on future postpartum contraceptive method choice

BackgroundTo compare the knowledge and preference of preconceptional contraception to future postpartum contraceptive method choice in high-risk pregnancies.Research questionDoes a high-risk pregnancy condition affect future postpartum contraceptive method choice?MethodWomen hospitalised at the High Risk Pregnancy unit of a tertiary research and training hospital were asked to complete a self-reported questionnaire that included demographic characteristics, presence of unintended pregnancy, contraceptive method of choice before the current pregnancy, plans for contraceptive use following delivery and requests for any contraceptive counselling in the postpartum period.FindingsA total of 655 pregnant women were recruited. The mean age, gravidity and parity of the women were 27.48 ± 6.25 years, 2.81 ± 2.15 and 1.40 ± 1.77, respectively. High-risk pregnancy indications included 207 (31.6%) maternal, 396 (60.5%) foetal and 52 (7.9%) uterine factors. All postpartum contraceptive choices except for combined oral contraceptives (COCs) usage were significantly different from preconceptional contraceptive preferences (p < 0.001). High-risk pregnancy indications, future child bearing, ideal number of children, income and education levels were the most important factors influencing postpartum contraceptive choices. While the leading contraceptive method in the postpartum period was long-acting reversible contraceptive methods (non-hormonal copper intrauterine device Cu-IUD, the levonorgestrel-releasing intrauterine system (LNG-IUS) (40%), the least preferred method was COCs use (5.2%) and preference of COCs use showed no difference between the preconceptional and postpartum periods (p = 0.202). Overall 73.7% of the women wanted to receive contraceptive counselling before their discharge.ConclusionA high-risk pregnancy condition may change the opinion and preference of contraceptive use, and also seems to affect the awareness of family planning methods.     

The Interrelations Between Internalized Homophobia,Depressive Symptoms,and Suicidal Ideation Among Australian Gay Men,Lesbians, and Bisexual Women

ABSTRACT

Internalized homophobia has been linked to depression among gay men, lesbians, and bisexuals. Relatively little research has investigated the link between internalized homophobia and suicidal thoughts and behaviors. The current research investigated the interrelations among internalized homophobia, depressive symptoms, and suicidal ideation by testing additive, mediation, and moderation models. Self-identified Australian gay men (n = 360), lesbians (n = 444), and bisexual women (n = 114) completed the Internalized Homophobia Scale, the Center for Epidemiological Studies Depression Scale, and the suicide subscale of the General Health Questionnaire. Results supported the additive and partial mediation models for gay men and the mediation and moderation models for lesbians. None of the models were supported for bisexual women. The findings imply that clinicians should focus on reducing internalized homophobia and depressive symptoms among gay men and lesbians, and depressive symptoms among bisexual women, to reduce suicidal ideation.     

Types of Personal Social Networks of Older Adults in Portugal

This study presents and discusses a three-dimensional typology for personal social networks of Portuguese older adults. We used a K-means cluster analysis of structural, functional and relational-contextual variables of the networks of 612 participants aged 65?+?(M?=?76?±?7.6), mostly women (63%). Four types of networks emerged: family networks, friendship networks, neighbourhood networks and institutional networks. The most frequent are family networks (61.8%), constituted by 94.6% of family ties, on average, attesting the familistic nature of the older persons’ networks in Portugal, followed by friendship networks (23.5%) and neighbourhood networks (11.9%). The less frequent type is the institutional network (2.8%), dominated by formal ties (M?=?59.3%). Sociographic profiles reveal that family networks are more likely to be held by middle-old focal subjects, married or widowed, and with children. Friendship and neighbourhood networks are held by young-old subjects with different marital status, many of them living alone, with a higher proportion of men with friendship networks. Institutional networks are held by old–old, widowed or single with no children. The presented typology contributes to understand social support needs and social isolation. The conclusions allow to anticipate social services’ demand trajectories and to propose intervention plans and social policy measures to promote the wellbeing of the older population.

     

Quantifying the differences in birth outcomes and out-of-pocket costs between Australian Defence Force servicewomen and civilian women: A data linkage study

ObjectivesServicewomen in Defence Forces the world over are constrained in their health service use by defence healthcare policy. These policies govern a woman’s ability to choose who she receives maternity care from and where. The aim of this study was to compare Australian Defence Force (ADF) servicewomen and children’s birth outcomes, health service use, and out-of-pocket costs to those of civilian women and children.MethodsRetrospective cohort study using linked administrative data for women giving birth between 1 July 2012 and 30 June 2018 in Queensland, Australia (n = 365,138 births). Women serving in the ADF at the time of birth were identified as having their care funded by the Department of Defence (n = 395 births). Propensity score matching was used to identify a mixed public/private civilian sample of women to allow for comparison with servicewomen, controlling for baseline characteristics. Sensitivity analysis was also conducted using a sample of civilian women accessing only private maternity care.FindingsNearly all servicewomen gave birth in the private setting (97.22%). They had significantly greater odds of having a caesarean section (OR 1.71, 95%CI 1.29?2.30) and epidural (OR 1.56, 95%CI 1.11?2.20), and significantly lower odds of having a non-instrumental vaginal birth (OR 0.57, 95%CI 0.43?0.75) compared to women in the matched public/private civilian sample. Compared to civilian children, children born to servicewomen had significantly higher out-of-pocket costs at birth ($275.93 ± 355.82), in the first ($214.98 ± 403.45) and second ($127.75 ± 391.13) years of life, and overall up to two years of age ($618.66 ± 779.67) despite similar health service use.ConclusionsADF servicewomen have higher rates of obstetric intervention at birth and also pay significantly higher out-of-pocket costs for their children’s health service utilisation up to 2-years of age. Given the high rates of obstetric intervention, greater exploration of servicewomen’s maternity care experiences and preferences is warranted, as this may necessitate further reform to ADF maternity healthcare policy.     

A comparison of two versus four sterile water injections for the relief of back pain in labour: A multicentre randomised equivalence trial

BackgroundRecent trials demonstrated the safety and efficacy of sterile water injections to provide relief from labour back pain. While four injections is the most common approach variations in technique, such as employing two injections, are also used.AimTo determine if the analgesic effect of two sterile water injections is clinically equivalent to four.Methods238 women in labour with a Visual Analogue Scale pain score (VAS) of 70 millimetres (mm) (0 = no pain; 100 = worst pain imaginable) were randomised to two or four sterile water injections. The primary outcome was pain measured on a VAS at 30 min post treatment. A priori margin of equivalence was set at ±10 mm. Secondary outcomes included the likelihood of achieving an at least 30% and 50% reduction in pain, birth and neonatal outcomes.ResultsAt 30 min post-injection the difference in VAS scores between the techniques was ?5.97 (95% Confidence Interval [CI] ?13.18–1.22). As the lower end of the CI exceeds the margin of ?10 mm equivalence was not demonstrated. Both techniques achieved an at least 30% reduction in pain in over 75% of participants though duration of effect was longer in the four injection group. There was no difference in other birth related secondary outcomes.ConclusionFour injections provided a margin of benefit over two injections in level and duration of analgesia.DiscussionFour injections remains the technique of choice though two injections still provided significant pain relief and would be suitable where it was not possible or desirable to provide four.     

Is Patients' Sexual Orientation a Blind Spot of Family Physicians?

ABSTRACT

Even though certain health needs of gay, lesbian, and bisexual (GLB) patients are unique and different from those of the heterosexual patient, physicians do not usually ask patients about their sexual orientation. This study investigates family physicians' common practice regarding their patients' sexual orientation. Most of the physicians surveyed knew of less than 0.5% GLB patients in their practice; 44.4% did not know of any GLB patients. Only one physician commonly asked his patients about their sexual orientation; other physicians rarely or never asked. Asking patients about their sexual orientation significantly (P < 0.01) predicted the number of GLB patients known to the physician. Asking about patients' sexual orientation is not a common practice for family physicians, and, thus, they are usually unaware of the GLB patients in their practice.     

A Social and Historical Perspective of the San Francisco Gay Men's Chorus

ABSTRACT

This study sought to understand the various roles music played for gay men who were members of the San Francisco Gay Men's Chorus, the world's first gay men's chorus. Specifically, it answers the following questions: What is the demographic profile of the chorus members? How has the chorus shaped or reflected social issues; how has the chorus shaped or reflected political issues; how has the music evolved over time?; How was the chorus impacted by the HIV/AIDS epidemic? Historical information for this study was gathered through eight interviews of original and long-time choral members as well as the current artistic director. Interviews were conducted in San Francisco at the San Francisco Gay Men's Chorus office, and additional data were derived from programs of previous choral concerts, two questionnaires (Internalized Homophobia Scale and Gay Chorus Questionnaire), and observations of choral rehearsals and concerts. As a follow-up to a previous study documenting the formation of the chorus in 1978–1982, this study historically documents the chorus's evolution from 1983 through 2003, emphasizing the chorus's impact on social and political issues, the musicality of the chorus, and the impact of HIV/AIDS on the chorus.     

A Scale on Beliefs about Children's Adjustment in Same-Sex Families: Reliability and Validity

In this study, we developed a new instrument named Scale Beliefs about Children's Adjustment on Same-Sex Families (SBCASSF). The scale was developed to assess of the adults' beliefs about negative impacts on children who are raised by same-sex parents. An initial pool of 95 items was generated by the authors based on a review of the literature on homophobia and feedback from several focus groups. Research findings, based on a sample of 212 university students (mean age 22 years, SD?=?8.28), supported the reliability and validity of the scale. The final versions of the SBCASSF included items reflecting the following two factors: individual opposition (α = .87) and normative opposition (α = .88). Convergent validity of the scale is demonstrated by predictable correlations with beliefs about the cause of same-sex sexual orientation and the support for gay and lesbian rights. Our study reveals a strong positive association between high scores on SBCASSF and beliefs that the origin of same-sex sexual orientation is learned and opposition to gay and lesbian rights.     

International Well-being Index: The Austrian Version

The International Well-being Index (IWI) measures both personal and national well-being. It comprises two subscales: the Personal Well-being Index (PWI) and the National Well-being Index (NWI). The aim of this paper is to test the psychometric properties (validity and reliability) of the translated scale in Austria. Convergent validity is assessed using the Scales of Psychological Well-Being, the Satisfaction with Life Scale and the Positive and Negative Affect Scale. In addition, a Visual–Analog Scales capturing “satisfaction with life as a whole” was applied. The participants were 581 students of the Medical University Innsbruck (female: 47.7%; age: 23.2 ± 3.7). Internal consistency (Cronbach’s α) of the IWI was for both scales > .70 (PWI: .85; NWI: .83). The exploratory factor analysis of the IWI identified a 2-factor-structure identical with the two scales of the IWI explaining 54.2% of the variance. The convergent validity hypotheses were confirmed, construct validity was partly confirmed for the PWI being a deconstruction of a first factor called “satisfaction with life” (38.1% explained variance). Happy participants scored higher on the PWI (84.3 ± 7.9 vs. 68.7 ± 13.7; p < .001) and NWI (64.3 ±  15.8 vs. 57.9 ±  15.1; p < .001) scores than unhappy participants. It is concluded that the Austrian version of the IWI is a reliable and valid instrument to assess personal and national well-being. Further studies including a representative sample should be carried out on a recurring basis to use the IWI as an indicator for social science research in Austria.     

Survey of Australian maternity hospitals to inform development and implementation of a stillbirth prevention ‘bundle of care’

Background‘Bundles of care’ are being implemented to improve key practice gaps in perinatal care. As part of our development of a stillbirth prevention bundle, we consulted with Australian maternity care providers.ObjectiveTo gain the insights of Australian maternity care providers to inform the development and implementation of a bundle of care for stillbirth prevention.MethodsA 2018 on-line survey of hospitals providing maternity services included 55 questions incorporating multiple choice, Likert items and open text. A senior clinician at each site completed the survey. The survey asked questions about practices related to fetal growth restriction, decreased fetal movements, smoking cessation, intrapartum fetal monitoring, maternal sleep position and perinatal mortality audit. The objectives were to assess which elements of care were most valued; best practice frequency; and, barriers and enablers to implementation.Results227 hospitals were invited with 83 (37%) responding. All proposed elements were perceived as important. Hospitals were least likely to follow best practice recommendations “all the time” for smoking cessation support (<50%), risk assessment for fetal growth restriction (<40%) and advice on sleep position (<20%). Time constraints, absence of clear guidelines and lack of continuity of carer were recognised as barriers to implementation across care practices.ConclusionsAreas for practice improvement were evident. All elements of care were valued, with increasing awareness of safe sleeping position perceived as less important. There is strong support from maternity care providers across Australia for a bundle of care to reduce stillbirth.     

A pilot study combining Go4Life® materials with an interactive voice response system to promote physical activity in older women

ABSTRACT

Telephone-based interactive voice response (IVR) systems could be an effective tool for promotion of physical activity among older women. To test IVR feasibility, we enrolled 30 older women in a 10-week physical activity intervention designed around National Institute on Aging (NIA) Go4Life® educational materials with IVR coaching. Participants (mean age = 76 years) significantly increased physical activity by a mean 79 ± 116 (SD) minutes/week (p < .001). Participants reported that the Go4Life® materials, pedometer, and IVR coaching (70% reported easy technology) were useful tools for change. This pilot study demonstrates IVR acceptability as an evidence-based physical activity program for older women.     

Barriers to Optimal Care between Physicians and Lesbian,Gay, Bisexual,Transgender, and Questioning Adolescent Patients

The objective of this article was to identify barriers to optimal care between physicians and LGBTQ (lesbian, gay, bisexual, transgender, and questioning) adolescents. To this end, 464 anonymous, self-administered surveys were distributed in 2003 to residents and attending physicians in pediatrics, internal medicine, obstetrics-gynecology, psychiatry, emergency medicine, and family practice at Upstate Medical University. The survey included questions pertaining to practice, knowledge, and attitude pertaining to lesbian, gay, transgender, or questioning (LGBTQ) adolescents. One hundred eight four surveys were returned. The majority of physicians would not regularly discuss sexual orientation, sexual attraction, or gender identity while taking a sexual history from a sexually active adolescent. As well, the majority of physicians would not ask patients about sexual orientation if an adolescent presented with depression, suicidal thoughts, or had attempted suicide. If an adolescent stated that he or she was not sexually active, 41% of physicians reported that they would not ask additional sexual health-related questions. Only 57% agreed to an association between being a LGBTQ adolescent and suicide. The majority of physicians did not believe that they had all the skills they needed to address issues of sexual orientation with adolescents, and that sexual orientation should be addressed more often with these patients and in the course of training. This study concludes that barriers in providing optimal care for LGBTQ adolescents can be found with regard to practice, knowledge, and attitude regardless of medical field and other demographics collected. Opportunities exist to enhance care for LGBTQ adolescents.     

Queering Ethnicity in the First Gay Films From Ex-Yugoslavia

Between 2002 and 2005 four of the Yugoslav successor states produced major feature films with lesbian or gay protagonists: Maja Weiss's Guardian of the Frontier (Slovenia, 2002), Dalibor Matani?'s Fine Dead Girls (Croatia, 2002), Dragan Marinkovi?'s Take a Deep Breath (Serbia, 2004), and Ahmed Imamovi?'s Go West (Bosnia and Hercegovina, 2005). As with other films from Eastern Europe that portray queer characters, all of these films were shot by straight directors, and the queer characters are not representations of real local queer communities, but instead are used as metaphors to address topics the filmmakers find more important, such as ethnicity and national identity. The ethnic hatreds that fueled the wars of the 1990s were mobilized through the heterosexual matrix. In these films anxieties about ethnicity are worked out through plots involving queer sexuality, though they work differently for male and female couples: female bodies can be conventionally objectified by the heterosexual male gaze, while male couples become the focus for anxieties about male rape.