GENDER ISSUES IN PSYCHOSOCIAL MORBIDITY IN GENERAL PRACTICE

The objective of this study was to compare differences in reasons for encounters, diagnosis and treatment between men and women patients presenting with psychosocial problems as recognised by their general practitioners. The research design was a survey based on structured questionnaires completed by the general practitioners on patients consulting with mental health problems in Bunbury in the rural South West region of Western Australia. The data collection took place for a period of 5 weeks. Twenty two general practitioners, from 5 surgeries, collected information on 428 patients, pertaining to socio-demographic characteristics, reasons for encounter, diagnoses, social problems, chronicity, counselling, medication and use of referral services. The gender differences in the illness profile was quite pronounced. Men patients were older, were more likely to be diagnosed with psychosis or character disorders, to have employment or unknown problems. On the other hand, female patients were younger and more likely not to be given a definite diagnosis, to report more social isolation, dependent/difficult relatives and problems resulting from assault. Men were more likely to be on medication and to be referred to psychiatrists, while women received more counselling from their GPs or were referred to counselling services. On the basis of the findings, it is pointed out that men and women differ in terms of the recognition that they are suffering from a problem, that outside help is needed and making the decision to consult. They also differ in terms of the social factors influencing gender differences in recognition of the illness by the GP and the decision to treat and/or refer.     

Anticipation of retirement among baby boomers

A total of 32 interviews were conducted with women in academia who were born between 1946 and 1964. Twenty-one of these interviews were completed with academic women in the United States. and eleven with academic women in New Zealand. The data were analyzed to determine what these "baby boomers" anticipate for their retirement as well as their concerns about facing retirement. Cohort and cross-cultural comparisons were made. The authors identified common themes in the interviews. These included rejection of the traditional definition of retirement, anticipated age at retirement determined by personal needs rather than age-graded societal norms, retirement projected to be an active period involving a mix of work and leisure activities, and major concerns, about health and health care, the availability of entitlements and finances. The findings from this study indicate baby boomers are forging a new path for retirement. Further research investigating the transition for women of the baby boom generation from worker to retiree may open windows into the future of retirement for women.     

Condom use,frequency of sex,and number of partners: Multidimensional characterization of adolescent sexual risk‐taking

Sexual health research often relies on single risk indicators. However, multi‐variable composites may better capture the underlying construct of risk‐taking. Latent Profile Analysis identified subgroups based on condom use consistency, partner numbers, and sex frequency among 605 adolescents. Three profiles were identified for each of grades 8 to 10 (Condom Users, Few Partners, and Risk‐Takers) and 4 in grades 11 and 12 (Condom Users, One Partner, Two Partners, and Risk‐Takers). Inconsistent condom use groups reported more non‐condom (and often less effective) birth control use and STD and pregnancy histories. Females had greater representation in the Few Partners, One Partners, and Two Partners groups, which also contained increasing proportions of participants in each subsequent year. Males had greater representation in the Risk‐Takers group. A profile approach to measurement has methodological advantages, can add to substantive knowledge, and can inform content, timing, and targets of sexual health interventions.     

Race, punishment, and the Michael Vick experience

Objective. The relationship between race and crime has been contentious, focusing primarily on offending and incarceration patterns among minorities. There has been some limited work on public perceptions of criminal punishment, and findings show that while minorities believe in the role and rule of law, they simultaneously perceive the justice system as acting in a biased and/or unfair manner. Two limitations have stalled this literature. First, research has focused mainly on criminal punishments to the neglect of noncriminal punishments. Second, most studies have not examined whether race remains salient after considering other demographic variables or discrimination and legitimacy attitudes.Methods. Using data from 400 adults, we examine how race affects perceptions of criminal punishment and subsequent reinstatement into the National Football League in the case of Michael Vick, a star professional quarterback who pled guilty to charges of operating an illegal dog-fighting ring.Results. Findings show that whites are more likely to view Vick's punishment as too soft and that he should not be reinstated, while nonwhites had the opposite views. Race remained significant after controlling for other variables believed to be related to punishment perceptions.Conclusion. Attitudes toward both criminal punishment and NFL reinstatement vary across race such that there exists important divides in how individuals perceive the system meting out punishment and subsequently reintegrating offenders back into society. These results underscore that white and nonwhites perceive the law and its administration differently.     

Nucleic acid amplification testing in suspected child sexual abuse

The American Academy of Pediatrics recommends that site-specific cultures be obtained, when indicated, for sexually victimized children. Nucleic acid amplification testing is a highly sensitive and specific methodology for identifying sexually transmitted infections. Nucleic acid amplification tests are also less invasive than culture, and this may provide an efficacious alternative for children suspected of being sexually abused.     

Probation Training: Evidence from Newly Qualified Officers

The Diploma in Probation Studies replaced the Diploma in Social Work as the qualification for probation officers in England and Wales in 1997. It had a controversial beginning, coming as it did after a lengthy struggle involving practitioners, employers and academics, who united in their opposition to the removal of probation from social work training. The fear was that the proposed new training would be too rigid, too functionalist, and too narrow in its focus to produce critical thinkers who would engage in thoughtful and anti‐oppressive probation practice. This paper reports a small qualitative study into the views of a group of 15 newly qualified probation officers from the first three cohorts to qualify about their experiences of this form of training. It finds that they felt they had a very heavy workload, with pressure points at certain times, and would have welcomed the work being more evenly spread. Some respondents struggled with what they saw as the very different requirements of academic work and the NVQ, but most felt that on this programme the NVQ had helped them to become reflective about their practice. They are positive about being well equipped for their jobs in today's probation service, but would welcome more support in their first period of practice after qualifying, to facilitate the continued development of their learning.     

A Portrait of America’s Children: The Impact of Poverty and a Call to Action

The responsibility for children's services is disseminated between a multitude of advocacy organizations, social service agencies, and numerous departments within our government. A lack of conceptual integration and fiscal commitment is evident at the federal, state, and local levels. The examination of poverty and children's lack of economic security, inadequate medical care, homelessness, and nutrition inadequacies reveals a portrait of America's children that is both unsettling and alarming. The paper concludes with a call for action and the commitment that will be required to rectify this problem.     

Book reviews

Krafft‐ebing: a reconsideration

Step Children of Nature: Krafft‐Ebing, Psychiatry, and the Making of Sexual Identity. By Harry Oosterhuis. Chicago: University of Chicago Press, 2000, 321 pages. Cloth, $30.00.

Love american style

Love and Eroticism. Edited by Mike Featherstone. London: 1999, 425 pages. Paper, $24.95.

Doing the right thing: Three new books on the importance of sex

Male, Female: The Evolution of Human Sex Differences. By David C. Geary. Washington, DC: American Psychological Association, 1998, 410 pages. Cloth, $49.95. Why Sex Matters. By Bobbi Low. Princeton, NJ: Princeton University Press, 1999, 328 pages. Cloth, $29.95. Sex Differences: Developmental and Evolutionary Strategies. By Linda Mealey. San Diego, CA: Academic Press, 2000, 492 pages. Cloth, $79.95.

Courageous, compassionate, and scholarly: An evolutionary analysis of rape and male sexual coercion

A Natural History of Rape: Biological Bases of Sexual Coercion. By Randy Thornhill and Craig T. Palmer. Cambridge, MA: The MIT Press, 2000, 251 pages. Cloth, $28.95.

Deconstructing the discourse of sexual dimorphism: rethinking, bending, and crossing sexual boundaries

Sexing the Body: Gender Politics and the Construction of Sexuality. By Anne Fausto‐Sterling. New York: Basic Books, 2000, 473 pages. Cloth, $35.00.     

Multiple Segment Factorial Vignette Designs

The multiple segment factorial vignette design (MSFV) combines elements of experimental designs and probability sampling with the inductive, exploratory approach of qualitative research. MSFVs allow researchers to investigate topics that may be hard to study because of ethical or logistical concerns. Participants are presented with short stories about hypothetical characters. These stories comprise 2 – 5 segments in which randomly assigned dimensions are introduced sequentially. Researchers control the occurrence and timing of when dimensions are presented. Respondents are asked questions after each segment. MSFVs may include written, oral, and visual stimuli. These efficient designs elicit quantitative data about causal relations and qualitative data within complex, multidimensional contexts. We discuss how to develop MSFV and suggest ways to avoid problems.