Bleeding with menopausal hormone therapy: physiological or pathological?

Abnormal bleeding is a common reason for discontinuation of hormone replacement therapy. There is little consensus regarding when to investigate abnormal bleeding, what to do about persistent bleeding or when reinvestigation is indicated. Transvaginal ultrasound, endometrial biopsy and hysteroscopy are discussed. The mechanisms of this bleeding are poorly understood and do not correlate well with endometrial histology or the type or dose of hormone therapy used. Endometrial bleeding requires breakdown of endometrial vessels and their overlying epithelium. Endometrial vascular breakdown appears to be largely locally regulated. Potential mechanisms involved in endometrial bleeding include: changes in the ratio of vascular endothelial growth factor (pro-angiogenic) to thrombospondin-1 (anti-angiogenic); alterations in matrix metalloproteinases and their tissue inhibitors; changes in endometrial haemostasis due to tissue factor; and increased endometrial leucocytes.     

Social Work Practice in Higher Education

This article examines two cases of social work practice in higher education within the context of identifying a model of social practice for use in postsecondary educational settings. The case studies provide insight into a model of social work practice that reflects both the traditional clinical model, which focuses on individual change, and the school-community-pupil relations model, which focuses on system change. The author also discusses implications for social work educators who see college/university counseling centers as an arena for social work practice.     

Step Up Love Story: Futari Etchi. By Katsu Aki

REPRODUCTIVE ETHICS. Michael D. Bayles. Englewood Cliffs, NJ: Prentice‐Hall, 1984; 141 pages; $10.95.

EXPLORING GENDER RELATIONS: A CANADIAN PERSPECTIVE. Marlene Mackie. Toronto: Butterworths, 1983; 358 pages; $17.95 (pa.).

SARAH: A SEXUAL BIOGRAPHY. Paul R. Abramson. Albany, NY: State University of New York Press, 1984; 142 pages; $9.95 (pa.); $29.50 (cl.).

SENSUOUS SPACES: DESIGNING YOUR EROTIC INTERIORS. Sivon Reznikoff. New York: Whitney Library of Design, Watson‐Guptill Publications, 1983; 204 pages; $32.50.

SEXUALLY TRANSMITTED DISEASES: AN ANNOTATED, SELECTIVE BIBLIOGRAPHY. Stephen Margolis. New York: Garland, 1985; 176 pages; $23.00.

WOMEN AND DEVIANCE: ISSUES IN SOCIAL CONFLICT AND CHANGE; AN ANNOTATED BIBLIOGRAPHY. Nanette J. Davis and Jone M. Keith. New York: Garland, 1984; 236 pages; $35.00     

Writing diversity: Ethnicity and race in Australian Social Work, 1947-1997

Abstract

In 1997, Australian Social Work celebrated 50 years of publication. This paper provides a content and discourse analysis of 50 years of articles on Indigenous and immigrant Australians in the journal and its predecessors. The analysis critically evaluates the published accounts of cross-cultural social work research, policy and practice and identifies the meanings these articles convey of race and ethnicity in Australian professional identity and practice. The analysis found little published analysis of social work practice with Indigenous Australians and that articles written about Indigenous Australians are either more negative or more positive than the generally approving tone of articles about immigrants. Only one or two articles in either category proposed a structural or community development approach to practice.

An early draft of this paper was given at the AASWWE Conference, Cairns, 1998.     

Disability stigmatization as a barrier to employment equity for legally-blind Canadians

Canada has expressed a strong commitment to the rights of its citizens against discrimination, including those with disabilities. A question remains whether Canadians with disabilities are able to practice these rights. Our mixed-methods study sheds light on the situation of one important sub-group of people with disabilities – those who are legally blind. Our survey results show that the labour-force participation rate for this population is very low compared with those without disabilities, and also lower than the rate for persons with other disabilities. Legally-blind working-age Canadians have significantly higher rates of unemployment and underemployment, and perceive major barriers to employment. In-person interviews reveal the negative impact of one major barrier – disability stigmatization – on accessing meaningful employment and other societal assets. We discuss the implications of these findings and suggest policy directions.     

Factors Associated with Suicidal Ideation Among Women Abused in Intimate Partner Relationships

This study examines factors associated with suicidal ideation among women abused in intimate partner relationships. Data were collected from the case records of 95 women screened upon in‐person contact with admissions workers in a domestic violence shelter in one Midwestern state. Forty‐three percent of the women reported suicidal ideation as significantly associated with childhood sexual abuse, childhood physical abuse, and adulthood intimate partner abuse lasting fewer than 12 months in duration. The results have policy and practice implications for those interested in the mental health needs of women abused in childhood and adulthood. Implications for research are presented that more precisely identify how the effects of past and current traumatic experiences intersect and contribute to suicidal ideation among women abused in intimate relationships.     

Abstracts of theses: July, 1952 Smith college School for social work

Abstract

This article examines models of addiction and heroin treatment outcomes as well as the history of xenophobia, racial scapegoating, and misinformation in the promotion of narcotics prohibition in the United States. The moral model of addiction holds that punishment of the addict will be effective deterrence, yet punishment has not prevented heroin use, and narcotics control costs continue to spiral. The medical model of addiction, the dominant philosophical underpinning for current treatment methods, is shown to lack scientific corrobora‐tion and therefore to be inappropriate as a basis for policy on heroin use and inadequate to govern options in heroin addiction treatment. The discouraging outcomes of all modes of heroin addiction treatment indicate that treatment will not end the demand for the drug. Gradual legalization of heroin, while instituting formal and informal social structures geared to controlled use, is recommended.