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Comacchio C, Antolini G, Ruggeri M, Colizzi M. Gender-Oriented Mental Health Prevention: A Reappraisal. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1493. [PMID: 35162515 PMCID: PMC8835536 DOI: 10.3390/ijerph19031493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 01/20/2022] [Accepted: 01/24/2022] [Indexed: 11/28/2022]
Abstract
Many studies have investigated the impact of gender on mental health, but only a few have addressed gender differences in mental health risk and prevention. We conducted a narrative review to assess the current state of knowledge on gender-specific mental health preventive interventions, along with an analysis of gender-based risk factors and available screening strategies. Out of 1598 articles screened using a comprehensive electronic search of the PubMed, Web-of-Science, Scopus, and Cochrane databases, 53 were included for review. Among risk factors for mental health problems, there are individual, familiar, social, and healthcare factors. Individual factors include childhood adversities, which show gender differences in distribution rates. However, current childhood abuse prevention programs are not gender-specific. Familiar factors for mental health problems include maternity issues and intimate partner violence, and for both, some gender-specific preventive interventions are available. Social risk factors for mental health problems are related to education, employment, discrimination, and relationships. They all display gender differences, but these differences are rarely taken into account in mental health prevention programs. Lastly, despite gender differences in mental health service use being widely known, mental health services appear to be slow in developing strategies that guarantee equal access to care for all individuals.
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Affiliation(s)
| | - Giulia Antolini
- Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Integrated University Hospital of Verona, 37126 Verona, Italy;
| | - Mirella Ruggeri
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy;
| | - Marco Colizzi
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy;
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, 33100 Udine, Italy
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
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Moncrieff G, Finlayson K, Cordey S, McCrimmon R, Harris C, Barreix M, Tunçalp Ö, Downe S. First and second trimester ultrasound in pregnancy: A systematic review and metasynthesis of the views and experiences of pregnant women, partners, and health workers. PLoS One 2021; 16:e0261096. [PMID: 34905561 PMCID: PMC8670688 DOI: 10.1371/journal.pone.0261096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 11/22/2021] [Indexed: 11/18/2022] Open
Abstract
Background The World Health Organization (WHO) recommends one ultrasound scan before 24 weeks gestation as part of routine antenatal care (WHO 2016). We explored influences on provision and uptake through views and experiences of pregnant women, partners, and health workers. Methods We undertook a systematic review (PROSPERO CRD42021230926). We derived summaries of findings and overarching themes using metasynthesis methods. We searched MEDLINE, CINAHL, PsycINFO, SocIndex, LILACS, and AIM (Nov 25th 2020) for qualitative studies reporting views and experiences of routine ultrasound provision to 24 weeks gestation, with no language or date restriction. After quality assessment, data were logged and analysed in Excel. We assessed confidence in the findings using Grade-CERQual. Findings From 7076 hits, we included 80 papers (1994–2020, 23 countries, 16 LICs/MICs, over 1500 participants). We identified 17 review findings, (moderate or high confidence: 14/17), and four themes: sociocultural influences and expectations; the power of visual technology; joy and devastation: consequences of ultrasound findings; the significance of relationship in the ultrasound encounter. Providing or receiving ultrasound was positive for most, reportedly increasing parental-fetal engagement. However, abnormal findings were often shocking. Some reported changing future reproductive decisions after equivocal results, even when the eventual diagnosis was positive. Attitudes and behaviours of sonographers influenced service user experience. Ultrasound providers expressed concern about making mistakes, recognising their need for education, training, and adequate time with women. Ultrasound sex determination influenced female feticide in some contexts, in others, termination was not socially acceptable. Overuse was noted to reduce clinical antenatal skills as well as the use and uptake of other forms of antenatal care. These factors influenced utility and equity of ultrasound in some settings. Conclusion Though antenatal ultrasound was largely seen as positive, long-term adverse psychological and reproductive consequences were reported for some. Gender inequity may be reinforced by female feticide following ultrasound in some contexts. Provider attitudes and behaviours, time to engage fully with service users, social norms, access to follow up, and the potential for overuse all need to be considered.
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Affiliation(s)
- Gill Moncrieff
- Research in Childbirth and Health Group, THRIVE Centre, University of Central Lancashire, Preston, United Kingdom
- * E-mail:
| | - Kenneth Finlayson
- Research in Childbirth and Health Group, THRIVE Centre, University of Central Lancashire, Preston, United Kingdom
| | - Sarah Cordey
- Research in Childbirth and Health Group, THRIVE Centre, University of Central Lancashire, Preston, United Kingdom
| | - Rebekah McCrimmon
- School of Health and Community Studies, University of Central Lancashire, Preston, United Kingdom
| | - Catherine Harris
- Applied Health Research Hub, University of Central Lancashire, Preston, United Kingdom
| | - Maria Barreix
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Özge Tunçalp
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Soo Downe
- Research in Childbirth and Health Group, THRIVE Centre, University of Central Lancashire, Preston, United Kingdom
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George J, Sharma V, Farooque K, Mittal S, Trikha V, Malhotra R. Injury Mechanisms of Hip Fractures in India. Hip Pelvis 2021; 33:62-70. [PMID: 34141692 PMCID: PMC8190498 DOI: 10.5371/hp.2021.33.2.62] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 12/04/2020] [Accepted: 12/16/2020] [Indexed: 01/16/2023] Open
Abstract
Purpose Hip fractures are a major cause of morbidity and mortality in the elderly; however, the current literature on the injury patterns of hip fractures in India is lacking. Understanding the injury profile of these patients is important to develop targeted interventions to prevent hip fractures. Materials and Methods This was a prospective study of all hip fracture patients aged 50 years or older admitted from February 2019 to December 2019. Details about the injury were recorded by an in-person interview. Multivariate logistic regression analysis was used to identify the factors associated with any particular injury mechanism. Results Two hundred and eighty-three hip fractures were included. The mechanism of injury for the majority of patients was a fall from a standing height (n=217, 76.7%) while 60 patients (21.2%) were injured as the result of a road traffic accident (RTA). Slipping on a wet floor (n=49, 22.6%) and change in posture (n=35, 16.1%) were the most commonly reported reasons for falling. Pedestrian injuries were the most common form of RTA (n=29, 48.3%). Increasing age (P<0.001) and female sex (P=0.001) were associated with fall as the mode of injury while sustaining another fracture in addition to hip fracture (P=0.032) was associated with RTA as the mode of injury. Conclusion A fall from standing height is the predominant mode of injury among elderly hip fractures especially among women. Environmental hazards and postural changes are responsible for the majority of falls while pedestrian accidents contribute to a majority of the RTAs.
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Affiliation(s)
- Jaiben George
- Department of Orthopedic Surgery, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Vijay Sharma
- Department of Orthopedic Surgery, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Kamran Farooque
- Department of Orthopedic Surgery, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Samarth Mittal
- Department of Orthopedic Surgery, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Vivek Trikha
- Department of Orthopedic Surgery, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Rajesh Malhotra
- Department of Orthopedic Surgery, All India Institute of Medical Sciences (AIIMS), New Delhi, India
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Roberts L, Renati S, Solomon S, Montgomery S. Women and Infertility in a Pronatalist Culture: Mental Health in the Slums of Mumbai. Int J Womens Health 2020; 12:993-1003. [PMID: 33192102 PMCID: PMC7654515 DOI: 10.2147/ijwh.s273149] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 10/12/2020] [Indexed: 01/07/2023] Open
Abstract
Background Infertility is a global problem, with high prevalence in India. As a pronatalist society, infertility is particularly problematic in India, causing stigma, shame, and blame especially for women. Infertility consequences for women include discrimination, social exclusion, and abandonment, putting them at high risk for mental health distress. Furthermore, mental health is highly stigmatized and specialized care is largely unavailable. Despite the cultural importance of childbearing, research on infertility distress and resulting mental health sequelae is lacking, particularly among low-income women. The purpose of this study is to assess mental health, using validated scales, among Mumbai slum-dwelling women with a history of infertility. Methods We conducted a mixed-method, cross-sectional study. A focus group discussion with community health workers (n = 7) informed the development of a comprehensive survey. The survey consisted of validated scales whenever possible, in addition to questions pertaining to women’s sociodemographic and reproductive history. After rigorous forward and back translation, the surveys were conducted as face-to-face structured interviews due to low literacy levels and the research naiveté of our respondents. Interviews were conducted by culturally, linguistically, gender-matched, trained research assistants. Results Mumbai slum-dwelling women of reproductive age suffering from infertility (N = 74) participated. Most (85%) women and their husbands (66%) reported previous infertility testing. Participants had elevated mental health distress (anxiety and depression symptomology) largely explained by general health, length of marriage, and coping strategy employed. Conclusion Women facing the double stigma of mental health and infertility need innovative programs to address their challenges.
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Affiliation(s)
- Lisa Roberts
- School of Nursing, Loma Linda University, Loma Linda, CA 92350, USA
| | - Solomon Renati
- Department of Psychology, Veer Wajekar A. S. & C. College, Navi Mumbai 400702, India
| | | | - Susanne Montgomery
- School of Behavioral Health, Behavioral Health Institute, Loma Linda University, Loma Linda, CA 92350, USA
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Ateriya N, Saraf A, Kanchan T, Meshram VP, Singh Shekhawat R, Setia P. Filicide-suicide: An unusual variant of dyadic death. Med Leg J 2019; 87:44-46. [PMID: 29992855 DOI: 10.1177/0025817218787392] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Dyadic suicides may be committed simultaneously or one after another by two or more people who may or may not have made a prior pact. The perpetrator is usually male and their victims female, and generally their intimate partners, with children less commonly involved. Another distinct type of homicide-suicide is the killing of children by a parent (filicide-suicide). The terms 'maternal filicide' or 'paternal filicide' are used respectively when the perpetrator is the mother or the father of the victim. We report a rare case of maternal filicide, where the mother drowned her three children and then herself in the same water tank. The case highlights the extreme stress put on a mother of girls in a patriarchal society where there is an overriding expectation and wish for sons. The resulting pressure on this mother for her 'failure' caused her to take her own and her children's lives.
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Affiliation(s)
- Navneet Ateriya
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Jodhpur, India
| | - Ashish Saraf
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Jodhpur, India
| | - Tanuj Kanchan
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Jodhpur, India
| | - Vikas P Meshram
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Jodhpur, India
| | | | - Puneet Setia
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Jodhpur, India
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Nahata L. The Gender Reveal: Implications of a Cultural Tradition for Pediatric Health. Pediatrics 2017; 140:peds.2017-1834. [PMID: 29175971 DOI: 10.1542/peds.2017-1834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/11/2017] [Indexed: 11/24/2022] Open
Affiliation(s)
- Leena Nahata
- Division of Endocrinology, Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio and Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
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Roberts L, Montgomery S, Ganesh G, Kaur HP, Singh R. Addressing Stillbirth in India Must Include Men. Issues Ment Health Nurs 2017; 38:590-599. [PMID: 28350492 DOI: 10.1080/01612840.2017.1294220] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Millennium Development Goal 4, to reduce child mortality, can only be achieved by reducing stillbirths globally. A confluence of medical and sociocultural factors contribute to the high stillbirth rates in India. The psychosocial aftermath of stillbirth is a well-documented public health problem, though less is known of the experience for men, particularly outside of the Western context. Therefore, men's perceptions and knowledge regarding reproductive health, as well as maternal-child health are important. METHODS Key informant interviews (n = 5) were analyzed and 28 structured interviews were conducted using a survey based on qualitative themes. RESULTS Qualitative themes included men's dual burden and right to medical and reproductive decision making power. Wives were discouraged from expressing grief and pushed to conceive again. If not successful, particularly if a son was not conceived, a second wife was considered a solution. Quantitative data revealed that men with a history of stillbirths had greater anxiety and depression, perceived less social support, but had more egalitarian views towards women than men without stillbirth experience. At the same time fathers of stillbirths were more likely to be emotionally or physically abusive. Predictors of mental health, attitudes towards women, and perceived support are discussed. CONCLUSIONS Patriarchal societal values, son preference, deficient women's autonomy, and sex-selective abortion perpetuate the risk for future poor infant outcomes, including stillbirth, and compounds the already higher risk of stillbirth for males. Grief interventions should explore and take into account men's perceptions, attitudes, and behaviors towards reproductive decision making.
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Affiliation(s)
- Lisa Roberts
- a School of Nursing, Loma Linda University , Loma Linda , California , USA
| | - Susanne Montgomery
- b School of Behavioral Health, Behavioral Health Institute, Loma Linda University , Loma Linda , California , USA
| | - Gayatri Ganesh
- c Christian Hospital Mungeli , Mungeli , Chhattisgarh , India
| | - Harinder Pal Kaur
- d Summer Institute Intern, School of Behavioral Health, Loma Linda University , Loma Linda , California , USA
| | - Ratan Singh
- c Christian Hospital Mungeli , Mungeli , Chhattisgarh , India
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