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Abstract Patients hospitalized for psychiatric reasons exhibit significantly elevated risk of suicide, yet the research literature contains very few outcome studies of interventions designed for suicidal inpatients. This pilot study examined the inpatient feasibility and effectiveness of The Collaborative Assessment and Management of Suicidality CAMS , a structured evidence-based method for risk assessment and treatment planning Jobes, The study used an open-trial, case-focused design to assess an inpatient adaptation of CAMS, spread over a period averaging 51 days. The intervention was provided via individual therapy to a convenience sample of 20 patients 16 females and four males, average age

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This article has been cited by other articles in PMC. However, our experiment demonstrates that gender-related social factors also matter, even for biological measures. Gender socialization may affect testosterone by encouraging men but not women toward behaviors that increase testosterone.

This shows that research on human sex biology needs to account for gender socialization and that nurture, as well as nature, is salient to hormone physiology.

Keywords: testosterone, gender, socialization, competition, sex Abstract Testosterone is typically understood to contribute to maleness and masculinity, although it also responds to behaviors such as competition. Competition is crucial to evolution and may increase testosterone but also is selectively discouraged for women and encouraged for men via gender norms. Using a novel experimental design, participants trained actors performed a specific type of competition wielding power in stereotypically masculine vs.

We hypothesized in H1 stereotyped behavior that wielding power increases testosterone regardless of how it is performed, vs. H2 stereotyped performance , that wielding power performed in masculine but not feminine ways increases testosterone. We found that wielding power increased testosterone in women compared with a control, regardless of whether it was performed in gender-stereotyped masculine or feminine ways.

Results supported H1 over H2: stereotyped behavior but not performance modulated testosterone. These results also supported theory that competition modulates testosterone over masculinity. Not surprisingly, then, research on testosterone in humans mainly focuses on men, with some notable exceptions e. Women, however, also have naturally occurring testosterone, and testosterone sometimes functions via conversion to estradiol 4.

Although testosterone exists and functions similarly in women and men, men have markedly higher average testosterone than women. This difference in testosterone is widely presumed to be a sex difference, that is, one that reflects maleness and femaleness caused by innate and evolved influences 3. Together, this leads to characterizations of testosterone as the essence of maleness, fixed and unchanging, and determined by only innate factors 3 , 5.

This occurs despite growing understandings of biology that emphasize plasticity and social modulation for example in the brain, immune system, and genetics. The view of testosterone as fixed and innate is empirically dubious, given a surprisingly large and underexplored nongenetic influence 6. This nongenetic influence includes meaningful and predictable variation from factors such as seasonal or diurnal rhythms 6.

In addition, there are profound social influences on testosterone that are sometimes more clear than the more widely studied effects of hormones on behavior 7 — 9.

Gender-related sociocultural experiences related to femininity sociocultural habits and norms tied to women and girls, usually promoting communality and nurturance 10 and masculinity sociocultural habits and norms tied to men and boys, usually promoting agency and competition 10 may affect physiological parameters such as testosterone.

This could occur in ways similar to how social experiences related to poverty or harsh parenting exert profound neurobiological effects 11 , Testosterone responds to social phenomena that are evolutionarily salient, but not all social phenomena have been evolutionarily selected to modulate testosterone or do so in the same ways.

Theory predicts that, for testosterone, one evolutionarily salient social context is competition 3. Competition drives evolution; its outcomes influence key indicators of evolutionary fitness such as survival and reproduction Competition involves attempts to acquire or defend real or perceived resources such as status, territory, partners, and, especially relevant to this article, power Research demonstrates in nonhuman animals that competition can experimentally increase testosterone, including most notably in males of various bird species 15 but also in others.

For example, male California mice who win competitions show increased testosterone Like humans, male cichlid fish who watch each other fight show increased testosterone Thus, evidence suggests that power, like competition, may increase testosterone. In humans, competition can increase testosterone, but competition and wielding power are also subject to social forces: Western gender norms promote wielding power for men and discourage it for women 10 , In addition, conceptualizations of masculinity tend to overlap with those of power and testosterone 3 , These gender considerations might influence how women and men engage in behaviors in ways that matter for testosterone.

When men engage in more frequent competition than women do, or in ways that accord more with masculinity norms, this may have implications for testosterone. If men, more than women, are socialized to engage in competitive behaviors such as wielding power that increase testosterone, then this may partially explain why men have higher testosterone than women. Clearly, testosterone responds to social context, but huge gaps remain in understanding how neuroendocrine plasticity is shaped by social norms, especially those related to gender.

There may be more than one pathway from gender to testosterone because gender is multifaceted and includes behavior, stereotypes, roles, identity, and so on. In this experiment, we tested two potential pathways from gender to testosterone using power as a specific example of competition Fig.

In both pathways, we hypothesize that gender can influence testosterone.

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Genotypic drug resistance testing could facilitate the choice of initial ART in areas with rising transmitted drug resistance TDR and enable care-providers to determine which individuals with virological failure VF on a first- or second-line ART regimen require a change in treatment. An inexpensive near point-of-care POC genotypic resistance test would be useful in settings where the resources, capacity, and infrastructure to perform standard genotypic drug resistance testing are limited. A POC genotypic resistance test is likely to involve the use of allele-specific point mutation assays for detecting drug-resistance mutations DRMs. One or more of these six DRMs was present in As the number of individuals with ADR has increased so has the proportion of newly infected individuals with TDR [ 7 , 14 — 16 ].

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Advocates of public reporting tend to support mandatory reporting, recognizing that under a voluntary public reporting system, poor performers will likely opt out. Evidence gives credence to this concern McCormick et al. In contrast, private reporting, for example sponsored by provider professional associations, which is motivated by interest in supporting internal quality improvement efforts, is workable within a voluntary context. The decision about voluntary vs.

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Integrating cervical cancer screening with HIV care in a district hospital in Abuja, Nigeria

S Tarka Street Abuja, Nigeria. E-mail: moc. This article has been cited by other articles in PMC. Materials and Methods: A cross-sectional study analysed routine service data collected at the antiretroviral therapy ART and cervical cancer screening services. Our program integrated screening for cervical cancer using VIA technique to HIV care and treatment services through a combination of stakeholder engagement, capacity building for health workers, creating a bi-directional referral between HIV and reproductive health RH services and provider initiated counselling and screening for cervical cancer. Logistic regression model was used to estimate factors that influence VIA results.

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Effects of gendered behavior on testosterone in women and men

Question 1. Research question Did the authors describe their goal in conducting this research? Is it easy to understand what they were looking to find? This issue is important for any scientific paper of any type. Higher quality scientific research explicitly defines a research question. Questions 2 and 3.

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