This paper contributes to a nascent scholarly discussion of sex and gender as determinants of health. Health is a composite of biological makeup and socioeconomic circumstances. Differences in health and illness patterns of men and women are attributable both to sex, or biology, and to gender, that is, social factors such as powerlessness, access to resources, and constrained roles. Using examples such as the greater life expectancy of women in most of the world, despite their relative social disadvantage, and the disproportionate risk of myocardial infarction amongst men, but death from MI amongst women, the independent and combined associations of sex and gender on health are explored. A model for incorporating gender into epidemiologic analyses is proposed.

ObjectivesTo examine whether the association between emotional support and indicators of health and quality of life differs between Canadian and Latin American older adults.DesignCross-sectional analysis of the International Mobility in Aging Study (IMIAS). Social support from friends, family members, children and partner was measured with a previously validated social network and support scale (IMIAS-SNSS). Low social support was defined as ranking in the lowest site-specific quartile. Prevalence ratios (PR) of good health, depression and good quality of life were estimated with Poisson regression models, adjusting for age, gender, education, income and disability in activities of daily living.SettingKingston and Saint-Hyacinthe in Canada, Manizales in Colombia and Natal in Brazil.Participants1600 community-dwelling adults aged 65–74 years, n=400 at each site.Outcome measuresLikert scale question on self-rated health, Center for Epidemiological Studies Depression Scale and 10-point analogical quality-of-life (QoL) scale.ResultsRelationships between social support and study outcomes differed between Canadian and Latin American older adults. Among Canadians, those without a partner had a lower prevalence of good health (PR=0.90; 95% CI 0.82 to 0.98), and those with high support from friends had a higher prevalence of good health (PR=1.09; 95% CI 1.01 to 1.18). Among Latin Americans, depression was lower among those with high levels of support from family (PR=0.63; 95% CI 0.48 to 0.83), children (PR=0.60; 95% CI 0.45 to 0.80) and partner (PR=0.57; 95% CI 0.31 to 0.77); good QoL was associated with high levels of support from children (PR=1.54; 95% CI 1.20 to 1.99) and partner (PR=1.31; 95% CI 1.03 to 1.67).ConclusionsAmong older adults, different sources of support were relevant to health across societies. Support from friends and having a partner were related to good health in Canada, whereas in Latin America, support from family, children and partner were associated with less depression and better QoL.

Background: The nurse-doctor relationship is historically one of female nurse deference to male physician authority. We investigated the effects of physicians' sex on female nurses' behaviour.

Sexual harassment of female doctors appears to occur frequently, and it is therefore an important topic to address in medical school and professional development.

Background: This study explores the associations between individual characteristics such as income and education with health behaviours and utilization of preventive screening.

The present study investigated the levels of phthalate esters in a total of 86 human milk samples collected among 21 breast-feeding mothers over a 6-month postpartum time. Di(2-ethylhexyl) phthalate (DEHP) was the predominant ester with the arithmetic mean value of 222 ng g(-1) (range: 156-398 ng g(-1), 95% confidence limit), followed by dibutyl phthalate (DBP), 0.87 (range: 0.62-1.2) ng g(-1). Diethyl phthalate (DEP), with a mean of 0.31 ng g(-1), was detected in only a small number of samples. Weak correlations between lipid content and levels of phthalate esters were observed. The levels of phthalate esters in human milk fluctuated over the 6-month period; this may indicate a need for multiple sample collection, to calculate average concentrations over the feeding period. Multiple sample collection would provide a better estimate of the exposure of breast-fed infants to phthalate in human milk. For infants relying on breast-feeding, the mean daily intake over the first 6-month period considering a 7 kg infant consuming 750 g of milk was estimated at 167 microg d(-1) for DEHP and less than 1 microg d(-1) for DBP and DEP. While the nutritional and social benefits of breast-feeding are well established, the potential transfer of phthalate esters from mothers to breast-fed infants should also be recognized.

When teaching contradicts institutional or learners' values, or is particularly inspiring, students notice and may be influenced to the extent that they rethink personal beliefs and plans to fit their future doctor selves to these models.

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