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Pride, prejudice, and paediatrics (women paediatricians in England before 1950).

ABSTRACT: Within the literature of the Enlightenment there are voices that called for the emancipation of women, and so began a--still unfinished--struggle for equality at home and in society. The campaign for women to enter the professions started in the 19th century. Women who wished to qualify and work as doctors faced what must have seemed to those of lesser courage and ability, to be insurmountable resistance. The early women doctors of the 19th century who were forced to obtain their training on the continent--in Zurich, Bern, and Paris--were part of a political movement and transatlantic network concerned with issues of women's rights, universal suffrage, women's health and public health measures. These women who "stormed the citadel" wanted to, and did, change society as well as medicine. Opposition to women's entry into medicine was led by doctors who defended the male monopoly against the threat to their prestige and purse. They argued that a woman's place was in the home as a wife and mother. Women's bodies, intellect, and temperament were not up to the demands of studying medicine, let alone practising as doctors. These arguments did not stop, but echoed down the 20th century long after women had gained the right to qualify in medicine.

SUBMITTER: Stevens D

PROVIDER: S-EPMC2066019 | biostudies-literature | 2006 Oct

REPOSITORIES: biostudies-literature

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Pride, prejudice, and paediatrics (women paediatricians in England before 1950).

Stevens D D

Archives of disease in childhood 20060803 10

Within the literature of the Enlightenment there are voices that called for the emancipation of women, and so began a--still unfinished--struggle for equality at home and in society. The campaign for women to enter the professions started in the 19th century. Women who wished to qualify and work as doctors faced what must have seemed to those of lesser courage and ability, to be insurmountable resistance. The early women doctors of the 19th century who were forced to obtain their training on the ...[more]

PMID: 16887858

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Project description:Scotland has disproportionately high rates of suicide compared with England. An analysis of trends may help reveal whether rates appear driven more by birth cohort, period or age. A 'birth cohort effect' for England & Wales has been previously reported by Gunnell et al. (B J Psych 182:164-70, 2003). This study replicates this analysis for Scotland, makes comparisons between the countries, and provides information on 'vulnerable' cohorts.Suicide and corresponding general population data were obtained from the National Records of Scotland, 1950 to 2014. Age and gender specific mortality rates were estimated. Age, period and cohort patterns were explored graphically by trend analysis.A pattern was found whereby successive male birth cohorts born after 1940 experienced higher suicide rates, in increasingly younger age groups, echoing findings reported for England & Wales. Young men (aged 20-39) were found to have a marked and statistically significant increase in suicide between those in the 1960 and 1965 birth cohorts. The 1965 cohort peaked in suicide rate aged 35-39, and the subsequent 1970 cohort peaked even younger, aged 25-29; it is possible that these 1965 and 1970 cohorts are at greater mass vulnerability to suicide than earlier cohorts. This was reflected in data for England & Wales, but to a lesser extent. Suicide rates associated with male birth cohorts subsequent to 1975 were less severe, and not statistically significantly different from earlier cohorts, suggestive of an amelioration of any possible influential 'cohort' effect. Scottish female suicide rates for all age groups converged and stabilised over time. Women have not been as affected as men, with less variation in patterns by different birth cohorts and with a much less convincing corresponding pattern suggestive of a 'cohort' effect.Trend analysis is useful in identifying 'vulnerable' cohorts, providing opportunities to develop suicide prevention strategies addressing these cohorts as they age.

Project description:BackgroundWe conducted a systematic review of incidence rates in England over a sixty-year period to determine the extent to which rates varied along accepted (age, sex) and less-accepted epidemiological gradients (ethnicity, migration and place of birth and upbringing, time).ObjectivesTo determine variation in incidence of several psychotic disorders as above.Data sourcesPublished and grey literature searches (MEDLINE, PSycINFO, EMBASE, CINAHL, ASSIA, HMIC), and identification of unpublished data through bibliographic searches and author communication.Study eligibility criteriaPublished 1950-2009; conducted wholly or partially in England; original data on incidence of non-organic adult-onset psychosis or one or more factor(s) pertaining to incidence.ParticipantsPeople, 16-64 years, with first -onset psychosis, including non-affective psychoses, schizophrenia, bipolar disorder, psychotic depression and substance-induced psychosis.Study appraisal and synthesis methodsTitle, abstract and full-text review by two independent raters to identify suitable citations. Data were extracted to a standardized extraction form. Descriptive appraisals of variation in rates, including tables and forest plots, and where suitable, random-effects meta-analyses and meta-regressions to test specific hypotheses; rate heterogeneity was assessed by the I²-statistic.Results83 citations met inclusion. Pooled incidence of all psychoses (N?=?9) was 31.7 per 100,000 person-years (95%CI: 24.6-40.9), 23.2 (95%CI: 18.3-29.5) for non-affective psychoses (N?=?8), 15.2 (95%CI: 11.9-19.5) for schizophrenia (N?=?15) and 12.4 (95%CI: 9.0-17.1) for affective psychoses (N?=?7). This masked rate heterogeneity (I²: 0.54-0.97), possibly explained by socio-environmental factors; our review confirmed (via meta-regression) the typical age-sex interaction in psychosis risk, including secondary peak onset in women after 45 years. Rates of most disorders were elevated in several ethnic minority groups compared with the white (British) population. For example, for schizophrenia: black Caribbean (pooled RR: 5.6; 95%CI: 3.4-9.2; N?=?5), black African (pooled RR: 4.7; 95%CI: 3.3-6.8; N?=?5) and South Asian groups in England (pooled RR: 2.4; 95%CI: 1.3-4.5; N?=?3). We found no evidence to support an overall change in the incidence of psychotic disorder over time, though diagnostic shifts (away from schizophrenia) were reported.LimitationsIncidence studies were predominantly cross-sectional, limiting causal inference. Heterogeneity, while evidencing important variation, suggested pooled estimates require interpretation alongside our descriptive systematic results.Conclusions and implications of key findingsIncidence of psychotic disorders varied markedly by age, sex, place and migration status/ethnicity. Stable incidence over time, together with a robust socio-environmental epidemiology, provides a platform for developing prediction models for health service planning.

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Pride, prejudice, and paediatrics (women paediatricians in England before 1950).

Publications

Pride, prejudice, and paediatrics (women paediatricians in England before 1950).

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