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Cheryl Hetherington (1991) proposed that sexual minority (LGBQ) college students’ sexual identity development conflicts with their career development, creating a “bottleneck” of limited time and psychological energy to contribute to both processes (which may be referred to as the bottleneck hypothesis). A small body of literature has supported this hypothesis but given both methodological limitations in the prior research and societal shifts regarding sexual minority individuals, a reexamination is warranted. This study used a social cognitive career theory framework to investigate whether sexual minority college students have greater difficulties in the career exploration and decision-making process than heterosexual students and whether indicators of both psychological and social aspects of sexual identity development explain unique variance in several career decision-making outcomes. The sample consisted of N = 512 undergraduate students who completed an online survey (n = 225 sexual minority and n = 287 heterosexual). Results showed no significant differences in the mean scores of the two groups on career decision-making process and outcome variables, such as career decision-making anxiety and level of career decidedness. The same sets of social cognitive predictors also accounted for significant variance in career-related exploratory goals, career decision-making anxiety, and career decidedness in both groups of students. One group-specific difference was, however, observed at the level of individual social cognitive predictors: the presence of social support for career decision-making uniquely predicted exploratory goals in the heterosexual sample but not in the sexual minority sample. In addition, a few indicators of sexual identity development explained unique variance in the career exploration and decisional outcomes beyond the social cognitive predictors. Notably, sexual minority students reporting higher levels of identity concealment held relatively fewer career-related exploratory goals. The study’s implications for Hetherington’s (1991) hypothesis of a bottleneck effect and for future research on sexual minority students’ career exploration and decision-making are discussed.

Background: women who gain too much weight in pregnancy are at increased risk of disease and of having children with increased risk. Interventions to improve health behaviours are usually designed for a general population of pregnant women, and trial outcomes show an average impact that does not represent the differences between individuals. To inform the development of future interventions, this study explored the factors that influenced women’s diet and physical activity during pregnancy and aimed to identify the needs of these women with regards to lifestyle support.Methods: women who completed a trial of vitamin D supplementation and nurse support in pregnancy were invited to take part in an interview. Seventeen women were interviewed about their lifestyles during pregnancy, the support they had, and the support they wanted. Interview transcripts were coded thematically and analysed to understand the factors that influenced the diets and physical activity levels of these women and their engagement with resources that could provide support.Results: women identified barriers to eating well or being physically active, and pregnancy-specific issues like nausea and pain were common. Women’s interest in maintaining a healthy lifestyle and their engagement with lifestyle support was related to the extent to which they self-identified as healthy people. Health-disengaged women were disinterested in talking about their lifestyles while health-focused women did not feel that they needed extra support. Women between these ends of the ‘health identity’ spectrum were interested in improving their health, and were able to identify barriers as well as sources of support.Conclusions: lifestyle interventions in pregnancy should be adapted to meet the needs of individuals with different health identities, and encouraging a change in health identity may be one way of supporting sustained change in health behaviours.

ObjectivesColorectal cancer (CRC) is the second-leading cause of cancer deaths globally, with low-income and middle-income countries (LMICs) disproportionately affected. Estimates of CRC rates in LMIC are scarce. We aimed to (1) estimate sex-specific incidence of CRC, (2) estimate temporal trend and (3) determine regional variations of CRC rates on the African continent.DesignSystematic review and meta-analysisMethodsPubMed (MEDLINE), OVID (MEDLINE), Scopus and Cochrane Library databases were systematically searched from inception to 12 December 2020. We included population-based studies that reported the incidence or prevalence estimates of CRC in Africa. Studies not conducted in humans or did not directly report the rates of CRC were excluded. Random effects model was used to pool the estimates. The methodological quality of studies was assessed with the Newcastle-Ottawa Scale.Outcome measuresOverall and sex-specific annual age-standardised incidence rates (ASIR) of CRC per 100 000 population.ResultsThe meta-analysis included 14 studies consisting of 3365 individuals with CRC (mean age, 58 years, 53% male). The overall ASIR of CRC in Africa per 100 000 population was 5.25 (95% CI 4.08 to 6.75). The rates were slightly higher in males (4.76) than in females (4.18), but not significantly different. Subgroup analysis indicated greater point estimates in North Africa (8.66) compared with sub-Saharan Africa (5.91); and higher estimates in Eastern (8.29) and Northern (8.66) Africa compared with Western (3.55) and Southern (3.57) Africa, but not statistically significant. The overall trend in ASIR has remained constant at nearly 5 per 100 000 population for the last 6 decades.ConclusionCRC estimates in Africa are heterogeneous and could be underestimated. High-quality data collection systems such as population-based cancer registries may facilitate accurate estimation of country-specific rates and provide critical information which would be lucrative to the consideration of resources needed for screening, early detection, treatment and improving overall patient outcomes.

Sexual minorities face experiences of heterosexist harassment in the college environment, which may contribute to decreased academic well-being. Thus, the present study investigated whether social cognitive variables and heterosexist harassment predict sexual minority college students’ academic satisfaction and intentions to persist. The sample consisted of 731 undergraduate students who completed an online survey. Social cognitive variables were hypothesized to predict academic satisfaction, as specified by the social cognitive model of academic satisfaction, with heterosexist harassment operating as a barrier. Results suggested that the social cognitive model provided good fit to the data. Heterosexist harassment was found to be associated indirectly with academic satisfaction via perceptions of lower environmental support and it was found to negatively predict intentions to persist. Implications of the results are that heterosexism may play a role in sexual minority students’ academic development and that social cognitive career theory may offer a useful framework for interventions.

New Voices In Public Policy, Vol 5, No 2 (2011)