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Pugazenthi S, Barpujari A, Patel S, Estes EM, Reddy V, Rogers JL, Hardi A, Lee H, Strahle JM. A Systematic Review of the State of Neurosurgical Disparities Research: Past, Present, and Future. World Neurosurg 2024; 182:193-199.e4. [PMID: 38040329 DOI: 10.1016/j.wneu.2023.11.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 11/25/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND The social determinants of health, which influence healthcare access, patient outcomes, and population-level burden of disease, contribute to health disparities experienced by marginalized patient populations. In the present study, we sought to evaluate the landscape of health disparities research within neurosurgery. METHODS Embase, Ovid-MEDLINE, Scopus, Web of Science, Cochrane Library, and ProQuest Dissertations databases were queried for original research on health disparities regarding access to, outcomes of, and/or postoperative management after neurosurgical procedures in the United States. RESULTS Of 883 studies screened, 196 were included, of which 144 had a neurosurgery-affiliated author. We found a significant increase in the number of neurosurgical disparities reports beginning in 2010, with only 10 studies reported before 2010. Of the included studies, 3.1% used prospective methods and 63.8% used data from national registries. The disparities analyzed were racial/ethnic (79.6%), economic/socioeconomic (53.6%), gender (18.9%), and disabled populations (0.5%), with 40.1% analyzing multiple or intersecting disparities. Of the included reports, 96.9% were in phase 1 (detecting phase of disparities research), with a few studies in phase 2 (understanding phase), and none in phase 3 (reducing phase). The spine was the most prevalent subspecialty evaluated (34.2%), followed by neuro-oncology (19.9%), cerebrovascular (16.3%), pediatrics (10.7%), functional (9.2%), general neurosurgery (5.1%), and trauma (4.1%). Senior authors with a neurosurgical affiliation accounted for 79.2% of the reports, 93% of whom were academically affiliated. CONCLUSIONS Although a recent increase has occurred in neurosurgical disparities research within the past decade, most studies were limited to the detection of disparities without understanding or evaluating any interventions for a reduction in disparities. Future research in neurosurgical disparities should incorporate the latter 2 factors to reduce disparities and improve outcomes for all patients.
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Affiliation(s)
- Sangami Pugazenthi
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Awinita Barpujari
- Department of Neurosurgery, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - Saarang Patel
- Department of Medicine, Seton Hall University, South Orange, New Jersey, USA
| | - Emily M Estes
- Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA
| | - Vamsi Reddy
- Department of Neurosurgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - James L Rogers
- Department of Neurosurgery, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Angela Hardi
- Becker Medical Library, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Hedwig Lee
- Department of Sociology, Duke University, Durham, North Carolina, USA
| | - Jennifer M Strahle
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.
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Šelb J, Cvetko F, Deutsch L, Bedrač L, Kuščer E, Maier AB. Personalization matters: the effect of sex in multivitamin-multimineral-based cancer prevention. GeroScience 2024; 46:1351-1356. [PMID: 37561385 PMCID: PMC10828342 DOI: 10.1007/s11357-023-00882-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 07/19/2023] [Indexed: 08/11/2023] Open
Abstract
The prevention of non-communicable diseases like cancer contributes to healthy aging. Dietary supplements might support such prevention; their effect likely depends on the personal characteristics of the individuals receiving them. To evaluate the influence of sex on reducing cancer incidence with multivitamin-multimineral (MVM) supplementation, sex-specific results of the efficacy of MVM supplementation for cancer prevention were collected and meta-analyzed (using fixed effect (FE) and random effect (RE) models). Three trials included in the "US Preventive Services Task Force Recommendation Statement Report regarding Vitamin, Mineral, and Multivitamin Supplementation to Prevent Cardiovascular Disease and Cancer" were used, namely, COSMOS, SU.VI.MAX, and PHS2. A total of 28,558 men and 20,542 women were included. Multivitamin-multimineral supplementation significantly reduced cancer incidence in the entire population (HR 0.93 [95% CI, 0.88-0.99], FE and RE); sex-specific meta-analysis showed beneficial effects of supplementation in men (HR 0.91 [95% CI, 0.85-0.97] (FE)/0.88 [95% CI, 0.77-1.01] (RE)); however, there was no effect in women (HR 1.00 [95% CI, 0.88-1.14], FR and RE); (Pdifference = 0.17). Sex could influence the effect of MVM supplementation in reducing cancer incidence, with supplementation being effective only in male individuals. These results might be informative for future research and public health policy makers.
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Affiliation(s)
- Julij Šelb
- The NU B.V., J.H. Oortweg 21, 2333CH, Leiden, The Netherlands.
- University Clinic of Respiratory and Allergic Diseases Golnik, Golnik 36, 4204, Golnik, Slovenia.
| | - Filip Cvetko
- The NU B.V., J.H. Oortweg 21, 2333CH, Leiden, The Netherlands
| | - Leon Deutsch
- The NU B.V., J.H. Oortweg 21, 2333CH, Leiden, The Netherlands
| | - Leon Bedrač
- The NU B.V., J.H. Oortweg 21, 2333CH, Leiden, The Netherlands
| | - Enej Kuščer
- The NU B.V., J.H. Oortweg 21, 2333CH, Leiden, The Netherlands
| | - Andrea Britta Maier
- The NU B.V., J.H. Oortweg 21, 2333CH, Leiden, The Netherlands
- Department of Human Movement Sciences, @AgeAmsterdam Amsterdam Movement Sciences Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
- Centre for Healthy Longevity, @AgeSingapore, National University Health System, Singapore, Republic of Singapore
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Wenger NK. Special issue on atherosclerotic cardiovascular disease: Sex and gender differences. Atherosclerosis 2023; 384:117271. [PMID: 37718138 DOI: 10.1016/j.atherosclerosis.2023.117271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 09/01/2023] [Indexed: 09/19/2023]
Affiliation(s)
- Nanette K Wenger
- Emory University School of Medicine, Emory Heart and Vascular Center, Emory Women's Heart Center, Atlanta, GA, USA.
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Wu J, Jiao B, Zhao J. Gender Disparities in Blood Pressure and the Role of Body Mass Index: A Birth Cohort Analysis in China. J Epidemiol Glob Health 2023; 13:485-494. [PMID: 37302107 PMCID: PMC10468457 DOI: 10.1007/s44197-023-00127-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 05/26/2023] [Indexed: 06/13/2023] Open
Abstract
BACKGROUND The slow decline in cardiovascular disease (CVD) mortality and the stagnant or increasing hypertension prevalence in low- and middle-income countries necessitate investigation. Evolving gender disparities suggested that male cardiovascular health disadvantage may be preventable, offering potential for enhancing population cardiovascular health. Despite global body mass index (BMI) increases, its role in shaping the gender disparities remains underexplored. OBJECTIVE This study investigated the birth cohort dynamics of gender disparities in systolic/diastolic blood pressure (SBP/DBP) in China, one of the world's largest low- and middle-income countries, and explored the potential role of BMI in explaining the changing gender disparities. METHODS Data from the China Health and Nutrition Survey (1991-2015) were analyzed using multilevel growth-curve models to estimate gender- and cohort-specific SBP/DBP trajectories among individuals born between 1950 and 1975. RESULTS Men had higher SBP and DBP than women at the sample's mean age of 41.7 years. The gender disparities in SBP and DBP increased with each successive one-year cohort from 1950 to 1975 by 0.14 mm Hg and 0.09 mm Hg, respectively. Adjusting for BMI reduced the increasing gender disparities in SBP and DBP by 31.9% and 34.4%, respectively. CONCLUSION Chinese men experienced a greater increase in SBP/DBP across successive cohorts compared to women. The increasing gender disparities in SBP/DBP were partially attributable to a greater BMI increase across cohorts among men. Given these findings, prioritizing interventions that aim to reduce BMI, particularly among men, could potentially alleviate the burden of CVD in China through lowering SBP/DBP.
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Affiliation(s)
- Jinjing Wu
- Asian Demographic Research Institute, Shanghai University, Shanghai, 200444, China
| | - Boshen Jiao
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, 02115, USA
| | - Jiaying Zhao
- RSSS Building, 146 Ellery Crescent, School of Demography, ANU College of Arts and Social Sciences, The Australian National University, Acton ACT, Canberra, 2601, Australia.
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Seeman MV. Schizophrenia in Women: Clinical Considerations. Psychiatr Clin North Am 2023; 46:475-486. [PMID: 37500245 DOI: 10.1016/j.psc.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Men and women, for biologic and sociocultural reasons, differ in the nature of their risks for schizophrenia and also in their care needs. Women with schizophrenia have several reproduction-associated risks and care needs that require special clinical consideration. They also have several specific risks related to antipsychotics and gender-associated needs not necessarily related to biology. These require clinicians' diagnostic acumen, treatment skills, cultural sensitivity, and advocacy know-how. Although this does not pertain to everyone, awareness on the part of clinicians is essential. This article addresses the current evidence for difference.
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Affiliation(s)
- Mary V Seeman
- Department of Psychiatry, University of Toronto, Toronto, Ontario M5P3L6, Canada.
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Wells J, Knoll MA, Lyons-Ruth K, Obsuth I. History of abuse and adolescent hostile-helpless attachment: The mediating role of mother-adolescent punitive interactions. Child Abuse Negl 2023; 140:106190. [PMID: 37060688 DOI: 10.1016/j.chiabu.2023.106190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 03/01/2023] [Accepted: 04/03/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND Hostile-Helpless (HH) state of mind is a form of disorganised attachment that is strongly associated with prior experiences of abuse. However, how abuse experiences contribute toward HH states of mind in late adolescence is unknown. Punitive control in adolescent-mother dyads has been implicated in the development of HH states of mind and adolescent sex/gender may influence how punitive interactions contribute to HH mind states. OBJECTIVE The present study aimed to explore how adolescent sex/gender and punitive control within adolescent-mother dyads are related to the links between HH states of mind and childhood abuse. PARTICIPANTS AND SETTING A sample of 109 low-moderate income late adolescents (aged 18-23 years, 65 females, 44 males) and their mothers were assessed in a conflict-resolution paradigm. METHODS Recordings of the interactions were coded using the Goal-Corrected Partnership in Adolescence Coding System for different aspects of attachment-based interactions including punitive control. Late-adolescent HH states of mind features were coded from Adult Attachment Interviews (AAI) and experiences of abuse were coded from adolescent self-reports and the AAI. RESULTS Moderated mediation analysis revealed a significant indirect pathway from abuse to HH states of mind through punitive control in late adolescent females (B = 0.06, SEBoot = 0.04, 95 % CIBoot 0.01, 0.15), but not males (B = -0.02, SEBoot = 0.02, 95 % CIBoot - 0.07, 0.02). CONCLUSIONS The results indicate that there are sex/gender-specific pathways to developing HH states of mind. Hostile behavior within mother-daughter dyads therefore may play an important role in linking abuse experiences and contradictory attachment representations in late adolescent females.
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Affiliation(s)
- Jasmine Wells
- Section of Clinical & Health Psychology, The University of Edinburgh, Old Medical School, Elsie Inglis Quad, Edinburgh EH89AG, Scotland, UK.
| | - Monja Angelika Knoll
- Section of Clinical & Health Psychology, The University of Edinburgh, Old Medical School, Elsie Inglis Quad, Edinburgh EH89AG, Scotland, UK.
| | - Karlen Lyons-Ruth
- Harvard Medical School, CHA Family Studies Lab, 1493 Cambridge Street, Cambridge, MA 02139, USA.
| | - Ingrid Obsuth
- Section of Clinical & Health Psychology, The University of Edinburgh, Old Medical School, Elsie Inglis Quad, Edinburgh EH89AG, Scotland, UK.
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McFayden TC, Putnam O, Grzadzinski R, Harrop C. Sex Differences in the Developmental Trajectories of Autism Spectrum Disorder. Curr Dev Disord Rep 2023; 10:80-91. [PMID: 37635854 PMCID: PMC10457022 DOI: 10.1007/s40474-023-00270-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2023] [Indexed: 01/28/2023]
Abstract
Purpose of Review Females and males are disproportionately diagnosed with autism, a sex difference that has historically represented this neurodevelopmental condition. The current review examines lifespan developmental trajectories of autism based on sex to elucidate behavioral phenotypic differences that may contribute to differential rates of diagnosis. Recent Findings We review sex differences in diagnostic criteria: social communication and restricted interests/repetitive behaviors (RRBs). Results suggest RRBs are more indicative of a diagnosis in males, whereas social differences are more indicative of a diagnosis in females. Factors contributing to a later diagnosis in females include social strengths (camouflaging) and diagnostic overshadowing. Summary Sex differences in diagnostic criteria may contribute to differential rates of identification in males and females. Sex differences are most pronounced when assessing naturalistic social communication instead of reliance on standardized measure. Numerous future directions are identified including increasing samples of sub-threshold autistic females and evaluating longitudinal sex differences.
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Affiliation(s)
- Tyler C. McFayden
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Orla Putnam
- Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Rebecca Grzadzinski
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Clare Harrop
- Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, USA
- TEACCH Autism Program, University of North Carolina at Chapel Hill, Chapel Hill, USA
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Min JY, Levin J, Weinberger AH. Associations of tobacco cigarette use and dependence with substance use disorder treatment completion by sex/gender and race/ethnicity. J Subst Abuse Treat 2022; 140:108834. [PMID: 35803029 DOI: 10.1016/j.jsat.2022.108834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 04/29/2022] [Accepted: 06/28/2022] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Individuals with substance use disorders (SUD) are approximately five times more likely to smoke cigarettes than the general population. Individuals who smoke cigarettes have greater odds of SUD relapse compared to individuals who do not smoke cigarettes, but we know little about how cigarette use is related to SUD treatment completion overall by sex/gender or race/ethnicity. METHODS This study examined 2855 adults (71.98 % male; >70 % racial/ethnic minority) in outpatient and residential SUD treatment at a New York-based treatment agency over a six-month period in 2018. RESULTS Overall, approximately three-fourths of SUD treatment-seeking participants smoked cigarettes, with high rates across sex/gender and racial/ethnic groups. Nicotine dependence did not differ by sex/gender, and White Non-Hispanic adults had the highest levels of nicotine dependence across racial/ethnic groups. Those who smoked cigarettes were significantly less likely to complete treatment compared to those who did not smoke cigarettes (OR = 0.69; 95 % CI: 0.58, 0.82). The study found no overall differences in SUD treatment completion and length of stay by sex/gender or race/ethnicity. CONCLUSIONS Given the high prevalence of cigarette smoking and lower odds of completing SUD treatment, the current system of care for SUD treatment may be enhanced by addressing cigarette smoking from onset of treatment.
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Affiliation(s)
- Jung-Yun Min
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA.
| | - Jacob Levin
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA.
| | - Andrea H Weinberger
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA; Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.
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Mena E, Bolte G. Classification tree analysis for an intersectionality-informed identification of population groups with non-daily vegetable intake. BMC Public Health 2021; 21:2007. [PMID: 34736424 PMCID: PMC8570019 DOI: 10.1186/s12889-021-12043-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 10/18/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Daily vegetable intake is considered an important behavioural health resource associated with improved immune function and lower incidence of non-communicable disease. Analyses of population-based data show that being female and having a high educational status is most strongly associated with increased vegetable intake. In contrast, men and individuals with a low educational status seem to be most affected by non-daily vegetable intake (non-DVI). From an intersectionality perspective, health inequalities are seen as a consequence of an unequal balance of power such as persisting gender inequality. Unravelling intersections of socially driven aspects underlying inequalities might be achieved by not relying exclusively on the male/female binary, but by considering different facets of gender roles as well. This study aims to analyse possible interactions of sex/gender or sex/gender related aspects with a variety of different socio-cultural, socio-demographic and socio-economic variables with regard to non-DVI as the health-related outcome. METHOD Comparative classification tree analyses with classification and regression tree (CART) and conditional inference tree (CIT) as quantitative, non-parametric, exploratory methods for the detection of subgroups with high prevalence of non-DVI were performed. Complete-case analyses (n = 19,512) were based on cross-sectional data from a National Health Telephone Interview Survey conducted in Germany. RESULTS The CART-algorithm constructed overall smaller trees when compared to CIT, but the subgroups detected by CART were also detected by CIT. The most strongly differentiating factor for non-DVI, when not considering any further sex/gender related aspects, was the male/female binary with a non-DVI prevalence of 61.7% in men and 42.7% in women. However, the inclusion of further sex/gender related aspects revealed a more heterogenous distribution of non-DVI across the sample, bringing gendered differences in main earner status and being a blue-collar worker to the foreground. In blue-collar workers who do not live with a partner on whom they can rely on financially, the non-DVI prevalence was 69.6% in men and 57.4% in women respectively. CONCLUSIONS Public health monitoring and reporting with an intersectionality-informed and gender-equitable perspective might benefit from an integration of further sex/gender related aspects into quantitative analyses in order to detect population subgroups most affected by non-DVI.
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Affiliation(s)
- Emily Mena
- Department of Social Epidemiology, University of Bremen, Institute of Public Health and Nursing Research, Grazer Straße 4, 28359, Bremen, Germany.
- Health Sciences Bremen, University of Bremen, Bremen, Germany.
| | - Gabriele Bolte
- Department of Social Epidemiology, University of Bremen, Institute of Public Health and Nursing Research, Grazer Straße 4, 28359, Bremen, Germany
- Health Sciences Bremen, University of Bremen, Bremen, Germany
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Stock S, Altin S, Nawabi F, Civello D, Shukri A, Redaèlli M, Alayli A. A cross-sectional analysis of health literacy: patient- versus family doctor-reported and associations with self-efficacy and chronic disease. BMC Fam Pract 2021; 22:187. [PMID: 34525978 PMCID: PMC8442421 DOI: 10.1186/s12875-021-01527-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 08/19/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Adequate health literacy (HL) levels contribute to good health outcomes and successful disease self-management in patients with chronic disease. Hence, it is essential that family doctors recognize patients with inadequate HL in need of additional support. This study had two aims: (1) to assess and compare patient self-reported versus family doctor-rated HL estimates, and (2) to explore associations between patient-reported HL, self-efficacy and chronic diseases. METHODS Participants in this cross-sectional survey were recruited through general practices in North Rhine-Westphalia, Germany. Patient self-reported HL was measured using the European Health Literacy Survey-16. Family doctor-rated HL was measured with an adapted version of this instrument. Using crosstabulations patient-reported and family doctor-rated HL estimates were compared for 346 patient-family doctor pairs. Associations between HL, self-efficacy and chronic disease were investigated using regression analyses. RESULTS Patient-reported and family doctor-rated HL estimates were concordant in 38% of all cases. On average family doctors rated their patients' HL lower than patients rated their own HL. The lower average family doctor ratings were more pronounced when patients were older, male and had more than one chronic disease. Female family doctors rated HL of male patients lower than their male colleagues. Patient reported HL had a significant positive association with self-efficacy. Mediation analysis provided support that self-efficacy acts as mediator between HL and the number of chronic diseases. CONCLUSIONS Our study findings indicate a significant discrepancy between patients' self-reported HL and externally rated HL by family doctors. A more systematic utilization of HL screeners might help reduce this discrepancy. At the same time, consideration should be given to enhancing communication training for family doctors and addressing critical HL skills in patient education.
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Affiliation(s)
- Stephanie Stock
- Institute for Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Gleueler Str. 176-178, 50924, Cologne, Germany
| | | | - Farah Nawabi
- Institute for Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Gleueler Str. 176-178, 50924, Cologne, Germany
| | - Daniele Civello
- Institute for Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Gleueler Str. 176-178, 50924, Cologne, Germany
| | - Arim Shukri
- Institute for Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Gleueler Str. 176-178, 50924, Cologne, Germany
| | - Marcus Redaèlli
- Institute for Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Gleueler Str. 176-178, 50924, Cologne, Germany
| | - Adrienne Alayli
- Institute for Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Gleueler Str. 176-178, 50924, Cologne, Germany.
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de Lacy N, Kutz JN, Calhoun VD. Sex-related differences in brain dynamism at rest as neural correlates of positive and negative valence system constructs. Cogn Neurosci 2021; 12:131-154. [PMID: 32715898 PMCID: PMC7881523 DOI: 10.1080/17588928.2020.1793752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 05/22/2020] [Indexed: 10/23/2022]
Abstract
Clinical anxiety and depression are the most prevalent mental illnesses, likely representing maladaptive expressions of negative valence systems concerned with conditioned responses to fear, threat, loss, and frustrative nonreward. These conditions exhibit similar, striking sex/gender-related differences in onset, incidence, and severity for which the neural correlates are not yet established. In alarge sample of neurotypical young adults, we demonstrate that intrinsic brain dynamism metrics derived from sex-sensitive models of whole-brain network function are significantly associated with valence system traits. Surprisingly, we found that greater brain dynamism is strongly positively correlated to anxiety and depression traits in males, but almost wholly decoupled from traits for important cognitive control and reappraisal strategies associated with positive valence. Conversely, intrinsic brain dynamism is strongly positively coupled to drive, novelty-seeking and self-control in females with only rare or non-significant directional negative correlation with anxiety and depression traits. Our results suggest that the dynamic neural correlates of traits for valence, anxiety and depression are significantly different in males/men and females/women. These findings may relate to the known sex/gender-related differences in cognitive reappraisal of emotional experiences and clinical presentations of anxiety and depression, with potential relevance to gold standard therapies based on enhancing cognitive control strategies.
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Affiliation(s)
- Nina de Lacy
- Department of Psychiatry and Behavioral Sciences, University of Washington, 1959 NE Pacific St, Seattle, WA 98195
| | - J. Nathan Kutz
- Department of Applied Mathematics, University of Washington, Lewis Hall 201, Seattle WA 98195
| | - Vince D. Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, 30303, USA
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Mena E, Bolte G. CART-analysis embedded in social theory: A case study comparing quantitative data analysis strategies for intersectionality-based public health monitoring within and beyond the binaries. SSM Popul Health 2021; 13:100722. [PMID: 33385059 PMCID: PMC7772559 DOI: 10.1016/j.ssmph.2020.100722] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 12/11/2020] [Accepted: 12/13/2020] [Indexed: 11/07/2022] Open
Abstract
Implementation of an intersectionality perspective into quantitative health research might support the process of unravelling complex socio-cultural and economic power relations which underly and shape patterns of health and disease within populations. Intersectionality-informed health monitoring and health reporting integrating a sex/gender-sensitive perspective could serve as a fertile ground to strengthen the essential function of health reporting to support political decision-making. We aimed at the integration of social theory into quantitative data analysis by taking into consideration 4 distinct central sex/gender theoretical concepts in health research. We developed and tested an intersectionality-based, sex/gender-sensitive strategy comparing 5 distinct models based on different combinations of the binary sex/gender variable, socio-cultural and economic variables (defined from an intersectionality perspective) as well as solution-linked sex/gender variables. We used CART-analysis as a quantitative, non-parametric, exploratory method to detect subgroups with high prevalence of frequent mental distress (FMD). Analyses were based on data from a National Health Telephone Interview Survey conducted in Germany. Depending on model and detected subgroup of our comparative approach, prevalence of FMD ranged between approximately 5 %-25%. Within the model including the binary sex/gender variable, socio-cultural and economic variables, sex/gender turned out to be the most important attribute. Comparing the models which included solution-linked sex/gender variables to the model not including these variables illustrated that the CART-algorithm was able to detect subgroups with the same prevalence of FMD, but with approximately 14% as opposed to 4.5% of the study population being affected. For these models, social support served as the primary splitting variable and not the binary sex/gender variable. Including or not including the binary sex/gender variable in the models with the solution-linked variables did not make a substantial difference. Embedding CART-analysis in social theory might have the potential to further sex/gender sensitivity in health reporting and might support decision-making when considering the allocation of health-related interventions.
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Affiliation(s)
- Emily Mena
- University of Bremen, Institute of Public Health and Nursing Research, Department of Social Epidemiology, Bremen, Germany
- Health Sciences Bremen, University of Bremen, Bremen, Germany
| | - Gabriele Bolte
- University of Bremen, Institute of Public Health and Nursing Research, Department of Social Epidemiology, Bremen, Germany
- Health Sciences Bremen, University of Bremen, Bremen, Germany
| | - AdvanceGender Study Group
- University of Bremen, Institute of Public Health and Nursing Research, Department of Social Epidemiology, Bremen, Germany
- Health Sciences Bremen, University of Bremen, Bremen, Germany
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13
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Kim SY, Song HK, Lee SK, Kim SG, Woo HG, Yang J, Noh HJ, Kim YS, Moon A. Sex-Biased Molecular Signature for Overall Survival of Liver Cancer Patients. Biomol Ther (Seoul) 2020; 28:491-502. [PMID: 33077700 PMCID: PMC7585639 DOI: 10.4062/biomolther.2020.157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 09/18/2020] [Accepted: 09/18/2020] [Indexed: 12/31/2022] Open
Abstract
Sex/gender disparity has been shown in the incidence and prognosis of many types of diseases, probably due to differences in genes, physiological conditions such as hormones, and lifestyle between the sexes. The mortality and survival rates of many cancers, especially liver cancer, differ between men and women. Due to the pronounced sex/gender disparity, considering sex/gender may be necessary for the diagnosis and treatment of liver cancer. By analyzing research articles through a PubMed literature search, the present review identified 12 genes which showed practical relevance to cancer and sex disparities. Among the 12 sex-specific genes, 7 genes (BAP1, CTNNB1, FOXA1, GSTO1, GSTP1, IL6, and SRPK1) showed sex-biased function in liver cancer. Here we summarized previous findings of cancer molecular signature including our own analysis, and showed that sex-biased molecular signature CTNNB1High, IL6High, RHOAHigh and GLIPR1Low may serve as a female-specific index for prediction and evaluation of OS in liver cancer patients. This review suggests a potential implication of sex-biased molecular signature in liver cancer, providing a useful information on diagnosis and prediction of disease progression based on gender.
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Affiliation(s)
- Sun Young Kim
- Department of Chemistry, College of Natural Sciences, Duksung Women's University, Seoul 01369, Republic of Korea
| | - Hye Kyung Song
- Department of Chemistry, College of Natural Sciences, Duksung Women's University, Seoul 01369, Republic of Korea
| | - Suk Kyeong Lee
- Department of Medical Life Sciences, Department of Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul 06649, Republic of Korea
| | - Sang Geon Kim
- College of Pharmacy and Integrated Research Institute for Drug Development, Dongguk University_Seoul, Goyang 10326, Republic of Korea
| | - Hyun Goo Woo
- Department of Physiology, Ajou University School of Medicine, Suwon 16499, Republic of Korea.,Department of Biomedical Science, Graduate School, Ajou University, Suwon 16499, Republic of Korea
| | - Jieun Yang
- Department of Physiology, Ajou University School of Medicine, Suwon 16499, Republic of Korea.,Department of Biomedical Science, Graduate School, Ajou University, Suwon 16499, Republic of Korea
| | - Hyun-Jin Noh
- Department of Biomedical Science, Graduate School, Ajou University, Suwon 16499, Republic of Korea.,Department of Biochemistry, Ajou University School of Medicine, Suwon 16499, Republic of Korea
| | - You-Sun Kim
- Department of Biomedical Science, Graduate School, Ajou University, Suwon 16499, Republic of Korea.,Department of Biochemistry, Ajou University School of Medicine, Suwon 16499, Republic of Korea
| | - Aree Moon
- Duksung Innovative Drug Center, College of Pharmacy, Duksung Women's University, Seoul 01369, Republic of Korea
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14
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Blair BJ, Blanco S, Ikombo-Deguenon F, Belcastro A. Sex/Gender Phenotypes and the Diagnosis and Treatment of Autism Spectrum Disorder: Implications for Applied Behavior Analysts. Behav Anal Pract 2020; 13:263-269. [PMID: 32231989 DOI: 10.1007/s40617-019-00376-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Research has consistently reported a higher rate of autism spectrum disorder (ASD) diagnoses in males than in females, but until recently, the impact of sex/gender differences has received little attention from applied behavior analysts. The underlying reasons for the difference in rates of diagnosis could be related to genetic or hormonal differences, sociocultural expectations of behavior based on sex/gender norms, or biases built into the assessment and observation of ASD symptoms. It is necessary to engage in further discussion and research in order to improve the treatment and quality of life of persons with ASD because misdiagnosis or late diagnosis can delay the start of early intervention and limit its proven benefits. Furthermore, differences in symptom presentation can impact interventions selected. We suggest that applied behavior analysts should be knowledgeable of these issues and the implications they may have on the field of applied behavior analysis in general.
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Affiliation(s)
- Bryan J Blair
- 1Long Island University - Brooklyn, Room 228, 1 University Plaza, Brooklyn, NY 11201 USA
| | - Sam Blanco
- 2The Sage Colleges-Albany and Comprehensive Behavior Supports, Albany, NY USA.,Comprehensive Behavior Supports, Brooklyn, NY USA
| | | | - Alyssa Belcastro
- 1Long Island University - Brooklyn, Room 228, 1 University Plaza, Brooklyn, NY 11201 USA
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15
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Zumwalt M, Reddy AP. Stem Cells for Treatment of Musculoskeletal Conditions - Orthopaedic/Sports Medicine Applications. Biochim Biophys Acta Mol Basis Dis 2020; 1866:165624. [PMID: 31794866 DOI: 10.1016/j.bbadis.2019.165624] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 11/22/2019] [Accepted: 11/23/2019] [Indexed: 12/20/2022]
Abstract
A myriad of musculoskeletal conditions afflicts a vast number of the world's population from birth to death. Countless pathological diseases and traumatic injuries (acute and chronic) contribute to different human disabilities, causing a tremendous financial toll on the economy of healthcare. The medical field is continually searching for novel ways to combat orthopedically related conditions. The immediate goal is the restoration of anatomy then ultimately return of function in hopes of enhancing quality if not the quantity of life. Traditional methods involve surgical correction/reconstruction of skeletal deformities from fractures/soft tissue damage/ruptures or replacement/resection of degenerated joints. Modern research is currently concentrating on innovative procedures to replenish/restore the human body close to its original/natural state [1, 2].
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Affiliation(s)
- Mimi Zumwalt
- Texas Tech University Health Sciences Center, Department of Orthopaedic Surgery, 3601 4(th) Street STOP 9436, Lubbock, TX 79430 United States of America.
| | - Arubala P Reddy
- Texas Tech University, 1301 Akron Avenue, Lubbock, TX 79409 United States of America.
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16
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Bourdon O, Raymond C, Marin MF, Olivera-Figueroa L, Lupien SJ, Juster RP. A time to be chronically stressed? Maladaptive time perspectives are associated with allostatic load. Biol Psychol 2020; 152:107871. [PMID: 32070718 DOI: 10.1016/j.biopsycho.2020.107871] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 02/01/2020] [Accepted: 02/13/2020] [Indexed: 11/30/2022]
Abstract
Living in the past, the present, or the future can affect stress and health. Our group has shown that acute stress (cortisol reactivity) is modulated by time perspectives, the ways we psychologically relate to time. Here, we expand this research with a comprehensive measure of multi-systemic chronic stress (allostatic load). Among 204 healthy adults (60 men; 144 women), we examined whether time perspectives modulate allostatic load measured with 23 neuroendocrine, immune, metabolic, and cardiovascular biomarkers. Five time perspective categories were measured (past negative, past positive, present hedonistic, present fatalistic, future). Multiple regressions controlling for sex, age, and depressive symptoms were used. Increased present fatalistic time perspective was positively correlated with allostatic load, while future time perspective was negatively correlated with allostatic load. Our preliminary findings link time perspective to multisystemic chronic stress and are discussed in the context of potential clinical implications.
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Affiliation(s)
- Olivier Bourdon
- Institut universitaire en santé mentale de Montréal, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Canada; Center on Sex⁎Gender, Allostasis, and Resilience, Canada
| | - Catherine Raymond
- Institut universitaire en santé mentale de Montréal, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Canada; Center on Sex⁎Gender, Allostasis, and Resilience, Canada; Center for Studies on Human Stress, Canada; Department of Neurological Sciences, Université de Montréal, Canada
| | - Marie-France Marin
- Institut universitaire en santé mentale de Montréal, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Canada; Department of Psychology, Université de Québec à Montréal, Canada
| | - Lening Olivera-Figueroa
- Yale University School of Medicine, Department of Psychiatry, United States; California Lutheran University, Graduate School of Psychology, United States
| | - Sonia J Lupien
- Institut universitaire en santé mentale de Montréal, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Canada; Center for Studies on Human Stress, Canada; Department of Psychiatry and Addiction, Université de Montréal, Canada
| | - Robert-Paul Juster
- Institut universitaire en santé mentale de Montréal, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Canada; Center on Sex⁎Gender, Allostasis, and Resilience, Canada; Department of Psychiatry and Addiction, Université de Montréal, Canada.
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17
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Habib RR, Ziadee M, Abi Younes E, Harastani H. Syrian refugee child workers: Gender differences in ergonomic exposures and musculoskeletal health. Appl Ergon 2020; 83:102983. [PMID: 31731094 DOI: 10.1016/j.apergo.2019.102983] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 09/26/2019] [Accepted: 10/20/2019] [Indexed: 06/10/2023]
Abstract
This study explores sex/gender-related differences in ergonomic exposures and musculoskeletal disorders for 4090 working Syrian refugee children (>8-≤18 years) in the Bekaa Valley, Lebanon (n = 2107 males; n = 1983 females). Data was collected on demographic, occupational, and socioeconomic indicators and musculoskeletal disorders. Results revealed that children engaged in strenuous work. Ergonomic exposures differed by sex/gender, with girls more likely to engage in repetitive movements and boys in heavy lifting. Girls bore a double burden of work inside and outside their households and were more prone to wrist and hand pain. More girls reported working under pressure to finish their job on time while more boys reported that their salary is based on finishing a specific number of items per day. Syrian refugee child workers need immediate protection to safeguard their health. Interventions could target children of legal age for work in safer conditions and keep younger children out of work.
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Affiliation(s)
- R R Habib
- Department of Environmental Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
| | - M Ziadee
- Department of Environmental Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - E Abi Younes
- Department of Environmental Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - H Harastani
- Department of Environmental Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
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18
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Berman Z, Assaf Y, Tarrasch R, Joel D. Macro- and microstructural gray matter alterations in sexually assaulted women. J Affect Disord 2020; 262:196-204. [PMID: 31662209 DOI: 10.1016/j.jad.2019.10.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 06/13/2019] [Accepted: 10/14/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Studies with trauma survivors documented structural alterations in brain regions involved in posttraumatic stress disorder (PTSD) neurocircuitry. Nonetheless, whether such alterations exist in women who were sexually assaulted in adulthood is not clear. We investigated the macro- and microstructure of key regions implicated in PTSD pathophysiology, namely the amygdala, hippocampus, anterior cingulate cortex (ACC), and insula, in this population. METHODS Thirty-eight sexually assaulted women (PTSD, n = 25; non-PTSD, n = 13) and 24 non-exposed controls (NEC) were studied with T1- and diffusion-weighted MRI. Gray matter volume, mean diffusivity (MD), and fractional anisotropy (FA) were calculated for each region. Between-group comparisons and correlations with PTSD symptom severity were performed. RESULTS Volumetric analyses revealed lower amygdala and insula volumes in the PTSD compared with the non-PTSD group. In contrast, altered microstructure was observed in both traumatized groups compared with NEC, including higher MD and lower FA in the right amygdala, and higher FA in the ACC bilaterally. Finally, the non-PTSD group had higher FA in the right insula compared with the PTSD group. PTSD symptom severity was correlated with amygdala and insula volumes, as well as with hippocampal FA and MD. LIMITATIONS Sample size may have led to reduced statistical power. CONCLUSIONS Sexual assault and the development of PTSD in women are linked with structural alterations in key regions implicated in PTSD following other trauma types (e.g., combat), though hippocampal and ACC volumes were preserved. Further studies are needed to disentangle the unique contribution of trauma type and of sex/gender to these observations.
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Affiliation(s)
- Zohar Berman
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Yaniv Assaf
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; Department of Neurobiology, Faculty of Life Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Ricardo Tarrasch
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; Jaime and Joan Constantiner School of Education, Tel Aviv University, Tel Aviv, Israel
| | - Daphna Joel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; School of Psychological Sciences, Faculty of Social Sciences, Tel Aviv University, Tel Aviv, Israel.
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19
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Mena E, Bolte G. Intersectionality-based quantitative health research and sex/gender sensitivity: a scoping review. Int J Equity Health 2019; 18:199. [PMID: 31864366 PMCID: PMC6925460 DOI: 10.1186/s12939-019-1098-8] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 11/18/2019] [Indexed: 01/23/2023] Open
Abstract
Background The implementation of a theoretical intersectionality framework into quantitative data analyses is gaining increasing interest in health research. The substantive foundation of intersectionality was established in the U.S., based on the claim of black feminists to broaden the scope of contemporary gender studies by considering the intersection between sex/gender and race/ethnicity more firmly. The aim of our scoping review with particular emphasis on sex/gender was to assess how intersectionality-informed studies in epidemiological research considered different social dimensions in their multivariable and multivariate analyses. Methods Following the PRISMA Extension for Scoping Reviews (PRISMA-ScR), we conducted a literature review in PubMed. Three distinct health-related fields were brought into focus: diabetes representing a frequent chronic disease, smoking as a wide-spread behavioural health determinant and physical activity as a central target for health promotion. Initially, we compared which and how different social dimensions were accounted for and how inter-categorical and intersectionality-informed analyses were conducted. Further, we assessed sex/gender sensitivity by comparing operationalisation of sex/gender, how sex/gender theories were used and which central theoretical sex/gender concepts were referred to when aiming at explanation of (intersectional) sex/gender differences. Results Our results suggest, that intersectionality-based analyses within the three selected health-related fields are mainly conducted in the U.S. and focused on the intersection between sex/gender and race/ethnicity by using them jointly as subgrouping variables and as parts of interaction terms in regression analyses. Income and education as proxies for social class as well as age are mainly used for adjustment in quantitative analyses. Other approaches for calculating interactions (i.a. synergy-index, CART-analysis) are an exception. Even though sex/gender was considered in every included study and Gender was the most frequent theoretical sex/gender concept referred to when theoretically explaining sex/gender differences, it was exclusively operationalised as binary and solution-linked sex/gender variables were hardly considered in quantitative analyses. Conclusion The systematic integration of solution-linked variables indicating modifiable aspects of sex/gender-related living conditions and disadvantages could improve sex/gender sensitivity as part of intersectionality-based quantitative data analysis in health research.
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Affiliation(s)
- Emily Mena
- Institute of Public Health and Nursing Research, Department of Social Epidemiology, Faculty of Human and Health Sciences, University of Bremen, Grazer Straße 4, 28359, Bremen, Germany. .,Health Sciences Bremen, University of Bremen, Bremen, Germany.
| | - Gabriele Bolte
- Institute of Public Health and Nursing Research, Department of Social Epidemiology, Faculty of Human and Health Sciences, University of Bremen, Grazer Straße 4, 28359, Bremen, Germany.,Health Sciences Bremen, University of Bremen, Bremen, Germany
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20
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López-Alcalde J, Stallings E, Cabir Nunes S, Fernández Chávez A, Daheron M, Bonfill Cosp X, Zamora J. Consideration of sex and gender in Cochrane reviews of interventions for preventing healthcare-associated infections: a methodology study. BMC Health Serv Res 2019; 19:169. [PMID: 30876452 PMCID: PMC6419810 DOI: 10.1186/s12913-019-4001-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 03/07/2019] [Indexed: 12/25/2022] Open
Abstract
Background Healthcare-associated infections (HAIs) are common and increase morbidity, mortality, and healthcare costs. Their control continues to be an unresolved issue worldwide. HAIs epidemiology shows sex/gender differences. Thus the lack of consideration of sex/gender in Cochrane reviews will limit their applicability and capacity to support informed decisions. This study aims to describe the extent to which Cochrane reviews of interventions for preventing HAIs consider sex and gender. Methods Methodology study appraising Cochrane reviews of interventions to prevent HAIs. Search methods: Cochrane Database of Systematic Reviews from 1995 (launch of the journal) to 31 December 2016. Two authors independently extracted data with EPPI-Reviewer 4 software, and independently appraised the sex/gender content of the reviews with the Sex and Gender Appraisal Tool for Systematic Reviews (SGAT-SR). Results This study included 113 reviews assessing the effects of interventions for preventing HAIs. 100 reviews (88%) used at least one sex or gender-related term. The terminology used was heterogeneous, being “sex” the term used in more reviews (51%). No review defined neither sex nor gender. Thus we could not assess the definitions provided. Consideration of sex and gender was practically absent in the included reviews; in fact, no review met all the applicable items of the SGAT-SR, and 51 reviews (50%) fulfilled no item. No review provided a complete description of the sex and the gender of the samples of the included studies. Only ten reviews (10%) planned to perform sex- and gender-based analysis and only three (3%) could complete the analysis. The method chosen was always the subgroup analysis based on sex (one review) or gender (two reviews). Three reviews (3%) considered sex or gender-related findings in the conclusions. Conclusion Consideration of sex and gender in Cochrane reviews of interventions for preventing HAIs was practically absent. This lack of attention to sex and gender reduces the quality of Cochrane reviews, and their applicability for all people: women and men, boys and girls, and people of diverse gender identities. Cochrane should attempt to address the shortfalls detected. Electronic supplementary material The online version of this article (10.1186/s12913-019-4001-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jesús López-Alcalde
- Department of Paediatrics, Obstetrics & Gynaecology and Preventative Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain. .,Faculty of Health Sciences, Universidad Francisco de Vitoria (UFV)-Madrid, Madrid, Spain. .,Clinical Biostatistics Unit, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain. .,Cochrane Associate Centre of Madrid, Madrid, Spain.
| | - Elena Stallings
- Clinical Biostatistics Unit, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain
| | | | | | | | - Xavier Bonfill Cosp
- Iberoamerican Cochrane Centre, IIB Sant Pau, Universitat Autònoma de Barcelona, Madrid, Spain.,CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Javier Zamora
- Clinical Biostatistics Unit, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain.,CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
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21
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Pöge K, Rommel A, Mena E, Holmberg C, Saß AC, Bolte G. [AdvanceGender-Joint project for sex/gender-sensitive and intersectional research and health reporting]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2018; 62:102-107. [PMID: 30498848 DOI: 10.1007/s00103-018-2855-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Health reporting provides information on the health of the population and thus forms the basis for adequate health promotion, prevention, and care. In order to better represent social diversity, the joint project AdvanceGender (funded by the German Federal Ministry for Education and Research) aims to promote the development of a gender-sensitive and intersectional approach to population-based studies and health reporting. The three subprojects research study participation, data analysis, and health reporting. Based on the results, recommendations for epidemiological studies and for health reporting will be developed.
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Affiliation(s)
- Kathleen Pöge
- Abteilung für Epidemiologie und Gesundheitsmonitoring, FG24 Gesundheitsberichterstattung, Robert Koch-Institut, General-Pape-Straße 62-66, 12101, Berlin, Deutschland.
| | - Alexander Rommel
- Abteilung für Epidemiologie und Gesundheitsmonitoring, FG24 Gesundheitsberichterstattung, Robert Koch-Institut, General-Pape-Straße 62-66, 12101, Berlin, Deutschland
| | - Emily Mena
- Abteilung Sozialepidemiologie, Institut für Public Health und Pflegeforschung, Universität Bremen, Bremen, Deutschland
| | - Christine Holmberg
- Institut für Sozialmedizin und Epidemiologie, Medizinische Hochschule Brandenburg Theodor Fontane, Brandenburg/Havel, Deutschland
| | - Anke-Christine Saß
- Abteilung für Epidemiologie und Gesundheitsmonitoring, FG24 Gesundheitsberichterstattung, Robert Koch-Institut, General-Pape-Straße 62-66, 12101, Berlin, Deutschland
| | - Gabriele Bolte
- Abteilung Sozialepidemiologie, Institut für Public Health und Pflegeforschung, Universität Bremen, Bremen, Deutschland
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22
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Hankivsky O, Springer KW, Hunting G. Beyond sex and gender difference in funding and reporting of health research. Res Integr Peer Rev 2018; 3:6. [PMID: 30167330 PMCID: PMC6112145 DOI: 10.1186/s41073-018-0050-6] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 07/30/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Understanding sex and gender in health research can improve the quality of scholarship and enhance health outcomes. Funding agencies and academic journals are two key gatekeepers of knowledge production and dissemination, including whether and how sex/gender is incorporated into health research. Though attention has been paid to key issues and practices in accounting for sex/gender in health funding agencies and academic journals, to date, there has been no systematic analysis documenting whether and how agencies and journals require attention to sex/gender, what conceptual explanations and practical guidance are given for such inclusion, and whether existing practices reflect the reality that sex/gender cannot be separated from other axes of inequality. METHODS Our research systematically examines official statements about sex/gender inclusion from 45 national-level funding agencies that fund health research across 36 countries (covering the regions of the EU and associated countries, North America, and Australia) and from ten top-ranking general health (the top five in "science" and the top five in "social science") and ten sex- and/or gender-related health journals. We explore the extent to which agencies and journals require inclusion of sex/gender considerations and to what extent existing strategies reflect state of the art understandings of sex/gender, including intersectional perspectives. RESULTS The research highlights the following: (a) there is no consistency in whether sex/gender are mentioned in funding and publishing guidelines; (b) there is wide variation in how sex/gender are conceptualized and how researchers are asked to address the inclusion/exclusion of sex/gender in research; (c) funding agencies tend to prioritize male/female equality in research teams and funding outcomes over considerations of sex/gender in research content and knowledge production; and (d) with very few exceptions, agency and journal criteria fail to recognize the complexity of sex/gender, including the intersection of sex/gender with other key factors that shape health. CONCLUSIONS The conceptualization and integration of sex/gender needs to better capture the interacting and complex factors that shape health-an imperative that can be informed by an intersectional approach. This can strengthen current efforts to advance scientific excellence in the production and reporting of research. We provide recommendations and supporting questions to strengthen consideration of sex/gender in policies and practices of health journals and funding agencies.
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Affiliation(s)
- Olena Hankivsky
- School of Public Policy, Institute for Intersectionality Research and Policy, Simon Fraser University, Harbour Centre Campus, Room 3274, 505 West Hastings Street, Vancouver, BC V68 5K3 Canada
| | - Kristen W. Springer
- Department of Sociology, Faculty Affiliate, Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey, 26 Nichol Avenue, New Brunswick, NJ 08901 USA
| | - Gemma Hunting
- Institute for Intersectionality Research and Policy, Simon Fraser University, Harbour Centre Campus, Room 3274, 505 West Hastings Street, Vancouver, BC V68 5K3 Canada
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23
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Bell JR, Curl CL, Harding TW, Vila Petroff M, Harrap SB, Delbridge LMD. Male and female hypertrophic rat cardiac myocyte functional responses to ischemic stress and β-adrenergic challenge are different. Biol Sex Differ 2016; 7:32. [PMID: 27390618 PMCID: PMC4936311 DOI: 10.1186/s13293-016-0084-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 06/22/2016] [Indexed: 01/19/2023] Open
Abstract
Background Cardiac hypertrophy is the most potent cardiovascular risk factor after age, and relative mortality risk linked with cardiac hypertrophy is greater in women. Ischemic heart disease is the most common form of cardiovascular pathology for both men and women, yet significant differences in incidence and outcomes exist between the sexes. Cardiac hypertrophy and ischemia are frequently occurring dual pathologies. Whether the cellular (cardiomyocyte) mechanisms underlying myocardial damage differ in women and men remains to be determined. In this study, utilizing an in vitro experimental approach, our goal was to examine the proposition that responses of male/female cardiomyocytes to ischemic (and adrenergic) stress may be differentially modulated by the presence of pre-existing cardiac hypertrophy. Methods We used a novel normotensive custom-derived hypertrophic heart rat (HHR; vs control strain normal heart rat (NHR)). Cardiomyocyte morphologic and electromechanical functional studies were performed using microfluorimetric techniques involving simulated ischemia/reperfusion protocols. Results HHR females exhibited pronounced cardiac/cardiomyocyte enlargement, equivalent to males. Under basal conditions, a lower twitch amplitude in female myocytes was prominent in normal but not in hypertrophic myocytes. The cardiomyocyte Ca2+ responses to β-adrenergic challenge differed in hypertrophic male and female cardiomyocytes, with the accentuated response in males abrogated in females—even while contractile responses were similar. In simulated ischemia, a marked and selective elevation of end-ischemia Ca2+ in normal female myocytes was completely suppressed in hypertrophic female myocytes—even though all groups demonstrated similar shifts in myocyte contractile performance. After 30 min of simulated reperfusion, the Ca2+ desensitization characterizing the male response was distinctively absent in female cardiomyocytes. Conclusions Our data demonstrate that cardiac hypertrophy produces dramatically different basal and stress-induced pathophenotypes in female- and male-origin cardiomyocytes. The lower Ca2+ operational status characteristic of female (vs male) cardiomyocytes comprising normal hearts is not exhibited by myocytes of hypertrophic hearts. After ischemia/reperfusion, availability of activator Ca2+ is suppressed in female hypertrophic myocytes, whereas sensitivity to Ca2+ is blunted in male hypertrophic myocytes. These findings demonstrate that selective intervention strategies should be pursued to optimize post-ischemic electromechanical support for male and female hypertrophic hearts. Electronic supplementary material The online version of this article (doi:10.1186/s13293-016-0084-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- James R Bell
- Department of Physiology, University of Melbourne, Melbourne, Victoria Australia
| | - Claire L Curl
- Department of Physiology, University of Melbourne, Melbourne, Victoria Australia
| | - Tristan W Harding
- Department of Physiology, University of Melbourne, Melbourne, Victoria Australia
| | - Martin Vila Petroff
- Centro de Investigaciones Cardiovasculares, Centro Cientifico Tecnologico La Plata, Facultad de Ciencias Medicas, Universidad Nacional de La Plata, La Plata, Argentina
| | - Stephen B Harrap
- Department of Physiology, University of Melbourne, Melbourne, Victoria Australia
| | - Lea M D Delbridge
- Department of Physiology, University of Melbourne, Melbourne, Victoria Australia.,Cardiac Phenomics Laboratory, Department of Physiology, University of Melbourne, Melbourne, Victoria 3010 Australia
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Duckworth JC, Doran KA, Waldron M. Childhood weight status and timing of first substance use in an ethnically diverse sample. Drug Alcohol Depend 2016; 164:172-178. [PMID: 27234661 PMCID: PMC4898759 DOI: 10.1016/j.drugalcdep.2016.05.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 03/21/2016] [Accepted: 05/09/2016] [Indexed: 01/06/2023]
Abstract
BACKGROUND We examined associations between weight status during childhood and timing of first cigarette, alcohol, and marijuana use in an ethnically diverse sample. METHODS Data were drawn from child respondents of the 1979 National Longitudinal Survey of Youth, including 1448 Hispanic, 2126 non-Hispanic Black, and 3304 non-Hispanic, non-Black (White) respondents aged 10 years and older as of last assessment. Cox proportional hazards regression was conducted predicting age at first use from weight status (obese, overweight, and underweight relative to healthy weight) assessed at ages 7/8, separately by substance class, sex, and race/ethnicity. Tests of interactions between weight status and respondent sex and race/ethnicity were also conducted. RESULTS Compared to healthy-weight females of the same race/ethnicity, overweight Hispanic females were at increased likelihood of alcohol and marijuana use and overweight White females were at increased likelihood of cigarette and marijuana use. Compared to healthy-weight males of the same race/ethnicity, obese White males were at decreased likelihood of cigarette and alcohol use and underweight Hispanic and Black males were at decreased likelihood of alcohol and marijuana use. Significant differences in associations by sex and race/ethnicity were observed in tests of interactions. CONCLUSIONS Findings highlight childhood weight status as a predictor of timing of first substance use among Hispanic and Non-Hispanic Black and White female and male youth. Results suggest that collapsing across sex and race/ethnicity, a common practice in prior research, may obscure important within-group patterns of associations and thus may be of limited utility for informing preventive and early intervention efforts.
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Affiliation(s)
- Jennifer C Duckworth
- Department of Counseling and Educational Psychology, Indiana University, 201 N. Rose Ave., Bloomington, IN, 47405-1006 USA
| | - Kelly A Doran
- Department of Counseling and Educational Psychology, Indiana University, 201 N. Rose Ave., Bloomington, IN, 47405-1006 USA
| | - Mary Waldron
- Department of Counseling and Educational Psychology, Indiana University, 201 N. Rose Ave., Bloomington, IN, 47405-1006 USA; Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, Campus Box 8134, 4560 Clayton Ave., Suite 1000, St. Louis, MO 63110-1502, USA.
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Fischer TH, Herting J, Eiringhaus J, Pabel S, Hartmann NH, Ellenberger D, Friedrich M, Renner A, Gummert J, Maier LS, Zabel M, Hasenfuss G, Sossalla S. Sex-dependent alterations of Ca2+ cycling in human cardiac hypertrophy and heart failure. Europace 2015; 18:1440-8. [PMID: 26493982 DOI: 10.1093/europace/euv313] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 08/19/2015] [Indexed: 11/12/2022] Open
Abstract
AIMS Clinical studies have shown differences in the propensity for malignant ventricular arrhythmias between women and men suffering from cardiomyopathies and heart failure (HF). This is clinically relevant as it impacts therapies like prophylactic implantable cardioverter-defibrillator implantation but the pathomechanisms are unknown. As an increased sarcoplasmic reticulum (SR) Ca(2+) leak is arrhythmogenic, it could represent a cellular basis for this paradox. METHODS/RESULTS We evaluated the SR Ca(2+) leak with respect to sex differences in (i) afterload-induced cardiac hypertrophy (Hy) with preserved left ventricular (LV) function and (ii) end-stage HF. Cardiac function did not differ between sexes in both cardiac pathologies. Human cardiomyocytes isolated from female patients with Hy showed a significantly lower Ca(2+) spark frequency (CaSpF, confocal microscopy, Fluo3-AM) compared with men (P < 0.05). As Ca(2+) spark width and duration were similar in women and men, this difference in CaSpF did not yet translate into a significant difference of the calculated SR Ca(2+) leak between both sexes at this stage of disease (P = 0.14). Epifluorescence measurements (Fura2-AM) revealed comparable Ca(2+) cycling properties (diastolic Ca(2+) levels, amplitude of systolic Ca(2+) transients, SR Ca(2+) load) in patients of both sexes suffering from Hy. Additionally, the increased diastolic CaSpF in male patients with Hy did not yet translate into an elevated ratio of cells showing arrhythmic events (Ca(2+) waves, spontaneous Ca(2+) transients) (P = 0.77). In the transition to HF, both sexes showed an increase of the CaSpF (P < 0.05) and the sex dependence was even more pronounced. Female patients had a 69 ± 10% lower SR Ca(2+) leak (P < 0.05), which now even translated into a lower ratio of arrhythmic cells in female HF patients compared with men (P < 0.001). CONCLUSION These data show that the SR Ca(2+) leak is lower in women than in men with comparable cardiac impairment. Since the SR Ca(2+) leak triggers delayed afterdepolarizations, our findings may explain why women are less prone to ventricular arrhythmias and confirm the rationale of therapeutic measures reducing the SR Ca(2+) leak.
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Affiliation(s)
- Thomas H Fischer
- Klinik für Kardiologie und Pneumologie/Herzzentrum, Georg-August-Universität Göttingen, Göttingen, Germany
| | - Jonas Herting
- Klinik für Kardiologie und Pneumologie/Herzzentrum, Georg-August-Universität Göttingen, Göttingen, Germany
| | - Jörg Eiringhaus
- Klinik für Kardiologie und Pneumologie/Herzzentrum, Georg-August-Universität Göttingen, Göttingen, Germany
| | - Steffen Pabel
- Klinik für Kardiologie und Pneumologie/Herzzentrum, Georg-August-Universität Göttingen, Göttingen, Germany
| | - Nico H Hartmann
- Klinik für Kardiologie und Pneumologie/Herzzentrum, Georg-August-Universität Göttingen, Göttingen, Germany
| | - David Ellenberger
- Institut für Medizinische Statistik, Georg-August-Universität Göttingen, Göttingen, Germany
| | - Martin Friedrich
- Abt. Thorax-, Herz- und Gefäßchirurgie, Herzzentrum, Georg-August-Universität Göttingen, Göttingen, Germany
| | - André Renner
- Abt. Thorax-, Herz-, Gefäßchirurgie, Herz- und Diabeteszentrum Nordrheinwestfalen, Bad Oeynhausen, Germany
| | - Jan Gummert
- Abt. Thorax-, Herz-, Gefäßchirurgie, Herz- und Diabeteszentrum Nordrheinwestfalen, Bad Oeynhausen, Germany
| | - Lars S Maier
- Klinik und Poliklinik für Innere Medizin II, Universitätsklinikum Regensburg, Regensburg, Germany
| | - Markus Zabel
- Klinik für Kardiologie und Pneumologie/Herzzentrum, Georg-August-Universität Göttingen, Göttingen, Germany Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Standort Göttingen, Germany
| | - Gerd Hasenfuss
- Klinik für Kardiologie und Pneumologie/Herzzentrum, Georg-August-Universität Göttingen, Göttingen, Germany Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Standort Göttingen, Germany
| | - Samuel Sossalla
- Klinik für Kardiologie und Pneumologie/Herzzentrum, Georg-August-Universität Göttingen, Göttingen, Germany Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Standort Göttingen, Germany
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Abstract
PROBLEM STATEMENT Men and women experience pronounced differences in functional decline as they age. The mechanisms behind these differences remain unclear, particularly among chronically ill populations. Drawing on the theory of the disablement process, this research examines sex differences in functional decline, focusing on two mechanisms suggested by the literature to partially mediate these disparities: health behaviors and social support. APPROACH Data from diabetics aged 50 and older from the Health and Retirement Study (n = 2,493) were examined for change in functional status over a 10-year period. Multivariate longitudinal multi-level models were conducted to analyze (1) health behavior (2) social support; and (3) a full model with health behavior and social support together, followed by a separate analysis using sex interaction terms. RESULTS Women and men both experienced functional decline over time. In the models that examined health behaviors and social support separately, women experienced steeper rates of decline. In the full model (which included health behaviors and social support together), men experienced a steeper rate of decline relative to women. The analyses suggest that it is the combination of health and social characteristics (largely through engagement in socially supportive activities that promote health) that are protective against functional decline. CONCLUSION/RECOMMENDATIONS As diabetic men experienced a steeper rate of functional decline than diabetic women once health behaviors and social support were both held constant, future research must examine (a) how these protective factors operate in tandem to protect against disablement of women with diabetes; and (b) how clinical and social policy can promote multi-pronged interventions to improve health behaviors in supportive contexts. Such research will benefit from multi-disciplinary collaborations.
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Affiliation(s)
- Emily Joy Nicklett
- School of Social Work, University of Michigan, 1080 South University Avenue, 3772, Ann Arbor, MI 48109
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