The influence of patient and doctor gender on diagnosing coronary heart disease

Using novel methods, this paper explores sources of uncertainty and gender bias in primary care doctors' diagnostic decision-making about coronary heart disease (CHD). Claims about gendered consultation styles and quality of care are re-examined, along with the adequacy of CHD models for women. Randomly selected doctors in the UK and the US (n=112, 56 per country, stratified by gender) were shown standardised videotaped vignettes of actors portraying patients with CHD. Patients' age, gender, ethnicity and social class were varied systematically. During interviews, doctors gave free-recall accounts of their decision-making, which were analysed to determine patient and doctor gender effects. We found differences in male and female doctors' responses to different types of patient information. Female doctors recall more patient cues overall, particularly about history presentation, and particularly amongst women. Male doctors appear less affected by patient gender but both male and especially female doctors take more account of male patients' age, and consider more age-related disease possibilities for men than women. Findings highlight the need for better integration of knowledge about female presentations within accepted CHD risk models, and do not support the contention that women receive better-quality care from female doctors.

Retrospective reports of child feeding practices, current eating behaviors, and BMI in college students

Research concerning child feeding practices has focused on children and adolescents, and little is known about how feeding practices used in childhood relate to eating behaviors and weight status in early adulthood. We assessed college students' and their parents' retrospective reports of child feeding practices used when the students were in middle childhood. We also assessed the college students' current reports of their eating behaviors using the Dutch Eating Behavior Questionnaire (DEBQ) and the Intuitive Eating Scale (IES), and measured their current BMI. Results showed that college students' and their parents' reports about previous parental use of child feeding practices were not correlated. Parent reports of their own use of child feeding practices were more related to students' eating behaviors and BMI than were students' recollections about feeding practices used by their parents. An analysis of gender effects showed that there were positive correlations between parental child feeding practices, BMI, and emotional eating for female students. These relationships did not exist for male students. The results suggest that child feeding practices recollected by parents are linked to the development of emotional eating and weight status of women in early adulthood.

Reduced gray matter volume in ventral prefrontal cortex but not amygdala in bipolar disorder:significant effects of gender and trait anxiety

Neuroimaging studies in bipolar disorder report gray matter volume (GMV) abnormalities in neural regions implicated in emotion regulation. This includes a reduction in ventral/orbital medial prefrontal cortex (OMPFC) GMV and, inconsistently, increases in amygdala GMV. We aimed to examine OMPFC and amygdala GMV in bipolar disorder type 1 patients (BPI) versus healthy control participants (HC), and the potential confounding effects of gender, clinical and illness history variables and psychotropic medication upon any group differences that were demonstrated in OMPFC and amygdala GMV. Images were acquired from 27 BPI (17 euthymic, 10 depressed) and 28 age- and gender-matched HC in a 3T Siemens scanner. Data were analyzed with SPM5 using voxel-based morphometry (VBM) to assess main effects of diagnostic group and gender upon whole brain (WB) GMV. Post-hoc analyses were subsequently performed using SPSS to examine the extent to which clinical and illness history variables and psychotropic medication contributed to GMV abnormalities in BPI in a priori and non-a priori regions has demonstrated by the above VBM analyses. BPI showed reduced GMV in bilateral posteromedial rectal gyrus (PMRG), but no abnormalities in amygdala GMV. BPI also showed reduced GMV in two non-a priori regions: left parahippocampal gyrus and left putamen. For left PMRG GMV, there was a significant group by gender by trait anxiety interaction. GMV was significantly reduced in male low-trait anxiety BPI versus male low-trait anxiety HC, and in high- versus low-trait anxiety male BPI. Our results show that in BPI there were significant effects of gender and trait-anxiety, with male BPI and those high in trait-anxiety showing reduced left PMRG GMV. PMRG is part of medial prefrontal network implicated in visceromotor and emotion regulation.

The effects of gender and COMT Val158Met polymorphism on fearful facial affect recognition:a fMRI study

The functional catechol-O-methyltransferase (COMT Val108/158Met) polymorphism has been shown to have an impact on tasks of executive function, memory and attention and recently, tasks with an affective component. As oestrogen reduces COMT activity, we focused on the interaction between gender and COMT genotype on brain activations during an affective processing task. We used functional MRI (fMRI) to record brain activations from 74 healthy subjects who engaged in a facial affect recognition task; subjects viewed and identified fearful compared to neutral faces. There was no main effect of the COMT polymorphism, gender or genotypegender interaction on task performance. We found a significant effect of gender on brain activations in the left amygdala and right temporal pole, where females demonstrated increased activations over males. Within these regions, Val/Val carriers showed greater signal magnitude compared to Met/Met carriers, particularly in females. The COMT Val108/158Met polymorphism impacts on gender-related patterns of activation in limbic and paralimbic regions but the functional significance of any oestrogen-related COMT inhibition appears modest. Copyright © 2008 CINP.

Differential gains from Business Link support and advice:a treatment effects approach

The provision of advisory support to small firms is almost ubiquitous in OECD countries, although it is organised in different ways and is justified on slightly different grounds. In England publicly supported advisory services are provided through the Business Link (BL) network. Here, we consider two questions: what sort of companies receive advisory support from BL; and, what types of firms benefit most from that support? Our analysis is based on a telephone survey of 2000 firms, around half of which had received intensive assistance from BL between April and October 2003. Probit analysis suggests that the probability of receiving assistance was greater among younger businesses, those with larger numbers of directors in the firm, and those with more gender diversity among the firm's leadership team. Our business-growth models suggest that BL intensive assistance was having a positive effect on employment growth in 2003. BL had a positive but insignificant impact on sales growth over the period. Employment growth effects tend to be larger where firms have a management and organisational structure, which is more conducive to absorbing and making use of external advice. The analysis suggests that BL might increase its impact through targeting these larger, more export-orientated, businesses. Employment growth effects differ little, however, depending on either the ethnic or the gender diversity of the leadership team.

Meta-analytic model comparisons of surface- and deep-level relational diversity effects on social integration and individual effectiveness

While diversity might give an organization a competitive advantage, individuals have a tendency to prefer homogenous group settings. Prior research suggests that group members who are dissimilar (vs. similar) to their peers in terms of a given diversity attribute (e.g. demographics, attitudes, values or traits) feel less attached to their work group, experience less satisfying and more conflicted relationships with their colleagues, and consequently are less effective. However, prior empirical findings tend to be weak and inconsistent, and it remains unclear when, how and to what extent such differences affect group members’ social integration (i.e. attachment with their work group, satisfaction and conflicted relationships with their peers) and effectiveness. To address these issues the current study conducted a meta-analysis and integrated the empirical results of 129 studies. For demographic diversity attributes (such as gender, ethnicity, race, nationality, age, functional background, and tenure) the findings support the idea that demographic dissimilarity undermines individual member performance via lower levels of social integration. These negative effects were more pronounced in pseudo teams – i.e. work groups in which group members pursue individual goals, work on individual tasks, and are rewarded for their individual performance. These negative effects were however non-existent in real teams - i.e. work groups in which groups members pursue group goals, work on interdependent tasks, and are rewarded (at least partially) based on their work group’s performance. In contrast, for underlying psychological diversity attributes (such as attitudes, personality, and values), the relationship between dissimilarity and social integration was more negative in real teams than in pseudo teams, which in return translated into even lower individual performance. At the same time however, differences in underlying psychological attributes had an even stronger positive effect on dissimilar group member’s individual performance, when the negative effects of social integration were controlled for. This implies that managers should implement real work groups to overcome the negative effects of group member’s demographic dissimilarity. To harness the positive effects of group members’ dissimilarity on underlying psychological attributes, they need to make sure that dissimilar group members become socially integrated.

Gender differences in factors predicting unsafe crossing decisions in adult pedestrians across the lifespan: a simulation study

Adult pedestrian accident data has demonstrated that the risk of being killed or seriously injured varies with age and gender. A range of factors affecting road crossing choices of 218 adults aged 17-90+ were examined in a simulation study using filmed real traffic. With increasing age, women were shown to make more unsafe crossing decisions, to leave small safety margins and to become poorer at estimating their walking speed. However, the age effects on all of these were ameliorated by driving experience. Men differed from women in that age was not a major factor in predicting unsafe crossing decisions. Rather, reduced mobility was the key factor, leading them to make more unsafe crossings and delay longer in leaving the kerb. For men, driving experience did not predict unsafe road crossing decisions. Although male drivers were more likely to look both ways before crossing than male non-drivers, the impact of being a driver had a negative effect in terms of smaller safety margins and delay in leaving the kerb. The implications of the different predictor variables for men and women for unsafe road crossing are discussed and possible reasons for the differences explored.

The effects of new technology on employment structures in the service sector

This thesis explores the interrelationships between the labour process, the development of technology and patterns of gender differentiation. The introduction of front office terminals into building society branches forms the focus of the research. Case studies were carried out in nine branches, three each from three building societies. Statistical data for the whole movement and a survey of ten of the top thirty societies provided the context for the studies. In the process of the research it became clear that it was not technology itself but the way that it was used, that was the main factor in determining outcomes. The introduction of new technologies is occurring at a rapid pace, facilitated by continuing high growth rates, although front office technology could seldom be cost justified. There was great variety between societies in their operating philosophies and their reasons for and approach to computerisation, but all societies foresaw an ultimate saving in staff. Computerisation has resulted in the deskilling of the cashiering role and increased control over work at all stages. Some branch managers experienced a decrease in autonomy and an increase in control over their work. Subsequent to this deskilling there has been a greatly increased use of part time staff which has enabled costs to be reduced. There has also been a polarisation between career and non-career staff which, like the use of part time staff, has occurred along gender lines. There is considerable evidence that societies' policies, structures and managerial attitudes continue to directly and indirectly discriminate against women. It is these practices which confine women to lower grades and ensure their dependence on the family and which create the pool of cheap skilled labour that societies so willingly exploit by increasing part time work. Gender strategies enter management strategies throughout the operations of the organisation.

Placement year academic benefit revisited:effects of demographics, prior achievement and degree programme

Investigations of whether students taking undergraduate work placements show greater academic improvement than those who do not have shown inconsistent results. In most studies, sample sizes have been relatively small and few studies have taken into account pre-existing student differences.Here data from over 6000 students at one university over six cohorts and a range of programmes are analysed. Consistent academic benefit from placement experience, regardless of ethnicity, gender, socioeconomic background and subject is shown. However the impact of demographic factors on both achievement and on the probability of taking a placement suggests that future research should take these factors into account. The role of placements in promoting employability is contextualised as a secondary benefit to the primary goal of educating the mind in the Newman (1852) tradition. Possible causes of, and further research into, the improved academic performance identified are discussed.

The effect of age, gender and attitudes on self-regulation in driving

Self-regulation in driving has primarily been studied as a precursor to driving cessation in older people, who minimise driving risk and compensate for physical and cognitive decline by avoiding driving in challenging circumstances, e.g. poor weather conditions, in the dark and at busy times. This research explores whether other demographic groups of drivers adopt self-regulatory behaviours and examines the effects of affective and instrumental attitudes on self-regulation across the lifespan. Quantitative data were collected from 395 drivers. Women were significantly more likely than men to engage in self-regulation, and to be negatively influenced by their emotions (affective attitude). A quadratic effect of age on self-regulation was determined such that younger and older drivers reported higher scores for self-regulation than middle-years' drivers. However, this effect was affected by experience such that when experience was controlled for, self-regulation increased with age. Nevertheless, anxious driving style and negative affective attitude were independent predictors of self-regulation behaviours. Results suggest that self-regulation behaviours are present across the driving lifespan and may occur as a result of driving anxiety or low confidence rather than as an effect of ageing.

Man, I feel like a woman:when and how gender-role motivation helps mind-reading

Two experiments were undertaken with 3 goals: (a) to determine whether manipulating the desirability of including empathy as part of one's gender-role identity motivates accurate mind-reading, (b) to ascertain whether target readability moderates the strength of this effect, and (c) to test whether these effects are mediated by the complexity of perceivers' inferential strategies. Participants viewed videotapes of 2 couples discussing relationship problems and attempted to infer each partner's thoughts and feelings. Both experiments demonstrated that motivation improved accuracy when male and female perceivers valued the empathy-relevant aspects of the traditional female gender role. However, as predicted, high levels of motivation facilitated the accurate reading of easy targets but not of difficult targets. Several mediational models were tested, the results of which showed that the complexity of perceivers' attributions mediated the link between motivation and mind-reading accuracy.

School children's attitudes towards computers as a fucntion of gender, course subjects and availability of home computers

The attitudes of 328 British Secondary School children towards computers were examined in a cross-sectional survey. Measures of both general attitudes towards computers and affective reactions towards working with computers were examined in relation to the sex of the subject, courses studied (computer related/noncomputer related) and availability of a home computer. A differential pattern of results was observed. With respect to general attitudes towards computers, main effects were found for all three independent variables indicating that more favourable attitudes increased as a function of being male, doing computer courses and having a home computer. In contrast to this, affective reactions to working with computers was primarily related to doing computer courses, such that those doing computer courses reported more positive and less negative reactions. The practical and theoretical implications of these results are discussed.

Surface- and deep-level dissimilarity effects on social integration and individual effectiveness related outcomes in work groups:a meta-analytic integration

Prior research linking demographic (e.g., age, ethnicity/race, gender, and tenure) and underlying psychological (e.g., personality, attitudes, and values) dissimilarity variables to individual group member's work-related outcomes produced mixed and contradictory results. To account for these findings, this study develops a contingency framework and tests it using meta-analytic and structural equation modelling techniques. In line with this framework, results showed different effects of surface-level (i.e., demographic) dissimilarity and deep-level (i.e., underlying psychological) dissimilarity on social integration, and ultimately on individual effectiveness related outcomes (i.e., turnover, task, and contextual performance). Specifically, surface-level dissimilarity had a negative effect on social integration under low but not under high team interdependence. In return, social integration fully mediated the negative relationship between surface-level dissimilarity and individual effectiveness related outcomes under low interdependence. In contrast, deep-level dissimilarity had a negative effect on social integration, which was stronger under high and weaker under low team interdependence. Contrary to our predictions, social integration did not mediate the negative relationship between deep-level dissimilarity and individual effectiveness related outcomes but suppressed positive direct effects of deep-level dissimilarity on individual effectiveness related outcomes. Possible explanations for these counterintuitive findings are discussed. © 2011 The British Psychological Society.

No gender differences in brain activation during the N-back task:An fMRI study in healthy individuals

Gender differences have been well established in verbal and spatial abilities but few studies have examined if these differences also extend into the domain of working memory in terms of behavioural differences and brain activation. The conclusions that can be drawn from these studies are not clear cut but suggest that even though gender differences might not be apparent from behavioural measures, the underlying neural substrate associated with working memory might be different in men and women. Previous research suggests activation in a network of frontal and parietal regions during working memory tasks. This study aimed to investigate gender differences in patterns of brain activation during a verbal version of the N-back working memory task, which incorporates the effects of increased demands on working memory. A total of 50 healthy subjects, aged 18 to 58 years, that were equally split by gender were recruited matched for age, levels of education and ethnicity. All subjects underwent functional magnetic resonance imaging. We found that men and women performed equally well in terms of accuracy and response times, while using similar brain regions to the same degree. Our observations indicate that verbal working memory is not affected by gender at the behavioural or neural level, and support the findings of a recent meta-analysis by Hyde ([2005]: Sex Roles 53:717-725) that gender differences are generally smaller than intra-gender differences in many cognitive domains. © 2009 Wiley-Liss, Inc.