Hepatitis C coinfection is independently associated with decreased adherence to antiretroviral therapy in a population-based HIV cohort

OBJECTIVE: To characterize the impact of hepatitis C (HCV) serostatus on adherence to antiretroviral treatment (ART) among HIV-infected adults initiating ART. METHODS: The British Columbia HIV/AIDS Drug Treatment Program distributes, at no cost, all ART in this Canadian province. Eligible individuals used triple combination ART as their first HIV therapy and had documented HCV serology. Statistical analyses used parametric and non-parametric methods, including multivariate logistic regression. The primary outcome was > or = 95% adherence, defined as receiving > or = 95% of prescription refills during the first year of antiretroviral therapy. RESULTS: There were 1186 patients eligible for analysis, including 606 (51%) positive for HCV antibody and 580 (49%) who were negative. In adjusted analyses, adherence was independently associated with HCV seropositivity [adjusted odds ratio (AOR), 0.48; 95% confidence interval (CI), 0.23-0.97; P = 0.003], higher plasma albumin levels (AOR, 1.07; 95% CI, 1.01-1.12; P = 0.002) and male gender (AOR, 2.53; 95% CI, 1.04-6.15; P = 0.017), but not with injection drug use (IDU), age or other markers of liver injury. There was no evidence of an interaction between HCV and liver injury in adjusted analyses; comparing different strata of HCV and IDU confirmed that HCV was associated with poor adherence independent of IDU. CONCLUSIONS: HCV-coinfected individuals and those with lower albumin are less likely to be adherent to their ART.

Performance of a new, 3D-monitor based random-dot stereotest for children under 4 years of age

BACKGROUND: The aim of this study was to determine the performance of a new, 3D-monitor based, objective stereotest in children under the age of four. METHODS: Random-dot circles (diameter 10 cm, crossed, disparity of 0.34 degrees) randomly changing their position were presented on an 3D-monitor while eye movements were monitored by infrared photo-oculography. If > or = 3 consecutive stimuli were seen, a positive response was assumed. One hundred thirty-four normal children aged 2 months to 4 years (average 17+/-15.3 months) were examined. RESULTS: Below the age of 12 months, we were not able to obtain a response to the 3D stimulus. For older children the following rates of positive responses were found: 12-18 months 25%, 18-24 months 10%, 24-30 months 16%, 30-36 months 57%, 36-42 months 100%, and 42-48 months 91%. Multiple linear logistic regression showed a significant influence on stimulus recognition of the explanatory variables age (p<0.00001) and child cooperation (p<0.001), but not of gender (p>0.1). CONCLUSIONS: This 3D-monitor based stereotest allows an objective measurement of random-dot stereopsis in younger children. It might open new ways to screen children for visual abnormalities and to study the development of stereovision. However, the current experimental setting does not allow determining random-dot stereopsis in children younger than 12 months.

Stroke events, and case fatalities in Switzerland based on hospital statistics and cause of death statistics

OBJECTIVE: In Switzerland there is a shortage of population-based information on stroke incidence and case fatalities (CF). The aim of this study was to estimate stroke event rates and both in- and out-of-hospital CF rates. METHODS: Data on stroke diagnoses, coded according to I60-I64 (ICD 10), were taken from the Federal Hospital Discharge Statistics database (HOST) and the Cause of Death database (CoD) for the year 2004. The number of total stroke events and of age- and gender-specific and agestandardised event rates were estimated; overall CF, in-hospital and out-of-hospital, were determined. RESULTS: Among the overall number of 13 996 hospital discharges from stroke (HOST) the number was lower in women (n = 6736) than in men (n = 7260). A total of 3568 deaths (2137 women and 1431 men) due to stroke were recorded in the CoD database. The number of estimated stroke events was 15 733, and higher in women (n = 7933) than in men (n = 7800). Men presented significantly higher age-specific stroke event rates and a higher age-standardised event rate (178.7/100 000 versus 119.7/100 000). Overall CF rates were significantly higher for women (26.9%) than for men (18.4%). The same was true of out-of-hospital CF but not of in-hospital CF rates. CONCLUSION: The data on estimated stroke events obtained indicate that stroke discharge rate underestimates the stroke event rate. Out-of-hospital deaths from stroke accounted for the largest proportion of total stroke deaths. Sex differences in both number of total stroke events and deaths could be explained by the higher proportion of women than men aged 55+ in the Swiss population.

Evaluating Integration. Research contributions for a gender sensitive migration policy: Research contributions for a gender sensitive migration policy

The integration of academic and non-academic knowledge is a key concern for researchers who aim at bridging the gap between research and policy. Researchers involved in the sustainability-oriented NCCR North-South programme have made the experience that linking different types of knowledge requires time and effort, and that methodologies are still lacking. One programme component was created at the inception of this transdisciplinary research programme to support exchange between researchers, development practitioners and policymakers. After 8 years of research, the programme is assessing whether research has indeed enabled a continuous communication across and beyond academic boundaries and has effected changes in the public policies of poor countries. In a first review of the data, we selected two case studies explicitly addressing the lives of women. In both cases – one in Pakistan, the other in Nepal – the dialogue between researchers and development practitioners contributed to important policy changes for female migration. In both countries, outmigration has become an increasingly important livelihood strategy. National migration policies are gendered, limiting the international migration of women. In Nepal, women were not allowed to migrate to specific countries such as the Gulf States or Malaysia. This was done in the name of positive discrimination, to protect women from potential exploitation and harassment in domestic work. However, women continued to migrate in many other and often illegal and more risky ways, increasing their vulnerability. In Pakistan, female labour migration was not allowed at all and male migration increased the vulnerability of the families remaining back home. Researchers and development practitioners in Nepal and Pakistan brought women’s shared experience of and exposure to the mechanisms of male domination into the public debate, and addressed the discriminating laws. Now, for the first time in Pakistan, the new draft policy currently under discussion would enable broadly-based female labour migration. What can we learn from the two case studies with regard to ways of relating experience- and research-based knowledge? The paper offers insights into the sequence of interactions between researchers, local people, development practitioners, and policy-makers, which eventually contributed to the formulation of a rights-based migration policy. The reflection aims at exploring the gendered dimension of ways to co-produce and share knowledge for development across boundaries. Above all, it should help researchers to better tighten the links between the spheres of research and policy in future.

Social Support Quality in Internet Based Information and Communication: From "Digital Divide" to "Voice Divide"

National and international studies demonstrate that the number of teenagers using the inter-net increases. But even though they actually do have access from different places to the in-formation and communication pool of the internet, there is evidence that the ways in which teenagers use the net - regarding the scope and frequency in which services are used as well as the preferences for different contents of these services - differ significantly in relation to socio-economic status, education, and gender. The results of the regarding empirical studies may be summarised as such: teenager with low (formal ) education especially use internet services embracing 'entertainment, play and fun' while higher educated teenagers (also) prefer intellectually more demanding and particularly services supplying a greater variety of communicative and informative activities. More generally, pedagogical and sociological studies investigating "digital divide" in a dif-ferentiated and sophisticated way - i.e. not only in terms of differences between those who do have access to the Internet and those who do not - suggest that the internet is no space beyond 'social reality' (e.g. DiMaggio & Hargittai 2001, 2003; Vogelgesang, 2002; Welling, 2003). Different modes of utilisation, that structure the internet as a social space are primarily a specific contextualisation of the latter - and thus, the opportunities and constraints in virtual world of the internet are not less than those in the 'real world' related to unequal distribu-tions of material, social and cultural resources as well as social embeddings of the actors involved. This fact of inequality is also true regarding the outcomes of using the internet. Empirical and theoretical results concerning forms and processes of networking and commu-nity building - i.e. sociability in the internet, as well as the social embeddings of the users which are mediated through the internet - suggest that net based communication and infor-mation processes may entail the resource 'social support'. Thus, with reference to social work and the task of compensating the reproduction of social disadvantages - whether they are medial or not - the ways in which teenagers get access to and utilize net based social sup-port are to be analysed.

CT scan based determination of optimal bone corridor for atlantoaxial ventral screw fixation in miniature breed dogs

OBJECTIVE: To describe the most reliable insertion angle, corridor length and width to place a ventral transarticular atlantoaxial screw in miniature breed dogs. STUDY DESIGN: Retrospective CT imaging study. SAMPLE POPULATION: Cervical CT scans of toy breed dogs (n = 21). METHODS: Dogs were divided into 2 groups--group 1: no atlantoaxial abnormalities; group 2: atlantoaxial instability. Insertion angle in medial to lateral and ventral to dorsal direction was measured in group 1. Corridor length and width were measured in groups 1 and 2. Corridor width was measured at 3 points of the corridor. Each variable was measured 3 times and the mean used for statistical analysis. RESULTS: Mean +/- SD optimal transarticular atlantoaxial insertion angle was determined to be 40 +/- 1 degrees in medial to lateral direction from the midline and 20 +/- 1 degrees in ventral to dorsal direction from the floor of the neural canal of C2. Mean corridor length was 7 mm (range, 4.5-8.0 mm). Significant correlation was found between corridor length, body weight, and age. Mean bone corridor width ranged from 3 to 5 mm. Statistically significant differences were found between individuals, gender and measured side. CONCLUSIONS: Optimal placement of a transarticular screw for atlantoaxial joint stabilization is very demanding because the screw path corridor is very narrow.

Gender-related mortality trends among diabetic patients with ST-segment elevation myocardial infarction: insights from a nationwide registry 1997-2010

BACKGROUND Data on temporal trends in outcomes, gender differences, and adherence to evidence-based therapy (EBT) of diabetic patients with ST-segment elevation myocardial infarction (STEMI) are sparse. METHODS We performed a retrospective analysis of prospectively acquired data on 3565 diabetic (2412 males and 1153 females) STEMI patients enrolled in the Swiss AMIS Plus registry between 1997 and 2010 and compared in-hospital outcomes and adherence to EBT with the nondiabetic population (n=15,531). RESULTS In-hospital mortality dramatically decreased in diabetic patients, from 19.9% in 1997 to 9.0% in 2010 (p trend<0.001) with an age-adjusted decrease of 6% per year of admission. Similar trends were observed for age-adjusted reinfarction (OR 0.86, p<0.001), cardiogenic shock (OR 0.88, p<0.001), as well as death, reinfarction, or stroke (OR 0.92, p<0.001). However, the mortality benefit over time was observed in diabetic males (p trend=0.006) but not females (p trend=0.082). In addition, mortality remained twice as high in diabetic patients compared with nondiabetic ones (12.1 vs. 6.1%, p<0.001) and diabetes was identified as independent predictor of mortality (OR 1.23, p=0.022). Within the diabetic cohort, females had higher mortality than males (16.1 vs. 10.2%, p<0.001) and female gender independently predicted in-hospital mortality (OR 1.45, p=0.015). Adherence to EBT significantly improved over time in diabetic patients (p trend<0.001) but remained inferior - especially in women - to the one of nondiabetic individuals. CONCLUSIONS In-hospital mortality and morbidity of diabetic STEMI patients in Switzerland improved dramatically over time but, compared with nondiabetic counterparts, gaps in outcomes as well as EBT use persisted, especially in women.

Suicide assisted by right-to-die associations: a population based cohort study

Background: In Switzerland, assisted suicide is legal but there is concern that vulnerable or disadvantaged groups are more likely to die in this way than other people. We examined socio-economic factors associated with assisted suicide. Methods: We linked the suicides assisted by right-to-die associations during 2003–08 to a census-based longitudinal study of the Swiss population. We used Cox and logistic regression models to examine associations with gender, age, marital status, education, religion, type of household, urbanization, neighbourhood socio-economic position and other variables. Separate analyses were done for younger (25 to 64 years) and older (65 to 94 years) people. Results: Analyses were based on 5 004 403 Swiss residents and 1301 assisted suicides (439 in the younger and 862 in the older group). In 1093 (84.0%) assisted suicides, an underlying cause was recorded; cancer was the most common cause (508, 46.5%). In both age groups, assisted suicide was more likely in women than in men, those living alone compared with those living with others and in those with no religious affiliation compared with Protestants or Catholics. The rate was also higher in more educated people, in urban compared with rural areas and in neighbourhoods of higher socio-economic position. In older people, assisted suicide was more likely in the divorced compared with the married; in younger people, having children was associated with a lower rate. Conclusions: Assisted suicide in Switzerland was associated with female gender and situations that may indicate greater vulnerability such as living alone or being divorced, but also with higher education and higher socio-economic position.

Strategies to increase the use and approval of gender-fair language

When masculine forms are used to refer to men and women, this causes male-biased cognitive representations and behavioral consequences, as numerous studies have shown. This effect can be avoided or reduced with the help of gender-fair language. In this talk, we will present different approaches that aim at influencing people’s use of and attitudes towards gender-fair language. Firstly, we tested the influence of gender-fair input on people’s own use of gender-fair language. Based on Irmen and Linner’s (2005) adaptation of the scenario mapping and focus approach (Sanford & Garrod, 1998), we found that after reading a text with gender-fair forms women produced more gender-fair forms than women who read gender-neutral texts or texts containing masculine generics. Men were not affected. Secondly, we examined reactions to arguments which followed the Elaboration Likelihood Model (Petty &Cacioppo, 1986). We assumed that strong pros and cons would be more effective than weak arguments or control statements. The results indicated that strong pros could convince some, but not all participants, suggesting a complex interplay of diverse factors in reaction to attempts at persuasion. The influence of people’s initial characteristics will be discussed. Currently, we are investigating how self-generated refutations, in addition to arguments, may influence initial attitudes. Based on the resistance appraisal hypothesis (Tormala, 2008), we assume that individuals are encouraged in their initial attitude if they manage to refute strong counter-arguments. The results of our studies will be discussed regarding their practical implications.

Norms on the gender perception of role nouns in Czech, English, French, German, Italian, Norwegian, and Slovak

We collected norms on the gender stereotypicality of an extensive list of role nouns in Czech, English, French, German, Italian, Norwegian, and Slovak, to be used as a basis for the selection of stimulus materials in future studies. We present a Web-based tool (available at https://www.unifr.ch/lcg/) that we developed to collect these norms and that we expect to be useful for other researchers, as well. In essence, we provide (a) gender stereotypicality norms across a number of languages and (b) a tool to facilitate cross-language as well as cross-cultural comparisons when researchers are interested in the investigation of the impact of stereotypicality on the processing of role nouns.

The gender typicality of faces and its impact on visual processing and on hiring decisions

Past research has shown that the gender typicality of applicants’ faces affects leadership selection irrespective of a candidate’s gender: A masculine facial appearance is congruent with masculine-typed leadership roles, thus masculine-looking applicants are hired more certainly than feminine-looking ones. In the present study, we extended this line of research by investigating hiring decisions for both masculine- and feminine-typed professional roles. Furthermore, we used eye tracking to examine the visual exploration of applicants’ portraits. Our results indicate that masculine-looking applicants were favored for the masculine-typed role (leader) and feminine-looking applicants for the feminine-typed role (team member). Eye movement patterns showed that information about gender category and facial appearance was integrated during first fixations of the portraits. Hiring decisions, however, were not based on this initial analysis, but occurred at a second stage, when the portrait was viewed in the context of considering the applicant for a specific job.

Gender Stereotypes and Gendered Vocational Aspirations among Secondary School Students

Research Topic/Aim: Horizontal gender inequalities appear to be rather stable, with girls more often choosing ‘female' service professions, and boys choosing career paths related to science, technology, engineering or mathematics, since measures to bring more women into typical ‘male' jobs and more men into typical ‘female' jobs did not turn out to be sustainable. This paper focuses on gender stereotypes, namely non-egalitarian patriarchal gender-role orientations and gender associations of the school subjects German and mathematics. Dealing with and abolishing such gender stereotypes may be key strategy to reach sustainability regarding more equal vocational choices. Thus, gender stereotypes will be theorised and empirically analysed as a major predictor of gender-typical vocational perspectives considering interest in these school subjects as a mediating factor. Furthermore, we focus on structural patriarchy as a root of gender-role orientations, and teacher gender regarding its impact on gendered images of subjects. Theoretical and methodology framework: Our analyses of gender segregation in vocational aspirations and vocational choice center on Gottfredson's (2002; Gottfredson and Becker, 1981) Theory of Circumscription, Compromise and Self-Creation. One of the main assumptions of this theory is that people associate jobs with particular sexes and those jobs that do not fit particular gender roles are not considered. Empirical analyses are based on survey data of eighth-graders in the Swiss canton of Bern (N = 672). Structural Equation Models (SEM) for male and female students are estimated. Conclusions/Findings: Results reveal different patterns for boys and girls; for boys, gender-typical (male) vocational perspective could be explained via gender role orientations, interest in mathematics and gender associations of the school subjects, for girls, the factors under consideration could be empirically linked to ‘atypical vocational perspective'. Relevance to Nordic educational research: The study focuses on gender relations in society and how they are reproduced. Gender segregation in vocational choice and at the labour market is a universal issue - affecting both egalitarian and non-egalitarian gender regimes in similar ways. Although in general Northern countries appear to be more equal regarding gender inequality, gender segregation is rather persistent (Jarman, Blackburn and Brooks, 2012) and therefore remains a relevant topic.

HIV-related malignancies: A community-based study using a linkage of cancer registry and HIV registry data

Background. Increased incidence of cancer is documented in immunosuppressed transplant patients. Likewise, as survival increases for persons infected with the Human Immunodeficiency Virus (HIV), we expect their incidence of cancer to increase. The objective of this study was to examine the current gender specific spectrum of cancer in an HIV infected cohort (especially malignancies not currently associated with Acquired Immunodeficiency Syndrome (AIDS)) in relation to the general population.^ Methods. Cancer incidence data was collected for residents of Harris County, Texas who were diagnosed with a malignancy between 1975 and 1994. This data was linked to HIV/AIDS registry data to identify malignancies in an HIV infected cohort of 14,986 persons. A standardized incidence ratio (SIR) analysis was used to compare incidence of cancer in this cohort to that in the general population. Risk factors such as mode of HIV infection, age, race and gender, were evaluated for contribution to the development of cancer within the HIV cohort, using Cox regression techniques.^ Findings. Of those in the HIV infected cohort, 2289 persons (15%) were identified as having one or more malignancies. The linkage identified 29.5% of these malignancies (males 28.7% females 60.9%). HIV infected men and women had incidences of cancer that were 16.7 (16.1, 17.3) and 2.9 (2.3, 3.7) times that expected for the general population of Harris County, Texas, adjusting for age. Significant SIR's were observed for the AIDS-defining malignancies of Kaposi's sarcoma, non-Hodgkin's lymphoma, primary lymphoma of the brain and cancer of the cervix. Additionally, significant SIR's for non-melanotic skin cancer in males, 6.9 (4.8, 9.5) and colon cancer in females, 4.0 (1.1, 10.2) were detected. Among the HIV infected cohort, race/ethnicity of White (relative risk 2.4 with 95% confidence intervals 2.0, 2.8) or Spanish Surname, 2.2 (1.9, 2.7) and an infection route of male to male sex, with, 3.0 (1.9, 4.9) or without, 3.4 (2.1, 5.5) intravenous drug use, increased the risk of having a diagnosis of an incident cancer.^ Interpretation. There appears to be an increased risk of developing cancer if infected with the HIV. In addition to the malignancies routinely associated with HIV infection, there appears to be an increased risk of being diagnosed with non-melanotic skin cancer in males and colon cancer in females. ^

An evaluation of a community-based program for homeless adults with mental disorders and comorbid alcohol drug and mental disorders

Limited research has been conducted evaluating programs that are designed to improve the outcomes of homeless adults with mental disorders and comorbid alcohol, drug and mental disorders. This study conducted such an evaluation in a community-based day treatment setting with clients of the Harris County Mental Health and Mental Retardation Authority's Bristow Clinic. The study population included all clients who received treatment at the clinic for a minimum of six months between January 1, 1995 and August 31, 1996. An electronic database was used to identify clients and to track their program involvement. A profile was developed of the study participants and their level of program involvement included an examination of the amount of time spent in clinical, social and other interventions, the type of interventions encountered and the number of interventions encountered. Results were analyzed to determine whether social, demographic and mental history affected levels of program involvement and the effects of the levels of program involvement on housing status and psychiatric functioning status.^ A total of 101 clients met the inclusion criteria. Of the 101 clients, 96 had a mental disorder, and five had comorbidity. Due to the limited numbers of participants with comorbidity, only those with mental disorders were included in the analysis. The study found the Bristow Clinic population to be primarily single, Black, male, between the ages of 31 and 40 years, and with a gross family income of less than $4,000. There were more persons residing on the streets at entry and at six months following treatment than in any other residential setting. The most prevalent psychiatric diagnoses were depressive disorders and schizophrenia. The Global Assessment of Functioning (GAF) scale which was used to determine the degree of psychiatric functioning revealed a modal GAF score of 31--40 at entry and following six months in treatment. The study found that the majority of clients spent less than 17 hours in treatment, had less than 51 encounters and had clinical, social, and other encounters. In regard to social and demographic factors and levels of program involvement, there were statistically significant associations between gender and ethnicity and the types of interventions encountered as well as the number of interventions encountered. There was also a statistically significant difference between the amount of time spent in clinical interventions and gender. Relative to outcomes measured, the study found female gender to be the only background variable that was significantly associated with improved housing status and the female gender and previous MHMRA involvement to be statistically associated with improvement in GAF score. The total time in other (not clinical or social) interventions and the total number of encounters with other interventions were also significantly associated with improvement in housing outcome. The analysis of previous services and levels of program involvement revealed significant associations between time spent in social and clinical interventions and previous hospitalizations and previous MHMRA involvement.^ Major limitations of this study include the small sample size which may have resulted in very little power to detect differences and the lack of generalizability of findings due to site locations used in the study. Despite these limitations, the study makes an important contribution to the literature by documenting the levels of program involvement and the social and demographic factors necessary to produce outcomes of improved housing status and psychiatric functioning status. ^

Troublesome Issues: Current Debates on Tensions between Gender Equality and Cultural Diversity in Austria

This paper will first deal with the legal and social situation of Islam and Muslims in Austria and then turn to particular “troublesome issues” at the intersection of gender equality and ethnic/religious diversity. The public debate on Muslims particularly focuses on the notion “not willing to integrate” and in the assumption of “parallel societies”. Hierarchical gender relations and “harmful traditions” such as veiling, female genital cutting, forced marriage and honour based violence recently became the centre of attention. We will show that the Austrian debate on these issues is shaped by the idea of “dangerous cultural difference” as something coming from outside and being concentrated in segregated Muslim enclaves. Despite the public authorities’ rejection of the idea that Islam was responsible for “harmful traditions”, legal as well as political measures in Austria not only combat violence against women but also fuel “cultural anxieties” between different ethnic and religious groups.