Patient and physician gender concordance in preventive care in university primary care settings.

OBJECTIVE To assess the quality of preventive care according to physician and patient gender in a country with universal health care coverage. METHODS We assessed a retrospective cohort study of 1001 randomly selected patients aged 50-80 years followed over 2 years (2005-2006) in 4 Swiss university primary care settings (Basel, Geneva, Lausanne, Zürich). We used indicators derived from RAND's Quality Assessment Tools and examined percentages of recommended preventive care. Results were adjusted using hierarchical multivariate logistic regression models. RESULTS 1001 patients (44% women) were followed by 189 physicians (52% women). Female patients received less preventive care than male patients (65.2% vs. 72.1%, p<0.001). Female physicians provided significantly more preventive care than male physicians (p=0.01) to both female (66.7% vs. 63.6%) and male patients (73.4% vs. 70.7%). After multivariate adjustment, differences according to physician (p=0.02) and patient gender (p<0.001) remained statistically significant. Female physicians provided more recommended cancer screening than male physicians (78.4 vs. 71.9%, p=0.01). CONCLUSIONS In Swiss university primary care settings, female patients receive less preventive care than male patients, with female physicians providing more preventive care than male physicians. Greater attention should be paid to female patients in preventive care and to why female physicians tend to provide better preventive care.

Gender differences in paediatric patients of the swiss inflammatory bowel disease cohort study.

PURPOSE Gender differences in paediatric patients with inflammatory bowel disease (IBD) are frequently reported as a secondary outcome and the results are divergent. To assess gender differences by analysing data collected within the Swiss IBD cohort study database since 2008, related to children with IBD, using the Montreal classification for a systematic approach. METHODS Data on gender, age, anthropometrics, disease location at diagnosis, disease behaviour, and therapy of 196 patients, 105 with Crohn's disease (CD) and 91 with ulcerative or indeterminate colitis (UC/IC) were retrieved and analysed. RESULTS THE CRUDE GENDER RATIO (MALE : female) of patients with CD diagnosed at <10 years of age was 2.57, the adjusted ratio was 2.42, and in patients with UC/IC it was 0.68 and 0.64 respectively. The non-adjusted gender ratio of patients diagnosed at ≥10 years was 1.58 for CD and 0.88 for UC/IC. Boys with UC/IC diagnosed <10 years of age had a longer diagnostic delay, and in girls diagnosed with UC/IC >10 years a more important use of azathioprine was observed. No other gender difference was found after analysis of age, disease location and behaviour at diagnosis, duration of disease, familial occurrence of IBD, prevalence of extra-intestinal manifestations, complications, and requirement for surgery. CONCLUSION CD in children <10 years affects predominantly boys with a sex ratio of 2.57; the impact of sex-hormones on the development of CD in pre-pubertal male patients should be investigated.

Gender references in job advertisements – relations to job status and gender equality

Research has shown that gender references in job advertisements play an important role for gender (in)equality in personnel selection. The use of pair forms (masculine and feminine form) in German-language job advertisements, for example, was found to reduce the lack of fit between women and leadership roles (Horvath & Sczesny, 2013). Therefore the present study addresses the question which forms of gender reference are used in job advertisements, how these forms are distributed in different countries and how language use is related to gender typicality and status of the job. We collected job advertisements published online in four countries with different rankings of gender equality (i.e., Switzerland, Austria, Poland, and Czech Republic; World Economic Forum, 2011). We randomly selected 100 advertisements per country from four branches that are characterized by different proportions of female and male employees: steels/metals, science, restaurants/food services, and health care. The advertisements were analyzed with regard to gender references as well as different indicators of job status. The results show that, in general, men and women are addressed more equally in Swiss and Austrian job advertisements compared to Polish and Czech job advertisements. The results also show that women and men are addressed more equally in branches where the proportion of women is high than where the proportion of women is low. We thus can conclude that the use of gender references is associated with the degree of gender equality achieved in a country and with the gender typicality of a profession.

Shakespeare, the Middle Ages and the Luck of the British: Medievalism and National Identity in The Hollow Crown (2012)

Images of the medieval past have long been fertile soil for the identity politics of subsequent periods. Rather than “authentically” reproducing the Middle Ages, medievalism therefore usually tells us more about the concerns and ideological climate of its own time and place of origin. To dramatise the nascent nation, Shakespeare resorts to medievalism in his history plays. Centuries later, the BBC-produced television mini-serial The Hollow Crown – adapting Shakespeare’s second histories tetralogy – revamps this negotiation of national identity for the “Cultural Olympiad” in the run-up to the 2012 London Olympics. In this context of celebratory introspection, The Hollow Crown weaves a genealogical narrative consisting of the increasingly “glorious” medieval history depicted and “national” Shakespearean heritage in order to valorise 21st-century “Britishness”. Encouraging a reading of the histories as medieval history, the films construct an ostensibly inclusive, liberal-minded national identity grounded in this history. Moreover, medieval kingship is represented in distinctly sentimentalising and humanising terms, fostering emotional identification especially with the no longer ambivalent Hal/Henry V and making him an apt model for present-day British grandeur. However, the fact that the films in return marginalise female, Scottish, Irish and Welsh characters gives rise to doubts as to whether this vision of Shakespeare’s Middle Ages really is, as the producers claimed, “for everybody”.

Reversal of gender differences in Educational Attainment – historical analysis of the West German Case

Background information: During the late 1970s and the early 1980s, West Germany witnessed a reversal of gender differences in educational attainment, as females began to outperform males. Purpose: The main objective was to analyse which processes were behind the reversal of gender differences in educational attainment after 1945. The theoretical reflections and empirical evidence presented for the US context by DiPrete and Buchmann (Gender-specific trends in the value of education and the emerging gender gap in college completion, Demography 43: 1–24, 2006) and Buchmann, DiPrete, and McDaniel (Gender inequalities in education, Annual Review of Sociology 34: 319–37, 2008) are considered and applied to the West German context. It is suggested that the reversal of gender differences is a consequence of the change in female educational decisions, which are mainly related to labour market opportunities and not, as sometimes assumed, a consequence of a ‘boy’s crisis’. Sample: Several databases, such as the German General Social Survey, the German Socio-economic Panel and the German Life History Study, are employed for the longitudinal analysis of the educational and occupational careers of birth cohorts born in the twentieth century. Design and methods: Changing patterns of eligibility for university studies are analysed for successive birth cohorts and gender. Binary logistic regressions are employed for the statistical modelling of the individuals’ achievement, educational decision and likelihood for social mobility – reporting average marginal effects (AME). Results: The empirical results suggest that women’s better school achievement being constant across cohorts does not contribute to the explanation of the reversal of gender differences in higher education attainment, but the increase of benefits for higher education explains the changing educational decisions of women regarding their transition to higher education. Conclusions: The outperformance of females compared with males in higher education might have been initialised by several social changes, including the expansion of public employment, the growing demand for highly qualified female workers in welfare and service areas, the increasing returns of women’s increased education and training, and the improved opportunities for combining family and work outside the home. The historical data show that, in terms of (married) women’s increased labour market opportunities and female life-cycle labour force participation, the raising rates of women’s enrolment in higher education were – among other reasons – partly explained by their rising access to service class positions across birth cohorts, and the rise of their educational returns in terms of wages and long-term employment.

Gender, Professional Networks, and Subjective Career Success within Early Academic Science Careers: The Role of Gender Composition in Inside and Outside Departmental Support Networks

The present study analyzed (a) gender differences in the gender composition (i.e., the proportion of male to female contacts) of professional support networks inside and outside an individual’s academic department and (b) how these differences in gender composition relate to subjective career success (i.e., perceived career success and perceived external marketability). Results showed that the networks’ gender composition is associated with subjective career success. Men’s networks consist of a higher proportion of male to female supporters, which, in turn, was positively related to subjective career success. Additional analyses revealed that the findings could not be accounted for by alternative factors, such as network size, networking behaviors, and career ambition.

Promoting gender equality in responses to climate change: The case of Kenya

The paper discusses how Kenyan policies and organisations address gender equality in climate change-related responses. The political support for gender issues is reflected in presidential directives on various actions for achieving gender equality such as the establishment of gender desk officers and ensuring 30 per cent female representation in government. Despite the well-advanced gender mainstreaming policy in Kenya, few policies focus on climate change and even fewer on its inter-linkages with gender. At the field level, encrusted traditions, inadequately trained staff, limited financial resources, and limited awareness of the inter-linkages between gender and climate change remain major challenges to promoting gender equality in the work of government organisations. The paper thus proposes measures for addressing these challenges and strengthening gender equality in responses to climate change.

Gender inequalities in the response to combination antiretroviral therapy over time: the Swiss HIV Cohort Study

OBJECTIVES Gender-specific data on the outcome of combination antiretroviral therapy (cART) are a subject of controversy. We aimed to compare treatment responses between genders in a setting of equal access to cART over a 14-year period. METHODS Analyses included treatment-naïve participants in the Swiss HIV Cohort Study starting cART between 1998 and 2011 and were restricted to patients infected by heterosexual contacts or injecting drug use, excluding men who have sex with men. RESULTS A total of 3925 patients (1984 men and 1941 women) were included in the analysis. Women were younger and had higher CD4 cell counts and lower HIV RNA at baseline than men. Women were less likely to achieve virological suppression < 50 HIV-1 RNA copies/mL at 1 year (75.2% versus 78.1% of men; P = 0.029) and at 2 years (77.5% versus 81.1%, respectively; P = 0.008), whereas no difference between sexes was observed at 5 years (81.3% versus 80.5%, respectively; P = 0.635). The probability of virological suppression increased in both genders over time (test for trend, P < 0.001). The median increase in CD4 cell count at 1, 2 and 5 years was generally higher in women during the whole study period, but it gradually improved over time in both sexes (P < 0.001). Women also were more likely to switch or stop treatment during the first year of cART, and stops were only partly driven by pregnancy. In multivariate analysis, after adjustment for sociodemographic factors, HIV-related factors, cART and calendar period, female gender was no longer associated with lower odds of virological suppression. CONCLUSIONS Gender inequalities in the response to cART are mainly explained by the different prevalence of socioeconomic characteristics in women compared with men.

Educational Systems and Gender Segregation in Education: A Three-Country Comparison of Germany, Norway and Canada

How do institutional settings and their embedded policy principles affect gender-typed enrolment in educational programmes? Based on gender-sensitive theories on career choice, we hypothesised that gender segregation in education is higher with a wider range of offers of vocational programmes. By analysing youth survey and panel data, we tested this assumption for Germany, Norway and Canada, three countries whose educational systems represent a different mix of academic, vocational and universalistic education principles. We found that vocational programmes are considerably more gender-segregated than are academic (e.g. university) programmes. Men, more so than women, can avoid gender-typed programmes by passing on to a university education. This in turn means that as long as their secondary school achievement does not allow for a higher education career, they have a higher likelihood of being allocated to male-typed programmes in the vocational education and training (VET) system. In addition, social background and the age at which students have to choose educational offers impact on the transition to gendered educational programmes. Overall, gender segregation in education is highest in Germany and the lowest in Canada. We interpret the differences between these countries with respect to the constellations of educational principles and policies in the respective countries.