Psychogenic dysphonia: diversity of clinical and vocal manifestations in a case series

Introduction: Psychogenic dysphonia is a functional disorder with variable clinical manifestations.Objective: To assess the clinical and vocal characteristics of patients with psychogenic dysphonia in a case series.Methods: The study included 28 adult patients with psychogenic dysphonia, evaluated at a University hospital in the last ten years. Assessed variables included gender, age, occupation, vocal symptoms, vocal characteristics, and videolaryngostroboscopic findings.Results: 28 patients (26 women and 2 men) were assessed. Their occupations included: housekeeper (n = 17), teacher (n = 4), salesclerk (n = 4), nurse (n = 1), retired (n = 1), and psychologist (n = 1). Sudden symptom onset was reported by 16 patients and progressive symptom onset was reported by 12; intermittent evolution was reported by 15; symptom duration longer than three months was reported by 21 patients. Videolaryngostroboscopy showed only functional disorders; no patient had structural lesions or changes in vocal fold mobility. Conversion aphonia, skeletal muscle tension, and intermittent voicing were the most frequent vocal emission manifestation forms.Conclusions: In this case series of patients with psychogenic dysphonia, the most frequent form of clinical presentation was conversion aphonia, followed by musculoskeletal tension and intermittent voicing. The clinical and vocal aspects of 28 patients with psychogenic dysphonia, as well as the particularities of each case, are discussed. (C) 2014 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Essays on Personnel Economics and Gender Issues

This thesis consists of four self-contained essays in economics. Tournaments and unfair treatment. This paper introduces the negative feelings associated with the perception of being unfairly treated into a tournament model and examines the impact of these perceptions on workers’ efforts and their willingness to work overtime. The effect of unfair treatment on workers’ behavior is ambiguous in the model in that two countervailing effects arise: a negative impulsive effect and a positive strategic effect. The impulsive effect implies that workers react to the perception of being unfairly treated by reducing their level of effort. The strategic effect implies that workers raise this level in order to improve their career opportunities and thereby avoid feeling even more unfairly treated in the future. An empirical test of the model using survey data from a Swedish municipal utility shows that the overall effect is negative. This suggests that employers should consider the negative impulsive effect of unfair treatment on effort and overtime in designing contracts and determining on promotions. Late careers in Sweden between 1970 and 2000. In this essay Swedish workers’ late careers between 1970 and 2000 are studied. The aim is to examine older workers’ career patterns and whether they have changed during this period. For example, is there a difference in career mobility or labor market exiting between cohorts? What affects the late career, and does this differ between cohorts? The analysis shows that between 1970 and 2000 the late careers of Swedish workers comprised of few job changes and consisted more of “trying to keep the job you had in your mid-fifties” than of climbing up the promotion ladder. There are no cohort differences in this pattern. Also a large fraction of the older workers exited the labor market before the normal retirement age of 65. During the 1970s and first part of the 1980s, 56 percent of the older workers made an early exit and the average drop-out age was 63. During the late 1980s and the 1990s the share of old workers who made an early exit had risen to 76 percent and the average drop-out age had dropped to 61.5. Different factors have affected the probabilities of an early exit between 1970 and 2000. For example, skills did affect the risk of exiting the labor market during the 1970s and up to the mid-1980s, but not in the late 1980s or the 1990s. During the first period old workers in the lowest occupations or with the lowest level of education were more likely to exit the labor market than more highly skilled workers. In the second period old workers at all levels of skill had the same probability of leaving the labor market. The growth and survival of establishments: does gender segregation matter? We empirically examine the employment dynamics that arise in Becker’s (1957) model of labor market discrimination. According to the model, firms that employ a large fraction of women will be relatively more profitable due to lower wage costs, and thus enjoy a greater probability of surviving and growing by underselling other firms in the competitive product market. In order to test these implications, we use a unique Swedish matched employer-employee data set. We find that female-dominated establishments do not enjoy any greater probability of surviving and do not grow faster than other establishments. Additionally, we find that integrated establishments, in terms of gender, age and education levels, are more successful than other establishments. Thus, attempts by legislators to integrate firms along all dimensions of diversity may have positive effects on the growth and survival of firms. Risk and overconfidence – Gender differences in financial decision-making as revealed in the TV game-show Jeopardy. We have used unique data from the Swedish version of the TV-show Jeopardy to uncover gender differences in financial decision-making by looking at the contestants’ final wagering strategies. After ruling out empirical best-responses, which do appear in Jeopardy in the US, a simple model is derived to show that risk preferences, the subjective and objective probabilities of answering correctly (individual and group competence), determine wagering strategies. The empirical model shows that, on average, women adopt more conservative and diversified strategies, while men’s strategies aim for the greatest gains. Further, women’s strategies are more responsive to the competence measures, which suggests that they are less overconfident. Together these traits make women more successful players. These results are in line with earlier findings on gender and financial trading.

Percorsi di gender performance: fotografia tra arte e moda dagli anni Novanta ad oggi

My project explores and compares different forms of gender performance in contemporary art and visual culture according to a perspective centered on photography. Thanks to its attesting power this medium can work as a ready-made. In fact during the 20th century it played a key role in the cultural emancipation of the body which (using a Michel Foucault’s expression) has now become «the zero point of the world». Through performance the body proves to be a living material of expression and communication while photography ensures the recording of any ephemeral event that happens in time and space. My questioning approach considers the gender constructed imagery from the 1990s to the present in order to investigate how photography’s strong aura of realism promotes and allows fantasies of transformation. The contemporary fascination with gender (especially for art and fashion) represents a crucial issue in the global context of postmodernity and is manifested in a variety of visual media, from photography to video and film. Moreover the internet along with its digital transmission of images has deeply affected our world (from culture to everyday life) leading to a postmodern preference for performativity over the more traditional and linear forms of narrativity. As a consequence individual borders get redefined by the skin itself which (dissected through instant vision) turns into a ductile material of mutation and hybridation in the service of identity. My critical assumptions are taken from the most relevant changes occurred in philosophy during the last two decades as a result of the contributions by Jacques Lacan, Michel Foucault, Jacques Derrida, Gilles Deleuze who developed a cross-disciplinary and comparative approach to interpret the crisis of modernity. They have profoundly influenced feminist studies so that the category of gender has been reassessed in contrast with sex (as a biological connotation) and in relation to history, culture, society. The ideal starting point of my research is the year 1990. I chose it as the approximate historical moment when the intersection of race, class and gender were placed at the forefront of international artistic production concerned with identity, diversity and globalization. Such issues had been explored throughout the 1970s but it was only from the mid-1980s onward that they began to be articulated more consistently. Published in 1990, the book "Gender trouble: feminism and the subversion of identity" by Judith Butler marked an important breakthrough by linking gender to performance as well as investigating the intricate connections between theory and practice, embodiment and representation. It inspired subsequent research in a variety of disciplines, art history included. In the same year Teresa de Lauretis launched the definition of queer theory to challenge the academic perspective in gay and lesbian studies. In the meantime the rise of Third Wave Feminism in the US introduced a racially and sexually inclusive vision over the global situation in order to reflect on subjectivity, new technologies and popular culture in connection with gender representation. These conceptual tools have enabled prolific readings of contemporary cultural production whether fine arts or mass media. After discussing the appropriate framework of my project and taking into account the postmodern globalization of the visual, I have turned to photography to map gender representation both in art and in fashion. Therefore I have been creating an archive of images around specific topics. I decided to include fashion photography because in the 1990s this genre moved away from the paradigm of an idealized and classical beauty toward a new vernacular allied with lifestyles, art practices, pop and youth culture; as one might expect the dominant narrative modes in fashion photography are now mainly influenced by cinema and snapshot. These strategies originate story lines and interrupted narratives using models’ performance to convey a particular imagery where identity issues emerge as an essential part of fashion spectacle. Focusing on the intersections of gender identities with socially and culturally produced identities, my approach intends to underline how the fashion world has turned to current trends in art photography and in some case turned to the artists themselves. The growing fluidity of the categories that distinguish art from fashion photography represents a particularly fruitful moment of visual exchange. Varying over time the dialogue between these two fields has always been vital; nowadays it can be studied as a result of this close relationship between contemporary art world and consumer culture. Due to the saturation of postmodern imagery the feedback between art and fashion has become much more immediate and then increasingly significant for anyone who wants to investigate the construction of gender identity through performance. In addition to that a lot of magazines founded in the 1990s bridged the worlds of art and fashion because some of their designers and even editors were art-school graduates encouraging innovation. The inclusion of art within such magazines aimed at validating them as a form of art in themselves supporting a dynamic intersection for music, fashion, design and youth culture: an intersection that also contributed to create and spread different gender stereotypes. This general interest in fashion produced many exhibitions of and about fashion itself at major international venues such as the Victoria and Albert Museum in London, the Metropolitan Museum of Art and the Solomon R. Guggenheim Museum in New York. Since then this celebrated success of fashion has been regarded as a typical element of postmodern culture. Owing to that I have also based my analysis on some important exhibitions dealing with gender performance like "Féminin-Masculin" at the Centre Pompidou of Paris (1995), "Rrose is a Rrose is a Rrose. Gender performance in photography" at the Solomon R. Guggenheim Museum of New York (1997), "Global Feminisms" at the Brooklyn Museum (2007), "Female Trouble" at the Pinakothek der Moderne in München together with the workshops dedicated to "Performance: gender and identity" in June 2005 at the Tate Modern of London. Since 2003 in Italy we have had Gender Bender - an international festival held annually in Bologna - to explore the gender imagery stemming from contemporary culture. In few days this festival offers a series of events ranging from visual arts, performance, cinema, literature to conferences and music. Being aware that any method of research is neither race nor gender neutral I have traced these critical paths to question gender identity in a multicultural perspective taking account of the political implications too. In fact, if visibility may be equated with exposure, we can also read these images as points of intersection of visibility with social power. Since gender assignations rely so heavily on the visual, the postmodern dismantling of gender certainty through performance has wide-ranging effects that need to be analyzed. In some sense this practice can even contest the dominance of visual within postmodernism. My visual map in contemporary art and fashion photography includes artists like Nan Goldin, Cindy Sherman, Hellen van Meene, Rineke Dijkstra, Ed Templeton, Ryan McGinley, Anne Daems, Miwa Yanagi, Tracey Moffat, Catherine Opie, Tomoko Sawada, Vanessa Beecroft, Yasumasa Morimura, Collier Schorr among others.

Diversity of the proximal femur in humans: morphological variations of the head-neck junction

The proximal femur is a high-diversity region of the human skeleton, especially at the anterior junction between head and neck, where various bony morphologies have been recognized since mid nineteenth century. Classical literature on this topic is chaotic and contradictory, making almost impossible the comparison of data from different researches. Starting from an extensive bibliographic review, the first standardized method to score these traits has been created. This method allows representing both the anatomical diversity of the region already described in literature and a part of variability not considered before, giving few and univocal definitions and allowing to collect comparable data. The method has been applied to three identified and five archaeological European skeletal collections, with the aim of investigating the distribution of these features by sex, age and side, in different places and time periods. It has also been applied to 3D digital reconstructions of femurs from CT scan files of coxo-femoral joints from fresh cadavers. In addition to the osseous traits described in the standardized method, the presence and frequency of some features known as herniation pits have been scored both on bones and on CT scans. The various osseous traits of the proximal femur are present at similar frequencies in skeletal samples from different countries and different historical periods, even if with clear local differentiation. Some of the features examined show significant trends related to their distribution by gender and age. Some hypotheses are proposed about the etiology of these morphologies and their possible implication with the acquisition of bipedalism in Humans. It is therefore highlighted the possible relation of some of these traits with the development of disorders of the hip joint. Moreover, it is not recommended the use of any of these features as a specific activity-related marker.

Building Peace and/or Gender Equality. Changing Attitudes around Peace, Development and Security in International Cooperation in Rwanda.

The times following international or civil conflicts but also violent revolutions often come with unequal share of the peace dividend for men and women. Delusions for women who gained freedom of movement and of roles during conflict but had to step back during reconstruction and peace have been recorded in all regions of the world. The emergence of peacebuilding as a modality for the international community to ensure peace and security has slowly incorporated gender sensitivity at the level of legal and policy instruments. Focusing on Rwanda, a country that has obtained significant gender advancement in the years after the genocide while also obtaining to not relapse into conflict, this research explores to what extent the international community has contributed to this transformation. From a review of evaluations, findings are that many of the interventions did not purse gender equality, and overall the majority understood gender and designed actions is a quite superficial way which would hardly account for the significative advancement in combating gender discrimination that the Government, for its inner political will, is conducting. Then, after a critique from a feminist standpoint to the concept of human security, departing from the assumption (sustained by the Governemnt of Rwanda as well) that domestic violence is a variable influencing level of security relevant at the national level, a review of available secondary data on GBV is conducted an trends over the years analysed. The emerging trends signal a steep increase in prevalence of GBV and in domestic violence in particular. Although no conclusive interpretation can be formulated on these data, there are elements suggesting the increase might be due to augmented reporting. The research concludes outlining possible further research pathways to better understand the link in Rwanda between the changing gender norms and the GBV.

Equality and Diversity in the Dutch Welfare State

Under the Constitution, the equality principle is very important in the Netherlands. This article argues that there is little evidence for equal citizenship in the Netherlands. There is anti-discrimination legislation in the Netherlands, but it is not very robust. The core argument in this article is that the equality principle must be supplemented by the diversity principle. Diversity is multi-dimensional and can refer to religion, philosophy of life, political persuasion, race (ethnicity), gender, nationality, sexual orientation, age, disability and chronic illness. In this paper multi-culturalism and disability are taken into account and we make a comparison of the social position of disabled people and people from ethnic minorities. Policies on diversity are needed to arrive at diverse citizenship in a varied society. This implies that a distinction has to be made between political citizenship and cultural citizenship. The former has to do with equality, and the latter with diversity.

The joint influence of gender and amount of smoking on weight gain one year after smoking cessation

Weight gain is often associated with smoking cessation and may discourage smokers from quitting. This study estimated the weight gained one year after smoking cessation and examined the risk factors associated with weight gain in order to identify socio-demographic groups at higher risk of increased weight after quitting. We analyzed data from 750 adults in two randomized controlled studies that included smokers motivated to quit and found a gradient in weight gain according to the actual duration of abstinence during follow-up. Subjects who were abstinent for at least 40 weeks gained 4.6 kg (SD = 3.8) on average, compared to 1.2 kg (SD = 2.6) for those who were abstinent less than 20 weeks during the 1-year follow-up. Considering the duration of abstinence as an exposure variable, we found an age effect and a significant interaction between sex and the amount of smoking before quitting: younger subjects gained more weight than older subjects; among light smokers, men gained more weight on average than women one year after quitting, while the opposite was observed among heavy smokers. Young women smoking heavily at baseline had the highest risk of weight gain after quitting.

Shaping gender inequalities: critical moments and critical places

Purpose – There is much scientific interest in the connection between the emergence of gender-based inequalities and key biographical transition points of couples in long-term relationships. Little empirical research is available comparing the evolution of a couple’s respective professional careers over space and time. The purpose of this paper is to contribute to filling this gap by addressing the following questions: what are the critical biographical moments when gender (in)equalities within a relationship begin to arise and consolidate? Which biographical decisions precede and follow such critical moments? How does decision making at critical moments impact the opportunities of both relationship partners in gaining equal access to paid employment? Design/methodology/approach – These questions are addressed from the perspectives of intersectionality and economic citizenship. Biographical interviewing is used to collect the personal and professional narratives of Swiss-, bi-national and migrant couples. The case study of a Swiss-Norwegian couple illustrates typical processes by which many skilled migrant women end up absently or precariously employed. Findings – Analysis reveals that the Scandinavian woman’s migration to Switzerland is a primary and critical moment for emerging inequality, which is then reinforced by relocation (to a small town characterized by conservative gender values) and the subsequent births of their children. It is concluded that factors of traditional gender roles, ethnicity and age intersect to create a hierarchical situation which affords the male Swiss partner more weight in terms of decision making and career advancement. Practical implications – The paper’s findings are highly relevant to the formulation of policies regarding gender inequalities and the implementation of preventive programmes within this context. Originality/value – Little empirical research is available comparing the evolution of a couple’s respective professional careers over space and time. The originality of this paper is to fill this research gap; to include migration as a critical moment for gender inequalities; to use an intersectional and geographical perspective that have been given scant attention in the literature; to use the original concept of economic citizenship; and to examine the case of a bi-national couple, which has so far not been examined by the literature on couple relationships.

Teachers’ beliefs about diversity: an analysis from a personal and professional perspective

The purpose of this study was to examine the beliefs that teachers have about diversity and their level of sensitivity towards some topics related to it. Moreover, beliefs were compared according to teachers’ personal and professional views and teaching experience. The Personal and Professional Beliefs about Diversity Scales (Pohan and Aguilar, 1999) were administered to a sample of 233 teachers. Results showed highly positive beliefs towards diversity in all its dimensions (cultural, linguistic and social diversity, ability, gender, sexual orientation and religion), especially regarding its personal implications compared to the professional ones. Likewise, it was observed a significant relationship between years of teaching experience and professional beliefs about diversity, so teachers with no school experience showed a higher tolerance than those with teaching experience, mainly in aspects related to cultural, linguistic and social differences, ability and gender. The implications that these results have for educational practice and the need for the development of multicultural education courses that favour an effective teaching are discussed.

Support for diversity initiatives in organisations: An intergroup perspective

Despite institutional commitment to diversity initiatives (e.g., affirmative action), employees often harbour negative attitudes towards such initiatives and their beneficiaries. Dispositional variables (e.g., neo-sexism), have often been implicated in these negative reactions. We reason that more immediate group-based beliefs (e.g., subjective beliefs about the intergroup context), also shape attitudinal and behavioural reactions and that individual and group-based beliefs are rationalised through appeals to justice and fairness concerns. In this study using early career academics we examined the role of individual differences and socio-structural beliefs (about the stability, legitimacy and permeability of the intergroup situation), to feelings of relative deprivation, perceived justice and attitudes towards gender equity initiatives. Results provided support for the role of group-based beliefs and for the mediating role of justice concerns.

Workplace gender discrimination and the implicit association test

Women are under-represented at senior levels within organisations. They also fareless well than their male counterparts in reward and career opportunities. Attitudestoward women in the workplace are thought to underpin these disparities and moreand more organisations are introducing attitude measures into diversity and inclusioninitiatives to: 1) raise awareness amongst employees of implicit attitudes, 2) educateemployees on how these attitudes can influence behaviour and 3) re-measure theattitude after an intervention to assess whether the attitude has changed. TheImplicit Association Test (IAT: Greenwald, et al., 1998) is the most popular tool usedto assess attitudes. However, questions over the predictive validity of the measurehave been raised and the evidence for the real world impact of the implicit attitudes islimited (Blanton et al., 2009; Landy, 2008; Tetlock & Mitchell, 2009; Wax, 2010).Whilst there is growing research in the area of race, little research has explored theability of the IAT to predict gender discrimination. This thesis addresses thisimportant gap in the literature. Three empirical studies were conducted. The firststudy explored whether gender IATs were predictive of personnel decisions thatfavour men and whether affect- and cognition-based gender IATs were equallypredictive of behaviour. The second two studies explored the predictive validity ofthe IAT in comparison to an explicit measure of one type of gender attitude,benevolent sexism. The results revealed implicit gender attitudes were stronglyheld. However, they did not consistently predict behaviour across the studies.Overall, the results suggest that the IAT may only predict workplace genderdiscrimination in a very select set of circumstances. The attitude component that anIAT assesses, the personnel decision and participant demographics all impact thepredictive validity of the tool. The interplay between the IAT and behaviour thereforeappears to be more complex than is assumed.

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.

Diversity faultlines, shared objectives, and top management team performance

Faultline theory suggests that negative effects of team diversity are better understood by considering the influence of different dimensions of diversity in conjunction, rather than for each dimension separately. We develop and extend the social categorization analysis that lies at the heart of faultline theory to identify a factor that attenuates the negative influence of faultlines: the extent to which the team has shared objectives. The hypothesized moderating role of shared objectives received support in a study of faultlines formed by differences in gender, tenure, and functional background in 42 top management teams. The focus on top management teams has the additional benefit of providing the first test of the relationship between diversity faultlines and objective indicators of organizational performance. We discuss how these findings, and the innovative way in which we operationalized faultlines, extend faultline theory and research as well as offer guidelines to manage diversity faultlines.

Ties that bind:understanding why and how diversity management relates to black and ethnic minority employees’ experience of organisational life

Despite much anecdotal and oftentimes empirical evidence that black and ethnic minority employees do not feel integrated into organisational life and the implications of this lack of integration for their career progression, there is a dearth of research on the nature of the relationship black and ethnic minority employees have with their employing organisations. Additionally, research examining the relationship between diversity management and work outcomes has returned mixed findings. Scholars have attributed this to the lack of an empirically validated measure of workforce diversity management. Accordingly, I sought to address these gaps in the extant literature in a two-part study grounded in social exchange theory. In Study 1, I developed and validated a measure of workforce diversity management practices. Data obtained from a sample of ethnic minority employees from a cross section of organisations provided support for the validity of the scale. In Study 2, I proposed and tested a social-exchange-based model of the relationship between black and ethnic minority employees’ and their employing organisations, as well as assessed the implications of this relationship for their work outcomes. Specifically, I hypothesised: (i) perception of support for diversity, perception of overall justice, and developmental experiences (indicators of integration into organisational life) as mediators of the relationship between diversity management and social exchange with organisation; (ii) the moderating influence of diversity climate on the relationship between diversity management and these indicators of integration; and (iii) the work outcomes of social exchange with organisation defined in terms of career satisfaction, turnover intention and strain. SEM results provide support for most of the hypothesised relationships. The findings of the study contribute to the literature on workforce diversity management in a number of ways. First, the development and validation of a diversity management practice scale constitutes a first step in resolving the difficulty in operationalising and measuring the diversity management construct. Second, it explicates how and why diversity management practices influence a social exchange relationship with an employing organisation, and the implications of this relationship for the work outcomes of black and ethnic minority employees. My study’s focus on employee work outcomes is an important corrective to the predominant focus on organisational-level outcomes of diversity management. Lastly, by focusing on ethno-racial diversity my research complements the extant research on such workforce diversity indicators as age and gender.