scholarly journals C.7 Does gender equality exist in the surgical management of degenerative lumbar disease?

2021 ◽  
Vol 48 (s3) ◽  
pp. S20-S20
Author(s):  
MA MacLean ◽  
CJ Touchette ◽  
J Han ◽  
SD Christie ◽  
G Pickett
Keyword(s):  
Gender Differences ◽  
Gender Equality ◽  
Clinical Assessment ◽  
Cohort Analysis ◽  
Research Network ◽  
Healthcare Resources ◽  
Assessment Scores ◽  
Pain Disability ◽  
Degenerative Lumbar Disease ◽  
Utilization Of Healthcare

Background: Despite efforts toward gender equality in clinical trial enrollment, females are frequently underrepresented and gender-specific data analysis is often unavailable. The purpose of this study was to determine if gender equality exists in the management of degenerative lumbar disease. Methods: Part 1: A systematic scoping review was conducted according to PRISMA guidelines, in order to synthesize the adult surgical literature regarding gender differences in pre- and post-operative clinical assessment scores for patients diagnosed with degenerative lumbar disease. Part 2: An ambispective cohort analysis (multi-variate logistic regression) of the Canadian Spine Outcomes Research Network registry was performed to address knowledge gaps identified in “Part 1”. Results: Part 1: Thirty articles were identified, accounting for 32,951 patients. Female patients have worse absolute pre-operative pain, disability and health-related quality-of-life (HRQoL). Following surgery, females have worse absolute pain, disability, and HRQoL, but demonstrate an equal or greater interval change compared to males. Part 2: Data was analyzed for 5,039 patients. Significant gender differences in pre-operative utilization of healthcare resources (medication use, diagnostic testing, medical and allied healthcare professional visits) were identified. Conclusions: Significant gender disparities in clinical assessment scores and the pre-operative utilization of healthcare resources were identified for patients undergoing surgery for degenerative lumbar disease.

Maximizing gender equality by minimizing course choice options? Effects of obligatory coursework in math on gender differences in STEM.

2017 ◽  
Vol 109 (7) ◽  
pp. 993-1009 ◽  
Author(s):  
Nicolas Hübner ◽  
Eike Wille ◽  
Jenna Cambria ◽  
Kerstin Oschatz ◽  
Benjamin Nagengast ◽  
...  
Keyword(s):  
Gender Differences ◽  
Gender Equality

Queen’s Gambit Declined: The Gender-Equality Paradox in Chess Participation Across 160 Countries

2022 ◽  
pp. 095679762110348
Author(s):  
Allon Vishkin
Keyword(s):  
Gender Differences ◽  
Gender Equality ◽  
Mediation Analyses ◽  
Science Technology ◽  
Generational Shift ◽  
Age Range ◽  
Curvilinear Effect

The gender-equality paradox refers to the puzzling finding that societies with more gender equality demonstrate larger gender differences across a range of phenomena, most notably in the proportion of women who pursue degrees in science, technology, engineering, and math. The present investigation demonstrates across two different measures of gender equality that this paradox extends to chess participation ( N = 803,485 across 160 countries; age range: 3–100 years), specifically that women participate more often in countries with less gender equality. Previous explanations for the paradox fail to account for this finding. Instead, consistent with the notion that gender equality reflects a generational shift, mediation analyses suggest that the gender-equality paradox in chess is driven by the greater participation of younger players in countries with less gender equality. A curvilinear effect of gender equality on the participation of female players was also found, demonstrating that gender differences in chess participation are largest at the highest and lowest ends of the gender-equality spectrum.

scholarly journals Factors Associated With Return to Work After Surgery for Degenerative Cervical Spondylotic Myelopathy: Cohort Analysis From the Canadian Spine Outcomes and Research Network

2020 ◽  
pp. 219256822095866
Author(s):  
Alexander Romagna ◽  
Jefferson R. Wilson ◽  
W. Bradley Jacobs ◽  
Michael G. Johnson ◽  
Christopher S. Bailey ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Return To Work ◽  
Odds Ratio ◽  
Cohort Analysis ◽  
Japanese Orthopaedic Association ◽  
Japanese Orthopaedic Association Score ◽  
Research Network ◽  
Duration Of Symptoms ◽  
Factors Associated

Study design: Retrosepctive analysis of prospectively collected data from the multicentre Canadian Surgical Spine Registry (CSORN). Objective: Degenerative cervical myelopathy (DCM) is the most common cause of spinal cord dysfunction in North America. Few studies have evaluated return to work (RTW) rates after DCM surgery. Our goals were to determine rates and factors associated with postoperative RTW in surgically managed patients with DCM. Methods: Data was derived from the prospective, multicenter Canadian Spine Outcomes and Research Network (CSORN). From this cohort, we included all nonretired patients with at least 1-year follow-up. The RTW rate was defined as the proportion of patients with active employment at 1 year from the time of surgery. Unadjusted and adjusted analyses were used to identify patient characteristics, disease, and treatment variables associated with RTW. Results: Of 213 surgically treated DCM patients, 126 met eligibility, with 49% working and 51% not working in the immediate period before surgery; 102 had 12-month follow-up data. In both the unadjusted and the adjusted analyses working preoperatively and an anterior approach were associated with a higher postoperative RTW ( P < .05), there were no significant differences between the postoperative employment groups with respect to age, gender, preoperative mJOA (modified Japanese Orthopaedic Association) score, and duration of symptoms ( P > .05). Active preoperative employment (odds ratio = 15.4, 95% confidence interval = 4.5, 52.4) and anterior surgical procedures (odds ratio = 4.7, 95% confidence interval = 1.2, 19.6) were associated with greater odds of RTW at 1 year. Conclusions: The majority of nonretired patients undergoing surgery for DCM had returned to work 12 months after surgery; active preoperative employment and anterior surgical approach were associated with RTW in this analysis.

scholarly journals Radiographic and clinical evidence: osteoarthritic knee can change surgical result for lumbar degenerative disease patient undergone surgery for 3-year follow-up: a retrospective comparative clinical study

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Yong-Chan Kim ◽  
Ki-Tack Kim ◽  
Kee-Yong Ha ◽  
Joonghyun Ahn ◽  
Seungnam Ko ◽  
...  
Keyword(s):  
Clinical Assessment ◽  
Sagittal Alignment ◽  
Posterior Instrumentation ◽  
Radiographic Assessment ◽  
Lumbar Degenerative Disease ◽  
Osteoarthritic Knee ◽  
Group I ◽  
Spinal Sagittal Alignment ◽  
Degenerative Lumbar Disease

Abstract Background There is a paucity of reports clarifying the implication of knee osteoarthritis (OA) on spinal sagittal alignment of patients undergone surgery for lumbar spine. This study aimed to analyze how osteoarthritic knee affects radiographic and clinical results of degenerative lumbar disease patients undergone lumbar fusion. Methods We retrospectively reviewed the medical records and radiographs of 74 consecutive degenerative lumbar disease patients who underwent posterior instrumentation and fusion surgery between May 2016 and June 2017 and were followed up for minimum 3 years postoperatively. The patients were divided into 2 groups according to the severity of knee OA by Kellgren-Lawrence grading (KLG) scale (group I, KLG 1 or 2 [n = 39]; group II, KLG 3 or 4 [n = 35]). Patient demographic data, comorbidities, spinal sagittal parameters and clinical scores were extracted and compared at preoperative, postoperative 1 month and the ultimate follow-up between the groups. In radiographic assessment, sagittal alignment parameters and sagittal balance were used. In clinical assessment, the scores of Oswestry disability index (ODI) and Scoliosis Research Society questionnaire (SRS-22) were used. For the frequency analysis of categorical variables across the groups, chi-square test was used and student t tests was used to compare the differences of continuous variables. Results In radiographic assessment, TLK (thoracolumbar kyphosis), LL (lumbar lordosis), PT (pelvic tilt), C7 SVA (sagittal vertical axis) in both groups improved significantly after surgery (p <  0.05). However, LL, PT, C7SVA improved at postoperative 1 month in the group II were not maintained at the ultimate postoperative follow-up. In clinical assessment, preoperative Oswestry disability index (ODI, %) and all SRS-22 subscores of the group I and II were not different (p > 0.05). There were significant differences between the groups at the ultimate follow-up in ODI (− 25.6 vs − 12.1, p <  0.001), SRS total score (%) (28 vs 20, p = 0.037), function subscore (1.4 vs 0.7, p = 0.016), and satisfaction subscore (1.6 vs 0.6, p < 0.001). Conclusion Osteoarthritic knee with KLG 3 or 4 have a negative influence on maintaining postoperative spinal sagittal alignment, balance, and the clinical outcomes achieved immediately by posterior instrumentation and fusion for lumbar degenerative disease. Trial registration This study was retrospectively registered with approval by the institutional review board (IRB) of our institution (approval number: 2018–11-007).

Active surveillance for localized prostate cancer: An analysis of patient contacts and utilization of healthcare resources

2014 ◽  
Vol 49 (1) ◽  
pp. 43-50 ◽  
Author(s):  
Frederik B. Thomsen ◽  
Kasper D. Berg ◽  
M. Andreas Røder ◽  
Peter Iversen ◽  
Klaus Brasso
Keyword(s):  
Prostate Cancer ◽  
Active Surveillance ◽  
Localized Prostate Cancer ◽  
Healthcare Resources ◽  
Utilization Of Healthcare

scholarly journals The gendered relationship with drunkenness among different generations in Mediterranean and Nordic countries

2020 ◽  
Vol 37 (2) ◽  
pp. 172-189 ◽  
Author(s):  
Sara Rolando ◽  
Jukka Törrönen ◽  
Franca Beccaria
Keyword(s):  
Gender Differences ◽  
Alcohol Consumption ◽  
Social Norms ◽  
Focus Groups ◽  
Gender Equality ◽  
Educational Level ◽  
Comparative Approach ◽  
Gender Inequalities ◽  
Age Cohort ◽  
Different Dimensions

The study adopts a qualitative comparative approach to better understand how different dimensions affect social norms regulating alcohol consumption. Female and male attitudes towards drunkenness were analysed on the basis of data from 27 focus groups involving a total of 166 participants from Italy, Finland and Sweden, grouped by age cohort (17–20 and 50–65 years) and educational level. Results suggest that gendered drinking norms may be affected more by the drinking culture than by the degree of gender equality, thus providing a possible explanation of why gender differences in drinking are not always consistent with broader gender inequalities.

scholarly journals Helicopter and ground emergency medical services transportation to hospital after major trauma in England: a comparative cohort study

2020 ◽  
Vol 5 (1) ◽  
pp. e000508 ◽  
Author(s):  
Oliver Beaumont ◽  
Fiona Lecky ◽  
Omar Bouamra ◽  
Dhushy Surendra Kumar ◽  
Tim Coats ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Emergency Medical Services ◽  
Major Trauma ◽  
Road Traffic ◽  
Cohort Analysis ◽  
Primary Outcome Measure ◽  
Research Network ◽  
Medical Services ◽  
Emergency Medical ◽  
The Uk

BackgroundThe utilization of helicopter emergency medical services (HEMS) in modern trauma systems has been a source of debate for many years. This study set to establish the true impact of HEMS in England on survival for patients with major trauma.MethodsA comparative cohort design using prospectively recorded data from the UK Trauma Audit and Research Network registry. 279 107 patients were identified between January 2012 and March 2017. The primary outcome measure was risk adjusted in-hospital mortality within propensity score matched cohorts using logistic regression analysis. Subset analyses were performed for subjects with prehospital Glasgow Coma Scale <8, respiratory rate <10 or >29 and systolic blood pressure <90.ResultsThe analysis was based on 61 733 adult patients directly admitted to major trauma centers: 54 185 ground emergency medical services (GEMS) and 7548 HEMS. HEMS patients were more likely male, younger, more severely injured, more likely to be victims of road traffic collisions and intubated at scene. Crude mortality was higher for HEMS patients. Logistic regression demonstrated a 15% reduction in the risk adjusted odds of death (OR=0.846; 95% CI 0.684 to 1.046) in favor of HEMS. When analyzed for patients previously noted to benefit most from HEMS, the odds of death were reduced further but remained statistically consistent with no effect. Sensitivity analysis on 5685 patients attended by a doctor on scene but transported by GEMS demonstrated a protective effect on mortality versus the standard GEMS response (OR 0.77; 95% CI 0.62 to 0.95).DiscussionThis prospective, level 3 cohort analysis demonstrates a non-significant survival advantage for patients transported by HEMS versus GEMS. Despite the large size of the cohort, the intrinsic mismatch in patient demographics limits the ability to statistically assess HEMS true benefit. It does, however, demonstrate an improved survival for patients attended by doctors on scene in addition to the GEMS response. Improvements in prehospital data and increased trauma unit reporting are required to accurately assess HEMS clinical and cost-effectiveness.

scholarly journals Competing for the benefit of offspring eliminates the gender gap in competitiveness

2016 ◽  
Vol 113 (19) ◽  
pp. 5201-5205 ◽  
Author(s):  
Alessandra Cassar ◽  
Feven Wordofa ◽  
Y. Jane Zhang
Keyword(s):  
Gender Differences ◽  
Gender Equality ◽  
Gender Gap ◽  
Male Competition ◽  
Evolutionary Significance ◽  
Female Competition ◽  
Competitive Strategies ◽  
Economic Experiments ◽  
Promote Gender Equality ◽  
The Right

Recent advances have highlighted the evolutionary significance of female competition, with the sexes pursuing different competitive strategies and women reserving their most intense competitive behaviors for the benefit of offspring. Influential economic experiments using cash incentives, however, have found evidence suggesting that women have a lower desire to compete than men. We hypothesize that the estimated gender differences critically depend on how we elicit them, especially on the incentives used. We test this hypothesis through an experiment with adults in China (n = 358). Data show that, once the incentives are switched from monetary to child-benefitting, gender differences disappear. This result suggests that female competition can be just as intense as male competition given the right goals, indicating important implications for policies designed to promote gender equality.

Sign in / Sign up

Export Citation Format

Share Document