BackgroundMatters of workplace harassment are an important issue. This issue needs to be recognized and studied to prevent occurrences. These important sensitive areas of effective workplace... Show moreBackgroundMatters of workplace harassment are an important issue. This issue needs to be recognized and studied to prevent occurrences. These important sensitive areas of effective workplace management are increasingly gaining more interest. We aimed to identify the prevalence of workplace sexual, verbal and physical harassment among headache professionals.MethodsWe adopted a cross‑sectional exploratory survey approach with quantitative design. The survey was distributed electronically among headache healthcare and research professionals globally through the International Headache Society (IHS).ResultsData were obtained from 579 respondents (55.3%; 320/579 women). A large percentage of respondents (46.6%; 270/579) had experienced harassment; specifically, 16.1% (93/578) reported sexual harassment, 40.4% (234/579) verbal harassment and 5.5% (32/579) physical harassment. Women were almost seven times more likely to experience sexual harassment compared to men (odds ratio = 6.8; 95% confidence interval = 3.5–13.2). Although women did also more frequently report other types of harassment, this was not statistically significant (odds ratio = 1.4; 95% confidence interval = 1.0–2.0).ConclusionsLifetime exposure to workplace harassment is prevalent among headache professionals, especially in women. The present study uncovers a widespread issue and calls for strategies to be implemented for building a healthy and safe workplace environment. Show less
Verhagen, I.E.; Arend, B.W.H. van der; Casteren, D.S. van; Cessie, S. le; MaassenVanDenBrink, A.; Terwindt, G.M. 2023
Objective: In this prospective cohort study, characteristics of perimenstrual and non-perimenstrual migraine attacks in women were compared with migraine attacks in men.Background: Women report... Show moreObjective: In this prospective cohort study, characteristics of perimenstrual and non-perimenstrual migraine attacks in women were compared with migraine attacks in men.Background: Women report longer migraine attacks and more accompanying symptoms than men in cross-sectional questionnaire studies, but this has not been confirmed in longitudinal studies. Supposed differences could result from different characteristics specific to perimenstrual migraine attacks, or of attacks in women in general.Methods: This cohort study was performed among patients with migraine who were treated at the Leiden Headache Clinic. We assessed differences in migraine attack characteristics between men and women who were prospectively followed by a previously validated electronic headache diary. The primary outcome was "attack" duration. Differences between perimenstrual (Days -2 to +3 of the menstrual cycle) and non-perimenstrual attacks in women versus attacks in men were corrected for age, chronic migraine, and medication overuse headache.Results: A total of 1347 women and 284 men were included, reflecting the preponderance of women in migraine prevalence. Crude median (first and third quartile [Q1-Q3]) attack duration in men was 32.1 [17.7-53.6] h, compared to 36.7 [21.9-62.4] h for non-perimenstrual migraine attacks and 44.4 [17.9-79.0] h for perimenstrual migraine attacks in women. After correction for confounding, perimenstrual migraine attacks were 1.62 (95% confidence interval [CI] 1.47-1.79; p < 0.001) and non-perimenstrual 1.15 (95% CI 1.05-1.25; p = 0.003) times longer compared to migraine attacks in men. The mean relapse percentage in men was 9.2%, compared to 12.6% for non-perimenstrual migraine attacks, and 15.7% for perimenstrual migraine attacks. Relapse risk was greater for perimenstrual (odds ratio [OR] 2.39, 95% CI 1.93-2.95; p < 0.001), but not for non-perimenstrual (OR 1.18, 95% CI 0.97-1.45; p = 0.060) attacks. Migraine attacks in women were more often accompanied by photophobia, phonophobia, and nausea, but less often aura.Conclusion: Compared to attacks in men, both perimenstrual and non-perimenstrual migraine attacks are of longer duration and are more often accompanied by associated symptoms. A sex-specific approach to migraine treatment and research is needed. Show less
IJzerman, N.S.; Werkhoven, E. van; Mohammadi, M.; Hollander, D. den; Bleckman, R.F.; Reyners, A.K.L.; ... ; Graaf, W.T.A. van der 2022
Background: Sex differences in cancer have gained attention in recent years. The role of sex as a prognostic factor in gastrointestinal stromal tumours (GIST) has not been well established. The aim... Show moreBackground: Sex differences in cancer have gained attention in recent years. The role of sex as a prognostic factor in gastrointestinal stromal tumours (GIST) has not been well established. The aim of this research was to elucidate potential sex differences in GIST patients and the influence of sex on disease-specific survival (DSS). Methods: A review of the literature was carried out to obtain an overview of all literature with sex as a covariate on GIST survival analyses. Furthermore, in the Dutch GIST Registry, GIST characteristics between males and females were compared and the influence of sex on DSS was analysed. Results: A total of 118 articles from the review of the literature met our selection criteria; 58% of the articles found no sex difference in survival and 42% did find a sex difference. All differences favoured female patients, although there was substantial overlap of individual patients in the various reported groups. The Dutch GIST Registry cohort consisted of 1425 patients (46% female). Compared with female patients, male patients had larger tumours (mean 9.0 cm versus 7.9 cm) and higher mitotic rates (34.4% versus 28.0% > 5 mitoses/5 mm(2)). GIST in males was more often metastasized at diagnosis (21.3% versus 13.7%) and incurable (38.5% versus 31.0%). Male patients less often received surgery of the primary tumour (71.7% versus 78.9%), but did experience more tumour ruptures (18.2% versus 13.3%). Male patients had a worse DSS than females. This was not statistically significant when corrected for differences in GIST characteristics. Conclusions: In case of sex differences in GIST in the literature, male patients have a worse outcome. In our Dutch GIST cohort a similar finding was made, but sex was shown not to be an independent factor. Male patients more often had aggressive GISTs, with larger tumours, higher mitotic rates, more tumour ruptures, and metastases, which could explain the sex differences in DSS. Show less
This paper considers ruling women through the lens of gender and succession, mostly between 1300 and 1800; it underlines the fundamental impact of matrilineal succession on worldwide dynastic... Show moreThis paper considers ruling women through the lens of gender and succession, mostly between 1300 and 1800; it underlines the fundamental impact of matrilineal succession on worldwide dynastic practice. First the paper asks how women surfaced and survived as sovereigns in a world that defined paramountcy in male terms. Second, it examines how changing patterns of descent, the rise of world religions and modernization have affected regional variations in the occurrence of sovereign women. Third, it revisits the ‘matrilineal puzzle', scrutinizing divergences between matrilineal and patrilineal formats of dynastic power. Finally, the fourth section of the paper reviews the connections between matriliny, the empowerment of women, and ‘contractual' kingship. The paper as a whole connects the historical examination of matriliny to recent work by archaeologists and evolutionary biologists on ‘female biased kinship’. It rekindles the age-old debate about the status of women in early history, shows the relevance of matriliny for current research, and makes explicit the patrilineal bent in common interpretations of dynastic power. Show less
Koposov, R.; Isaksson, J.; Vermeiren, R.; Schwab-Stone, M.; Stickley, A.; Ruchkin, V. 2021
Background: Many children and adolescents experience violent events which can be associated with negative consequences for their development, mental health, school, and social functioning. However,... Show moreBackground: Many children and adolescents experience violent events which can be associated with negative consequences for their development, mental health, school, and social functioning. However, findings between settings and on the role of gender have been inconsistent. This study aimed to investigate cross-country and gender differences in the relationship between community violence exposure (CVE) and school functioning in a sample of youths from three countries. Methods: A self-report survey was conducted among school students (12-17 years old) in Belgium (Antwerp, N = 4,743), Russia (Arkhangelsk, N = 2,823), and the US (New Haven, N = 4,101). Students were recruited from within classes that were randomly selected from within schools that had themselves been randomly selected (excepting New Haven, where all students were included). CVE was assessed with the Screening Survey of Exposure to Community Violence. School functioning was assessed with four measures: the Perceived Teacher Support scale, Negative Classroom Environment scale, and Academic Motivation and Perception of Safety at School scales. Multivariate Analyses of Covariance were performed to assess differences in the levels of school-related problem behaviors in boys and girls, who reported different degrees of CVE. Results: Participants in all three countries reported a relatively high prevalence of violence exposure (36.2% in Belgium, 39.3% in Russia and 45.2% in the US who witnessed violence), with a higher proportion of girls than boys witnessing violent events (varied from 37.4 to 51.6% between the countries), whereas boys reported more episodes of victimization by violence than girls (varied from 32.3 to 49.9% between the countries). Youths who experienced increased CVE (from no exposure to witnessing to victimization) reported an increase in all school functioning problems in all of the countries and this association was not gender-specific. Conclusions: Our findings suggest that regardless of differences in the level of CVE by country and gender, violence exposure is negatively associated with school functioning across countries. Nonetheless, even though reactions to community violence among adolescents may be expressed in a similar fashion, cross-country differences in social support systems should also be taken into account in order to provide culturally sensitive treatment modalities. Show less
Boel, A.; Lopez-Medina, C.; Heijde, D.M.F.M. van der; Gaalen, F.A. van 2021
Objective: Age at onset is useful in identifying chronic back patients at an increased risk of axial SpA (axSpA). However, the majority of data on which the criterion of age at onset. Methods:... Show moreObjective: Age at onset is useful in identifying chronic back patients at an increased risk of axial SpA (axSpA). However, the majority of data on which the criterion of age at onset. Methods: Analyses were applied to patients from 24 countries across the world with an axSpA diagnosis and known age at onset of axial complaints. Cumulative probability plots were used to display the cumulative distribution of age at onset of axial symptoms. Linear regression models were built to assess the effect of HLA-B27 and gender on age at onset of axial symptoms. Results: Of 2579 axSpA patients, 92% had an age at onset of axial symptoms <45 years, with only small variations across the geographical regions [Asia, n = 574 (94%); Europe and North America, n = 988 (92%); Latin America, n = 246 (89%); Middle East and North Africa, n = 771 (91%)]. Age at onset of axial symptoms was consistently lower in HLA-B27-positive patients {median 25 years [interquartile range (IQR) 19-32] vs 31 [IQR 22-39]} and male patients [median 25 years (IQR 19-33) vs 28 (IQR 21-37)], but in multivariable models an additional statistically significant effect of male gender independent of HLA-B27 was only found in Asia. Conclusion: Around the world, the great majority of axSpA patients had an age at onset of axial disease of <45 years, with HLA-B27 and male gender associated with earlier disease onset. Show less
Objectives This research aimed to provide a deeper insight into the gender-specific barriers to smoking cessation and gender-specific preferences for interventions in primary care, in order to... Show moreObjectives This research aimed to provide a deeper insight into the gender-specific barriers to smoking cessation and gender-specific preferences for interventions in primary care, in order to contribute to better aligned cessation care for women. Design Qualitative study using focus groups. Setting Regularly smoking female and male adults were recruited from four different general practices in The Hague (The Netherlands). Participants A total of 11 women and nine men participated. Participants included were regular smokers with a minimum age of 18 and sufficient command of the Dutch language, who were willing to talk about smoking cessation. Inclusion ended when saturation was reached for both women and men. Participants were selected by means of purposeful sampling, whereby looking at age, educational level and experience with quitting. Results The main barriers to smoking cessation in women were psychological factors, such as emotion and stress, compared with environmental factors in men. Women indicated they were in need of support and positivity, and both women and men expressed the desire for assistance without judgement. Contrary to men, women were not drawn to restrictions and (dis)incentives. Conclusion When counselling smokers, in women the focus should be on perceived internal problems, as opposed to more external obstacles in men. Contrary to men, female smokers seem to prefer non-coercive interventions, such as a group intervention offering support and positivity. Future research should focus on these gender differences, and how they could improve treatment in primary care. Show less
J. dal; Skov, B.G.; Andersen, M.; Feldt-Rasmussen, U.; Feltoft, C.L.; Karmisholt, J.; ... ; Jorgensen, J.O.L. 2020
Objective Data on sex differences in acromegaly at the time of diagnosis vary considerably between studies.Design A nationwide cohort study including all incident cases of acromegaly (1978-2010, n ... Show moreObjective Data on sex differences in acromegaly at the time of diagnosis vary considerably between studies.Design A nationwide cohort study including all incident cases of acromegaly (1978-2010, n = 596) and a meta-analysis on sex differences in active acromegaly (40 studies) were performed.Method Sex-dependent differences in prevalence, age at diagnosis, diagnostic delay, pituitary adenoma size, insulin-like growth factor 1 (IGF-I) and growth hormone (GH) concentrations were estimated.Results The cohort study identified a balanced gender distribution (49.6% females) and a comparable age (years) at diagnosis (48.2 CI95% 46.5-49.8 (males) vs. 47.2 CI95% 45.5-48.9 (females), p = 0.4). The incidence rate significantly increased during the study period (R-2 = 0.42, p < 0.01) and the gender ratio (F/M) changed from female predominance to an even ratio (SR: 1.4 vs. 0.9, p = 0.03). IGF-I-SDS was significantly lower in females compared to males, whereas neither nadir GH nor pituitary adenoma size differed between males and females.In the meta-analysis, the weighted percentage female was 53.3% (CI95% 51.5-55.2) with considerable heterogeneity (I-2 = 85%) among the studies. The mean age difference at diagnosis between genders was 3.1 years (CI95% 1.9-4.4), and the diagnostic delay was longer in females by 0.9 years (CI95% -0.4 to 2.1). Serum IGF-I levels were significantly lower in female patients, whereas nadir GH, and pituitary adenoma size were comparable.Conclusion There are only a minor sex differences in the epidemiology of acromegaly at the time of diagnosis except that female patients are slightly older and exhibit lower IGF-I concentrations and a longer diagnostic delay. Show less
Iwaki, H.; Blauwendraat, C.; Leonard, H.L.; Makarious, M.B.; Kim, J.J.; Liu, G.Q.; ... ; Nalls, M.A. 2020
Background Previous studies reported various symptoms of Parkinson's disease (PD) associated with sex. Some were conflicting or confirmed in only one study. Objectives We examined sex associations... Show moreBackground Previous studies reported various symptoms of Parkinson's disease (PD) associated with sex. Some were conflicting or confirmed in only one study. Objectives We examined sex associations to PD phenotypes cross-sectionally and longitudinally in large-scale data. Methods We tested 40 clinical phenotypes, using longitudinal, clinic-based patient cohorts, consisting of 5946 patients, with a median follow-up of 3.1 years. For continuous outcomes, we used linear regressions at baseline to test sex-associated differences in presentation, and linear mixed-effects models to test sex-associated differences in progression. For binomial outcomes, we used logistic regression models at baseline and Cox regression models for survival analyses. We adjusted for age, disease duration, and medication use. In the secondary analyses, data from 17 719 PD patients and 7588 non-PD participants from an online-only, self-assessment PD cohort were cross-sectionally evaluated to determine whether the sex-associated differences identified in the primary analyses were consistent and unique to PD. Results Female PD patients had a higher risk of developing dyskinesia early during the follow-up period, with a slower progression in activities of daily living difficulties, and a lower risk of developing cognitive impairments compared with male patients. The findings in the longitudinal, clinic-based cohorts were mostly consistent with the results of the online-only cohort. Conclusions We observed sex-associated contributions to PD heterogeneity. These results highlight the necessity of future research to determine the underlying mechanisms and importance of personalized clinical management. (c) 2020 International Parkinson and Movement Disorder Society Show less
Despite the large literature on gender differences in politics, there have been relatively few empirical studies testing the effects of gender in public administration. This paper examines how male... Show moreDespite the large literature on gender differences in politics, there have been relatively few empirical studies testing the effects of gender in public administration. This paper examines how male and female public managers show attitudinal differences toward innovation in the public sector. We hypothesize that male and female managers differ in three aspects. Firstly, female managers are more result-oriented than rule-following, and more oriented toward societal interests. Secondly, female public managers are more open to new ideas and creativity, and more willing to challenge the status quo. Yet, thirdly, female leaders are less eager to take risks when would-be innovations may put their organizations in peril. Thus, we argue that female managers are more prudent and entrepreneurial than their male counterparts. We test these hypotheses using a data set of 5,909 senior public managers from 20 European countries. The results of multilevel model analysis find statistically significant gender differences in attitudes toward innovation. Despite the small size of gender impacts, our findings challenge prevailing stereotypes on women’s entrepreneurial attitudes. Show less
Background and purpose Migraine is recognized as a vascular risk factor, especially in women. Presumably, migraine, stroke and cardiovascular events share pathophysiological mechanisms. Self... Show moreBackground and purpose Migraine is recognized as a vascular risk factor, especially in women. Presumably, migraine, stroke and cardiovascular events share pathophysiological mechanisms. Self-reported cold extremities were investigated as a marker for vascular dysfunction in migraine. Secondly, it was hypothesized that suffering from cold extremities affects sleep quality, possibly exacerbating migraine attack frequency.Methods In this case-control study, a random sample of 1084 migraine patients and 348 controls (aged 22-65 years) from the LUMINA migraine cohort were asked to complete questionnaires concerning cold extremities, sleep quality and migraine.Results A total of 594 migraine patients and 199 controls completed the questionnaires. In women, thermal discomfort and cold extremities (TDCE) were more often reported by migraineurs versus controls (odds ratio 2.3, 95% confidence interval 1.4-3.7; P < 0.001), but not significantly so in men (odds ratio 2.5, 95% confidence interval 0.9-6.9; P = 0.09). There was no difference in TDCE comparing migraine with or without aura. Female migraineurs who reported TDCE had higher attack frequencies compared to female migraineurs without TDCE (4 vs. 3 attacks per month; P = 0.003). The association between TDCE and attack frequency was mediated by the presence of difficulty initiating sleep (P = 0.02).Conclusion Women with migraine more often reported cold extremities compared with controls, possibly indicating a sex-specific vascular vulnerability. Female migraineurs with cold extremities had higher attack frequencies, partly resulting from sleep disturbances. Future studies need to demonstrate whether cold extremities in female migraineurs are a predictor for cardiovascular and cerebrovascular events. Show less
Aims There are significant sex-specific differences in left ventricular ejection fraction (LVEF), with a higher LVEF being observed in women. We sought to assess the clinical relevance of an... Show moreAims There are significant sex-specific differences in left ventricular ejection fraction (LVEF), with a higher LVEF being observed in women. We sought to assess the clinical relevance of an increased LVEF in women and men.Methods and results A total of 4632 patients from the CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter) registry (44.8% women; mean age 58.7 +/- 13.2 years in men and 59.5 +/- 13.3 years in women, P = 0.05), in whom LVEF was measured by cardiac computed tomography, were categorized according to LVEF (low <55%, normal 55-65%, and high >65%). The prevalence of high LVEF was similar in both sexes (33.5% in women and 32.5% in men, P = 0.46). After 6 years of follow-up, no difference in mortality was observed in patients with high LVEF in the overall cohort (P = 0.41). When data were stratified by sex, women with high LVEF died more often from any cause as compared to women with normal LVEF (8.6% vs. 7.1%, log rank P = 0.032), while an opposite trend was observed in men (5.8% vs. 6.8% in normal LVEF, log rank P = 0.89). Accordingly, a first order interaction term of male sex and high LVEF was significant (hazard ratios 0.63, 95% confidence intervals 0.41-0.98, P = 0.043) in a Cox regression model of all-cause mortality adjusted for age, cardiovascular risk factors, and severity of coronary artery disease (CAD).Conclusion Increased LVEF is highly prevalent in patients referred for evaluation of CAD and is associated with an increased risk of death in women, but not in men. Differentiating between normal and hyperdynamic left ventricles might improve risk stratification in women with CAD. Show less
Quest’articolo indaga il rapporto tra affronto verbale, genere e agentività legale nella Bologna della prima età moderna. Per molto tempo gli studiosi hanno trascurato di considerare l’impegno... Show moreQuest’articolo indaga il rapporto tra affronto verbale, genere e agentività legale nella Bologna della prima età moderna. Per molto tempo gli studiosi hanno trascurato di considerare l’impegno delle donne nell’attività criminale, o ne hanno sottolineato la distinzione. In tale contesto l’insulto è spesso stato caratterizzato una forma criminale tipicamente femminile e considerato in rapporto all’incapacità delle donne di agire in altri ambiti sociali, economici e politici della vita. Il presente studio intende sottoporre a meditazione critica tale assunto, esaminando il linguaggio e la pratica dell’affronto verbale quale discorso deviante attraverso il casellario giudiziario del Tribunale del Torrone, la corte penale di Bologna nella prima età moderna. Mentre tale fonte conferma l’esistenza di un lessico altamente sessista degli insulti, si sostiene che l’insulto maschile e femminile non vadano trattati distintamente, dal momento che i protagonisti maschili e quelle femminili attinsero a un ampio spettro di convenzioni e pratiche culturali condivise che vale la pena di esplorare. Show less
Social quality is the extent to which people are able to participate in social relationships under conditions which enhance their well-being, capacities and potential and enables them to shape... Show moreSocial quality is the extent to which people are able to participate in social relationships under conditions which enhance their well-being, capacities and potential and enables them to shape their own circumstances and contribute to societal development. We assessed whether women in homeless shelters differed from men on social quality factors that constitute the quality of their daily life and whether factor scores changed at a different rate for women and men after shelter exit. Data were collected as part of a randomised controlled trial. In 18 shelters across the Netherlands, 183 participants were recruited between December 2010 and December 2012 and followed for 9 months. Adults were eligible if they were about to move from shelter to (supported) independent housing and their shelter stay had been shorter than 14 months. At baseline, women were significantly younger than men. They were more likely to have children, to have minor children staying with them, to be lower educated, to be unemployed and to have been victimised than men. Women had used more services and reported lower self-esteem, less satisfaction with health and empowerment and higher psychological distress. They were less likely than men to have used alcohol excessively or cannabis. We found no significant differences between women and men in changes over time on the social quality factors. As women were disadvantaged at baseline compared to men regarding many factors, we concluded that women in homeless shelters are a particularly vulnerable group. Moreover, an opportunity remains for shelter services to improve women's social quality during and after their shelter stay. Show less
The conditional cash transfer programme Bono de Desarrollo Humano in Ecuador has allowed the increase in coverage of the social protection system to families in a situation of poverty, drawing... Show moreThe conditional cash transfer programme Bono de Desarrollo Humano in Ecuador has allowed the increase in coverage of the social protection system to families in a situation of poverty, drawing attention to care activities for human capital for- mation. Although women have gained more visibility and have been included in a significant way under this scheme, their inclusion has not resulted in a ruptu- re of traditional gender roles in the household and society. In what ways can we re-imagine non-contributory social protection to reduce gender gaps and include women in a meaningful and transformative way? This article addresses this question by means of an institutional discussion of the hindrances of the current de- sign and invites a consideration of alternatives aimed at framing a new politics of distribution guided by a right-based rationale and rupture of the normative elements that confine women to the care of the household.El programa de transferencias monetarias condicionadas Bono de Desarrollo Humano en Ecuador ha permitido extender la cobertura del sistema de protec- ción social a familias en situación de pobreza, dando relevancia a las labores de cuidado en la construcción de capital humano. A pesar de que las mujeres han ganado mayor visibilidad y han sido incluidas de manera significativa bajo es- te esquema, su inserción no ha generado rupturas con asignaciones tradiciona- les de género dentro del hogar y la sociedad. ¿De qué manera puede reimaginar- se la protección social no contributiva para reducir las brechas de género e incluir de manera significativa y transformativa a las mujeres? El presente artículo abor- da esta pregunta con una discusión institucional de los limitantes del diseño ac- tual e invita a evaluar alternativas encaminadas hacia una nueva política de distri- bución guiada por una lógica de derechos y ruptura con los elementos normativos que relegan a la mujer al cuidado del hogar. Show less
