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[Evaluation of gender differences of family caregivers with reference to the mode of caregiving at home and caregiver distress in Japan].

PURPOSE: Male caregivers are growing in number, as the frequency of spouse caregiving rapidly increases. This study aimed to examine gender differences in family caregivers with reference to the mode of caregiving and caregiver distress in Japan. It was designed to clarify the characteristics of both female and male caregivers. METHODS: The subjects were 2,020 users of public Long-term Care Insurance, randomly stratified and sampled in Higashi-osaka city, Osaka prefecture. Data were collected through mailed, anonymous self-report questionnaires. 1,287 (63.7%) surveys were collected and data from 868 caregivers and care recipients were analyzed, after excluding incomplete cases from 947 participants who were family caregivers. We compared males and females for the level of nursing needs, cognitive disorders of their care recipients, the types and amounts of care provided, the levels of their burdens and the depression associated with providing care, the availability of informal support, the frequency of usage of Long-term care insurance services, and the types of stress coping strategies. RESULTS: Of the total, 27.1% of the caregivers were male. Their age was higher than that of females, but the age of care recipients of female caregivers was significantly higher than that of care recipients of males. There were no significant gender differences in the level of nursing needs of recipients. However, cognitive disorders of care recipients of female caregivers were more severe. Female caregivers spent more time providing care, and performed a greater number of care activities. In particular, female caregivers assisted their care recipients in taking medications, dressing, bathing, eating, meal preparation, shopping, laundry, and money management more often to a significant degree. Furthermore, the average scores for burden and depression were higher in female than in male caregivers. Concerning the usage of Long-term care insurance services, males used a Home-helper service more often. Female caregivers used types of Informal support seeking and Positive acceptance of caregiving role as coping strategies more often than the men. Multiple logistic regression analysis indicated that caregiver's subjective burden and types of informal support seeking, as well as acceptance of the caregiving role were significantly higher in female caregivers. CONCLUSIONS: These results suggest that there are significant gender differences regarding the mode of caregiving and experience of caregiver distress in Japan. It is important that future research be focused on supplying appropriate social support for family caregivers, taking gender differences into account.

Aged↗

Gender differences in the psychosocial correlates of suicidal ideation among adolescents.

Gender differences in the psychosocial correlates of suicidal ideation were studied. A sample of 613 high school students (ages 14-19) completed measures of suicidal ideation, depression, hopelessness, life stress, loneliness, alcohol and drug use, and reasons for living. The results of a discriminant function analysis indicated that males reported higher loneliness and substance abuse scores than females whereas females reported greater suicidal ideation, depression, and reasons for living. The results of multiple regression analyses found that, although the same four variables, depression, hopelessness, substance abuse, and few reasons for living emerged as significant predictors of suicidal ideation in both samples, the predictive equation accounted for more of the variance in ideation scores in females (57%) than in males (46%). In a final analysis a discriminant function analysis of the subscales of the reasons for living inventory revealed that females have a greater fear of death and injury whereas males have a greater fear of social disapproval over having suicidal thoughts. This may account for the greater rate of suicide completing among males. Fear of social disapproval, more anger and impulsivity, and less help-seeking behavior among males are offered as potential variables to explain the observed gender differences.

Adolescent↗

Gender differences in recurrent coronary events; the FINMONICA MI register.

BACKGROUND: Male gender is an established risk factor for first myocardial infarction, but some studies have suggested that among myocardial infarction survivors, women fare worse than men. Therefore, we examined the long-term prognosis of incident myocardial infarction survivors in a large, population-based MI register, addressing gender differences in mortality as well as the number of events and time intervals between recurrent events. METHODS AND RESULTS: Study subjects included 4900 men and women, aged 25-64 years, with definite or probable first myocardial infarctions who were alive 28 days after the onset of symptoms. At first myocardial infarction, women were older and more likely to be hypertensive or diabetic than men, and had a greater proportion of probable vs definite events. After adjustment for age and geographic region, men had 1.74 times the risk of fatal coronary heart disease relative to women (hazard ratio=1.63 and 1.55 for cardiovascular disease and all-cause mortality, respectively) over an average of 5.9 years of follow-up. Number and time intervals between any recurrent event--fatal and non-fatal--did not differ by gender. CONCLUSION: These data suggest that men are far more likely to have a fatal recurrent event than women despite comparable numbers of events.

Adult↗

Gender differences in regional body composition and somatotrophic influences of IGF-I and leptin.

This study evaluated the arm, trunk, and leg for fat mass, lean soft tissue mass, and bone mineral content (BMC) assessed via dual-energy X-ray absorptiometry in a group of age-matched (approximately 29 yr) men (n = 57) and women (n = 63) and determined their relationship to insulin-like growth factor I (IGF-I) and leptin. After analysis of covariance adjustment to control for differences in body mass between genders, the differences that persisted (P < or = 0.05) were for lean soft tissue mass of the arm (men: 7.1 kg vs. women: 6.4 kg) and fat mass of the leg (men: 5.3 kg vs. women: 6.8 kg). Men and women had similar (P > or = 0.05) values for fat mass of the arms and trunk and lean soft tissue mass of the legs and trunk. Serum IGF-I and insulin-like growth factor binding protein-3 correlated (P < or = 0.05) with all measures of BMC (r values ranged from 0.31 to 0.39) and some measures of lean soft tissue mass for women (r = 0.30) but not men. Leptin correlated (P < or = 0.05) similarly for measures of fat mass for both genders (r values ranging from 0.74 to 0.85) and for lean soft tissue mass of the trunk (r = 0.40) and total body (r = 0.32) for men and for the arms in women (r = 0.56). These data demonstrate that 1) the main phenotypic gender differences in body composition are that men have more of their muscle mass in their arms and women have more of their fat mass in their legs and 2) gender differences exist in the relationship between somatotrophic hormones and lean soft tissue mass.

Absorptiometry, Photon↗

Gender Differences in Arithmetic Strategy Use: A Function of Skill and Preference.

This study was designed to examine whether first-grade boys' use of retrieval and first-grade girls' use of manipulatives reflected gender differences in their abilities to use these strategies or gender differences in preferences for strategy use. Eighty-four first-grade students, 42 boys and 42 girls, from two suburban elementary schools participated in this study. The children solved basic arithmetic problems under two conditions: a free-choice condition in which they were allowed to solve the problems any way they preferred and a game condition in which the children's strategy use was constrained so that all children used the same strategies on the same arithmetic problems. Strategy use during the free-choice session replicated the findings of earlier research indicating that girls tend to use strategies utilizing manipulatives and boys tend to use retrieval. During the game condition, when we controlled the types of strategies children used on different problems we found that boys were as able as girls to calculate solutions using manipulatives. Girls, however, were not as capable as boys in their retrieval of answers to arithmetic problems from memory. No differences were found in error rates or speed of retrieval. Gender differences were found in the variability of correct retrieval, with boys being significantly more variable than girls. Copyright 2001 Academic Press.

Journal Article↗

Gender differences in motivational style: a comparison of measures and curriculum area.

BACKGROUND: Gender has long been implicated in school-based performance with gender differences varying across curriculum domains. Motivational differences have often been cited as a possible cause. However, evidence for the pattern of motivational difference between the genders is unclear. AIMS: This study compares the motivational responses of girls and boys in the curriculum areas of mathematics and English. Two different measures of motivation are employed. SAMPLES: The sample consists of all pupils from years 7, 9 and 11 in two secondary schools in Northern England. A total of 435 yr 7, 389 yr 9 and 357 yr 11 students was available. METHODS: Students completed two assessments of motivation, one based on self-report measures of goal strength and the other on performance over four tasks. Some school performance data were also available. RESULTS: The two motivation measures produce different patterns of results. The task-based measure shows no gender based differences while the other indicates a pattern of differences broadly suggestive of an advantage for girls. CONCLUSIONS: Future exploration of gender effects in motivation needs to give careful consideration to the type of motivation under consideration. Univariate models are unlikely to be adequate.

Achievement↗

Ethnic and gender differences in smoking prevalence among a longitudinal sample of inner-city adolescents.

PURPOSE: To determine if ethnic and gender differences in smoking (lifetime prevalence and 30-day prevalence) exist among a cohort of Asian, black, Hispanic, and white inner-city adolescents during the 3-year middle school period. METHODS: Students in 22 urban schools completed self-report questionnaires and provided carbon monoxide breath samples at three annual assessments. Chi-square analyses were conducted to test for associations between ethnic group (Asian, black, Hispanic, and white) and smoking and to test for gender differences in smoking within each ethnic group. Additional analyses examined differences in smoking between two Hispanic subgroups (Puerto Rican and Dominican). RESULTS: Ethnicity was associated with lifetime smoking prevalence at all three assessment points but was only associated with 30-day smoking prevalence at the 2-year follow-up. However, there were no differences in smoking between Puerto Rican and Dominican youth. Black girls reported higher lifetime smoking prevalence than black boys at all three assessments. At the 2-year follow-up, Asian boys reported higher lifetime smoking prevalence than Asian girls; Hispanic girls reported higher 30-day prevalence than Hispanic boys. CONCLUSIONS: White and Hispanic adolescents were at higher risk for smoking relative to Asian and black adolescents. With the exception of white youth, gender differences were found within each ethnic group.

Adolescent↗

Gender differences in moral reasoning among physicians, registered nurses and enrolled nurses engaged in geriatric and surgical care.

Physicians, registered nurses (RNs) and enrolled nurses (ENs) engaged in geriatric (n = 49) and surgical (n = 59) care at a large hospital in Sweden gave 180 accounts of morally difficult care episodes. In total, the ENs (n = 40) gave 78, the RNs (n = 38) 55 and the physicians (n = 30) 47 accounts; there were 83 from geriatric care and 97 from surgical care. Forty-nine participants were male, and 59 were female; there were no differences in gender in the form and content of the moral reasoning disclosed in either morally difficult care episodes or in the complete interviews when coded as mainly narrative or propositional, or as showing a care or a justice orientation. The ENs showed a care orientation, while RNs and physicians, to an equal degree, showed both a justice and a care orientation. The ENs also used narrative reasoning more often than RNs and physicians. No differences were seen between the two health care specialties.

Ethical Analysis↗

[Gender difference of clinical features in Japanese patients with alcoholic liver cirrhosis].

Gender difference of alcohol intake and laboratory data was investigated in 165 Japanese patients with alcoholic liver cirrhosis. Mean age of first drinking and habitual drinking were higher in female. Duration of drinking was shorter in female. Although cumulative alcohol intake was larger in male, mean daily alcohol intake did not differ in both gender. Moreover, daily alcohol intake adjusted to body weight was significantly larger in female. Body mass index, serum levels of total protein, albumin and cholinesterase were significantly decreased in female. Platelet counts on admission did not differ in both gender. However, it was significantly increased in female after one month abstinence. C reactive protein, ammonia and serum levels of total bilirubin were significantly higher in female as compared to male. In conclusion, female alcoholics seems to progress to liver cirrhosis earlier because of high daily alcohol intake adjusted to body weight, poor nutritional condition and inflammation caused by endotoxin.

Adult↗

Gender differences in dietary intake among adults of Hindu communities in lowland Nepal: assessment of portion sizes and food consumption frequencies.

OBJECTIVE: To elucidate gender differences in dietary intake among adults in lowland Nepalese communities. SUBJECTS AND METHODS: For 122 male and 195 female subjects aged 20 years and over from 94 randomly selected households, interviews using a 19-item food frequency questionnaire were conducted. To determine the portion sizes of these foods, the samples consumed by 56 subjects in a full 1-day period were weighed. Energy expenditure was estimated by time spent on daily activities. RESULTS: Gender differences in per-day energy and protein intakes were related to sex differences in body size and energy expenditure. Apparent gender differences in the crude intakes disappeared when they were expressed by nutrient density (mg or microg/MJ) since micronutrient intakes were significantly correlated with energy intake. However, males' iron intake was larger even after adjustment for energy intake, attributing to their larger portion sizes of commonly consumed staple foods and higher frequencies of consuming luxury foods (fish and tea). CONCLUSION: The intrahousehold unequal distribution of food incurs risk of iron deficiency among female subjects. SPONSORSHIP: This study was financially supported by the Ajinomoto Foundation for Dietary Culture and the Alliance for Global Sustainability Program.

Adult↗

Gender differences in health perceptions and their predictors.

This study explored the degree to which risks embedded in the social construction of gender roles and personality traits explained gender differences in health perceptions and reporting among mild hypertensive patients (134 women and 104 men) under the same treatment regime. Compared with men, women were less educated, less likely to be employed, less happy, more distressed, less satisfied with family functioning, and had a weaker sense of coherence. Twice as many women as men evaluated their health as 'poor', and on average reported 2.6 more symptoms than men. These gender differences largely disappeared when unhappiness, distress, and sense of coherence were controlled. While education attainment, employment, and satisfaction with family functioning decreased gender differences in some half of the symptoms, multivariate analysis suggested that unhappiness, distress, and the sense of coherence are far better predictors of gender differential health perceptions. It is suggested that beyond biological predispositions, women's health is in double jeopardy by gender role related risks, which affect morbidity both directly through immunology system and indirectly through health perceptions.

Adult↗

Gender differences in glucose kinetics and substrate oxidation during exercise near the lactate threshold.

The purpose of this investigation was to determine plasma glucose kinetics and substrate oxidation in men and women during exercise relative to the lactate threshold (LT). Subjects cycled for 25 min at 70 and 90% of O(2) uptake (VO(2)) at LT (70 and 90% LT, respectively). Plasma glucose appearance (R(a)) and disappearance (R(d)) were determined with a primed constant infusion of [6,6-(2)H]glucose. There were no significant differences in glucose R(a) between men [22.6 +/- 1.9 and 39.9 +/- 3.9 micromol x kg fat-free mass (FFM)(-1) x min(-1) for 70 and 90% LT, respectively] and women (22.3 +/- 2.7 and 33.9 +/- 5.7 micromol x kg FFM(-1) x min(-1) for 70 and 90% LT, respectively). Similarly, there were no significant differences in glucose R(d) between men (21.2 +/- 1.9 and 38.1 +/- 3.7 micromol x kg FFM(-1) x min(-1) for 70 and 90% LT, respectively) and women (21.3 +/- 2.8 and 33.3 +/- 5.6 micromol x kg FFM(-1) x min(-1) for 70 and 90% LT, respectively). Although there were no differences between genders in the relative contribution of carbohydrate (CHO) to total energy expenditure, the relative contribution of muscle glycogen to total CHO oxidation (75.8 +/- 3.2 and 64.2 +/- 8.0% for men and women, respectively, at 70% LT and 75.1 +/- 2.6 and 60.1 +/- 11.2% for men and women, respectively, at 90% LT) was lower in women. Consequently, the relative contribution of blood glucose to total CHO oxidation was significantly higher in women. These results indicate that although plasma glucose R(a) and R(d) are similar in men and women, the relative contribution of muscle glycogen and blood glucose is significantly different in women during moderate-intensity exercise relative to LT.

Adult↗

Gender differences in depressive symptoms among Spanish elderly.

The aim of this study is to describe gender differences in depressive symptomatology among an elderly Spanish population and to see whether women are more at risk than men and whether the effects of known risk factors for depression differ between the genders. Data come from the study Envejecer en Leganés (Growing Old in Leganés), where a representative sample of community residing elderly was screened by an at-home interview for high depressive symptomatology using the Center for Epidemiologic Studies Depression Scale (CES-D). Sociodemographic characteristics, health status, Activities of Daily Living and Instrumental Activities of Daily Living, disability, social support, and locus of control were measured as possible correlates of depressive symptoms. Screening was completed in 1116 subjects. The prevalence of high depressive symptomatology varied, being 19.6% for men and 46% for women (OR = 3.4; 95% CI = 2.6; 4.5). In addition to gender, comorbidity, low emotional support from children, lack of a confidant, few social activities, and a sense of lack of control were independently associated with high levels of depressive symptoms. None of the interactions of gender by the known risk factors of depression was significant. Although the prevalence of depressive symptomatology is higher in women than in men, the known risk factors do not totally explain the difference between genders in this population of Spanish elderly. This difference could be due to the cultural definitions of gender roles that have affected them throughout their lives.

Activities of Daily Living↗

Gender differences in risk factors for attempted suicide among young adults: findings from the Third National Health and Nutrition Examination Survey.

PURPOSE: To identify the significant factors associated with attempted suicide among men and women, and determine whether socioeconomic status (SES) and social support indictors, health risk factors, and lifetime history of medical and psychiatric illnesses can explain gender differences in attempted suicide. METHODS: We used data from 3357 men and 4004 women aged 17 to 39 years, who completed a mental disorder diagnostic interview as a part of the Third National Health and Nutrition Examination Survey, 1988-1994. Adjusted odds ratios (ORs) were calculated for the association between risk factors and attempted suicide. RESULTS: The prevalence of lifetime attempted suicides was 7.58% (SE, 0.66) in women and 3.69% (SE, 0.49) in men. In men, low income and smoking were associated with attempted suicide, while attempted suicide in women was associated with poor self-evaluated health, low educational attainment, and drug use. A history of medical and psychiatric illnesses was associated with attempted suicide in both genders, for cancer/pulmonary disease, OR=2.89 (95% CI, 1.25-6.67) in men and 1.94 (1.09-3.45) in women; for major depressive disorder, OR=9.86 (5.08-19.14) in men and 5.00 (3.19-7.83) in women. The significant gender difference of attempted suicide prevalence remained after being adjusted for risk factors selected. CONCLUSION: There were significant gender differences in the risk factors for attempted suicide among young adults, and the gender difference in the prevalence of lifetime attempted suicides could not be explained by differential exposure to risk factors selected.

Adult↗

No gender difference in the clinical management and outcome of unstable angina.

BACKGROUND: Women with myocardial infarction have a less favorable prognosis than men. Many studies have indicated gender bias in the evaluation and treatment of myocardial infarction, but few data exist concerning these aspects in the management of unstable angina. OBJECTIVE: To investigate gender differences in the baseline characteristics, clinical presentation, treatment and prognosis of women with unstable angina. METHOD: Data were collected prospectively as part of the Acute Coronary Syndromes Israeli Survey in 2000 at Soroka University Medical Center. In-hospital management and 2 year follow-up were monitored for 226 consecutive patients with unstable angina admitted to our medical center during February and March 2000. RESULTS: Women were older (71 +/- 12 vs. 66 +/- 12, P = 0.006), more diabetic (41.3% vs. 34.5%, not significant) and hypertensive (76.3% vs. 64.6%, P = 0.07). Women presented more often with atypical chest pain (18.8% vs. 7.5%, P = 0.038). Heparin, aspirin and angiotensin-converting enzyme inhibitor were delivered equally, but more beta-blockers were administered to women (88.5% vs. 75.7%, P = 0.02) and more statins to men (48.1% vs. 35.4%, P = 0.07). Angiography rates were similar (17.7% vs. 19.6%). Similar management was documented during the 2 year follow-up. Re-hospitalization rates were similar (53.3% of women and 63.7% of men, NS). Men had a tendency to develop acute myocardial infarction more often (9.6% vs. 2.7%, P = 0.06) and to develop peripheral vascular disease (3.7% vs. 0%, P = 0.09), and they had a non-significant higher rate of coronary artery bypass graft (6.7% vs. 1.3%, P = 0.08). No gender difference was found in angiography (14.7% of women vs. 16.3% of men) or percutaneous intervention (13% vs. 16.7%). At 2 years there was no gender-related difference in mortality (13.3% of women vs. 16.3% of , NS). Kaplan-Meier analysis for event-free survival after 2 years showed no gender difference in survival. Multi-regression analysis showed that gender was not a prognostic factor for survival. CONCLUSIONS: We found no major difference in the management of men and women with unstable angina. Although men showed a tendency to suffer more major cardiac events, their 2 year prognosis was the same as for women.

Aged↗

Prevalence of HIV infection among young adult injecting and non-injecting heroin users in Spain in the era of harm reduction programmes: gender differences and other related factors.

The aims were to assess the prevalence of HIV infection among young adult heroin users, including injecting heroin users (IHUs) and non-injecting heroin users (NIHUs), and to explore the differences by gender and other factors. The design was a cross-sectional cohort study between April 2001 and December 2003, which included 961 current heroin users (HU), aged 18-30 years: 422 in Madrid, 351 in Barcelona and 188 in Seville; 621 were IHUs and 340 were NIHUs. All were street-recruited by chain referral methods. Face-to-face interviews were conducted using a structured questionnaire with computer-assisted personal interviewing (CAPI). Samples for HIV testing (dried blood spot) were collected and tested with ELISA and Western Blot. Bivariate, logistic regression, and classification and regression tree analyses were performed. The overall prevalence of HIV infection among IHUs was 25.8% (95% CI 22.3-29.3) [32.4% (95% CI 26.6-38.1) in Madrid, 20.5% (95% CI 15.6-25.4) in Barcelona, and 20.6% (95% CI 9.8-31.4) in Seville], whereas in NIHUs it was 4.0% (95% CI 2.1-6.7), with no differences among cities. The prevalence was significantly higher in women than in men in NIHUs (10.9%, 95% CI 4.3-17.5 vs. 1.7%, 95% CI 0.5-4.2) and was non-significantly higher in IHUs (30.4%, 95% CI 23.0-37.8 vs. 24.1%, 95% CI 20.1-28.1). HIV prevalence in short-term IHUs was 12.9% (CI 8.8-17.02), with no differences among cities. In the logistic analysis, the variables associated with infection in IHUs were ever having injected with used syringes (OR 3.4, 95% CI 2.2-5.3), ever having been in prison (OR 2.6, 95% CI 1.6-4.0), and heroin as the first drug injected at least weekly (OR 2.3, 95% CI 1.1-4.5). Factors positively associated with HIV infection in NIHUs were female sex (OR 8.7, 95% CI 2.6-29.2) and age >25 years (OR 3.1, 95% CI 0.9-11.1), while primary educational level was inversely associated (OR 0.26, 95% CI 0.1-0.9). Although there are important geographic differences, HIV prevalence in IHUs remains high, even in short-term IHUs, whereas it was almost six times lower in NIHUs. The prevalence in women is higher than in men, particularly among NIHUs. A wide range of preventive strategies should be developed, aimed primarily at empowering women to negotiate safe sex.

Adult↗

Gender differences for the predictors of depression in young adults with genital herpes.

Genital herpes is a chronic, stigmatizing, sexually transmitted disease (STD), which is increasing despite efforts to control its spread. Depression is commonly reported among people diagnosed with genital herpes and differences in depression by gender have been reported. Therefore, the purpose of this study was to identify gender differences in the predictors of depression in young adults with genital herpes by secondary analyses of baseline data from a randomized clinical trial (RCT). For the RCT, young adults (193 females, 59 males) with genital herpes were recruited from newspaper advertisements. Participants completed questionnaires measuring illness burden, attitudes toward herpes, stress symptoms, mood states, depression, self-concealment, self-disclosure, substance use, and demographics. Univariate analyses and multiple regression techniques were used to identify variables predictive of depression in this sample. In women, increased anger, decreased vigor, increased confusion, a negative attitude toward herpes, self-concealment, and stress symptoms from genital herpes predicted more depression (R2 = 0.63). In men, increased depression was predicted by increased anger, a negative attitude toward herpes, and a decreased willingness to share personal information with a stranger (R2 = 0.51). Findings suggest that future psychoeducational interventions should address anger as a predictor of depression in this population. Gender-specific interventions need to be developed in order to assist young adults who are living with genital herpes.

Adaptation, Psychological↗

Gender differences in self-concept and psychological well-being in old age: a meta-analysis.

Because of women's higher risk of being widowed, having health problems, and needing care, one might expect them to have a more negative self-concept and lower subjective well-being (SWB). However, women may also have greater access to sources of SWB (e.g., relations to adult children) and may engage in processes to protect the self (e.g., lowered aspirations). Meta-analysis was used to synthesize findings from 300 empirical studies on gender differences in life satisfaction, happiness, self-esteem, loneliness, subjective health, and subjective age in late adulthood. Older women reported significantly lower SWB and less positive self-concept than men on all measures, except subjective age, although gender accounted for less than 1% of the variance in well-being and self-concept. Smaller gender differences in SWB were found in younger than in older groups. Statistically controlling for gender differences in widowhood, health, and socioeconomic status decreased gender differences in SWB. Cohort differences in SWB are reported as well.

Aged↗