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Gender differences in career and practice patterns of PGD-trained dentists.

This study compares differences by gender in the practice patterns and professional activities of general dentists, specialists, and dentists with Advanced Education in General Dentistry (AEGD) or General Practice Residency (GPR) training. The UCLA School of Dentistry surveyed a random sample of 6,725 dentists graduating from dental school in 1989, 1993, and 1997 as part of an evaluation of the impact of federal funding on postgraduate general dentist (PGD) programs. The survey asked about current practice, services referred and provided, and professional activities. Of the 2,029 dentists (30 percent) who responded, 49 percent were general dentists with no specialty training; 7 percent had AEGD training; 20 percent had GPR training; and 24 percent had specialty training. General dentists were more likely to be in private practice (p < 0.05). AEGDs, specialists, and females were more likely to report faculty positions as a secondary occupation. General dentists were more likely to be practice owners than AEGD- or GPR-trained dentists. The mean number of patients seen was highest for specialists. Females reported fewer patients than males, and this difference was significant for GPR-trained dentists. With respect to services, GPR-trained dentists reported significantly more biopsy procedures, conscious sedation, periodontal surgery, and implants than general dentists. AEGD-trained dentists reported more conscious sedation than general dentists. GPR dentists were more likely to volunteer time than general dentists without specialty training. PGD training appears to result in different types of employment and specific practice patterns that strengthen primary care dentistry. We further conclude that there are gender differences in the types of practice, patients seen, and services provided. These findings occur in addition to training differences.

Career Choice↗

Gender differences in alcohol and substance use relapse.

This review explores gender differences in relapse and characteristics of relapse events in alcohol and substance use. For alcohol, relapse rates were similar across gender. Although negative mood, childhood sexual abuse, alcohol-related self-efficacy, and poorer coping strategies predicted alcohol relapse, gender did not moderate these effects. Gender did moderate the association between marriage and alcohol relapse. For women, marriage and marital stress were risk factors for alcohol relapse; among men, marriage lowered relapse risk. This gender difference in the role of marriage in relapse may be a result of partner differences in problem drinking. Alcoholic women are more likely to be married to heavy drinking partners than are alcoholic men; thus, alcoholic women may be put at risk of relapse by marriage and alcoholic men may be protected by marriage. There are fewer studies documenting gender differences in substance abuse relapse so conclusions are limited and tentative. In contrast to the lack of gender differences in alcohol relapse rates, women appear less likely to experience relapse to substance use, relative to men. Women relapsing to substance use appear to be more sensitive to negative affect and interpersonal problems. Men, in contrast, may be more likely to have positive experiences prior to relapse.

Alcoholism↗

How, When, and for Whom Does Daily Weight Bias Internalization Undermine Body Image Satisfaction? A Daily Diary Study of Perceived Weight, Exercise Duration, and Gender Differences Among Adolescents.

Although body image satisfaction is increasingly recognized as a dynamic experience that fluctuates across daily contexts, little is known about how weight bias internalization shapes these fluctuations or the cognitive mechanisms and contextual factors involved. The present study examined whether perceived weight mediates the association between weight bias internalization and body image satisfaction, whether exercise duration moderates this association, and whether these effects differ by gender. Daily diary data were collected over 10 consecutive days from 305 Chinese adolescents (Mage = 12.59 years, SD&#x2009;=&#x2009;0.63 years; 49.2% girls). Multilevel analyses revealed that, at both within- and between-person levels, higher weight bias internalization was associated with lower body image satisfaction. Perceived weight significantly mediated the association between weight bias internalization and body image satisfaction at both levels. Additionally, exploratory analyses using dynamic structural equation modeling further indicated that perceived weight mediated the relationship between weight bias internalization and body image satisfaction at the between-person level, but not at the within-person level. Furthermore, exercise duration moderated the association between perceived weight and body image satisfaction among female adolescents but not among male adolescents. Specifically, the negative association between perceived weight and body image satisfaction was stronger on days when girls engaged in more exercise than usual and among girls with higher average exercise duration. In addition, exercise duration moderated the indirect association between weight bias internalization and body image satisfaction through perceived weight at both within- and between-person levels among girls. These findings highlight the dynamic cognitive processes linking weight bias internalization to body image satisfaction, and the importance of considering gender and daily exercise context in understanding adolescents' body image experiences.

Humans↗

Early gender differences in adolescent tobacco use--the experience of a Swedish cohort.

BACKGROUND: In Sweden, the prevalence of tobacco use in the youth population differs by product and gender, but there are no longitudinal studies of gender differences in the uptake of smoking and use of oral snuff (OS). METHODS: A prospective cohort study ongoing in the County of Stockholm, encompassing 3,019 children recruited in 1997 in the fifth grade of compulsory school, of whom 96% were followed-up in the sixth grade. RESULTS: At baseline, 22% of the boys and 15% of the girls had ever smoked, respectively 8% and 3% had ever used oral moist snuff. One year later, the overall smoking prevalence had markedly increased, as did the transition to more advanced stages of smoking, especially among girls. Among boys who at baseline had only used oral snuff, 41% had also smoked cigarettes at follow-up. Lack of a firm intention to abstain from tobacco use was strongly associated with onset of experimentation within one year, particularly among boys. CONCLUSIONS: Tobacco uptake in pre-adolescence differs between genders, with an earlier initiation among boys and a more rapid transition to regular smoking among girls. In most cases, experimentation with oral snuff among boys marks the transition to cigarette smoking.

Adolescent↗

Gender differences in the onset of depression following a shared life event: a study of couples.

BACKGROUND: Gender differences in clinically relevant depression are well established, appear to be greatest in childbearing years and may be the result of gender differences in social roles. METHODS: A community sample of 100 couples who had recently experienced at least one threatening life event that was potentially depressogenic for both of them was studied using a semi-structured interviewer-rated interview. Onset of depression was assessed using the Present State Examination, and, rather than assuming that a gender difference in roles existed uniformly across the couples, they were characterized according to their actual role activity and commitment. RESULTS: Women were found to have a greater risk of a depressive episode following the life event than men, and this difference was of a similar magnitude to other reports of gender differences in depression. Consistent with a role hypothesis, this greater risk was entirely restricted to episodes that followed events involving children, housing or reproductive problems. In addition, it was found that women's greater risk of a depressive episode following such events was only present among those couples where there were clear gender differences in associated roles. There was some suggestion that differences in roles on the one hand resulted in women being more likely to hold themselves responsible for such events and, on the other hand, enabled men to distance themselves from them. CONCLUSIONS: These results support the hypothesis that gender differences in rates of depression in the general population are, to a considerable extent, a consequence of role differences.

Adult↗

Gender differences in the utilisation of optometric services in Victoria.

Medicare and population data demonstrate clear gender differences in utilisation of health services. There are three broad hypotheses that may explain different utilisation rates of health services by gender: differences in access, differences in incidence and differences in attitudes in seeking health care between the genders. Men are 28 per cent less likely than women to see an optometrist in Victoria. Both women's and men's utilisation of optometric services in Victoria increase with age but there are clear gender differences apparent at every stage of life after childhood. These utilisation rates between genders are tested against incidence rates between genders for eye conditions. There are few noted gender differences apparent in the incidence or prevalence of ocular conditions. The data on the incidence of health conditions often has limitations, either in measurement tools or in differences in incidence between genders. These limitations are not as evident in eye care incidence data. Access and incidence differences do not adequately explain the differences in optometric service utilisation rates. This promotes the hypothesis that attitudinal differences in seeking health care between men and women are significant.

Adolescent↗

Is terror gender-blind? Gender differences in reaction to terror events.

OBJECTIVE: This study examines gender differences in posttraumatic vulnerability in the face of the terror attacks that occurred during the Al-Aqsa Intifada. In addition, the contribution of level of exposure, sense of safety, self-efficacy, and coping strategies is assessed. METHOD: Participants were 250 men and 262 women, who constitute a representative sample of Israel's adult population. Data were collected via a structured questionnaire consisting of 51 items that were drawn from several questionnaires widely used in the study of trauma. RESULTS: The findings indicate that women endorsed posttraumatic and depressive symptoms more than men and that, generally, their odds of developing posttraumatic stress symptoms are six times higher than those of men. Results also revealed that women's sense of safety and self-efficacy are lower than men's and that there are gender differences in coping strategies in the face of terror. CONCLUSIONS: Gender differences in vulnerability to terror may be attributable to a number of factors, among these are women's higher sense of threat and lower self-efficacy, as well as their tendency to use less effective coping strategies than men. Level of exposure to terror was ruled out as a possible explanation for the gender differences in vulnerability.

Adaptation, Psychological↗

How important are gender differences in pharmacokinetics?

Gender-related differences in pharmacokinetics have frequently been considered as potentially important determinants for the clinical effectiveness of drug therapy. The mechanistic processes underlying gender-specific pharmacokinetics can be divided into molecular and physiological factors. Major molecular factors involved in drug disposition include drug transporters and drug-metabolising enzymes. Men seem to have a higher activity relative to women for the cytochrome P450 (CYP) isoenzymes CYP1A2 and potentially CYP2E1, for the drug efflux transporter P-glycoprotein, and for some isoforms of glucuronosyltransferases and sulfotransferases. Women were suggested to have a higher CYP2D6 activity. No major gender-specific differences seem to exist for CYP2C19 and CYP3A. The often-described higher hepatic clearance in women compared with men for substrates of CYP3A and P-glycoprotein, such as erythromycin and verapamil, may be explained by increased intrahepatocellular substrate availability due to lower hepatic P-glycoprotein activity in women relative to men. Physiological factors resulting in gender-related pharmacokinetic differences include the generally lower bodyweight and organ size, higher percentage of body fat, lower glomerular filtration rate and different gastric motility in women compared with men. Although gender disparity in pharmacokinetics has been identified for numerous drugs, differences are generally only subtle. For a few drugs, e.g. verapamil, beta-blockers and selective serotonin reuptake inhibitors, gender-related differences in pharmacokinetics have been shown to result in different pharmacological responses, but their clinical relevance remains unproven. In contrast, gender differences of clinical importance have clearly been identified for pharmacodynamic processes such as QTc prolongation, and intensive future research efforts are needed to assess the full scope and impact of pharmacodynamic gender disparity on applied pharmacotherapy.

Female↗

Gender differences in ADHD subtype comorbidity.

OBJECTIVE: To examine gender differences in attention-deficit/hyperactivity disorder ("ADHD") symptom comorbidity with "oppositional defiant disorder", "conduct disorder", "separation anxiety disorder", "generalized anxiety disorder", speech therapy, and remedial reading in children. METHOD: From 1994 to 1995, data from a large sample (N = 4,371) of twins and siblings studied in the Australian Twin ADHD Project were obtained by mailed DSM-IV-based questionnaires, investigating patterns of comorbidity in the three subtypes of "ADHD": "inattentive", "hyperactive/impulsive", and "combined". A total of 1,550 questionnaires were returned (87%) over the next 12 to 18 months. RESULTS: Analysis of variance showed significant between-group differences in males and females for inattention and hyperactive/impulsive symptom counts with higher rates of "oppositional defiant disorder" and "conduct disorder" in males, and higher rates of "separation anxiety disorder" in females indicating internalizing disorders are more common in females and externalizing disorders are occurring more often in males. Differences were found between the "ADHD" subtypes and the no ADHD category for all comorbid conditions, for both males and females. Children without ADHD consistently had fewer symptoms, while children with the combined subtype showed consistently more comorbid symptoms indicating a strong relationship between high rates of externalizing symptoms and high rates of internalizing symptoms. Gender differences in speech therapy were significant only for the children without ADHD. The rates of "separation anxiety disorder" were higher in females with the "inattention" subtype and the rate of "generalized anxiety disorder" higher for females with the "combined" subtype, indicating that the subtypes of ADHD were associated with these internalizing disorders in different ways. CONCLUSIONS: Although comorbidity differs among ADHD subtypes, there were no significant gender differences in comorbidity for externalizing disorders. Inattentive girls may present with anxiety. Clinical approaches for both males and females should be sensitive to possible language and reading problems.

Analysis of Variance↗

Smoking, changes in smoking habits, and rate of decline in FEV1: new insight into gender differences.

We wanted to test the hypothesis that gender differences in effects of smoking on the rate of decline in pulmonary function may be related to gender differences in the frequency of smoking. Data from the Vlagtwedde-Vlaardingen study in The Netherlands were analysed, to investigate the rate of decline in forced expiratory volume in one second (delta FEV1) in relation to smoking status and gender. 4,554 participants, initially aged 15-54 yrs, provided 16,900 pairs of observations at 3 yr intervals over 24 yrs of follow-up. Lifetime nonsmokers accounted for 11% of male participants and 45% of female participants. Compared with lifetime nonsmokers, estimated excess delta FEV1 for light, moderate, and heavy continued smokers was 4.4, 9.5 and 13.5 ml.yr-1 for men and 6.1, 10.8 and 18.8 ml.yr-1 for women, respectively. Female former smokers had a significantly more rapid delta FEV1 (beta = 4.4, SE = 1.6 ml.yr-1) than lifetime nonsmokers; but male former smokers had a slower rate of decline (beta = 4.1, SE = 2.3 ml.yr-1) than lifetime nonsmokers. Overall gender difference in smoking effects on delta FEV1 was statistically significant. Among subjects who smoked an identical amount at the beginning of the study period those who quit smoking during the period had a significantly slower delta FEV1 than those who continued smoking, for both men (beta = 20.6, SE = 3.9 ml.yr-1) and women (beta = 15.7, SE = 3.4 ml.yr-1). Younger quitters (< 45 yrs) benefited significantly more from smoking cessation than older quitters (> or = 45 yrs).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Gender differences in autonomic modulation of ventricular repolarization in humans.

BACKGROUND: Gender differences in the incidence of ventricular arrhythmias have been reported and torsades de pointes associated with long QT syndrome are more common in women than men. Although increased sympathetic tone has an important role in vulnerability to arrhythmia, little is currently known regarding gender differences in the dynamic electrophysiological response to sympathetic stimulation. Therefore, we investigated whether there is a gender difference in humans with respect to the dynamic response of ventricular repolarization to beta-adrenergic stimulation and to autonomic blockade. METHODS: Twelve-lead ECGs were continuously recorded during isoproterenol infusion (protocol 1) and autonomic blockade with propranolol and atropine infusion (protocol 2) in 24 healthy volunteers (12 men, 23 +/- 2 years; 12 women, 23 +/- 5 years). QT (QTc) intervals were measured at the baseline and at a heart rate of 75, 100, and 120 beats/min. RESULTS: (1) The morphology of the T wave dynamically and transiently changed to bifid or biphasic during the acute phase of isoproterenol infusion. The incidence of these morphologic changes was higher in women than men (P < 0.05). (2) The QTc interval was initially prolonged and then shortened in both men and women during isoproterenol administration. However, QTc prolongation was significantly greater in women (0.44 +/- 0.02 to 0.55 +/- 0.03 sec) than men (0.42 +/- 0.03 to 0.51 +/- 0.04 sec; P < 0.05). (3) The QTc interval was significantly prolonged under autonomic blockade and the intrinsic QTc interval was longer in women than men (P < 0.05). CONCLUSION: While sympathetic stimulation and autonomic blockade modulated the dynamics of ventricular repolarization in both sexes, it was more pronounced in women. This gender difference may partially account for the susceptibility of women to arrhythmogenesis.

Adult↗

Gender differences in the control of alcohol-impaired driving in California.

OBJECTIVE: An examination of gender differences in alcohol-impaired driving. METHOD: Attitudes, perceptions and behaviors concerning drinking and driving were compared for male and female California drivers in three random-digit-dialing telephone survey interviews from 1983, 1986 and 1994 (survey response rates of 58%, 52% and 49%, respectively). A moral reasoning framework was applied to account for observed gender differences. RESULTS: Gender differences were examined within aggregate data from the 1983 and 1986 surveys (n = 291), and within the 1994 survey data (n = 608). Self-reported drinking-driving violations showed a substantial decline for both men and women across the survey periods (although violations remained much higher for men), paralleling the well-documented drop in alcohol-related traffic crashes during this time span. Men and women responded equally to the threat of punishment from the legal system (threat of arrest, jail, loss of license, fine, increased insurance), but women were much more responsive to social and internal controls (perceived disapproval from friends, feelings of guilt, violation of a moral standard). CONCLUSIONS: These gender differences suggest that women may play an important role in strengthening broad social and moral constraints regarding alcohol-impaired driving. Implications of these findings to deterrence, the effects of sanctions, and social change are discussed.

Alcohol Drinking↗

Gender differences in knowledge, intentions, and behaviors concerning pregnancy and sexually transmitted disease prevention among adolescents.

Gender differences in knowledge, intentions, and behaviors regarding preventing pregnancies and sexually transmitted diseases were studied. Data for the study were collected from 1,033 students in 13 California high schools. Females in this sample were more likely than males to have discussed sexuality topics with parents, to have engaged in sexual intercourse more frequently, to have experienced a pregnancy scare, to have used oral contraceptives during their last sexual encounter, to perceive that a larger proportion of their peers were engaging in sex and using birth control, to obtain birth control from health facilities, and to report intentions to abstain or use protection in hypothetical situations placing them at risk for unprotected sex. In contrast, males reported that they were more likely to have always used birth control, to have used birth control during their first sexual encounter, and to have used a condom during their last sexual encounter. Furthermore, males were more likely to obtain birth control from a store or a friend. Finally, males knew more about using condoms correctly and their role in preventing sexually transmitted diseases. The efficacy of interventions designed to reduce unintended pregnancy and sexually transmitted diseases among adolescents may be increased by addressing these gender differences. Understanding gender differences may also facilitate an increased role for males in the overall prevention scheme. Further research is clearly needed to increase knowledge about these gender differences.

Adolescent↗

Gender differences in premorbid cognitive performance in a national cohort of schizophrenic patients.

Despite significant research, there are still inconsistent findings regarding gender differences in cognitive performance in individuals already diagnosed with schizophrenia; studies have found that males suffering from schizophrenia are more, less or equally impaired compared with females. Gender differences in cognitive performance in individuals suffering from schizophrenia may be influenced by gender differences in premorbid cognitive performance; the very few and very small N studies published indicated that males have a poorer pre-morbid cognitive performance than females. This study examined the gender differences in premorbid cognition, utilizing cognitive assessments performed on female and male adolescents before induction into military service. The Israeli Draft Board Registry, which contains cognitive assessments equivalent to IQ scores on 16-18 year old Israeli adolescents, was linked with the Israeli National Psychiatric Hospitalization Case Registry, which records all psychiatric hospitalizations in the country. Scores on premorbid cognitive performance in schizophrenia were examined in 90 female-male case pairs matched for school attended as a proxy for socio-economic status. The mean age of first hospitalization was 20. 1+/-1.8 years of age for males and 19.6+/-1.8 years of age for females. A repeated-measures ANCOVA with age of first hospitalization and years of formal education as covariates, and controlling for gender differences in cognitive performance in healthy adolescents, revealed a significant difference in pre-morbid cognitive performance between males and females on all four cognitive measures [F(1,87)=8.07, P=0.006] with females scoring lower (worse) than males. In this national cohort, pre-morbid cognition was poorer in female, compared with male, adolescents who will suffer from schizophrenia in the future, a result consistent with some, but not all, similar studies. These results may be valid only for patients with first hospitalization around age 20. Hence, gender differences in premorbid cognition should be taken into account when assessing gender differences in cognition in schizophrenia.

Adolescent↗

Gender differences in electroconvulsive therapy: a retrospective chart review.

BACKGROUND: There is a growing interest in gender differences of different psychiatric disorders, especially major depression. We sought a possible gender difference related to electroconvulsive therapy (ECT). METHODS: This retrospective study compared 20 male and 23 female depressed adult patients treated by ECT. We compared their findings on gender differences to those of 12 female and 4 male bipolar patients and 11 male and 19 female schizophrenic patients, all treated in the same ECT setting. RESULTS: Depressed female patients underwent significantly fewer antidepressant drug trials than males before being referred to ECT (t41=2.09, P<0.05). A similar gender difference was found in the treatment of patients suffering from schizophrenia: female patients underwent fewer pharmacological antipsychotic trials than males before being referred to ECT (t28=3.11, P<0.01). ECT was significantly more effective in female patients than in male patients suffering from schizophrenia (U=38, P<0.05). LIMITATIONS: This is a retrospective pilot study whose results are based on subjective evaluations. CONCLUSION: The findings of this study may support a gender difference both in referral and in the outcome of ECT. CLINICAL RELEVANCE: there might be a need to consider lowering the number of pre-ECT drug trials for depressed males and to consider ECT as a viable therapeutic option for schizophrenic females.

Major Depressive Disorder↗

Pathways to psychotropic drugs. Understanding the basis of gender differences.

Earlier studies have established substantial gender differences in the likelihood of obtaining a psychotropic drug prescription, and a correlation, especially among women, with such family characteristics as family responsibilities, marital separation, divorce or widowhood, and the presence of family stressors such as an ill spouse. However, the pathways to psychotropic drug use are not clearly understood. Data from the National Medical Care Expenditure Survey show that gender differences in obtaining a psychotropic drug can be accounted for by the greater likelihood of women to perceive illness, particularly mental illness and musculoskeletal conditions, diagnostic conditions that together account for roughly half of all psychotropic drug prescriptions. In relation to family responsibilities, employment significantly decreases the likelihood of a psychotropic drug prescription for both men and women. The greater likelihood of divorced, separated, or widowed women to obtain psychotropic drugs can be explained by their greater likelihood of episodes of illness, particularly those involving mental illness, and by their greater number of physician visits. The presence of all ill spouse is associated with psychotropic drug use only indirectly by increasing the likelihood of Medicaid coverage. Thus, differences between men and women in the likelihood of obtaining prescriptions for psychotropic drugs do not appear to result from different physician-patient interactions or from gender-determined treatment norms by physicians.

Adult↗

[Gender differences in mood disorders. A literature review].

The study of gender differences in mood disorders may have important clinical implications such as identifying clinical subtypes or symptoms clusters specific to each sex, and will help better understand pathophysiological mechanisms involved in affective illness. In unipolar depression the most frequent gender differences found are a greater prevalence of depression in women than in men and a worst outcome in women: they are more likely to have a chronic and recurrent course with longer episodes. Also, depressed women have higher rates of comorbidity than depressed men. Gender differences in response to treatment are as yet inconclusive. Women tend to display more side effects at the usual doses. It may be useful to consider a dosage adjustment during the premenstrual period and if hormonal therapies are being administered. No gender differences in the prevalence of bipolar disorder have been found, except for a greater incidence of rapid cycling in women (ratio 3:1).

Age of Onset↗

Gender differences in romantic jealousy.

Findings of studies of gender differences in jealousy are contradictory. In the present study, conflicting literature was addressed by distinguishing 5 dimensions of jealousy: level, trigger, experience, focus, and responses. In 4 studies, 3 in the U.S. and 1 in Israel, gender differences were explored in these 5 dimensions of romantic jealousy. Although there were no gender differences in the likelihood, frequency, duration, or intensity of jealousy, there were differences in the responses to certain jealousy-producing occasions as well as in the focus, experience, and expression of jealousy.

Adult↗