Consistent Gender Effects Research Articles

2.28 Transforming Pediatric Practices to Provide Mental Health Services

2.28 Transforming Pediatric Practices to Provide Mental Health Services

Women’s political empowerment and welfare policy decisions: a spatial analysis of European countries

ABSTRACT This study analyses the impact of female political empowerment on European countries’ welfare policies. Following a spatial econometric approach, the results reveal the presence of a spatial dependence across countries and a consistent gender effect. In particular, the descriptive representation seems to favour a higher distribution of resources to sectors in which women are disproportionately active (health, family, housing, elderly care). Moreover, the study reveals positive spatial spillovers arising from women’s political empowerment in neighbouring countries that suggest the existence of an active and visible role model crossing national jurisdictions. These outcomes are robust to different metrics of neighbourliness.

Is moral redemption possible? The effectiveness of public apologies for sexual misconduct

Amidst an international movement against sexual violence in 2017, hundreds of high-profile men were accused of sexual misconduct, and people's news feeds were flooded with apologies issued by many of these men. In five studies (N = 1931), we examined people's reactions to these apologies, with a focus on how their perceived content (participants' evaluations of how comprehensive and non-defensive they were), the gender of the audience, and the severity of the allegations against the accused influenced their effectiveness relative to denials and “no comment” statements. Using both real statements issued during the #MeToo movement (Study 1) and experimentally controlled statements issued by fictitious (Studies 2–4) and real (Study 5) public figures, we found that what the accused men said in their statements indeed mattered. Apologies were more effective when they were more comprehensive and less defensive, and when they were offered in response to lower (versus higher) severity allegations. Consistent effects of gender also emerged, with women reacting less favorably to denials and “no comment” statements than men. On the whole, the findings provide intriguing evidence for parallels between public and interpersonal apologies, revealing that high-quality apologies hold some value in a context where doubts about the remorsefulness and morality of the apologizer abound. However, the benefits of even the highest quality apologies were modest, resembling those found in the literature on intergroup apologies. These findings thus suggest that the public may view apologies for sexual misconduct as an appropriate starting point—but certainly not endgame—for the accused men.

Impact of Colonoscopy Preparation Video on Boston Bowel Preparation Scale Score.

Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States and the third most common cancer in men and the second most common cancer among women. Early detection of localized adenocarcinoma and adenomatous polyps helps reduce the mortality related to colon cancer. According to the American Gastroenterological Association, colonoscopy (CSPY) is the gold standard in screening for CRC. To improve the results of screening, the CSPY preparation (prep) needs to be optimal. This study was undertaken to determine whether a supplemental standardized educational video on bowel preparation in the viewer's native language would improve bowel preparation at the time of CSPY. After institutional review board approval, the records of adult patients who presented to the gastroenterology clinic were reviewed. Patients who underwent a CSPY were assigned according to whether they watched a supplemental educational video on CSPY bowel preparation in their native language. This video reflects the same information provided in written and verbal form at the time of CSPY scheduling. Bowel prep was rated by the endoscopist using the Boston Bowel Preparation Scale (BBPS) and quantifies the adequacy of the preprocedure bowel prep. Participant characteristics and BBPS scores were statistically assessed for significant differences. We identified a total of 186 patients, 91 in March 2015 (pre-video intervention) and 95 in March 2016 (post-video intervention). Mean BBPS score was 7.9 and 8.54 for the March 2015 and 2016 group, respectively (p value of .0039). Although there was no statistical difference between the 2 groups with concern to gender and age, the racial makeup and BBPS score were statistically different. Multivariate analysis was performed. There was no interaction between gender or race and year effect to account for any difference in that factors' performance. Thus, it can be implied that there is not a consistent race effect but there is a consistent gender effect with females having higher success rates, regardless of video intervention (p value of .003). After controlling for both gender and race, the year effect is modestly significant (p value of .025), with the post-video subjects having higher prep success rates. A supplemental educational video incorporated into precolonoscopy teaching may provide a standardized method of effectively conveying simple bowel prep instructions in an efficient manner. This study demonstrated that using such a video produced significant results in improving the quality of bowel preparation.

Impact of Colonoscopy Preparation Video on Boston Bowel Preparation Score

Introduction: Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States (US) and the third most common cancer in men and the second most common cancer among women. Early detection of localized adenocarcinoma and adenomatous polyps helps to reduce the mortality related to colon cancer. The CSPY preparation (prep) needs to be optimal. This study's purpose was to determine whether a supplemental educational CSPY video in the viewer's native language would improve bowel preparation, among adult patients at the local county medical facility.Figure: CPRIT colonoscopy preparation video.Figure: Final multivariate analysis results.Methods: Patients who underwent a CSPY were assigned according to whether they watched a supplemental educational video on CSPY bowel preparation in their native language. This video reflects the same information provided in written and verbal form at the time of CSPY scheduling. Bowel prep was rated by the endoscopist using the Boston Bowel Prep Score (BBPS). Participant characteristics and BBPS were collected. Results: There were 186 patients; 91 seen in March 2015 (pre-video) and 95 in March 2016 (postvideo). Mean BBPS was 7.9 and 8.54 for the March 2015 and 2016 group, respectively (P value 0.0039). There was statistical difference between the two groups' racial make-up and BBPS. There was no interaction between gender or race and year effect to account for any difference in that factors' performance. Analyzed data supported a consistent gender effect with females having higher success rates, regardless of video intervention (P value-0.003). After controlling for both gender and race, the year is modestly significant (P value-0.025), with the post-video subjects having higher prep success rates. Conclusion: Only females and Hispanics were found to have a statistically significant relationship as a variable to mean BBPS. There was a strong association with the female gender, when BBPS were viewed dichotomously. Upon multivariate analysis, there was a consistent gender effect with females having higher success rates, regardless of video intervention, and a modest video effect, with the post-video subjects having higher prep success rates. A post-hoc power analysis based on our sample size indicated 76% power to detect differences in BBPS, pre- and post-intervention. Limitations include: 1) no assessment of educational level (Illiteracy rate is 40%), 2) single institution setting, and 3) a short recruiting time frame.

Do neuropsychological test norms from African Americans in the United States generalize to a Zambian population?

Healthy Zambian adults (N = 324) were evaluated to determine to what degree a Western neuropsychological (NP) test battery, with African American norms adjusted for age, gender, and education could be used in healthy Zambians, including 157 men (48.46%) and 167 women (51.54%) with an average age of 38.48 (SD = 12.80) years and an average education level of 11.02 (SD = 2.58) years. The NP battery included tests of attention/working memory, executive function, verbal fluency, processing speed, verbal and visual episodic memory, and fine motor skills. The Zambian Achievement Test (ZAT) and the U.S. Wide Range Achievement Test-4 (WRAT-4) reading subtest also were administered to assess literacy and quality of education. Similar to findings in Western countries, the Zambian results show substantial age and education effects on most tests and smaller, less consistent effects of gender. Beyond the basic demographic effects, urban/rural background had small effects on some cognitive variables, and the ZAT (but not WRAT-4) reading level was a robust predictor of performance on many NP tests, even when other background characteristics were controlled. Women in the United States tend to outperform men on tests of processing speed and episodic memory. However, Zambian women showed modest but statistically significant disadvantages versus their male counterparts. The results show that tests developed in the United States may be used in Zambia. Nevertheless, development and use of local cultural norms remains very important and is a must. New demographically corrected norms were developed for the cohort that was examined.

The global prevalence of common mental disorders: a systematic review and meta-analysis 1980-2013.

Since the introduction of specified diagnostic criteria for mental disorders in the 1970s, there has been a rapid expansion in the number of large-scale mental health surveys providing population estimates of the combined prevalence of common mental disorders (most commonly involving mood, anxiety and substance use disorders). In this study we undertake a systematic review and meta-analysis of this literature. We applied an optimized search strategy across the Medline, PsycINFO, EMBASE and PubMed databases, supplemented by hand searching to identify relevant surveys. We identified 174 surveys across 63 countries providing period prevalence estimates (155 surveys) and lifetime prevalence estimates (85 surveys). Random effects meta-analysis was undertaken on logit-transformed prevalence rates to calculate pooled prevalence estimates, stratified according to methodological and substantive groupings. Pooling across all studies, approximately 1 in 5 respondents (17.6%, 95% confidence interval:16.3-18.9%) were identified as meeting criteria for a common mental disorder during the 12-months preceding assessment; 29.2% (25.9-32.6%) of respondents were identified as having experienced a common mental disorder at some time during their lifetimes. A consistent gender effect in the prevalence of common mental disorder was evident; women having higher rates of mood (7.3%:4.0%) and anxiety (8.7%:4.3%) disorders during the previous 12 months and men having higher rates of substance use disorders (2.0%:7.5%), with a similar pattern for lifetime prevalence. There was also evidence of consistent regional variation in the prevalence of common mental disorder. Countries within North and South East Asia in particular displayed consistently lower one-year and lifetime prevalence estimates than other regions. One-year prevalence rates were also low among Sub-Saharan-Africa, whereas English speaking counties returned the highest lifetime prevalence estimates. Despite a substantial degree of inter-survey heterogeneity in the meta-analysis, the findings confirm that common mental disorders are highly prevalent globally, affecting people across all regions of the world. This research provides an important resource for modelling population needs based on global regional estimates of mental disorder. The reasons for regional variation in mental disorder require further investigation.

Bizarre behaviors and risk assessment in 3xTg-AD mice at early stages of the disease

Bizarre behaviors (stereotyped stretching, stereotyped rearing, backward movements and jumps) were conspicuously elicited in classical unconditioned tests with different levels of anxiogenic conditions. They were characterized for the first time as early-BPSD-like symptoms in 6 month-old male and female 3xTg-AD mice. The pattern of these behaviors differed from that exhibited by their age- and gender-matched NTg counterparts. Confrontation of an open and illuminated field was the best trigger of such behaviors as compared to mild neophobia in the corner test or the choice between two compartments in the dark-light box. Here we also report that increased freezing, delayed thigmotaxis and enhancement of emotional behaviors were early BPSD-like symptoms indicative of their response to low-stressful environments. Independently of the genotype, consistent gender effects pointed toward the relevance of female gender to study bizarre behaviors and risk assessment. The identification of items of behavior and its gender component were relevant to find out bidirectional and selective behavioral long-lasting effects of postnatal handling. This early life treatment reduced freezing and most of the bizarre behaviors whereas potentiated risk assessment and the horizontal locomotor activity. In contrast, vertical exploratory activity was not modified by the treatment. The results also talk in favor of the beneficence of early-life interventions on the behavioral outcome in adulthood in both healthy and disease conditions. As shown, the consideration of bizarre behaviors and risk assessment may become an additional tool for evaluating BPSD-like symptoms in relation to preventive and/or therapeutical strategies targeted at AD. It may also have a role in the evaluation of the potential risk factors for the disease.

Gender Differences in Response to PAH Therapy: 6MWD and Time to Clinical Worsening

Purpose Pulmonary Arterial Hypertension is a female predominant disease but there is little data on therapy response by gender. 1 We assessed treatment response in males vs females by examining change in six-minute walk distance (6MWD) and time to clinical worsening (TCW). We also investigated the effects of menopause on treatment response using age as a predictor of menopausal status. 1. Shapiro S, et al. REVEAL. Chest. 2011;10-3114. Methods and Materials 6MWD was recorded before and after 16 weeks of treatment in the PHIRST study in a cohort of 340 subjects (264 F and 76 M), among a total of 405 subjects (317 F and 88 M). 2 Wilcoxon Rank sum test was used to assess gender effect on change in 6MWD and Log-rank test was used to assess gender effect on TCW. The females were subdivided by age to estimate menopausal status: 14-44 yrs premenopausal, 45-55yrs perimenopausal and ≥56yrs postmenopausal. Log-rank test was performed on TCW by age among females. 2.Galie N, et al. Tadalafil Therapy for PH. Circulation. 2009;10.1161. Results A statistically significant difference in change in 6MWD among males vs females (Median: 51.5 m vs. 26.5 m; p=0.008) was found. Log-rank test, however, did not show a consistent gender effect on TCW. There was a trend for a female age-dependent effect in change in 6MWD; the premenopausal group showed the greatest improvement, followed by peri- and postmenopausal. However, Log-rank test did not show a consistent age group effect on TCW. Conclusions Overall these analyses indicate a need for further investigation of the effects of gender and menopause on treatment response. Despite significant differences between the genders in 6MWD there was no consistent gender effect on TCW. It is possible that a smaller change in 6MWD may be tolerated in females. Given the suggested trend for more progressive worsening in postmenopausal females, a longitudinal study may be helpful to characterize this trend. Future work might explore the correlation between 6MWD and TCW in women.

Predicting domain-specific outcomes using delay and probability discounting for sexual versus monetary outcomes

Discounting, the tendency to devalue an outcome as a function of its delay or probability, is emerging as a fundamental process that underlies a broad range of impulsivity-related behaviors. Recent research suggests that people discount the value of sexual outcomes and individual differences in rate of discounting of sexual outcomes may represent an important behavioral process that underlies sexual risk behavior. However, it is not clear that discounting the value of domain-specific sexual outcomes (e.g., sexual activity) is a better predictor of sexual behaviors than is discounting for domain non-specific outcomes (e.g., money). Adult undergraduates (n=103) completed delay and probability discounting procedures in relation to money and sexual activity and a series of self-report measures concerning sexual and non-sexual outcomes. Results revealed domain-specific relationships such that (1) discounting for sexual and monetary outcomes were significantly correlated; (2) discounting for sexual activity was significantly associated with sexual excitability, but not with non-sexual outcomes; and (3) discounting for money was not related to the sexual outcomes. A consistent gender effect across measures suggests that gender may moderate the relationships between discounting and sexual and non-sexual outcomes. The relevance of these findings for domain-specific discounting is discussed.

Who Suggests Drinking Less? Demographic and National Differences in Informal Social Controls on Drinking

The purpose of this study was to examine variation in reports of pressuring others to drink less, as a form of informal social control of drinking, across countries and different types of relationship to the respondent. A cross-sectional survey was administered to 19,945 respondents ages 18-69 years in 14 countries included in the data set of the Gender, Alcohol and Culture: An International Study (GENACIS). Outcome variables were respondents' reports of pressuring others to drink less (yes/no) across a variety of relationships (their partners, other family members, workmates, or friends). Multilevel, multivariable logistic regression analysis was carried out on each outcome variable. The fixed-effects components included the Level 1 (individual) covariates of respondent age, gender, drinking status, and education level as well as the Level 2 (country level) covariates of percentage female drinkers and purchasing power parity. The random-effects components included country and current drinking status. Respondents most frequently reported pressuring male friends to drink less (18%), followed by male family members (other than partners, 15%), partners (15%), work colleagues (12%), female friends (9%), female family members (other than partners, 6%), and children (5%). There was marked variation across countries, with pressuring frequently reported in Uganda, Costa Rica, and Nicaragua across most relationship types. Multivariable logistic regression revealed consistent effects of gender, with women more likely than men to report pressuring others to drink less across most relationship types. The patterns in relation to education status and age were less consistent and varied across relationship type. Informal social control of drinking varies dramatically according to whom is most likely to pressure whom to drink less as well as the country in which people live.

Effectiveness of a parent training program in (pre)adolescence: Evidence from a randomized controlled trial

The present randomized controlled trial examined the effectiveness of the parent training program Parents and Children Talking Together (PCTT) for parents with children in the preadolescent period who experience parenting difficulties. The program is focused on reducing child problem behavior by improving parents’ communication and problem solving skills, and disciplining behavior. Largest effects were expected for families with higher SES, and with children in mid-adolescence. Multi-informant and multi-method data were used from 78 self-referred families with children aged 9–16 (M=13.09, SD=1.75). Intention-to-treat analysis (retention rate 95%; immediate posttest only) showed that participation in PCTT significantly improved parents' communication and problem solving skills (F(1,70)=11.77, p<0.01 and F(1,70)=12.87, p<0.01), and reduced their dysfunctional disciplining behavior in conflict situations (F(1,70)=5.25, p<.0.05). The PCTT intervention was most effective for parents with higher SES and for parents with children between the ages of 14 and 16. No consistent gender effects were found.

Age and gender differences in preferences for rational and experiential thinking

Cognitive-Experiential Self Theory assumes that reasoning conforms to a parallel dual processing model (comprising rational and experiential systems), through which we make sense of the world. The Rational Experiential Inventory was developed to measure an individual’s preference for rational (need for cognition) and experiential (faith in intuition) thinking, with individual differences proposed to influence the respective dominance of each. While small but consistent gender effects have been found previously, age effects have rarely been reported or investigated across the lifespan. We examine both age and gender differences in Rational Experiential Inventory scores, using combined data from five studies involving adult participants ( n = 520, 61.9% male) with a mean age of 41.45 years ( SD = 11.73, range 20–74 years). Results suggest a convergence of the rational and experiential systems in adulthood, although the timing may be different for women and men. In later adulthood, the relationship appears to diverge again.

Untangling the Causal Effects of Sex on Judging

We explore the role of sex in judging by addressing two questions of long‐standing interest to political scientists: whether and in what ways male and female judges decide cases distinctly—“individual effects”—and whether and in what ways serving with a female judge causes males to behave differently—“panel effects.” While we attend to the dominant theoretical accounts of why we might expect to observe either or both effects, we do not use the predominant statistical tools to assess them. Instead, we deploy a more appropriate methodology: semiparametric matching, which follows from a formal framework for causal inference. Applying matching methods to 13 areas of law, we observe consistent gender effects in only one—sex discrimination. For these disputes, the probability of a judge deciding in favor of the party alleging discrimination decreases by about 10 percentage points when the judge is a male. Likewise, when a woman serves on a panel with men, the men are significantly more likely to rule in favor of the rights litigant. These results are consistent with an informational account of gendered judging and are inconsistent with several others.

Multiple Auditory Steady State Responses (80-101 Hz): Effects of Ear, Gender, Handedness, Intensity and Modulation Rate

To evaluate how the amplitudes and latencies of auditory steady state responses (ASSRs) to multiple stimuli presented at rates between 80 and 101 Hz vary with the ear of stimulation, the handedness or gender of a subject, and the rate and intensity of the stimuli. ASSRs were recorded in a group of 56 young adults (27 females, 13 left handed) using several stimulus conditions. In the two main conditions, four sinusoidally amplitude-modulated tones (each uniquely modulated using rates between 80 and 105 Hz) with carrier frequencies of 500, 1000, 2000, and 4000 Hz, were presented concurrently to each ear (eight total). In the first condition the modulation rates for the left ear were slower than those for the right and in the second condition this relationship was reversed. Other conditions evaluated the responses to single stimuli, to multiple stimuli presented in one ear only and to multiple stimuli presented dichotically (four in each ear) with rates that decreased rather than increased with increasing carrier frequency. Stimuli were presented at an intensity of 73 dB SPL except in two conditions wherein the intensity was 53 dB SPL. At 73 dB SPL, multiple-stimulus ASSRs were significantly reduced (monotic or dichotic) compared with single-stimulus ASSRs, especially at 1000 and 2000 Hz. There were significant differences between monotic and dichotic stimulation. When the stimuli were presented dichotically, the amplitude of the response varied with the relative rates of modulation for the stimuli presented in each ear. ASSRs were larger in the ear with the higher rate when the carrier frequencies were 500 and 1000 Hz and when the modulation rates were <90 Hz. There were no consistent effects of gender or ear of stimulation. There were also no significant effects of handedness. Presenting multiple stimuli at 73 dB SPL in the same ear decreases the amplitude of the ASSR compared with when the stimuli are presented singly. This is caused by the masking effect of low on higher carrier frequencies and some other inhibitory effect of high on lower frequencies. Dichotic stimulation can increase the amplitude of the response to stimuli modulated more rapidly (and concomitantly decrease the responses to the stimuli modulated more slowly). This effect occurs only for carrier frequencies <2000 Hz and for modulation frequencies <90 Hz. Dichotic stimulation also causes a small but highly significant decrease in the latency of the response compared with monotic stimulation.

Social inequality and alcohol consumption-abuse in Bahia, Brazil

This paper reports findings on Alcohol Consumption-Abuse (ACAb) in Bahia, Brazil, a research setting characterized by racial/ethnic and socioeconomic diversity. A household survey was conducted with a sample of 2,302 adults. ACAb was defined as daily intake of more than two units of beverage, with drunkenness, or weekly binge drinking plus episodes of drunkenness, or any use of alcoholic beverages with frequent drunkenness, with failed attempts to stop drinking. The rate of 12-month prevalence was 7%, with an overall male: female ratio of 6:1. A positive association of ACAb prevalence with education and social class was found. Male gender and higher socio-economic status were associated with increased odds of ACAb. No relationship was found between ethnicity and ACAb. Stratified analysis yielded consistent gender effects, throughout all strata of independent variables. A strong interaction of gender (male) and social class (upper class) was found for Mulattos and Morenos (maximum Prevalence rate=9.04). Interaction patterns found defy simple generalizations based on class, ethnicity, and gender considered alone.

Alcohol drinking patterns by gender, ethnicity, and social class in Bahia, Brazil.

To study patterns of alcohol consumption and prevalence of high-risk drinking. A household survey was carried out in a sample of 2,302 adults in Salvador, Brazil. Cases of High-Risk Drinking (HRD) were defined as those subjects who referred daily or weekly binge drinking plus episodes of drunkenness and those who reported any use of alcoholic beverages but with frequent drunkenness (at least once a week). Fifty-six per cent of the sample acknowledged drinking alcoholic beverages. Overall consumption was significantly related with gender (male), marital status (single), migration (non-migrant), better educated (college level), and social class (upper). No significant differences were found regarding ethnicity, except for cachaça (Brazilian sugarcane liquor) and other distilled beverages. Overall 12-month prevalence of high-risk drinking was 7%, six times more prevalent among males than females (almost 13% compared to 2.4%). A positive association of HRD prevalence with education and social class was found. No overall relationship was found between ethnicity and HRD. Male gender and higher socioeconomic status were associated with increased odds of HRD. Two-way stratified analyses yielded consistent gender effects throughout all strata of independent variables. The findings suggest that social and cultural elements determine local patterns of alcohol-drinking behavior. Additional research on long-term and differential effects of gender, ethnicity, and social class on alcohol use and misuse is needed in order to explain their role as sources of social health inequities.

Meanings of Basic Values for Women and Men: A Cross-Cultural Analysis

Do men and women construe basic values in the same way? The authors investigate possible gender differences in value meaning at three levels: 2 dimensions that organize value systems, 10 motivationally distinct values, and 45 value items. They assess differences across and within diverse cultures and perform multidimensional scaling analysis (MDS) and Procrustes analyses on responses to a value survey by 11,244 respondents in eight cultural regions (Chinese East Asia, Eastern Europe, Finland, France, Israel, Japan, Latin America, and the United States). Statistical fit indices and inspection of graphic representations reveal neither cross-culturally consistent gender effects on value meaning nor Gender × Culture interactions. The implications of these findings for theories of gender effects and for the cross-cultural study of gender differences in value importance are discussed.

Changes in rat heart histomorphometry due to two-week dietary restriction.

In preclinical safety studies in which the administration of a test compound causes reductions in food consumption, body weights, and organ weights, it may be difficult to differentiate direct compound-induced effects on organ weights from those simply due to reduced nutrition. To address this problem in reference to the heart, hearts were obtained from rats that were known to have had reductions in body weights and absolute heart weights as a result of feed restriction. Rats (40/sex) were divided into 4 groups (10/sex) and given quantities of ad libitum diet for 2 wk as follows: Group 1, 100%; Group 2, 75%; Group 3, 50%; and Group 4, 25%. Routine histologic evaluation was performed on longitudinal sections of paraffin-embedded hearts stained with hematoxylin and eosin. Computer-assisted image analysis was conducted on left ventricular free-wall of picrosirius red-stained sections for histomorphometric evaluation of ratio of cross-sectional area occupied by myofibers versus interstitium and for quantification of myofiber width. No differences were detected histologically among groups, and no difference in the mean myofiber: interstitium ratio was detected between Groups 1 (9.1) and 4 (9.5). Mean values for myofiber width ranged from 24.6 microns for Group 1 to 17.3 microns for Group 4. Two-way ANOVA revealed a strong effect of dietary restriction on reduction of myofiber width but no consistent gender effect. The significant dietary effects occurred in Groups 3 and 4 compared to corresponding controls. The present authors speculate that, if reductions in feed intake were < 50% in short-term preclinical studies, any reductions in myofiber width could imply a primary test article effect. Conversely, if reductions in feed intake were > or = 50% in such studies, reductions in myofiber width could be caused either solely by inadequate nutrition or by combined effects of nutrition and test article.

Respiratory disease in a textile factory in nicaragua

This is the first epidemiologic study conducted in a textile mill in Nicaragua using techniques and diagnostic criteria similar to those used in the United States and England. The prevalence of byssinosis and nonspecific respiratory symptoms were studied in 194 workers in a cotton mill in Managua. Limited environmental sampling, performed using a vertical elutriator in yarn preparation and weaving areas, indicated that exposures were similar to those reported in other parts of the developing world. A modified translated version of the Medical Research Council respiratory questionnaire was administered. Pulmonary function tests were performed before and after the Monday workshift to measure across-shift change in ventilatory function. The prevalence of byssinosis was 5.9% and all the cases occurred among exposed women. Nonspecific respiratory symptoms were also more prevalent among exposed workers. After adjusting for age, gender, smoking habit, and work tenure, the exposure odds ratios for usual cough and usual phlegm were 3.3 and 2.2, respectively. The association between exposure and across-shift decrement in FEV1 was not significant. Byssinotic workers, however, had greater decrements in FEV1% than those without byssinosis: 5.5% versus 1.8%. A consistent gender effect was observed in which both exposed and unexposed women were found to have greater across-shift decrements in FEV1 than men. The gender difference existed among long-term workers as well as workers who had been employed less than 2 years. Results are related to cotton dust exposure, as has been documented elsewhere. The poorer health status of the women in this study population deserves follow-up.