Role Of Sex Research Articles

Exploring Stakeholders' Interventions in Addressing Gender Roles and Norms that Obstruct Refugee Women's Access to Higher Education: A Case of Bidibidi Refugee Settlement in Northern Uganda

Gender roles and norms are known to affect women more than their male counterparts disproportionately. In effect, it discourages women and denies them the opportunity to fulfil their potential in various sectors/fields. Specifically, this study focuses on stakeholders' interventions in addressing gender roles and norms obstructing refugee women in Uganda from accessing higher education. The study was carried out in Bidibidi Refugee Settlement in Northern Uganda. The study used the qualitative research approach anchored in the advocacy worldview using intersectionality with a liberal feminist perspective as a philosophical lens. Using purposive and snowball sampling, 49 participants took part in the study. Using one-on-one interviews and focus group discussions, the study found that some stakeholders' initiatives have facilitated refugee women's access to higher education. Initiatives such as awareness raising, career guidance and mentorship, and legal and policy frameworks, among others, have been put in place to promote refugee women's access to higher education. Nevertheless, the study found that these initiatives have not adequately addressed the cultural, gender, socio-economic, and structural barriers that are still hindering refugee women's access to higher education. Thus, the study recommends that stakeholders should undertake more rigorous and intensive sensitization and advocacy to raise community awareness on aspects of gender roles and norms to break the gender-role stereotyping that is largely hindering refugee women's access to higher education. Also, the study recommends that livelihood and skilling programmes should target women refugees to curb the risk of being forced into desperate survival situations. These should be continuously monitored and evaluated, and refugee women are also encouraged to seek family planning services to relieve them from the childcare role so as to enable access and participation in higher education

The onset of mental health disparities in sexual minority and majority youth: evidence from the UK Millennium Cohort Study.

Decades of research shows that sexual minority youth (SMY) display heightened risk for mental health problems, although the onset of such disparities remains unclear. The Millennium Cohort Study is the largest nationally representative longitudinal study of adolescents in the United Kingdom. In this study, participants (N = 10,047, 50% female) self-reported their sexual identity at age 17 and had parent-reported mental health data, from the Strengths and Difficulties Questionnaire, reported across five waves at ages 5, 7, 11, 14, and 17. Multilevel linear spline models, stratified by sex, were used to examine mental health trajectories between sexual identity groups (completely heterosexual, mostly heterosexual, SMY). SMY showed heightened peer problems from the baseline assessment at age five, increasing over time, and heightened emotional problems from age 11, increasing over time. Mostly heterosexual youth showed heightened emotional problems at age 11 in males, and at age 17 in females. Findings are discussed in light of the literature on minority stress and gender conformity in youth. The use of parent-reported mental health data means that estimates are likely to be conservative. We conclude that interventions supporting SMY should start early and be available throughout adolescence.

Deep learning models reveal replicable, generalizable, and behaviorally relevant sex differences in human functional brain organization

Sex plays a crucial role in human brain development, aging, and the manifestation of psychiatric and neurological disorders. However, our understanding of sex differences in human functional brain organization and their behavioral consequences has been hindered by inconsistent findings and a lack of replication. Here, we address these challenges using a spatiotemporal deep neural network (stDNN) model to uncover latent functional brain dynamics that distinguish male and female brains. Our stDNN model accurately differentiated male and female brains, demonstrating consistently high cross-validation accuracy (>90%), replicability, and generalizability across multisession data from the same individuals and three independent cohorts (N ~ 1,500 young adults aged 20 to 35). Explainable AI (XAI) analysis revealed that brain features associated with the default mode network, striatum, and limbic network consistently exhibited significant sex differences (effect sizes > 1.5) across sessions and independent cohorts. Furthermore, XAI-derived brain features accurately predicted sex-specific cognitive profiles, a finding that was also independently replicated. Our results demonstrate that sex differences in functional brain dynamics are not only highly replicable and generalizable but also behaviorally relevant, challenging the notion of a continuum in male-female brain organization. Our findings underscore the crucial role of sex as a biological determinant in human brain organization, have significant implications for developing personalized sex-specific biomarkers in psychiatric and neurological disorders, and provide innovative AI-based computational tools for future research.

Carving in and "Carving Out" Space:

Skateboarding is a subculture with an ideology that counters normative authority and standards of masculinity. Yet, it continues to uphold persistent misogynistic perspectives and gender discrepancies in participation (Beal 1996; McCarthy 2022). Therefore, it is critical to understand the experiences of marginalized genders in the skateboarding subculture to discover how ideas of authenticity are formed and upheld in the skate subculture and how these standards impact skateboarders of marginalized genders. This qualitative study examines the unexplored skateboard subculture in Halifax, Nova Scotia through an analysis of its symbolic membership and physical and social space. This study identifies a disassociation from ‘typical’ masculinity and outwardly favourable attitudes towards gender diversity within the Halifax skateboard community; however, gender barriers remain within this still hyper-masculine setting disguised through support. Nevertheless, the historically resistant and rebellious attitudes that coincide with skateboarding may provide a space for female and non-binary skaters to counter subcultural and societal gender norms.

Differential Evaluation of Straight and Gay Men for Nonverbal Effeminate Behavior.

The purpose of this study was to determine how violation of gender-based expectancies might influence straight men's attitudes toward men who differ by sexual orientation (i.e., straight or gay). This study was specifically designed to avoid methodological issues that may have been present in similar research. Hypotheses were informed by Expectancy-Violation Theory (EVT) and the Black Sheep Effect (BSE), which together suggest that an effeminate straight man should be evaluated by other straight men more negatively than an effeminate gay man because the former target negatively violated expectations. Additionally, EVT suggests that a masculine gay man should be evaluated more positively than a masculine straight man because the former positively violates expectations, while the BSE instead suggests the latter should be evaluated more positively than the former due to ingroup bias. Self-identified straight men evaluated a male target whose sexual orientation and gender conformity were manipulated through a photo and vignette. A moderated mediation analysis was performed to determine if perceived expectancy violation mediated the relationship between sexual orientation and evaluations for both effeminate and masculine men. Straight effeminate targets were evaluated more negatively than gay effeminate targets; however, straight masculine targets were evaluated more favorably than gay masculine targets, a finding more consistent with the BSE. In addition, perceived expectancy violation did not mediate the relationship between sexual orientation and evaluations regardless of gender expression. More research should be conducted to identify the mechanisms through which evaluations of straight and gay targets differ based on gender expression.

Understanding auditory gaydar experiences of lesbian women and gay men

ABSTRACT Voice-based categorisation of others’ sexual orientations, known as auditory gaydar judgments, can represent stressful and stigmatising events for targets. This mixed-methods study examined sense-making about others’ auditory gaydar judgements. Sixty-seven lesbian women and 77 gay men described negative episodes in which they thought that their sexual orientation was inferred from their voices. Those reporting such experiences also rated their emotional distress and their engagement with coping strategies. Those reporting no experiences explained why they might have had none. We analysed whether participants’ judgements represented stigmatising experiences and how gender conformity perceptions shaped individuals’ sense-making. Gay men reported experiencing auditory gaydar more often, rated such experiences as more emotionally distressing, and reported engaging more with coping strategies than lesbian women did. Gay men described both being stigmatised by others’ gaydar judgements and their own attempts to sound straight. Gaydar experiences of gay men were occasioned by deviations from gender conformity. Lesbians’ experiences were sometimes interpreted through emic subcultural gender concepts. In line with the minority stress model, auditory gaydar judgements should be considered as stressors contributing to individuals’ wellbeing, at least for gay men.

The role of lifestyle factors, biological sex, and racial identity for (visually induced) motion sickness susceptibility: Insights from an online survey

Motion sickness (MS) and visually induced motion sickness (VIMS) are common side-effects when travelling or when using visual devices, respectively. A variety of individual factors may determine one’s susceptibility to MS/VIMS. Here, the role of lifestyle factors including video-game usage, physical activity, diet, and substance use on self-reported susceptibility to MS/VIMS was investigated. Additionally, the roles of biological sex and racial identity on the overall prevalence of MS/VIMS were analyzed. A total of 711 responses to an online survey were collected from adults between the ages of 17–49 years. Methods of analyses included correlations, comparison tests, and multiple regressions. The results showed that, overall, VIMS is a prevalent issue for most participants, with approximately 24 % of users reporting nausea at least sometimes when using visual displays. Although some lifestyle factors (video game usage, assorted dietary elements) were identified as potentially relevant for MS/VIMS susceptibility, these factors only explained a minimal amount of the variance in MS/VIMS susceptibility. Significant sex differences were found, with female participants reporting higher susceptibility for MS/VIMS than male participants. Additionally, East Asians participants reported higher MS susceptibility. Our findings do not suggest that lifestyle factors are prominent predictors for the susceptibility of VIMS and MS.

Impact of Frailty on Heart Failure Prognosis: Is Sex Relevant?

Heart failure (HF) is one of the most frequent causes of hospital admission in elderly patients, especially in women, who present a high prevalence of geriatric syndromes like frailty. Studies have suggested that frailty and its impact may also differ between males and females. Understanding how frailty may differently affect HF patients depending on sex is therefore imperative for providing personalized care. The aim of this review is to summarize the role of sex in the prognostic impact of frailty in HF patients. Numerous studies have identified frailty as a significant predictor of all-cause mortality and hospital readmissions. A recent study of elderly HF out-patients demonstrated that while women had a higher prevalence of frailty, it was an independent predictor of mortality and readmission only in men. Moreover, another study revealed that physical frailty was associated with time to first clinical event among men but not among women. These results raise the question about why frailty affects differently HF prognosis in men and women. Women with HF present a higher prevalence of frailty, especially when it is considered as physical decline. Nevertheless, frailty affects differently HF prognosis in men and women. Women with HF present lower mortality than men and frailty is related with prognosis only in men. The different severity of HF between men and women and other hormonal, psychosocial, and clinical factors might be involved in this fact.

Digital Déjà vu: The Enduring Presence of Gender Stereotypes in Memes

Memes are a crucial cultural unit for exploring and understanding the dynamics of the digital society in which examining the gender balance is a key pathway for measuring where it states. It is very important for any social science researcher to read and see if the new generation is rewriting the sexist behavior composed by the culture over the past ages and that too in a platform, which is extensively dominated by them. Hence, the main purpose of this study is to explore gender communication and gender construction in new media through memes. The study was conducted by analyzing 152 memes collected from Facebook. Theoretically it attempts to read gender from a gender-constructionist perspective. Thematic analysis was used as the method of going through these memes and the major themes were pointed out and an overall analysis was presented. The main finding from the analysis is that despite the expectation of progressive views, memes continue to reinforce traditional gender stereotypes, with a predominant focus on men narrating content that perpetuates established roles, overshadowing limited challenges to patriarchal norms. This study attempts to decode the influence of memes as cultural artifacts on the portrayal and reinterpretation of gender roles in the digital era. By scrutinizing the interplay between the new generation's expressions and prevailing cultural norms, the study unravels the transformative potential of memes in reshaping societal attitudes towards gender.

Prenatal tobacco, tobacco-cannabis coexposure, and child emotion regulation: The role of child autonomic functioning and sensitive parenting.

Prenatal tobacco exposure (PTE) and tobacco-cannabis coexposure (PTCE) co-occur with negative maternal emotional functioning (termed prenatal risks) and together increase risk for child regulatory problems at early school age (ESA). Little is known about developmental processes in early childhood that may mediate this association. We examined two hypothesized mediational processes linking prenatal risks to ESA emotion regulation (ER) and lability-negativity; parasympathetic functioning at toddler age and chronic risk reflected by continued postnatal maternal negative emotional functioning (i.e., depression, anger/hostility, and emotion dysregulation) and substance exposure. Congruent with differential susceptibility theory, we examined interactions between sensitive parenting and toddler parasympathetic functioning predicting ESA ER. Finally, we explored the role of child sex as a moderator. Mothers (N = 247; 53% male infants; 51% Black, 31% White, 19% Hispanic, and 8% other or mixed race) were recruited in the first trimester of pregnancy into one of three groups: PTE (n = 81), PTCE (n = 97), and no substance exposure (n = 69) matched on age and education. Substance exposure was assessed using multiple methods, maternal negative emotional functioning via self-reports, parenting with observations, and child ER using teacher, maternal, and lab assessor reports. Results supported a chronic risk pathway with less support for a parasympathetic pathway. Toddlers who demonstrated respiratory sinus arrhythmia withdrawal to frustration were susceptible to the positive context of sensitive parenting in predicting higher ER. Results emphasize the importance of chronicity of postnatal risks including substance exposure and evaluating the differential impact of positive environments for children with substance exposure. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Association of per- and polyfluoroalkyl substances (PFAS) with periodontitis: the mediating role of sex hormones

ObjectivesTo investigate the association between serum per- and polyfluoroalkyl substances (PFAS) and periodontitis, and further explore the possible mediating role of sex hormones in this association.MethodsWe extracted data from National Health and Nutrition Examination Survey (NHANES) 2009–2014. Univariable and multivariable logistic regression models were performed to investigate the association between serum levels of seven PFASs and periodontitis. Bayesian kernel machine regression (BKMR) was conducted to assess the joint effect of PFASs in mixtures. Mediation analyses were used to explore the potential mediating role of sex hormones.ResultsParticipants with periodontitis had higher concentrations of serum perfluorooctane sulfonate (PFOS) and perfluorononanoic acid (PFNA) than those without periodontitis (both P < 0.05). In fully adjusted models, high serum concentrations of PFOS and PFNA were positively associated with periodontitis (tertile 3 vs. tertile 1: prevalence ratio (PR) = 1.19 for PFOS, 95% CI: 1.01–1.39; PR = 1.17 for PFNA, 95% CI: 1.02–1.34). The results from the BKMR models consistently showed a positive association between PFAS mixtures and periodontitis. Of note, testosterone and the ratio of testosterone to estradiol significantly mediated the relationship between high level of PFOS and periodontitis, accounting for 16.5% and 31.7% of the total effect, respectively. Sensitivity analyses yielded similar results when using periodontal clinical indices (mean loss of attachment, mean periodontal probing depth, and the number of teeth) as dependent variables.ConclusionsThese findings provide evidence to support a positive association between certain PFASs and periodontitis, which might be partially mediated by sex hormones.

Sex and pubertal variation in reward-related behavior and neural activation in early adolescents

This study aimed to characterize the role of sex and pubertal markers in reward motivation behavior and neural processing in early adolescence. We used baseline and two-year follow-up data from the Adolescent Brain and Cognitive DevelopmentSM study (15844 observations; 52% from boys; age 9–13). Pubertal development was measured with parent-reported Pubertal Development Scale, and DHEA, testosterone, and estradiol levels. Reward motivation behavior and neural processing at anticipation and feedback stages were assessed with the Monetary Incentive Delay task. Boys had higher reward motivation than girls, demonstrating greater accuracy difference between reward and neutral trials and higher task earnings. Girls had lower neural activation during reward feedback than boys in the nucleus accumbens, caudate, rostral anterior cingulate, medial orbitofrontal cortex, superior frontal gyrus and posterior cingulate. Pubertal stage and testosterone levels were positively associated with reward motivation behavior, although these associations changed when controlling for age. There were no significant associations between pubertal development and neural activation during reward anticipation and feedback. Sex differences in reward-related processing exist in early adolescence, signaling the need to understand their impact on typical and atypical functioning as it unfolds into adulthood.

Comorbidity patterns in cardiovascular diseases: the role of life-stage and socioeconomic status.

Cardiovascular diseases stand as a prominent global cause of mortality, their intricate origins often entwined with comorbidities and multimorbid conditions. Acknowledging the pivotal roles of age, sex, and social determinants of health in shaping the onset and progression of these diseases, our study delves into the nuanced interplay between life-stage, socioeconomic status, and comorbidity patterns within cardiovascular diseases. Leveraging data from a cross-sectional survey encompassing Mexican adults, we unearth a robust association between these variables and the prevalence of comorbidities linked to cardiovascular conditions. To foster a comprehensive understanding of multimorbidity patterns across diverse life-stages, we scrutinize an extensive dataset comprising 47,377 cases diagnosed with cardiovascular ailments at Mexico's national reference hospital. Extracting sociodemographic details, primary diagnoses prompting hospitalization, and additional conditions identified through ICD-10 codes, we unveil subtle yet significant associations and discuss pertinent specific cases. Our results underscore a noteworthy trend: younger patients of lower socioeconomic status exhibit a heightened likelihood of cardiovascular comorbidities compared to their older counterparts with a higher socioeconomic status. By empowering clinicians to discern non-evident comorbidities, our study aims to refine therapeutic designs. These findings offer profound insights into the intricate interplay among life-stage, socioeconomic status, and comorbidity patterns within cardiovascular diseases. Armed with data-supported approaches that account for these factors, clinical practices stand to be enhanced, and public health policies informed, ultimately advancing the prevention and management of cardiovascular disease in Mexico.

The Role of Concussion History and Biological Sex on Pupillary Light Reflex Metrics in Adolescent Rugby Players: A Cross-Sectional Study.

Background: Concussion examination is based primarily on clinical evaluation and symptomatic reporting. Pupillary light reflex (PLR) metrics may provide an objective physiological marker to inform concussion diagnosis and recovery, but few studies have assessed PLR, and normative data are lacking, particularly for adolescents. Aim: To capture PLR data in adolescent rugby players and examine the effects of concussion history and biological sex. Design: Cross-sectional. Methods: Male and female adolescent rugby union players aged 16 to 18 years were recruited at the start of the 2022-2023 playing season. PLR was recorded using a handheld pupillometer which provided seven different metrics relating to pupil diameter, constriction/dilation latency, and velocity. Data were analysed using a series of 2 × 2 ANOVAs to examine the main effects of independent variables: biological sex, concussion history, and their interactions, using adjusted p-values (p < 0.05). Results: 149 participants (75% male) were included. A total of 42% reported at least one previous concussion. Most metrics were unaffected by the independent variables. There were however significant main effects for concussion history (F = 4.11 (1); p = 0.05) and sex (F = 5.42 (1); p = 0.02) in end pupil diameters, and a main effect for sex in initial pupil diameters (F = 4.45 (1); p = 0.04). Although no significant interaction effects were found, on average, females with a concussion history presented with greater pupillary diameters and velocity metrics, with many pairwise comparisons showing large effects (SMD > 0.8). Conclusions: Pupillary diameters in adolescent athletes were significantly affected by concussion history and sex. The most extreme PLR metrics were recorded in females with a history of concussion (higher pupillary diameters and velocities). This highlights the importance of establishing baseline PLR metrics prior to interpretation of the PLR post-concussion. Long-standing PLR abnormalities post-concussion may reflect ongoing autonomic nervous system dysfunction. This warrants further investigation in longitudinal studies.

Use of Quantitative Electroencephalography to Inform Age- and Sex-Related Differences in NMDA Receptor Function Following MK-801 Administration.

Sex- and age-related differences in symptom prevalence and severity have been widely reported in patients with schizophrenia, yet the underlying mechanisms contributing to these differences are not well understood. N-methyl-D-aspartate (NMDA) receptor hypofunction contributes to schizophrenia pathology, and preclinical models often use NMDA receptor antagonists, including MK-801, to model all symptom clusters. Quantitative electroencephalography (qEEG) represents a translational approach to measure neuronal activity, identify targetable biomarkers in neuropsychiatric disorders and evaluate possible treatments. Abnormalities in gamma power have been reported in patients with schizophrenia and correspond to psychosis and cognitive impairment. Further, as gamma power reflects cortical glutamate and GABA signaling, it is highly sensitive to changes in NMDA receptor function, and NMDA receptor antagonists aberrantly increase gamma power in rodents and humans. To evaluate the role of sex and age on NMDA receptor function, MK-801 (0.03-0.3 mg/kg, SC) was administered to 3- and 9-month-old male and female Sprague-Dawley rats that were implanted with wireless EEG transmitters to measure cortical brain function. MK-801-induced elevations in gamma power were observed in 3-month-old male and female and 9-month-old male rats. In contrast, 9-month-old female rats demonstrated blunted maximal elevations across a wide dose range. Importantly, MK-801-induced hyperlocomotor effects, a common behavioral screen used to examine antipsychotic-like activity, were similar across all groups. Overall, sex-by-age-related differences in gamma power support using qEEG as a translational tool to evaluate pathological progression and predict treatment response across a heterogeneous population.

Sex differences in risk-based decision-making and the modulation of risk preference by dopamine-2 like receptors in rats

Heightened risk-based decision-making is observed across several neuropsychiatric disorders including schizophrenia, bipolar disorder, and Parkinson's disease, yet no treatments exist that effectively normalize this aberrant behavior. Preclinical risk-based decision-making paradigms have identified the important modulatory roles of dopamine and sex in the performance of such tasks, though specific task parameters may alter such effects (e.g., punishment and reward values). Previous work has highlighted the role of dopamine 2-like receptors (D2R) during performance of the Risk Preference Task (RPT) in male rats, however sex was not considered as a factor in this study, nor were treatments identified that reduced risk preference. Here, we utilized the RPT to determine sex-dependent differences in baseline performance and impact of the D2R receptor agonist pramipexole (PPX), and antagonist sulpiride (SUL) on behavioral performance. Female rats exhibited heightened risk-preference during baseline testing. Consistent with human studies, PPX increased risk-preference across sex, though the effects of PPX were more pronounced in female animals. Importantly, SUL reduced risk-preference in these rats across sexes. Thus, under the task specifications of the RPT that does not include punishment, female rats were more risk-preferring and required higher PPX doses to promote risky choices compared to males. Furthermore, blockade of D2R receptors may reduce risk-preference of rats, though further studies are required.

Gender-Affirming Surgery Improves Mental Health Outcomes and Decreases Anti-Depressant Use in Patients with Gender Dysphoria.

Patients with gender dysphoria face significant health disparities and barriers to care. Transition-related care includes hormonal therapy, mental healthcare, and gender-affirming surgeries. Studies have described favorable surgical outcomes and patient satisfaction, however, the degree to which these procedures impact mental health conditions is not fully understood. The purpose of this study was to evaluate the effect of gender-affirming plastic surgery on mental health and substance abuse in the transgender population. A national insurance claims-based database was used for data collection. Patients with a diagnosis of gender dysphoria were propensity score-matched for the likelihood of undergoing gender-affirming surgery (no surgery being the control cohort), based on comorbidities, age, and sex. Primary outcomes included post-operative antidepressant use and the prevalence of mental health conditions. A total of 3,134 patients with gender dysphoria were included in each cohort. Patients in the surgery group had overall lower rates of mental health conditions, substance abuse, and SSRI/SNRI use. There was an absolute decrease of 8.8% in SSRI or SNRI prescription after gender-affirming plastic surgery (p<0.001), and significant decreases in post-operative depression (7.7%), anxiety (1.6%), suicidal ideation (5.2%) and attempts (2.3%), alcohol abuse (2.1%), and drug abuse (1.9%). Gender-affirming surgery in appropriately selected gender dysphoric patients is associated with decreased postoperative rates of SSRI or SNRI use and improved mental health.

Understanding populist far-right anti-immigration and anti-gender stances beyond the paradigm of gender as ‘a symbolic glue’: Giorgia Meloni’s modern motherhood, neo-Catholicism, and reproductive racism

Building on theoretical framings in critical race and queer studies, this article focuses on the first female prime minister of Italy, Giorgia Meloni, as an entry point to examining the current alignment between far-right populism, anti-gender movements, and White supremacist conspiracy theories in Europe. First, considering the contradictions that female leaders of far-right populist parties seem to negotiate, this article compares Meloni’s communication strategies and political interventions to those of her counterparts in Europe. Second, employing the concept of ‘productive racism’, the article examines Meloni’s birth rate agenda and related ambivalent stance towards ‘migrant’ women. In so doing, this article first demonstrates how existing theoretical frames, developed to examine current entanglements between feminist, anti-gender, and anti-immigration discourses, fall short of explaining why ‘gender’ can be used to ‘stick’ ‘migrant’ and queer subjects together, characterising both as threats to the sexual order of Europe. Even when ‘migrant’ women are depicted as hopeless victims, populist far-right leaders appraise them as either aberrant or otherwise deficient mothers. The article concludes by urging scholars of far-right populism, migration, and religion and their intersections with gender, to adopt race as a primary category of analysis and, therefore, consider that it is race that makes gender ‘stick’ as the common enemy of disparate political actors.

Comparison of nurse and resident physician paging frequency by sex in the emergency department.

The role of biological sex in interprofessional relationships is an important factor in collaborative health care settings such as the emergency department (ED) but one that has been sparsely studied. While there is anecdotal evidence on gender-based differences in communication, little research has focused on this topic. The goal of this study was to determine whether there are differences in paging frequency between nurses and male and female residents. We conducted a retrospective review of patient visits to our urban, tertiary care academic ED between January 1 and April 1, 2021. Only pages from nurses to emergency medicine (EM) residents were included. Outcome variables included number of pages received by sex, number of unique ED visits, and mean number of pages per unique visit. Pearson's chi-square tests were used to analyze differences between observed and expected results. A total of 15,617 pages from nurses to residents over 6843 unique patient visits to the ED were analyzed. This included 187 nurses, 162 (87%) of whom were female and 25 (13%) were male. Of the 39 residents, 12 (31%) were female and 27 (69%) were male. Female residents received 4500 pages over 2228 unique patient ED visits, or a mean of two pages per patient with a mean of 186 unique ED visits per female resident. Male residents received 11,117 pages over 4615 unique patient ED visits, or a mean of 2.4 pages per patient, with a mean of 171 unique ED visits per male resident. This difference in pages per patient was statistically significant (χ2(1) = 369, p < 0.001). We found that male residents received significantly more pages per patient than their female colleagues. Overall, further research is required to understand the factors, such as characteristics of patients or preferred communication methods of providers, that drive this disparity and what the implications are for patient outcomes.

Perceived neighborhood social cohesion and functional disability among older adults: The moderating roles of sex, physical activity, and multi-morbidity.

Though the Ghanaian social structure is largely communal in several of its social life and social spaces, the extent to which cohesive neighbourhood affects functional ability of older persons and the moderating factors of the relationship, are unknown in Ghana. This study examines the moderating roles of sex, multimorbidity, and physical activity on the association between neighbourhood social cohesion and functional disability among older people in Ghana. A cross-sectional study of 4,446 people-50 years and older-from WHO's Study on global AGEing and adult health Ghana Wave 2 was employed. Functional disability-WHO Disability Assessment Schedule 2.0-and neighbourhood social cohesion measured with community-level participation, perceived trust and safety were studied. Generalised Logistic regressions with interactional tests were used to examine the associations. A more socially cohesive neighbourhood was significantly associated with a lower functional disability among older people (OR = 0.94, 95%CI: 0.93, 0.94; P<0.001). A similar relationship was found for community-level participation (aOR = 0.94, 95%CI: 0.94, 0.95; P<0.001) and perceived trust (aOR = 1.00, 95%CI: 0.99, 1.00; P<0.001). Community-level participation is associated with a lower functional disability among older people who were physically active (aOR = 0.98, 95%CI: 0.96, 0.99; P<0.001). Among the three individual-level measures of neighbourhood social cohesion, only physical activity (OR = 0.98, 95%CI: 0.98, 0.99; P<0.01) moderated the association between community-level participation and functional disability. Community-level participation, along with physical activity, may be relevant in improving functional ability among older people. The results highlight the usefulness of policy to ensure a more socially cohesive neighbourhood for older people in Ghana to improve their quality of life.