Gender Differences In Efficacy Research Articles

Gender differences in the efficacy of brief interventions with a stepped care approach in general practice patients with alcohol-related disorders

To analyse gender differences in the efficacy of stepped care brief interventions for general practice patients with alcohol problems. Data are part of "Stepped Interventions for Problem Drinkers," in which 10,803 patients from 85 general practitioners were screened using alcohol related questionnaires; 408 patients were randomized (32% were female) to a control (booklet only) or two different intervention groups: stepped care (feedback, manual, and up to three counselling sessions depending on the success of the previous intervention) and fixed care (four sessions). Response rate for the 12 months follow-up was 91.7%. Regression analysis revealed a significant effect size only in women (P = 0.039). After excluding alcohol dependents and binge drinkers, an effect size (R(2)) of 0.031 (P = 0.050) in women and an effect size (R(2)) of 0.069 (P = 0.057) in men was obtained. Among the patients in stepped care who, by the first assessment point, had reduced drinking to within safe-drinking limits, there was a tendency for females to have achieved this more often than males (40% vs. 24%; P = 0.089). In a heterogeneous sample, the intervention was only effective for women. Women tended to profit more from the first, less intensive intervention than men. When analysis was limited to those reporting "at risk" average daily consumption and "alcohol abuse," the gender differences in efficacy appeared to be less, but the study was not sufficiently powered to affirm that.

Gender Differences in Nighttime Plasma Arginine Vasopressin and Delayed Compensatory Urine Output in the Elderly Population After Desmopressin

Monosymptomatic polyuric nocturia is a consequence of aging. We investigated physiological differences between nonpolyuric and polyuric nocturia in the elderly population in relation to urine production regulation in young volunteers with special reference to gender. We performed a study in 37 elderly healthy volunteers 65 years or older and 30 young healthy volunteers 20 to 40 years old who were hospitalized for 48 hours. Before admittance and during hospitalization fluid intake was standardized. The first 24 hours were at baseline conditions. On night 2 participants were given a single oral dose of desmopressin (0.4 mg). During 48 hours urine and blood samples were taken at predetermined time points to measure urine output and plasma arginine vasopressin levels. Elderly individuals with nocturnal polyuria had an inverted rhythm in urine output, which was restored after a single dose of desmopressin. There was an age related change in the circadian rhythm of arginine vasopressin secretion, which was associated with the presence or absence of nocturnal polyuria. A novel and unexpected finding was a decreased circadian rhythm of arginine vasopressin secretion in young women, similar to the pattern observed in elderly women but with a preserved decrease in nighttime urine production. Compensatory diuresis following the induction of temporary antidiuresis was markedly postponed in elderly participants. Age and gender related decreased arginine vasopressin secretion at night underscores the fact that other factors modulate urine production. The pharmacodynamics of desmopressin as an antidiuretic in the elderly population are different from those in young individuals.

Gender differences in efficacy and sexual function in long-term trazodone treatment (preliminary results)

Objects. To evaluate the effect of trazodone on depressive or anxiety symptoms and sexual function depending on patient gender. Method. A total of 111 patients (59 men, 52 women) subjected to long-term treatment with trazodone were studied. The effect of the therapy was recorded according to the Clinical Global Impression – Severity of Illness (CGI-S) scale. The incidence of sexual dysfunction was assessed on the Utvalg for Kliniske Undersogelser (UKU) scale. Results. The effect of the therapy was similar in both genders. The incidence of diminished sexual desire was low and comparable in both genders; orgasmic dysfunctions were present only in women at the level of statistical significance. A positive correlation between the severity of the illness and the occurrence of diminished sexual desire and orgasmic dysfunction was found in women but not in men. Conclusion. The occurrence of sexual dysfunctions in trazodone therapy was lower than in population. It seems that trazodone is an effective therapy of depressive and anxiety symptoms in both genders and it is convenient for sexually active patients, because the occurrence of sexual dysfunctions was present the general to a low degree.

Nicotine patch and lozenge are effective for women

It has been hypothesized that women may be less likely to obtain therapeutic benefit from nicotine replacement therapy (NRT). The present study tested this hypothesis, using two different types of NRT medications. A secondary analysis of two randomized clinical trials was performed: One compared active 21-mg nicotine patch with placebo among 193 men and 309 women, and the other compared active 2-mg or 4-mg nicotine lozenge with placebo among 788 men and 1,030 women. Using logistic regression analysis of 6-month continuous abstinence and survival analysis, we assessed the efficacy of patch and lozenge among women and tested for a gender x treatment interaction. Active NRT was more effective than placebo among women, for both patch and lozenge. In the lozenge trial, women were less successful than men. The gender x treatment interaction was not significant in either study, whether assessed by logistic regression or survival analysis. In the lozenge trial, gender moderated the effects of smoking rate and dependence (but not treatment) on outcome: These variables affected success rates only among women. Treatment with nicotine patch or lozenge is effective for women, and the analysis did not reveal significant gender differences in efficacy. Gender differences in outcome may be moderated by nicotine dependence.

The Role of Choice in Children's Learning: A Distinctive Cultural and Gender Difference in Efficacy, Interest, and Effort.

Une experience transculturelle testant les effets du choix personnel sur l'apprentissage a ete menee aupres d'enfants de cinquieme et sixieme annee du Canada (n = 130) et de Taiwan (n = 153) a l'aide d'une tâche informatisee d'apprentissage d'une langue etrangere. Les resultats ont montre que le choix n'a pas d'incidence significative sur l'interet, l'effort ou le resultat de l'apprentissage des enfants. Bien que les convictions d'efficacite des enfants chinois et canadiens soient comparables, les enfants canadiens se sont dits plus interesses, mais ont montre moins d'effort et une moins bonne performance de la tâche. Les garcons canadiens avaient une conviction d'efficacite plus faible et montraient de facon constante moins d'interet et d'effort que les filles; cet ecart entre les sexes n'etait toutefois pas evident chez les enfants chinois. Contrairement aux canadiens, l'effort des enfants chinois n'etait pas lie aux convictions d'efficacite ou a l'interet. Lorsqu'on leur disait de facon explicite qu'il n'y aurait pas de test, les enfants chinois devenaient plus interesses dans la tâche, mais il n'y avait pas d'effet sur les enfants canadiens. Les implications de ces conclusions font l'objet de discussion et d'autres etudes sont suggerees.

Fluvastatin and niacin in hypercholesterolemia: A preliminary report on gender differences in efficacy

A total of 74 hypercholesterolemic patients were randomized to receive double-blind treatment for 6 weeks with either 20 mg of fluvastatin daily or placebo. Open-label niacin, to a maximum of 3 g daily, was added to each treatment for a further 9 weeks. Changes in lipid parameters were derived from averaged data, with monotherapy at weeks 3 and 6 and with combination therapy at weeks 12 and 15. The reduction in low-density lipoprotein cholesterol (LDL-C) was significantly greater with fluvastatin (20.8%) compared with placebo (p <0.001) after 3–6 weeks of treatment. At the end of 12–15 weeks, the addition of niacin potentiated the response to 43.7% with the fluvastatin + niacin combination and to 26.5% with the placebo + niacin combination (p <0.001, vs baseline and between treatment groups). Significant gender differences were noted in the LDL-C response to the fluvastatin + niacin combination. Women achieved LDL-C reductions of 54.6% whereas men achieved reductions of 38.2% (p <0.005, between gender groups). Women also tended to have greater LCL-C reductions with the placebo + niacin combination, compared with men (p <0.05). At the end of 12–15 weeks, there were HDL-C increases of 33.1% (p <0.001) whereas triglyceride levels declined by 32.3% (p <0.001). In conclusion, fluvastatin, both as monotherapy and in combination with niacin, proved to be an effective and well-tolerated alternative for the treatment of hypercholesterolemia. The differential response in LDL-C between men and women should be further explored in other trials of lipid-lowering therapy.