Gender bias

性别偏见
  • 文章类型: Journal Article
    我们使用来自30个国家的数据,发现一个学科中的女性越多,该学科的研究质量评估越低,资助成功率越低。这影响到男人和女人,随着年龄的增长,研究成果的数量,以及可获得此类数据的文献计量措施。我们的工作建立在其他人的发现上,即女性的工作价值较低,不管是谁做的工作。
    科学领域对性别歧视的关注越来越多。研究发现,从事科学工作的女性往往工资较低,与处于职业生涯类似阶段的男性相比,他们的工作不太可能获得信贷,获得的赠款也更少。这会让女性更难在职业生涯中取得进步,导致女性担任领导职务的人数少于男性。科学学科之间也存在性别不平衡,与其他领域相比,在某些领域工作的女性比例更高。这里,詹姆斯等人。开始研究是否有更多的女性在某一学科工作会导致对研究评估方式的偏见。该团队检查了四个数据集,其中包括30个不同国家的数千名研究人员的研究评估和资助成功的信息。分析表明,在女性占主导地位的学科中工作的科学家在赠款申请中成功的可能性较小。与在男性主导的领域工作的研究人员相比,他们的研究也经常被评估为质量较低。这些偏见适用于在这些学科工作的男性和女性。没有足够的数据来分析非二元个体面临的模式。詹姆斯等人的研究。无法确定这些结果的具体原因。然而,它建议资助组织应分析跨学科成功申请的模式,并考虑采取措施确保所有学科都有相似的成功率。詹姆斯等人。还建议在招聘或晋升时,科学机构在比较不同学科的研究人员时应该小心,并确保没有内在的假设,即男性主导的领域本质上更好。
    We use data from 30 countries and find that the more women in a discipline, the lower quality the research in that discipline is evaluated to be and the lower the funding success rate is. This affects men and women, and is robust to age, number of research outputs, and bibliometric measures where such data are available. Our work builds on others\' findings that women\'s work is valued less, regardless of who performs that work.
    There have been growing concerns around sexism in science. Studies have found that women in science are often paid less, are less likely to get credit for their work and receive fewer and smaller grants than men at similar stages in their careers. This can make it harder for women to advance in their careers, resulting in less women than men taking up positions of leadership. There are also gender imbalances between scientific disciplines, with a higher proportion of women working in some fields compared to others. Here, James et al. set out to find whether having more women working in a discipline leads to biases in how the research is evaluated. The team examined four datasets which included information on the research evaluations and funding success of thousands of researchers across 30 different countries. The analysis suggested that scientists working in women-dominated disciplines were less likely to succeed in their grant applications. Their research was also often evaluated as being lower quality compared to researchers working in fields dominated by men. These biases applied to both men and women working in these disciplines. There were not sufficient data to analyse patterns faced by non-binary individuals. The study by James et al. cannot pinpoint a specific cause for these outcomes. However, it suggests that funding organisations should analyse the pattern of successful applications across disciplines and consider taking steps to ensure all disciplines have similar success rates. James et al. also propose that when hiring or making promotions, scientific institutions should take care when comparing researchers across disciplines and ensure there is no built-in assumption that fields dominated by men are intrinsically better.
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  • 文章类型: Journal Article
    评估诊断时社会人口统计学和临床性别/性别相关因素对痴呆严重程度的影响。
    回顾性,横断面研究使用2007-2020年来自赫罗纳痴呆症登记处(ReDeGi)的数据,从赫罗纳健康区(加泰罗尼亚东北部地区,西班牙)。在诊断时根据性别和痴呆严重程度比较社会人口统计学和临床变量。按性别分层的多变量分析评估了患有中度/重度痴呆诊断的风险。
    在9614例新的痴呆病例中,6040(62.8%)是女性,男性3574人(37.2%)。75-85岁的女性和男性的中度/重度诊断风险低27.9%(p=.003)和43.1%(p<.001),分别,比那些>85。与男性(114.8%;p=0.030)相比,女性住院增加了中度/重度诊断的风险(159.9%;p<.001)。单身和受过高等教育会使中度/重度诊断的风险增加76.2%(p=0.039)和69.8%(p=.021),分别,只有在女人。
    年龄,教育水平,婚姻状况,在诊断时,女性和男性的居住地与中度/重度痴呆有不同的相关性,在诊断时表明痴呆严重程度的性别/性别差异,对女性的影响越来越大。
    UNASSIGNED: To evaluate the impact of sociodemographic and clinical sex/gender-associated factors on dementia severity at the time of diagnosis.
    UNASSIGNED: Retrospective, cross-sectional study using 2007-2020 data from the Registry of Dementia of Girona (ReDeGi), collecting information from new dementia diagnoses in the seven hospitals of the Health Region of Girona (Northeast region of Catalonia, Spain). Sociodemographic and clinical variables were compared by sex and dementia severity at diagnosis. A multivariate analysis stratified by sex evaluated the risk of having a moderate/severe dementia diagnosis.
    UNASSIGNED: Of 9614 new dementia cases, 6040 (62.8%) were women, and 3574 (37.2%) were men. Women and men aged 75-85 years had 27.9% (p = .003) and 43.1% (p < .001) less risk of moderate/severe diagnosis, respectively, than those >85. Being institutionalized increased the risk of moderate/severe diagnosis more in women (159.9%; p < .001) than in men (114.8%; p = .030). Being single and having a higher education increased the risk of moderate/severe diagnosis by 76.2% (p = .039) and 69.8% (p = .021), respectively, only in women.
    UNASSIGNED: Age, education level, marital status, and place of residence were differentially associated with moderate/severe dementia at the time of diagnosis in women and men, indicating sex/gender differences in dementia severity at diagnosis, with an increased impact on women.
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  • 文章类型: Journal Article
    目标:解决工作场所进步的问题,弹性,保留在医学中对于创造公平文化至关重要,尊重,和包容性,特别是对女性和非二元(WNB)提供商,包括高级实践提供商(APP),尤其是那些来自边缘化群体的人。这也直接影响医疗质量,患者结果,以及患者和员工的总体满意度。这项研究的目的是扩大儿科学术医疗机构中WNB提供商面临的挑战的声音,对解决进步的工作场所干预措施进行排名,弹性,和保留强调解决这些问题的紧迫性,and,最后,就如何提高包容性提供建议。
    方法:参与者是一家儿科医疗机构及其附属医科大学雇用的自我鉴定的WNB提供者。150名合格受访者完成了资格筛选,和40个WNB实际上参加了研究访谈。访谈使用半结构化访谈指南进行,以对旨在改善公平性的干预措施进行排名,与时间分配给受访者讨论他们的个人生活和个人情况如何影响他们的职业经历。
    结果:WNB供应商呼吁高效的工作流程和减少无报酬的工作需求。支持家庭责任,灵活的财务/薪酬模式,和改进的工作资源都得到了类似的认可。参与者对直接主管和领导支持的排名大大低于其他干预措施。结论:对WNB个人的职业指导和学术支持是公认的晋升和保留干预措施,但未被列为首要任务。受访者专注于与家庭有关的个人支持,作业资源,和灵活的薪酬模式。未来的研究应该专注于实施现实的期望和结构,支持整个生活,包括职业抱负,与家人共度时光,个人追求,和自我照顾。
    OBJECTIVE:  Addressing the issues of workplace advancement, resilience, and retention within medicine is crucial for creating a culture of equity, respect, and inclusivity especially towards women and nonbinary (WNB) providers including advanced practice providers (APPs), most notably those from marginalized groups. This also directly impacts healthcare quality, patient outcomes, and overall patient and employee satisfaction. The purpose of this study was to amplify the voices on challenges faced by WNB providers within a pediatric academic healthcare organization, to rank workplace interventions addressing advancement, resilience, and retention highlighting urgency towards addressing these issues, and, lastly, to provide suggestions on how to improve inclusivity.
    METHODS:  Participants were self-identified WNB providers employed by a pediatric healthcare organization and its affiliated medical university. An eligibility screener was completed by 150 qualified respondents, and 40 WNBs actually participated in study interviews. Interviews were conducted using a semi-structured interview guide to rank interventions targeted at improving equity, with time allotted for interviewees to discuss their personal lives and how individual circumstances impacted their professional experiences.
    RESULTS:  WNB providers called for efficient workflows and reducing uncompensated job demands. Support for family responsibilities, flexible financial/compensation models, and improved job resources all were endorsed similarly. Participants ranked direct supervisor and leader support substantially lower than other interventions.  Conclusions: Career mentorship and academic support for WNB individuals are recognized interventions for advancement and retention but were not ranked as top priorities. Respondents focused on personal supports as they relate to family, job resources, and flexible compensation models. Future studies should focus on implementing realistic expectations and structures that support whole lives including professional ambitions, time with family, personal pursuits, and self-care.
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  • 文章类型: Journal Article
    背景:巴西有一个大型的公共移植计划,但目前尚不清楚肾脏候补标准是否能有效分配器官.这项研究旨在调查性别,种族,临床特征,和巴西地区影响已故供体肾脏移植(DDKT)的机会。
    方法:我们使用国家移植系统/巴西数据库进行了一项回顾性队列研究,其中包括2012年1月至2022年12月肾脏移植候补名单上的所有患者,随后至2023年5月。评估的主要结果是DDKT的机会,使用子分布危险和特定原因危险模型(子分布危险比[sHR])测量。
    结果:我们分析了10年研究期间118617名等待患者。男性患者的sHR为1.07([95%CI:1.05-1.10],p<0.001),表明DDTK的机会更高。与白种人患者相比,混合种族和黄色/土著种族的患者接受移植的比例较低,sHR为0.97(95%CI:0.95-1)和0.89(95%CI:0.95-1),分别。来自南部地区的患者有最高的机会DDKT,其次是中西部和东北部的人,与来自东南部的患者相比,sHR为2.53(95%CI:2.47-2.61),1.21(95%CI:1.16-1.27),和1.10(95%CI:1.07-1.13),分别。北部地区发生DDTK的可能性最低,sHR为0.29(95%CI:0.27-0.31)。
    结论:我们发现妇女和少数族裔在肾移植中面临不利的问题。此外,我们观察到地区差异,北部地区DDKT的可能性最低,并且在等待上市之前进行透析的时间更长。相比之下,南部地区的患者有机会接受DDKT,且在被列入候补名单之前接受透析的时间较短.迫切需要采取各种方法来提高北部地区的移植能力,并解决移植中的种族和性别差异。
    BACKGROUND: Brazil has a large public transplant program, but it remains unclear if the kidney waitlist criteria effectively allocate organs. This study aimed to investigate whether gender, ethnicity, clinical characteristics, and Brazilian regions affect the chance of deceased donor kidney transplant (DDKT).
    METHODS: We conducted a retrospective cohort study using the National Transplant System/Brazil database, which included all patients on the kidney transplant waitlist from January 2012 to December 2022, followed until May 2023. The primary outcome assessed was the chance of DDKT, measured using subdistribution hazard and cause-specific hazard models (subdistribution hazard ratio [sHR]).
    RESULTS: We analyzed 118 617 waitlisted patients over a 10-year study period. Male patients had an sHR of 1.07 ([95% CI: 1.05-1.10], p < 0.001), indicating a higher chance of DDTK. Patients of mixed race and Yellow/Indigenous ethnicity had lower rates of receiving a transplant compared to Caucasian patients, with sHR of 0.97 (95% CI: 0.95-1) and 0.89 (95% CI: 0.95-1), respectively. Patients from the South region had the highest chance of DDKT, followed by those from the Midwest and Northeast, compared to patients from the Southeast, with sHR of 2.53 (95% CI: 2.47-2.61), 1.21 (95% CI: 1.16-1.27), and 1.10 (95% CI: 1.07-1.13), respectively. The North region had the lowest chance of DDTK, sHR of 0.29 (95% CI: 0.27-0.31).
    CONCLUSIONS: We found that women and racial minorities faced disadvantages in kidney transplantation. Additionally, we observed regional disparities, with the North region having the lowest chance of DDKT and longer times on dialysis before being waitlisted. In contrast, patients in the South regions had a chance of DDKT and shorter times on dialysis before being waitlisted. It is urgent to implement approaches to enhance transplant capacity in the North region and address race and gender disparities in transplantation.
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  • 文章类型: Journal Article
    分裂型涉及精神分裂症样特征和症状,威斯康星州分裂分型量表(WSS)在以前的研究中经常使用。有一些证据表明精神分裂症的症状水平,包括使用WSS时,可能因性别、种族和族裔而异。然而,以前的研究很少研究WSS在多大程度上表现出性别和种族偏见。Further,以前没有对认知滑移量表进行过检查,杂乱无章的分裂类型的度量。在这项研究中,我们在一个大样本的本科生(n=21,829)中检查了WSS项目子集的偏差。使用项目响应理论来测试差异项目功能(DIF)的水平,我们发现所有尺度的DIF都有问题的证据,包括负面的,积极的,和杂乱无章的分裂型尺度。有证据表明DIF存在问题,尤其是性别以及黑人和多种族参与者。总的来说,目前的结果表明,在使用这些量表时,性别和/或种族偏见应该是一个重要的考虑因素,我们的结果可能对评估精神分裂症-谱系症状有意义.
    Schizotypy involves schizophrenia-like traits and symptoms, with the Wisconsin Schizotypy Scales (WSS) being frequently used in previous research. There is some evidence that schizophrenia-spectrum symptom levels, including when using the WSS, might vary both by gender and by race and ethnicity. However, previous research has rarely examined to what extent the WSS show gender and racial bias. Further, this has not been previously examined for the Cognitive Slippage Scale, a measure of disorganized schizotypy. In this study, we examined biases for a subset of items from the WSS in a large sample of undergraduate students (n = 21,829). Using item response theory to test for levels of differential item functioning (DIF), we found some evidence of problematic DIF for all scales, including for negative, positive, and disorganized schizotypy scales. There was evidence of problematic DIF especially by gender and for Black and Multiracial participants. Overall, the current results suggest that gender and/or racial bias on these scales should be an important consideration in using these scales and our results could have implications for assessment of schizophrenia-spectrum symptoms.
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  • 文章类型: Journal Article
    背景:近几十年来,性别差异的话题已经成为许多研究领域的核心,包括药物。本研究探讨了移情方面的性别差异,性别角色意识形态,和医学生的性别敏感性,强调可以为医学教育和培训计划提供信息的重大变化。
    方法:该研究涉及来自医学系的155名学生(男性占52.1%;平均年龄:22.68±2.48岁),手术,和巴罗尼西萨勒诺大学的牙科,意大利南部参与者完成了两个标准化量表:杰斐逊移情量表(JSE)评估移情,和奈梅亨医学性别意识量表(N-GAMS)评估性别意识。基于性别的暴力陈述中还包括六个不限成员名额的问题。
    结果:ANOVA分析显示,在N-GAMS量表中,男女学生的得分存在显着差异,表明性别在这些变化中的重要作用。这些发现表明有必要进行进一步的研究,以了解影响因素并为医学教育提供有针对性的干预措施。此外,在同情护理(因素2)和患者穿鞋行走(因素3)方面存在显著差异,强调性别对移情后几个方面的实质性影响。
    结论:这些性别差异对医学教育具有重要意义。培训计划应针对男女学生的具体需求和特征进行调整。例如,鼓励男学生保持性别敏感性,同时挑战传统的性别角色意识形态可以促进更具包容性的患者护理方法。对于女学生来说,培养对他们富有同情心的护理能力的信心,并提供以不同方式表达同情的机会,可以帮助克服社会限制。
    BACKGROUND: In recent decades, the topic of gender differences has become central to many areas of study, including medicine. The present study explored gender differences in empathy, gender role ideologies, and gender sensitivity among medical students, highlighting significant variations that can inform medical education and training programs.
    METHODS: The study involved 155 students (52.1% male; mean age: 22.68±2.48 years) from the Department of Medicine, Surgery, and Dentistry of the University of Salerno in Baronissi, Southern Italy. Participants completed two standardized scales: the Jefferson Scale of Empathy (JSE) to assess empathy, and the Nijmegen Gender Awareness in Medicine Scale (N-GAMS) to evaluate gender awareness. Six open-ended questions were also included in the gender-based violence representations.
    RESULTS: The ANOVA analysis reveals significant differences in scores between male and female students across the N-GAMS scales, indicating a strong role of gender in these variations. These findings suggest the necessity for further research to understand the contributing factors and inform targeted interventions in medical education. Additionally, there are significant differences in compassionate care (Factor 2) and walking in the patient\'s shoes (Factor 3), highlighting the substantial impact of gender on these latter aspects of empathy.
    CONCLUSIONS: These gender differences have significant implications for medical education. Training programs should be tailored to address the specific needs and characteristics of both male and female students. For example, encouraging male students to maintain their gender sensitivity while challenging traditional gender role ideologies can promote a more inclusive approach to patient care. For female students, fostering confidence in their compassionate care abilities and providing opportunities to express empathy in diverse ways can help overcome societal constraints.
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  • 文章类型: Journal Article
    对护理专业的看法在塑造公众对其成员的态度方面起着关键作用,主要受与护士和媒体代表的互动影响。然而,它可能会受到历史和传统刻板印象的显著影响,再加上持久的性别偏见和其他先入为主的观念。
    这项研究旨在研究“护士”这个头衔如何反映职业身份,被认为是女性职业,以及作为医疗保健活动的地位。它还评估了护士角色的意识,教育和公共存在,比较克罗地亚共和国的一般人群和患者意见。
    作为横断面研究进行,这项研究采用了结构化问卷和便利抽样方法。它包括普通人群和来自克罗地亚的患者,数据收集时间为2023年2月15日至2023年3月16日,总样本量为624名参与者。统计分析包括描述性和推理技术,显著性设置为p<0.01(双尾)。
    相当比例的受访者,达38.1%,将术语“护士”与医生助理的角色相关联,而只有49.5%的人将其与工作领域内的真正专业功能相关联。此外,73.7%的研究参与者认为护理专业是男性所希望的。在检查了普通人群和患者的观点后,在他们对护理专业人员的工作范围(p<.001)和足够的教育程度(p<.001)的看法方面,出现了统计学上的显著差异.
    分析揭示了克罗地亚共和国对护理专业的不同看法,以及护理角色中对性别多样性的看法不断演变。在这项研究中,普通人群和患者之间的不同观点强调需要量身定制的教育和沟通计划,以改善护理形象。
    UNASSIGNED: The way the nursing profession is perceived plays a pivotal role in shaping the public\'s attitude toward its members, primarily influenced by interactions with nurses and media representation. However, it can be significantly impacted by historical and traditional stereotypes, coupled with enduring gender bias and other preconceived notions.
    UNASSIGNED: The study aimed to examined how the title \"nurse\" reflects the profession\'s identity, perception as a female occupation, and status as a healthcare activity. It also assessed awareness of nurses\' roles, education and public presence, comparing general population and patients\' opinions in the Republic of Croatia.
    UNASSIGNED: Conducted as a cross-sectional study, this research employed a structured questionnaire and a convenience sampling approach. It encompassed both the general population and patients from Croatia, with data collection spanning from February 15, 2023, to March 16, 2023, and resulting in a total sample size of 624 participants. Statistical analysis included both descriptive and inferential techniques, and significance was set at p < .01 (two-tailed).
    UNASSIGNED: A substantial proportion of respondents, amounting to 38.1%, correlate the term \"nurse\" with the role of the physician\'s assistant, whereas only 49.5% associate it with a true professional functioning within their field of work. Furthermore, 73.7% study participants perceive the nursing profession as being desirable for men. Upon examining the perspectives of the general population and patients, statistically significant differences emerged in terms of their perceptions regarding the perceived work scope (p < .001) and the level of sufficient educational attainment (p < .001) of nursing professionals.
    UNASSIGNED: The analysis uncovers varying perceptions of the nursing profession in the Republic of Croatia, as well as evolving perceptions of gender diversity within nursing roles. Differing viewpoints between the general population and patients in this study emphasize the need for tailored education and communication initiatives to improve the image of nursing.
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  • 文章类型: Journal Article
    患者越来越多地使用在线评论来评估心脏病专家。在线评论可以提供对驱动患者满意度的因素的见解。关于年龄和性别对心脏病专家的患者体验的影响知之甚少。
    这项研究的目的是将自然语言处理技术应用于在线评论,以确定积极和消极的患者经历的潜在因素以及年龄和性别对心脏病专家的患者经历的影响。
    将混合效应逻辑回归和情感分析应用于1998年至2023年Healthgrades的在线心脏病专家评论。然后按性别和年龄分析结果,以显示评级统计方面的趋势,情绪分析,和2字短语的频率。
    有100,334对9,461名心脏病专家的在线评论。与男性心脏病专家相比,女性心脏病专家的平均评分较低,接受阳性评价的可能性降低了34.5%(OR:0.655;95%CI:0.481-0.893;P=0.015)。与年轻的心脏病专家相比,年龄较大的心脏病专家的平均评分较低(4.145±0.908vs4.348±0.795;P<0.01)。积极评价与患者花费的时间相关(OR:1.383;95%CI:1.251-1.528;P<0.01),回答问题(OR:2.622;95%CI:2.324-2.959;P<0.01),患者认为他们可以信任提供者的决定(OR:2.285;95%CI:2.053-2.543;P<0.01)。
    积极的评价与心脏病专家的全面和患者对这种关系的信任感有关。基于年龄和性别的评级存在差异,女性和老年心脏病专家的评级较低。
    UNASSIGNED: Patients are increasingly using online reviews to evaluate cardiologists. Online reviews can provide insights into factors driving patient satisfaction. Little is known about the effects of age and sex on the patient experience with cardiologists.
    UNASSIGNED: The purpose of this study was to apply natural language processing techniques on online reviews to determine the factors underlying positive and negative patient experiences and the effects of age and sex on the patient experience with cardiologists.
    UNASSIGNED: Mixed effects logistic regression and sentiment analysis were applied to online cardiologist reviews from Healthgrades between 1998 and 2023. The results were then analyzed by sex and age to show trends with respect to rating statistics, sentiment analysis, and frequency of 2-word phrases.
    UNASSIGNED: There were 100,334 online reviews of 9,461 cardiologists. Female cardiologists received lower average ratings compared to male cardiologists and were 34.5% less likely to receive a positive review (OR: 0.655; 95% CI: 0.481-0.893; P = 0.015). Older cardiologists received lower average ratings compared to younger cardiologists (4.145 ± 0.908 vs 4.348 ± 0.795; P < 0.01). Positive reviews were associated with time spent with patients (OR: 1.383; 95% CI: 1.251-1.528; P < 0.01), answering questions (OR: 2.622; 95% CI: 2.324-2.959; P < 0.01), and patients feeling they could trust their providers\' decisions (OR: 2.285; 95% CI: 2.053-2.543; P < 0.01).
    UNASSIGNED: Positive reviews were associated with cardiologists being comprehensive and patients feeling a sense of trust in the relationship. There was a difference in ratings based on age and sex with female and older cardiologists receiving lower ratings.
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  • 文章类型: Journal Article
    Purpose: The aim of this study was to assess the sex differences in enrollment into clinical trials for Dupuytren\'s disease (DD), treatment efficacy, and complications. Methods: Three databases were searched; Ovid MEDLINE, Ovid EMBASE, and EBSCO CINAHL. Included studies were clinical trials on adult patients with DD. Exclusion criteria were non-English studies and other study designs. Two independent reviewers completed abstract screening, full-text review, and data extraction. The number and percentage of studies that reported ad hoc analyses for sex differences in treatment efficacy, tolerability, and complications were reported. A meta-analysis was performed on the proportion of female participants enrolled in clinical trials for DD. Results: A total of 3172 references were screened, and 59 studies were identified for full-text review. We identified 28 clinical trials for DD of which none reported secondary analyses for sex differences. Only 2 trials discussed sex differences in complications, and one trial reported sex differences in tolerability. The proportion of female participants in the meta-analysis was 19.5% [95% CI: 16.1-23.0%]. Conclusion: Sex differences in the clinical trials for DD are not widely considered in clinical trials despite their critical role. Males and females do not have equal representation in clinical trials for DD. Future studies should account for sex differences in the design and the analysis of clinical trials.
    Objectif: La présente étude visait à évaluer les différences selon les sexes à l’égard de l’inscription à des études cliniques sur la maladie de Dupuytren (MD), l’efficacité du traitement et les complications. Méthodologie: Les chercheurs ont fouillé trois bases de données, soit Ovid MEDLINE, Ovid EMBASE et EBSCO CINAHL et ont retenu les études cliniques sur les patients adultes atteints de MD. Ils ont exclu les études qui n’étaient pas rédigées en anglais et qui reposaient sur d’autres méthodologies. Deux analystes indépendants ont examiné les résumés, analysé les textes intégraux et extrait les données. Ils ont rendu compte du nombre et du pourcentage d’études qui ont fait état d’analyses ponctuelles sur les différences selon les sexes à l’égard de l’efficacité du traitement, de la tolérabilité et des complications. Ils ont procédé à une méta-analyse sur la proportion de participantes inscrites aux études cliniques sur la MD. Résultats: Au total, les chercheurs ont examiné 3172 références et ont retenu 59 études en vue d’en évaluer le texte intégral. Ils ont répertorié 28 études cliniques sur la MD, et aucune ne contenait d’analyses secondaires sur les différences selon les sexes. Seulement deux études abordaient les différences selon les sexes pour ce qui est des complications, et une étude constatait des différences selon les sexes quant à la tolérabilité. Dans la méta-analyse, la proportion de participantes s’élevait à 19,5% [IC à 95% : 16,1% à 23,0%]. Conclusion: On ne tient pas tellement compte des différences selon les sexes dans les études cliniques sur la MD, malgré leur rôle capital. Les hommes et les femmes ne sont pas représentés équitablement dans les essais cliniques sur la MD. De prochaines études devraient tenir compte des différences selon les sexes au moment d’établir la méthodologie des études cliniques et de les analyser.
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  • 文章类型: Journal Article
    背景:自闭症谱系条件(ASC)的个体的特征是社会交往中的非典型性,与典型发展中的个体(TD)相比。社会动机理论认为,这些困难源于预期减弱,接待处,和/或从社会奖励中学习。尽管从社会情感结果中学习是该理论的核心,迄今为止的研究是稀疏和不一致的。这可能来自理论的结合,方法和样本相关问题。这里,我们评估了参与者对导致理想的社会情感结果的行为产生自发偏好的能力(接近/避免快乐/愤怒的个体,分别),在生态有效的社会场景中。我们预计ASC个体的学习能力会受到损害,特别是对附属社会反馈的回应。
    方法:我们运行了一个在线社交强化学习任务,在两个有(n=274)和没有(n=290)ASC的大型在线队列中,性别匹配,年龄和教育。参与者必须指出他们将坐在候诊室中的位置。每个座位都与接近/避免情绪个体的不同概率相关。重要的是,任务是隐含的,由于参与者没有被指示学习,情感表达从未被提及。我们将两种分类分析与ASC和TD组进行对比,并对情感问卷进行维度因子分析。
    结果:与我们的假设相反,参与者从社会情感结果中表现出自发的学习,不管他们的诊断组。然而,当考虑自闭症特征的维度变化时,以及抑郁和焦虑,在未能制定明确学习策略的女性中出现了两个主要发现:(1)ASC中的自闭症严重程度与接近快乐个体的学习能力降低相关;(2)ASC和TD参与者的焦虑抑郁严重程度与接近/避免快乐/愤怒个体的学习能力降低相关,分别。
    结论:从社会情感结果中获得的内隐自发学习在自闭症患者中通常不会受损,但在患有ASC的女性中可能与自闭症严重程度特别相关,当他们没有一个明确的策略来适应他们的社会环境。临床诊断和干预应考虑其复杂性的个体差异,包括共病的焦虑和抑郁,在处理自闭症中的社会非典型问题时。
    Individuals with Autism Spectrum Condition (ASC) are characterized by atypicalities in social interactions, compared to Typically Developing individuals (TD). The social motivation theory posits that these difficulties stem from diminished anticipation, reception, and/or learning from social rewards. Although learning from socioemotional outcomes is core to the theory, studies to date have been sparse and inconsistent. This possibly arises from a combination of theoretical, methodological and sample-related issues. Here, we assessed participants\' ability to develop a spontaneous preference for actions that lead to desirable socioemotional outcomes (approaching/avoiding of happy/angry individuals, respectively), in an ecologically valid social scenario. We expected that learning abilities would be impaired in ASC individuals, particularly in response to affiliative social feedback.
    We ran an online social reinforcement learning task, on two large online cohorts with (n = 274) and without (n = 290) ASC, matched for gender, age and education. Participants had to indicate where they would sit in a waiting room. Each seat was associated with different probabilities of approaching/avoiding emotional individuals. Importantly, the task was implicit, as participants were not instructed to learn, and emotional expressions were never mentioned. We applied both categorical analyses contrasting the ASC and TD groups and dimensional factor analysis on affective questionnaires.
    Contrary to our hypothesis, participants showed spontaneous learning from socioemotional outcomes, regardless of their diagnostic group. Yet, when accounting for dimensional variations in autistic traits, as well as depression and anxiety, two main findings emerged among females who failed to develop explicit learning strategies: (1) autism severity in ASC correlated with reduced learning to approach happy individuals; (2) anxiety-depression severity across both ASC and TD participants correlated with reduced learning to approach/avoid happy/angry individuals, respectively.
    Implicit spontaneous learning from socioemotional outcomes is not generally impaired in autism but may be specifically associated with autism severity in females with ASC, when they do not have an explicit strategy for adapting to their social environment. Clinical diagnosis and intervention ought to take into account individual differences in their full complexity, including the presence of co-morbid anxiety and depression, when dealing with social atypicalities in autism.
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