"Nenhuma Pessoa Idosa Merece Passar por Isso": Compreensão da Violência para Mulheres Gerontes / "Ninguna Persona Adulta Mayor Merece Pasar Por Esto": Comprensión de la Violencia para las Mujeres Adultas Mayores / "No Elderly Person Deserves to Go Through This": Understanding Violence Towards Elderly Women

Resumo Introdução: A violência contra idosos é um fenômeno crescente, ocasionando prejuízos à saúde, com diferentes desfechos e consequências às vítimas. A chance de idosas sofrerem-na no âmbito familiar supera a dos homens, sendo o gênero um fator de risco considerável. Objetivo: Analisar a compreensão da violência contra pessoas idosas segundo mulheres gerontes. Metodologia: Pesquisa descritiva com abordagem qualitativa desenvolvida com 22 idosas de uma comunidade no estado da Paraíba, Brasil, escolhidas por conveniência. Utilizou-se para coleta de dados entrevistas semiestruturadas, processadas pelo software Iramuteq, com posterior Análise de Conteúdo. Resultados: Foram evidenciadas cinco classes: ciclo de violência; rede de apoio ao idoso vítima de violência; Vivência de situações violentas; violência financeira; e simbologia da violência na sociedade, as quais denotam compreensão da violência envolvendo os diferentes tipos. Apoiam-se nos fatores da vivência familiar, cultura e outros, consubstanciando o profissional de saúde como fundamental para o desfecho. O gênero influenciou no que concerne ao olhar lançado sobre a violência física e psicológica, bem como na relevância dada às equipes de saúde para identificação de ocorrências e prevenção de possíveis danos. Conclusão: Os diversos tipos de violência contra a pessoa idosa foram reconhecidos, incluindo fatores individuais, comunitários e sociais no ciclo violento. Além disso, associaram o envelhecimento a maior suscetibilidade para sofrer violência, independente da tipologia. Destaca-se a potencialidade do serviço de saúde na assistência à pessoa idosa vítima de violência, elucidando casos e atuando precocemente para interrupção dos ciclos perpetrados, exigindo a necessidade constante de atualização profissional para lidar com situações detectadas.

Resumen Introducción: La violencia contra las personas adultas mayores es un fenómeno creciente, que causa daños a la salud, con diferentes desenlaces y consecuencias para las víctimas. La posibilidad de que las mujeres adultas mayores la sufran en el ámbito familiar supera la de los hombres, siendo el género un factor de riesgo considerable. Objetivo: Analizar la comprensión de la violencia contra las personas mayores según las mujeres adultas mayores. Metodología: Investigación descriptiva con enfoque cualitativo desarrollada con 22 mujeres adultas mayores de una comunidad en el estado de Paraíba, Brasil, elegidas por conveniencia. Para la recolección de datos, se utilizaron entrevistas semiestructuradas, procesadas por el software Iramuteq, con posterior análisis de contenido. Resultados: Se evidenciaron cinco tipos de violencia: ciclo de la violencia, red de apoyo población adulta mayor víctima de violencia, experimentar situaciones violentas, violencia financiera y simbología de la violencia en la sociedad, que denotan la comprensión de la violencia de diferentes tipos. Estas ideas están respaldadas en los factores de la experiencia familiar, la cultura y otros, donde la persona profesional de la salud se identifica como fundamental para el cuidado y apoyo. El género influyó en la mirada lanzada sobre la violencia física y psicológica, así como en la relevancia dada a los equipos de salud para la identificación de sucesos y la prevención de posibles daños. Conclusión: Se han reconocido los diversos tipos de violencia contra las personas mayores, incluidos los factores individuales, comunitarios y sociales en el ciclo de violencia. Además, asociaron el envejecimiento con una mayor susceptibilidad a sufrir violencia, independientemente de la tipología. Destaca la potencialidad del servicio de salud en la asistencia a la persona mayor víctima de violencia, mediante la identificación de casos y la actuación temprana para la interrupción de los ciclos perpetrados. De manera que, se evidencia la necesidad constante de actualización profesional para hacer frente a situaciones detectadas.

Abstract Introduction: Violence against the elderly is a growing phenomenon, causing damage to health, with different outcomes and consequences to the victims. The possibility of elderly women suffering it in the family context surpasses that of men, with gender being a considerable risk factor. Objective: To analyze the understanding of violence against the elderly according to elderly women. Method: Descriptive research with a qualitative approach developed with 22 elderly women from a community in the state of Paraíba, Brazil, chosen for convenience. The data collection was based on semi-structured interviews, processed by the Iramuteq software, with subsequent Content Analysis. Results: Five classes of violence against the elderly were evidenced: cycle of violence; support network for the elderly victims of violence; experience of violent situations; financial violence; and symbolism of violence in society, which denote an understanding of violence involving the different types. They are based on the factors of family experience, culture, and others, placing the health professional as a fundamental element for care and support. Gender influenced the perspective on physical and psychological violence, as well as the relevance given to health teams for the identification of occurrences and the prevention of possible damage. Conclusion: The various types of violence against the elderly have been recognized, including individual, community, and social factors in the violent cycle. In addition, they associated aging with greater susceptibility to suffering violence, regardless of the typology. It highlights the potential of the health service in assisting the elderly victim of violence, elucidating cases, and acting early to interrupt the cycles perpetrated, requiring the constant need for professional updating to deal with detected situations.

Associations between Rat Infestations and Mental Health Vary by Gender, Race, and Income in Chicago.

Rats are an understudied stressor for people in urban environments around the world but the effects may not be distributed equally among residents. In this study, we examined associations between residential rat sightings and mental health in Chicago, where rat complaints are the highest of any American city. We examined how this relationship varied by frequency of rat sightings, race, ethnicity, income, home ownership, and gender and explored potential psychosocial pathways (e.g., feelings about the home) between rat sightings and mental distress. We conducted a randomized household survey along an income gradient in 2021 and asked about depressive symptoms in the past week (i.e., Center for Epidemiologic Studies Depression scale), frequency of rat sightings in/around the home, perceptions of rats, neighborhood conditions, and socio-demographic characteristics. We used logistic regression to assess relationships among these variables for our entire sample and for specific demographics using stratified models. Respondents (n = 589; 409 complete cases) who saw rats in/around the home daily/almost daily had 5.5 times higher odds of reporting high depressive symptoms relative to respondents who saw rats less frequently after accounting for socio-demographics and neighborhood conditions. This relationship was significant for men and respondents with lower incomes or race or ethnicity other than white. Our results show that rat infestations should be considered a threat to mental health among urban residents. Increased mental health support for residents living in rat-infested housing may improve public health in cities.

Depression and thoughts of self-harm or suicide among gender and sexually diverse people in a regional Australian community.

ISSUES ADDRESSED: There is a paucity of data regarding depression and thoughts of self-harm or suicide among gender and sexually diverse (GSD) people living within Australian regional/rural locations. This study aims to elucidate these issues and fill a critical gap. METHODS: The sample included 91 GSD people from a regional community in South-West Queensland utilising the PHQ-9 to determine presence/severity of depression and self-harm/suicide ideation. These data were drawn from a larger health and wellbeing survey. Raw mean scores were calculated to determine prevalence/severity of clinical symptoms. Bayesian ordinal regression models were employed to analyse between-subgroup differences in depression and self-harm/suicide ideation. RESULTS: Overall, 80.2% of GSD sample experienced depression (35.2% severe, 45.1% mild/moderate) and 41.8% experienced self-harm/suicide ideation in the past two-weeks. Trans and nonbinary people experienced higher levels of depressions than sexually diverse cisgender people. Pansexual and bisexual people experienced higher levels of depression than gay people. Trans people experienced higher prevalence of self-harm/suicide ideation than cisgender and nonbinary people, with no differences between sexuality subgroups. CONCLUSIONS: These findings contribute to deeper and more nuanced insights regarding clinically salient depressive and self-harm/suicide ideation symptoms among trans, nonbinary, bisexual, pansexual and queer people in regional Australian communities, with the aim to ultimately reduce mental health prevalence, improve mental health outcomes and health promotion among GSD people. SO WHAT?: The current findings revealed GSD people experience high prevalence of depression and self-harm/suicide ideation indicating tailored mental health awareness-raising, training and health promotion is warranted to enhance psychological support.

Social Activities and Risk of Dementia in Community-Dwelling Older People: Gender-Specific Findings from a Prospective Cohort Study.

OBJECTIVES: This study examines gender-specific associations between a wide range of social activities and dementia risk. METHODS: A prospective cohort study was conducted involving community-dwelling older Australians (≥70 years) without significant cognitive impairment at enrolment. During the first year of enrolment, we assessed 25 self-reported social activities covering various aspects, including support from relatives and friends, community participation, social interactions with surroundings, and loneliness. Dementia diagnosis followed DSM-IV criteria, adjudicated by an international expert panel. To estimate hazard ratios (HR) and 95% confidence intervals (CI) for associations between social activities and dementia, we performed Cox proportional hazards models, adjusting for age, educational attainment, baseline global cognition, and depressive symptoms. RESULTS: Among 9,936 participants who completed all social activity questionnaires (median [IQR]age:73.4[71.6-77.1] years; 47.4% men), dementia was diagnosed in 3.8% of men (n=181/4,705) and 2.6% of women (n=138/5,231) over a median 6.4 years (IQR:5.3-7.6, range:0.2-10.1) follow-up. Gender-specific relationships emerged: caregiving for a person with illness/disability in women (HR:0.65,95%CI:0.42-0.99), and having ≥9 relatives feeling close to call for help in men (HR:0.56, 95%CI:0.33-0.96; reference <9 relatives) were associated with reduced dementia risk. Unexpectedly, in women, having ≥5 friends with whom they felt comfortable discussing private matters was associated with a greater dementia risk (HR:1.69,95%CI:1.10-2.59; reference ≤2 friends). Imputed models further identified that babysitting/childminding was associated with a lower dementia risk in men (HR:0.75,95%CI:0.56-0.99). No other social activities showed significant associations with dementia. DISCUSSION: This study provides evidence of social activities influencing dementia risk. Further investigations are required to uncover the mechanisms driving these observed relationships.

Systemic Barriers to Fertility Preservation for Sexually and Gender Diverse Populations.

Fertility preservation is the process of collecting and storing oocytes, sperm, or reproductive tissue so that a person may retain their ability to have biologically related children. In instances of infertility caused by medical intervention or an underlying medical condition, this procedure is often sought by affected patient populations. U.S. Title 21 regulations have produced disparities in access, disproportionately restricting services for sexually and gender diverse subpopulations capable of producing sperm. This article examines policies contributing to these disparities, explores how these policies may translate to real-world health care delivery, and proposes policy changes that would increase equitable access to care.

Minority Stressors, Social Provisions, and Past-Year Suicidal Ideation and Suicide Attempts in a Sample of Sexual Orientation and Gender Identity/Expression Minority People in Canada.

Purpose: Mental health disparities in sexual orientation and/or gender identity and/or expression (SOGIE) minority groups are well-documented, with research consistently showing higher levels of suicidality, even in Canada, considered one of the world's most accepting countries of SOGIE minority groups. Adverse outcomes in these groups are often framed using minority stress theory, with social support frequently studied as an integral buffer to these outcomes. This analysis explores facets of minority stress and social support associated with past-year suicidal ideation and suicide attempts. Methods: A cross-sectional internet survey of SOGIE diverse people in Canada (n = 1542) was conducted. Binary logistic regression calculated bivariate and multivariate factors associated with past-year suicidal ideation and suicide attempts. Backward elimination (retaining sociodemographic factors and self-rated mental health) identified salient minority stress and social support (provisions) factors. Results: Over half (56.72%) of participants had ever thought of dying by suicide, with 24.84% having attempted suicide. During the past year, 26.80% had thought of dying by suicide, with 5.32% having attempted suicide. Victimization events, and guidance (e.g., someone to talk to about important decisions) and attachment (e.g., close relationships providing emotional security) social provision subscales remained salient after backward elimination procedures. Conclusion: Our findings emphasize that a fulsome, multilevel approach considering structural, community, and individual strategies to address overt discrimination, integrating social connections and guidance, is necessary to prevent dying by suicide.

Misperception of peer beliefs reinforces inequitable gender norms among Tanzanian men.

Gender role ideology, i.e. beliefs about how genders should behave, is shaped by social learning. Accordingly, if perceptions about the beliefs of others are inaccurate this may impact trajectories of cultural change. Consistent with this premise, recent studies report evidence of a tendency to overestimate peer support for inequitable gender norms, especially among men, and that correcting apparent 'norm misperception' promotes transitions to relatively egalitarian beliefs. However, supporting evidence largely relies on self-report measures vulnerable to social desirability bias. Consequently, observed patterns may reflect researcher measurement error rather than participant misperception. Addressing this shortcoming, we examine men's gender role ideology using both conventional self-reported and a novel wife-reported measure of men's beliefs in an urbanising community in Tanzania. We confirm that participants overestimate peer support for gender inequity. However, the latter measure, which we argue more accurately captures men's true beliefs, implies that this tendency is relatively modest in magnitude and scope. Overestimation was most pronounced among men holding relatively inequitable beliefs, consistent with misperception of peer beliefs reinforcing inequitable norms. Furthermore, older and poorly educated men overestimated peer support for gender inequity the most, suggesting that outdated and limited social information contribute to norm misperception in this context.

Inequality on the frontline: A multi-country study on gender differences in mental health among healthcare workers during the COVID-19 pandemic.

Healthcare workers (HCWs) were at increased risk for mental health problems during the COVID-19 pandemic, with prior data suggesting women may be particularly vulnerable. Our global mental health study aimed to examine factors associated with gender differences in psychological distress and depressive symptoms among HCWs during COVID-19. Across 22 countries in South America, Europe, Asia and Africa, 32,410 HCWs participated in the COVID-19 HEalth caRe wOrkErS (HEROES) study between March 2020 and February 2021. They completed the General Health Questionnaire-12, the Patient Health Questionnaire-9 and questions about pandemic-relevant exposures. Consistently across countries, women reported elevated mental health problems compared to men. Women also reported increased COVID-19-relevant stressors, including insufficient personal protective equipment and less support from colleagues, while men reported increased contact with COVID-19 patients. At the country level, HCWs in countries with higher gender inequality reported less mental health problems. Higher COVID-19 mortality rates were associated with increased psychological distress merely among women. Our findings suggest that among HCWs, women may have been disproportionately exposed to COVID-19-relevant stressors at the individual and country level. This highlights the importance of considering gender in emergency response efforts to safeguard women's well-being and ensure healthcare system preparedness during future public health crises.

Exploring the Intersectionality of Place and Gender Among Older Adults in Ghana: An Examination of Women's Disability Disadvantage.

Background and Objectives: Ghana's older adult population is growing rapidly and is projected to double by 2050. It is well-documented that social, health, and housing factors influence segmented aging trajectories that lead to disparate rates of disability. However, little is known about how the intersection of place (i.e., urban and rural) and gender (i.e., woman and man) inform rates of disability among older Ghanaians. We seek to examine this gap in the literature through an intersectional approach. Research Design and Methods: Using logistic regression with Wave 1 (2007/2008) data from the World Health Organization's Study on global AGEing and adult health (SAGE) Ghana, we investigate the prevalence of reporting activities of daily living (ADL) disability among respondents ages 50+ (n = 4,106). To document gender differences by place, we compute separate adjusted odds ratio models among urban and rural respondents. We also control for health, social, and housing factors that might explain gender differences. Results: Compared to urban men, urban women's ADL disability disadvantage was explained by marital status, particularly widowhood. In contrast, rural women consistently reported an ADL disability disadvantage when compared to rural men. Additionally, we found that the morbidity profiles of those who reported ADL disability differed by place and that certain ADL difficulties (i.e., bed transferring and toileting) were especially common among women respondents. Discussion and Implications: Women, regardless of urban or rural residence, were especially vulnerable to ADL disability. Marital status, particularly widows, explained the difference in disability risk between urban men and urban women. This finding suggests that urban women's risk of ADL disability is attenuated during the partnership. Also, we speculate that varied morbidity associations with ADL disability are due to different stressors in urban versus rural environments. These findings also generate further interest in about rural women's disability disadvantage.

Disparities in Mistreatment During Childbirth.

Importance: Lack of respectful maternity care may be a key factor associated with disparities in maternal health. However, mistreatment during childbirth has not been widely documented in the US. Objectives: To estimate the prevalence of mistreatment by health care professionals during childbirth among a representative multistate sample and to identify patient characteristics associated with mistreatment experiences. Design, Setting, and Participants: This cross-sectional study used representative survey data collected from respondents to the 2020 Pregnancy Risk and Monitoring System in 6 states and New York City who had a live birth in 2020 and participated in the Postpartum Assessment of Health Survey at 12 to 14 months' post partum. Data were collected from January 1, 2021, to March 31, 2022. Exposures: Demographic, social, clinical, and birth characteristics that have been associated with patients' health care experiences. Main Outcomes and Measures: Any mistreatment during childbirth, as measured by the Mistreatment by Care Providers in Childbirth scale, a validated measure of self-reported experiences of 8 types of mistreatment. Survey-weighted rates of any mistreatment and each mistreatment indicator were estimated, and survey-weighted logistic regression models estimated odds ratios (ORs) and 95% CIs. Results: The sample included 4458 postpartum individuals representative of 552 045 people who had live births in 2020 in 7 jurisdictions. The mean (SD) age was 29.9 (5.7) years, 2556 (54.4%) identified as White, and 2836 (58.8%) were commercially insured. More than 1 in 8 individuals (13.4% [95% CI, 11.8%-15.1%]) reported experiencing mistreatment during childbirth. The most common type of mistreatment was being "ignored, refused request for help, or failed to respond in a timely manner" (7.6%; 95% CI, 6.5%-8.9%). Factors associated with experiencing mistreatment included being lesbian, gay, bisexual, transgender, queer identifying (unadjusted OR [UOR], 2.3; 95% CI, 1.4-3.8), Medicaid insured (UOR, 1.4; 95% CI, 1.1-1.8), unmarried (UOR, 0.8; 95% CI, 0.6-1.0), or obese before pregnancy (UOR, 1.3; 95% CI, 1.0-1.7); having an unplanned cesarean birth (UOR, 1.6; 95% CI, 1.2-2.2), a history of substance use disorder (UOR, 2.6; 95% CI, 1.3-5.1), experienced intimate partner or family violence (UOR, 2.3; 95% CI, 1.3-4.2), mood disorder (UOR, 1.5; 95% CI, 1.1-2.2), or giving birth during the COVID-19 public health emergency (UOR, 1.5; 95% CI, 1.1-2.0). Associations of mistreatment with race and ethnicity, age, educational level, rural or urban geography, immigration status, and household income were ambiguous. Conclusions and Relevance: This cross-sectional study of individuals who had a live birth in 2020 in 6 states and New York City found that mistreatment during childbirth was common. There is a need for patient-centered, multifaceted interventions to address structural health system factors associated with negative childbirth experiences.

Direct and vicarious exposure to healthcare discrimination and erasure among transgender and gender independent individuals: Testing the indirect effect of mistrust in healthcare on utilization behaviors.

RATIONALE: Direct exposure to gender identity-related discrimination and erasure among the transgender and gender independent (TGI) population are associated with healthcare underutilization, which may further exacerbate the health disparities that exist between this population and cisgender individuals in the United States (U.S.). Although the impacts of direct exposure to healthcare discrimination and erasure may have on TGI individuals are known, exposure to such harm vicariously (i.e., through observation or report) is underexplored. OBJECTIVE: The present study examined the relationships among direct and vicarious gender identity-related healthcare discrimination and erasure exposure and past-year healthcare utilization. METHOD: Gender identity-based mistrust in healthcare was also assessed, as a mechanism through which direct and vicarious gender identity-related healthcare discrimination and erasure predict healthcare utilization behaviors among a sample (N = 385) of TGI adults in the U.S., aged 18 to 71 recruited online. RESULTS: Results indicated direct lifetime and vicarious healthcare discrimination and erasure exposure significantly predicted past-year healthcare underutilization when participants anticipated encountering gender identity-related healthcare discrimination. Mediational analyses indicated that higher levels of exposure to direct lifetime and vicarious healthcare discrimination and erasure were related to higher levels of mistrust in healthcare, through which past-year underutilization was significantly related. CONCLUSIONS: These findings are vital to informing healthcare practice and policy initiatives aimed at ensuring the barriers that deleteriously influence the accessibility of healthcare among TGI individuals are ameliorated.

Association between Serum Estradiol and Cardiovascular Health among Transgender Adults Using Gender-Affirming Estrogen Therapy.

INTRODUCTION: Gender-affirming estrogen therapy (GAET) is commonly used for feminization in transgender and non-binary (TNB) individuals, yet the optimal rate of change (ROC) in estradiol levels for cardiovascular health is unclear. We examined the association between serum estradiol levels and cardiovascular-related mortality, adverse events, and risk factors in TNB adults using GAET. METHODS: Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE and Web of Science were systematically searched (inception-April 2023) for original articles reporting serum estradiol levels and cardiovascular-related mortality, adverse events, and risk factors in TNB adults using GAET. Data extraction was completed in duplicate following PRISMA guidelines. Stratified random effects meta-analyses using serum estradiol ROC (serum estradiolbaseline-serum estradiolfollow-up/study duration) was used to assess longitudinal studies (Low:0

Gender health care inequalities in health crisis: when uncertainty can lead to inequality.

BACKGROUND: In health crisis, inequalities in access to and use of health care services become more evident. The objective of this study is to analyse the existence and evolution of gender inequalities in access to and use of healthcare services in the context of the COVID-19 health crisis. METHODS: Retrospective cohort study using data from all individuals with a confirmed COVID-19 infection from March 2020 to March 2022 in Aragón (Spain) (390,099 cases). Health care access and use was analysed by gender for the different pandemic waves. Univariate and multivariate analyses were conducted to evaluate the effect of sex in health care. Blinder-Oaxaca decomposition methods were performed to explain gender gaps observed. RESULTS: The health care received throughout the COVID-19 pandemic differed between men and women. Women were admitted to hospital and intensive care units less frequently than men and their stays were shorter. Differences observed between men and women narrowed throughout the pandemic, but persisted even after adjusting for age, socioeconomic status, morbidity burden or the patient's place of residence. Differences in sociodemographic characteristics and morbidity burden could explain partially the gender inequalities found, mainly in the later phases of the pandemic, but not in the earlier waves. CONCLUSIONS: There were gender inequalities in access to and use of health services during the COVID-19 pandemic. Inequalities were greater in the first waves of the pandemic, but did not disappear. Analysis of health crises must take into account an intersectional gender perspective to ensure equitable health care.

Men With Type II Diabetes in Peru: The Role of Masculine Gender Norms in the Perception of Family Support.

Type II diabetes is increasingly becoming a problem in Latin American countries such as Peru. People living with diabetes must incorporate several behavioral changes in their everyday lives, which are done outside the purview of medical professionals. Support from friends and family members is essential to the successful management of any chronic condition. Our study discusses the role of family involvement in supporting the management of diabetes among Peruvian men and examines how masculine norms play a role in the way such support is received and perceived, and their influence in motivation to adhere to treatment recommendations. In-depth interviews with 20 men from a low socioeconomic status, aged 27 to 68 with a diagnosis of Type II diabetes were conducted. Our analysis suggests the importance of the close, complex, and integrated experience that connects family members and patients with a chronic condition. Participant accounts demonstrate they receive multiple forms of support from a diverse range of social relationships. The overwhelming majority of the people giving the support were female and were especially significant in supporting management practices. The participants' accounts were able to demonstrate how living with a chronic condition, such as diabetes, affects the whole family-physically, mentally, and emotionally-and they experience the disease as one unit. Our study demonstrates the need for a family health experience approach that considers masculine gender norms around health and provides relevant insights to inform family-based treatments and therapies to allow for more and better targeted health care for men.

Fluid face but not gender: Enfacement illusion through digital face filters does not affect gender identity.

It has been shown that observing a face being touched or moving in synchrony with our own face increases self-identification with the former which might alter both cognitive and affective processes. The induction of this phenomenon, termed enfacement illusion, has often relied on laboratory tools that are unavailable to a large audience. However, digital face filters applications are nowadays regularly used and might provide an interesting tool to study similar mechanisms in a wider population. Digital filters are able to render our faces in real time while changing important facial features, for example, rendering them more masculine or feminine according to normative standards. Recent literature using full-body illusions has shown that participants' own gender identity shifts when embodying a different gendered avatar. Here we studied whether participants' filtered faces, observed while moving in synchrony with their own face, may induce an enfacement illusion and if so, modulate their gender identity. We collected data from 35 female and 33 male participants who observed a stereotypically gender mismatched version of themselves either moving synchronously or asynchronously with their own face on a screen. Our findings showed a successful induction of the enfacement illusion in the synchronous condition according to a questionnaire addressing the feelings of ownership, agency and perceived similarity. However, we found no evidence of gender identity being modulated, neither in explicit nor in implicit measures of gender identification. We discuss the distinction between full-body and facial processing and the relevance of studying widely accessible devices that may impact the sense of a bodily self and our cognition, emotion and behaviour.

Training in the implementation of sex and gender research policies: an evaluation of publicly available online courses.

BACKGROUND: Recently implemented research policies requiring the inclusion of females and males have created an urgent need for effective training in how to account for sex, and in some cases gender, in biomedical studies. METHODS: Here, we evaluated three sets of publicly available online training materials on this topic: (1) Integrating Sex & Gender in Health Research from the Canadian Institutes of Health Research (CIHR); (2) Sex as a Biological Variable: A Primer from the United States National Institutes of Health (NIH); and (3) The Sex and Gender Dimension in Biomedical Research, developed as part of "Leading Innovative measures to reach gender Balance in Research Activities" (LIBRA) from the European Commission. We reviewed each course with respect to their coverage of (1) What is required by the policy; (2) Rationale for the policy; (3) Handling of the concepts "sex" and "gender;" (4) Research design and analysis; and (5) Interpreting and reporting data. RESULTS: All three courses discussed the importance of including males and females to better generalize results, discover potential sex differences, and tailor treatments to men and women. The entangled nature of sex and gender, operationalization of sex, and potential downsides of focusing on sex more than other sources of variation were minimally discussed. Notably, all three courses explicitly endorsed invalid analytical approaches that produce bias toward false positive discoveries of difference. CONCLUSIONS: Our analysis suggests a need for revised or new training materials that incorporate four major topics: precise operationalization of sex, potential risks of over-emphasis on sex as a category, recognition of gender and sex as complex and entangled, and rigorous study design and data analysis.

Recently implemented research policies requiring the inclusion of females and males have created an urgent need for effective training in how to account for sex, and in some cases gender, in biomedical studies. We evaluated three publicly available online trainings on this topic: (1) Integrating Sex & Gender in Health Research from the Canadian Institutes of Health Research; (2) Sex as a Biological Variable: A Primer from the United States National Institutes of Health; and (3) The Sex and Gender Dimension in Biomedical Research, developed as part of "Leading Innovative Measures to Reach Gender Balance in Research Activities (LIBRA)" from the European Commission. We reviewed each course with respect to their coverage of (1) What is required by the policy; (2) Rationale for the policy; (3) Handling of the concepts "sex" and "gender;" (4) Research design and analysis; and (5) Interpreting and reporting data. All three discussed the importance of including males and females to better generalize results, discover potential sex differences, and tailor treatments to men and women. The interconnectedness of sex and gender, how to operationalize sex, and potential downsides of focusing on sex more than other sources of variation were minimally discussed. Notably, all three courses explicitly endorsed invalid analytical approaches that lead to incorrect findings of differences. Our analysis suggests a need for revised or new training materials that cover four major topics: precise operationalization of sex, attention to potential risks of over-emphasizing sex, consideration of gender and sex as complex and intertwined, and rigorous study design and data analysis.

Motivational variations in fitness: a population study of exercise modalities, gender and relationship status.

Introduction: Motivation plays a crucial role in determining whether or not a person adheres to an exercise program. The present study aimed to determine the motivational differences between people exercising in fitness alone, in groups/aerobics and with a personal trainer by gender and relationship status. Methods: The Exercise Motivations Inventory-2 (EMI-2) questionnaire was completed by 830 users of 20 largest fitness centers in Slovenia. Results: The Kruskal-Wallis test followed by a Dunn post-hoc test revealed that health-related motives such as ill-health avoidance were most frequently associated with exercising with a personal trainer compared to other exercise modalities, especially among females (p = 0.032, M = 4.88) and people in a relationship (p = 0.020, M = 5.18). On the other hand, intrinsic motivations such as enjoyment and stress management were mostly associated with exercising alone (p = 0.002, M = 4.98 and p = 0.021, M = 4.68, respectively). These results were also transferred to females and to some extent to people in a relationship (for enjoyment only). It is expected that intrinsic motivation is related to sustained exercise behavior. Discussion: Future studies could implement a longitudinal design to test this statement and examine the proposed relationships over a longer period to better understand whether there may be causal relationships between motivation and different exercise modalities depending on different characteristics of participants.

An Update on Gender Disparity in Critical Care Conferences.

This commentary's objective was to identify whether female representation at critical care conferences has improved since our previous publication in 2018. We audited the scientific programs from three international (International Symposium on Intensive Care and Emergency Medicine [ISICEM], European Society of Intensive Care Medicine [ESICM], and Society of Critical Care Medicine [SCCM]) and two national (State of the Art [SOA] and Critical Care Canada Forum) critical care conferences from the years 2017 to 2022. We collected data on the number of female faculty members and categorized them into physicians, nurses, allied health professions (AHPs), and other. Across all conferences, there was an increased representation of females as speakers and moderators over the 6 years. However, at each conference, male speakers outnumbered female speakers. Only two conferences achieved gender parity in speakers, SCCM in 2021 (48% female) and 2022 and SOA in 2022 (48% female). These conferences also had the highest representation of female nursing and AHP speakers (25% in SCCM, 2021; 19% in SOA, 2022). While there was a statistically significant increase in female speakers (p < 0.01) in 2022 compared with 2016, there was a persistent gender gap in the representation of men and female physicians. While the proportion of female moderators increased in each conference every year, the increase was statistically only significant for ISICEM, ESICM, and SCCM (p < 0.05). The proportion of female nurses and AHP speakers increased in 2022 compared with 2016 (p < 0.0001) but their overall representation was low with the highest proportion (25%) in the 2022 SCCM conference and the lowest (0.5%) in the 2017 ISICEM conference. This follow-up study demonstrates a narrowing but persisting gender gap in the studied critical care conferences. Thus, a commitment toward minimizing gender inequalities is warranted.

A psychobiographical analysis of Empress Dowager Cixi: exploring the femininity castrated complex.

In Chinese culture, there is a widely circulated phrase, 'A hen crows in the morning'. This phrase is used to humiliate women who steal power and engage in the political field. It demonstrates the complicated relationship between women and power in the context of Chinese culture. Women are not completely excluded from the politics, but women in power are often stigmatised. This study explores the life of Empress Dowager Cixi (1835-1908), the last female dominator in Chinese history, takes psychobiography as the research method, and attempts to understand the complicated relationship between women and power in Chinese culture through analysing Cixi's life from the perspective of complex and cultural complex theory which originated with C.G. Jung and analytical theory. The research findings show that humiliating and suppressing women with political talent can trigger their complexes, both personal and cultural. This study attempts to propose the femininity castrated complex to better describe the conscious and unconscious psychological dynamics impacting on women within patriarchal, political Chinese culture. This complex further relates to (1) denying her biological sex in order to avoid accusations of superego and, (2) the relationship with her son who is not only her son, but also her enemy regarding (political) power.