Gender inequalities in secondary prevention of cardiovascular disease: a scoping review.

BACKGROUND: Despite significant progress in cardiovascular disease (CVD) management, it remains a public health priority and a global challenge. Within the disease process, health care after a cardiovascular event (secondary prevention) is essential to prevent recurrences. Nonetheless, evidence has suggested the existence of gender disparities in CVD management, leaving women in a vulnerable situation. The objective of this study is to identify all available evidence on the existence of gender differences in health care attention after a major adverse cardiovascular event. METHODS: A scoping review following the structure of PRISMA-ScR was conducted. To define the inclusion criteria, we used Joanna Briggs Institute (JBI) population, concept, context framework for scoping reviews. A systematic search was performed in MEDLINE (PubMed), EMBASE and Cochrane. The methods of this review are registered in the International Platform of Registered Systematic Review and Meta-Analysis Protocols (INPLASY) (INPLASY202350084). RESULTS: The initial search retrieved 3,322 studies. 26 articles were identified manually. After the reviewing process, 93 articles were finally included. The main intervention studied was the pharmacological treatment received (n = 61, 66%), distantly followed by guideline-recommended care (n = 26, 28%) and cardiac rehabilitation (CR) referral (n = 16)". Literature described gender differences in care and management of secondary prevention of CVD. Women were less frequently treated with guideline-recommended medications and seem more likely to be non-adherent. When analysing guideline recommendations, women were more likely to make dietary changes, however, men were more likely to increase physical activity. Studies also showed that women had lower rates of risk factor testing and cholesterol goals attainment. Female sex was associated with lower rates of cardiac rehabilitation referral and participation. CONCLUSIONS: This review allowed us to compile knowledge on the existence of gender inequalities on the secondary prevention of CVD. Additional research is required to delve into various factors influencing therapeutic disparities, referral and non-participation in CR programs, among other aspects, in order to improve existing knowledge about the management and treatment of CVD in men and women. This approach is crucial to ensure the most equitable and effective attention to this issue.

The association between gender equality and climate adaptation across the globe.

INTRODUCTION: Climate change has a disproportionate impact on women in comparison to men, and women have a key role to play in climate adaptation. However, evidence is lacking on how gender inequalities may be associated with climate vulnerability and ability to respond at country level. METHODS: This ecological study investigated the association between climate adaptation, measured by the Notre Dame Global Adaptation Initiative Country Index (ND-GAIN), and gender equality, measured by the Global Gender Gap Index (GGGI) developed by the World Economic Forum and the Gender Inequality Index (GII) developed by the United Nations. Simple linear regression was used to estimate the associations between the indices and their subdomains for 146 countries. RESULTS: There was an approximately linear association between the GGGI and climate adaptation. Each 1% increase in gender equality was associated with a 0.6% increase in the ND-GAIN score (the slope was 0.59, with a 95% confidence interval [0.33 to 0.84]). This was driven by a negative association between gender equality and vulnerability (-0.41 [-0.62 to -0.20]), and a positive association between gender equality and readiness (0.77 [0.44 to 1.10]). The strongest associations between gender equality and climate adaptation were observed for the education domain of the GGGI. There was a strong negative linear association between the GII and climate adaptation, which explained most (86%) of the between-country variation in climate adaptation. Each 1% increase in gender inequality was associated with a 0.5% decrease in the ND-GAIN score (-0.54 [-0.57 to -0.50]). The association between gender inequality and readiness was stronger than the association with vulnerability (0.41 [0.37 to 0.44] for vulnerability versus - 0.67 [-0.72 to -0.61] for readiness). CONCLUSIONS: Gender inequality, measured broadly across different domains of life, is associated with climate adaptation at country level, both in terms of vulnerability to impact and readiness to respond.

Adolescents' digital career aspirations: Evidence for gendered pathways in a digital future.

INTRODUCTION: Computers and technology are still perceived as a male domain. As a result of this "digital gender gap" boys aspire careers in the information and communication technology (ICT) branches much more than girls. Guided by the situated expectancy-value theory of motivated behavioral choices, the present study aims to shed light on the predictors of digital career aspirations. METHODS: Self-report questionnaires were completed by 1018 Austrian adolescents (52.3% girls; 72% non-immigrants; Mage = 13.55, SDage = 0.88) attending 61 Grade 7 and 8 classes located in 17 vocational secondary schools between April and June 2019. Individual and class-level predictors of digital career aspirations were investigated with multilevel modeling. RESULTS: Hierarchical linear models revealed that boys, younger adolescents, and second-generation immigrant adolescents had higher levels of digital career aspirations compared to girls, older adolescents, and non-immigrants. Hours spend with the laptop per day, digital self-efficacy and media appraisal positively predicted digital career aspirations on the individual level, while a higher number of immigrants in the classes and higher levels of teacher discussions about media were significant positive predictors on the class level. The model explained 17% of the individual level and 52% of the class level variance. Cross-level interactions were nonsignificant. CONCLUSIONS: These results have major implications for educational practice. Most importantly, educational interventions should enhance girls' digital self-efficacy believes and media appraisal. Furthermore, teachers should increase their discussion about digital media as they foster adolescents' digital career aspirations and might prevent future gender segregation in the ICT sector.

The triggers and consequences of the Queen Bee phenomenon: A systematic literature review and integrative framework.

Staines, Tavris and Jayaratne (1974) first introduced the Queen Bee Phenomenon (QBP). The term has been extensively employed to explain specific behaviors driven by organizational inequalities where women engaged in leadership positions actively restrain the opportunities of upper mobility for junior women. While the literature constantly addresses the causes and behaviors of this phenomenon, the current scholarship still lacks an integrated view of the QBP literature and a concise integrative framework that explores its triggers and consequences to advance research and provide evidence-based results to guide policy and managerial decisions. Thus, the purpose of this paper is to identify, analyze and synthesize the literature on the QBP. We conducted a systematic literature review engaging bibliometrics and content analysis. Our results highlight the current state of the art of the QBP literature and introduce a new integrative framework that shows the interplay between the triggers, traits and consequences of the QBP. We contribute to the field by integrating previous research in the field into a framework that synthesizes and connects the scattered literature. Our results are helpful for designing new organizational policies that reduce the impacts of the QBP in the workplace. The research agenda propose avenues for advancing our understanding of the phenomenon.

Analysis of Racial and Gender Distribution of US MD Graduates Entering Into General Surgery and Surgical Subspecialties Residencies: The Need for Effective & Sustainable Diversity, Equity, and Inclusion Strategies.

INTRODUCTION: We aim to investigate disparities & inequities based on race, sex, graduating age, and the number of peer-reviewed publications among allopathic U.S. Doctor of Medicine graduates who reported entering a surgical training program over a span of 5 y. METHODS: A retrospective cohort analysis of the Association of American Medical Colleges student records system and Electronic Residency Application Service for graduates entering a surgical specialty residency during graduate medical education training cycles 2015-2020. RESULTS: African American, Asian, and Hispanic applicants each accounted for less than 1% of graduates who reported entering a surgical training program. Asians (OR = 0.58, P = 0.01) and those identifying as other races (OR = 0.74, P = 0.01) were significantly less likely to enter a surgical subspecialty when compared to Caucasians. Orthopedic surgery contained the lowest proportion of minorities; African Americans 0.5% (n = 18), Asians 0.3% (n = 11), Hispanics 0.1% (n = 4), and others with 2% (n = 68). Females who reported entering Orthopedic surgery training represented the smallest female population in surgical specialties (17%, n = 527). The number of peer-reviewed publications was significantly associated with male sex (ß = 0.28, P < 0.01), age between 30 and 32 at graduation (ß = 1.76, P < 0.01), and identification as other races (ß = 1.53, P < 0.01). CONCLUSIONS: Racial minorities represented only 5.1% of graduates who reported entering a surgical specialty graduate medical education training program. Minority races and females were significantly less likely to enter a surgical subspecialty training program compared to Caucasian graduates and males, especially in orthopedic surgery. Implementation of specialty-specific programs and diversity, equity, and inclusion departments that promote mentorship and guidance toward residency programs is needed to combat continued race and sex disparities.

Gender inequalities in violence victimization and depression in Brazil: results from the 2019 national health survey.

BACKGROUND: Violence is a worldwide public health challenge and has been linked to depression in many settings. Depression is higher in women and differential exposure to violence is a potential risk factor - especially in countries with high-levels of violence. This paper provides a comprehensive characterization of the association between violence victimization and depression in Brazil, focusing on sex/gender inequalities. METHODS: We used data from the 2019 wave of the National Health Survey (PNS) in Brazil to assess whether respondents had depression (using PHQ-9) and if they were victims of violence, differentiating by the type of violence, the frequency of victimization, and the primary aggressor. We used logit models to assess the association between victimization and the likelihood of having depression. We predicted probabilities of being depressed, considering the interaction between violence victimization and sex/gender, to analyze the differences between men and women. RESULTS: Rates of violence victimization and depression were higher among women than among men. The odds of being depressed were 3.8 (95%CI: 3.5-4.2) times higher among victims of violence than among non-victims, and 2.3 (95%CI: 2.1-2.6) times higher among women than among men, adjusting for socioeconomic factors. For any given income level, racial/ethnic or age group, victims of violence who were women had the highest predicted probabilities of being depressed - e.g., 29.4% (95%CI: 26.1-32.8) for lower-income women, 28.9% (95%CI: 24.4-33.2) for black women, and 30.4% (95%CI: 25.4-35.4) for younger women that suffered violence. Over one in three women that suffered multiple types of violence, experienced violence more frequently, or where the aggressor was an intimate partner or another family member were predicted to have depression. CONCLUSIONS: Being a victim of violence was strongly associated with higher risk of depression in Brazil, with women more likely to be both victims of violence and develop depression. Frequent, sexual, physical or psychological violence, and intimate partners or family member perpetrators were major risk factors for depression and should be a public health priority.

Gender-Based Violence Narratives in Internet-Based Conversations in Nigeria: Social Listening Study.

BACKGROUND: Overcoming gender inequities is a global priority recognized as essential for improved health and human development. Gender-based violence (GBV) is an extreme manifestation of gender inequities enacted in real-world and internet-based environments. In Nigeria, GBV has come to the forefront of attention since 2020, when a state of emergency was declared due to increased reporting of sexual violence. Understanding GBV-related social narratives is important to design public health interventions. OBJECTIVE: We explore how gender-related internet-based conversations in Nigeria specifically related to sexual consent (actively agreeing to sexual behavior), lack of consent, and slut-shaming (stigmatization in the form of insults based on actual or perceived sexuality and behaviors) manifest themselves and whether they changed between 2017 and 2022. Additionally, we explore what role events or social movements have in shaping gender-related narratives in Nigeria. METHODS: Social listening was carried out on 12,031 social media posts (Twitter, Facebook, forums, and blogs) and almost 2 million public searches (Google and Yahoo search engines) between April 2017 and May 2022. The data were analyzed using natural language processing to determine the most salient conversation thematic clusters, qualitatively analyze time trends in discourse, and compare data against selected key events. RESULTS: Between 2017 and 2022, internet-based conversation about sexual consent increased 72,633%, from an average 3 to 2182 posts per month, while slut-shaming conversation (perpetrating or condemning) shrunk by 9%, from an average 3560 to 3253 posts per month. Thematic analysis shows conversation revolves around the objectification of women, poor comprehension of elements of sexual consent, and advocacy for public education about sexual consent. Additionally, posters created space for sexual empowerment and expressions of sex positivity, pushing back against others who weaponize posts in support of slut-shaming narrative. Time trend analysis shows a greater sense of empowerment in advocating for education around the legal age of consent for sexual activity, calling out double standards, and rejecting slut-shaming. However, analysis of emotions in social media posts shows anger was most prominent in sexual consent (n=1213, 73%) and slut-shaming (n=226, 64%) posts. Organic social movements and key events (#ArewaMeToo and #ChurchToo, the #SexforGrades scandal, and the #BBNaija television program) played a notable role in sparking discourse related to sexual consent and slut-shaming. CONCLUSIONS: Social media narratives are significantly impacted by popular culture events, mass media programs, social movements, and micro influencers speaking out against GBV. Hashtags, media clips, and other content can be leveraged effectively to spread awareness and spark conversation around evolving gender norms. Public health practitioners and other stakeholders including policymakers, researchers, and social advocates should be prepared to capitalize on social media events and discourse to help shape the conversation in support of a normative environment that rejects GBV in all its forms.

Gender inequalities in heat-related mortality in the Czech Republic.

It is acknowledged that climate change exacerbates social inequalities, and women have been reported as more vulnerable to heat than men in many studies in Europe, including the Czech Republic. This study aimed at investigating the associations between daily temperature and mortality in the Czech Republic in the light of a sex and gender perspective, taking into account other factors such as age and marital status. Daily mean temperature and individual mortality data recorded during the five warmest months of the year (from May to September) over the period 1995-2019 were used to fit a quasi-Poisson regression model, which included a distributed lag non-linear model (DLNM) to account for the delayed and non-linear effects of temperature on mortality. The heat-related mortality risks obtained in each population group were expressed in terms of risk at the 99th percentile of summer temperature relative to the minimum mortality temperature. Women were found generally more at risk to die because of heat than men, and the difference was larger among people over 85 years old. Risks among married people were lower than risks among single, divorced, and widowed people, while risks in divorced women were significantly higher than in divorced men. This is a novel finding which highlights the potential role of gender inequalities in heat-related mortality. Our study underlines the relevance of including a sex and gender dimension in the analysis of the impacts of heat on the population and advocates the development of gender-based adaptation policies to extreme heat.

Gendered experiences of loneliness during COVID-19 isolation: Insights for intersectional feminist social work - the case of Çankaya/Ankara, Turkey.

The aim of this study is to understand the phenomenon of isolation due to COVID-19 through the lens of a feminist perspective. It focuses on daily life experiences of oppressed individuals living in Çankaya, whose spatial, socio-cultural, and political positions intersect with their age, disability, and gender. Semi-structured in-depth interviews were conducted with 37 people, of different ages, disabilities, and gender statements. Findings show that multi-dimensional oppressions and discriminations have undermined solidarity relations and result in more profound loneliness. The results highlight that new social work approaches involving intersectional feminist consciousness of oppressions need to be developed.

"If You Do Not Fit in With the Stereotype, They Eat You Alive": Discourses of Masculinities and Their Reflections in Young Spanish Men's Health.

Hegemonic masculinity has been especially linked, among other aspects, to unhealthy behaviors and heterosexuality. This study aimed to explore the discourses of masculinities with young Spanish men with different sexual orientations (heterosexuals, bisexuals, and homosexuals), comparing them with the social representations that are put into practice on Instagram. Three qualitative approaches were triangulated to seek a richer comprehension and interpretational level: discussion groups, semi-structured interviews, and an online non-participant observation on Instagram with a total of 26 young men aged between 18 and 24. Results indicate that hegemonic masculinity discourse is still significant when understanding and experiencing young men's masculinities, promoting behaviors that put their health at risk and generating psychological discomfort, especially among non-heterosexual men. Our findings provide knowledge of the social framework that legitimizes and reproduces male domination in younger generations both online and offline and how this is reflected in men's health.

Gender inequality and health disparity amid COVID-19.

Gender inequalities could lead to grave human and economic consequences, especially amid global health crises of the coronavirus 2019's (COVID-19) scale. The COVID-19 pandemic exacerbated gender inequalities women face and introduced new challenges that are unprecedented to society at large. Adverse effects of COVID-19, compounded by unintended consequences caused by public health policies such as lockdowns (e.g., delayed or canceled health services), have forced women to face issues ranging from COVID-19 infections and deaths, prolonged unemployment, to unparalleled scale and severity of domestic violence. However, though women face a canopy of debilitating challenges, there is a shortage of research that examines health solutions that can mitigate, if not offset, challenges women experience amid COVID-19. In this paper, we aim to shed light on why timely solutions are needed to mitigate gender inequalities and health disparities women face amid COVID-19 promptly. Furthermore, we underscore the imperative for cost-effective interventions that could shed light on the current health crisis and future pandemics.

Gender inequalities in depression/anxiety and the consumption of psychotropic drugs: Are we medicalising women's mental health?

Aims: Clinical studies show that women are more likely to be diagnosed with depression and anxiety, and to consume prescribed psychotropic drugs. Applying an intersectional perspective that considers age, education and social class, the present study assesses gender inequalities in the diagnosis of depression/anxiety and in psychotropic consumption. Methods: We analysed data from the 2018 Basque Country Health Survey (Spain; n=8014). Prevalence rates of poor mental health, diagnosis of depression/anxiety and psychotropic consumption were calculated for each sex by age and socio-economic status. Poisson regression models were calculated to estimate PRs of these variables in women, adjusted for age, mental health status and health-care visits, and for diagnosis of depression/anxiety in the case of psychotropic drug consumption. Results: Women were 2.48 times more likely than men to be diagnosed with depression or anxiety, and this difference remained significant after adjustments (prevalence ratio (PR)=1.86; 95% confidence interval (CI) 1.40-2.47). Women also took significantly more prescribed psychotropic drugs, even controlling for their poorer mental health, their higher prevalence of diagnosis and their more frequent health-care visits (PR=1.52; 95% CI 1.28-1.82). No gender inequalities were observed in those younger than 45 or with the highest level of education. Conclusions: Gender inequalities in the diagnosis and prescription of psychotropic drugs exist, and these cannot be explained by differences in mental-health status or health-care visit frequency. It seems, then, that medicalisation of mental health is occurring among women. Further evidence about the mechanisms that underlie the results is crucial to design truly gender-sensitive health policies that reduce medicalisation of women's mental health.

Medical education too: sexual harassment within the educational context of medicine - insights of undergraduates.

BACKGROUND: Assessment of the presence and characteristics of sexual harassment in academic medicine is a global issue. Only limited international data are available so far. METHODS: Aim: To assess the extent of sexual harassment and identify the perpetrators in the student population of the medical school of Münster, Germany. A survey was undertaken, using the Medical Women's International Association sexual harassment questionnaire translated into German. The anonymous online questionnaire was sent as a link to all medical undergraduates at Münster Medical School via a mailing list between 1 October and 30 November 2018. Identifying or potentially identifying data were not collected. Data were analysed by descriptive statistical methods such as categorical variables. Baseline characteristics, e.g. answers by male or female medical students, were correlated with their individual sexual harassment experiences and perpetrator groups by means of univariate analysis. RESULTS: A total of 2162 medical students were asked to participate, with 623 (28.8%) completing the survey. Sexual harassment is a significant issue among medical students at Münster Medical School with over half (58.9%) of all undergraduates being exposed to sexually harassing behaviour. In total, 31.8% of all participants reported having experienced unwanted physical sexual contact such as unwanted physical touching, with 87.6% of the victims being female. Overall, 41.3% personally experienced verbal sexual harassment of which 87.4% were female. Furthermore, 8.5% of undergraduates faced forced sexual contact such as oral, anal or vaginal penetration, intercourse and rape, with all victims being female. Perpetrators in these cases were mostly male medical superiors (7.0%) and male patients (18.3%). In general, most perpetrators were patients, followed by medical superiors and educators, and less frequently by colleagues. CONCLUSIONS: Sexual harassment in medical education and the medical workplace is a significant problem in a German medical school. Most students experiencing sexual harassment are females. Female students also experience the more serious forms of sexual harassment more often.

It takes a curfew: The effect of Covid-19 on female homicides.

Gender-based violence is a global phenomenon threatening women irrespective of race, nationality, education or socio-economic status. Evidence shows that domestic violence help calls have been increasing in many countries during the Covid-19 pandemic, but the effect on female homicides, this extreme form of violence, is not clear. In this study, we analyze the effects of social distancing measures and in particular the impact of curfews on female homicides in Turkey where domestic violence and female homicides are on the rise, causing public uproar. We find that the probability that a woman is killed by an intimate partner declined by about 57 percent during the period of strict social distancing measures, and by 83.8 percent during curfews in comparison to the same period between 2014 and 2019. We do not find any impact on female homicides by other perpetrator types. We argue that the decline in female homicides is driven by physical difficulties faced by ex-partners to reach victims, especially during curfews and fewer women leaving current partners due to economic hardships and fear of infection. Increased probability of getting caught might have also played a role in deterring deadly crimes against women.

Improved outcomes after live donor renal transplantation for septuagenarians.

The average age of renal transplant recipients in the United States has increased over the past decade. The implications, however, have not been fully investigated. We explored predictors of success and demographic variables related to outcomes in elderly live donor transplantation. Retrospective analysis was performed using the UNOS database between 2001 and 2016. Donor characteristics and the graft failure rate of recipients above and below 70 years of age were compared across four eras: 2001-2004, 2005-2008, 2009-2012, and 2013-2016. There was a steady increase in average donor age from the first era to the fourth era (40-44) which was more evident among the septuagenarian patients (43-50) (P < .001). The 2-year graft survival rate improved from 92% in the first era to 96% in the fourth era (P < .001), and this was also more prominent in the >70 population (87%-93%) (P < .001). The >70 recipients were more likely to be non-Hispanic white (80.1% vs 65.1%, P < .001) and male (70.1% vs 61.0% P < .001), respectively. The donors were more likely to be non-Hispanic white and female in the >70 population. Live donation in the elderly is justified based on graft survival and patient survival. However, racial and gender differences exist in septuagenarian recipients and their donors.

Shifting and transforming gender-inequitable beliefs, behaviours and norms in intimate partnerships: the Indashyikirwa couples programme in Rwanda.

This paper explores the relationship between changes in individual beliefs and behaviours, couple relationship dynamics and gender norms - and how interventions can influence these. It draws on longitudinal qualitative research with heterosexual couples who participated in the Indashyikirwa programme in Rwanda. The couples followed a curriculum designed to improve relationship skills and reduce the gender-inequitable beliefs, behaviours and norms that underpin intimate partner violence. Qualitative findings show that the programme resulted in moderate, but significant, positive 'shifts' in individual beliefs and behaviours, couple relationship dynamics and levels of inequality - increasing men's engagement in domestic duties, women's participation in household decision making, and women's access to economic resources. They also suggest which parts of the couples' curriculum were most effective in catalysing these changes. However, the data also show that these 'shifts' occurred without fully transforming deeply-entrenched beliefs and norms around gender roles and male authority over economic resources. The paper suggests that the persistence of these beliefs and norms constrained the extent of changes among couples - and could potentially constrain their longevity and act as an obstacle to longer-term, larger-scale changes in gender inequalities and violence.

When abortion is not within reach: Ethiopian university students struggling with unintended pregnancies.

BACKGROUND: In spite of increasing international commitment to young people's sexual and reproductive health, unintended pregnancies remain a major problem for young women worldwide. This article explores the issue of unintended pregnancies among Ethiopian university students and investigates narratives of students who carried their pregnancy to term. Ethiopia's relatively permissive abortion law forms part of the backdrop for the exploration. We also consider how socio-cultural and religious norms surrounding female premarital sex/pregnancy, and gendered and urban-rural inequities, play a role in how students handle the challenge. METHODS: The article is based on research conducted among students at Addis Ababa, Jimma and Mekelle Universities in Ethiopia between September 2016 and June 2017. Drawing on an interpretative, phenomenological approach to science and employing a qualitative methodology, the authors conducted in-depth interviews with 53 students and 24 selected staff at the three universities, and held two focus group discussions with students at Addis Ababa University. RESULTS: The study findings show three possible scenarios for how students can deal with an unwanted pregnancy. The first is to have the pregnancy terminated secretly, and thereby avoid the stigma linked to premarital pregnancy. The second is to make a deliberate decision to keep the pregnancy and face the consequences to come. The third scenario is found in cases where the student seems paralyzed by feelings of shame, and where she ends up keeping the pregnancy due to her inability to act. Students who end up carrying their pregnancy to term face many problems. Few support structures at the university are in place to cater for their needs. Moreover, family support is endangered by pregnancy, as it puts the student at risk of being ostracized from her family due to the shame she has imposed on them. Shame and silence are thus important social forces in these students' lives, underpinned by gendered inequities and patriarchal norms. CONCLUSIONS: Along with rural-urban and gendered inequities, the article demonstrates how a shame-silence nexus forcefully operates in the lives of female students struggling with reproductive challenges, and the serious consequences a pregnancy may have for those who carry it to term.

Nursing professionalization and welfare state policies: A critical review of structural factors influencing the development of nursing and the nursing workforce.

Nursing professionalization is both ongoing and global, being significant not only for the nursing workforce but also for patients and healthcare systems. For this reason, it is important to have an in-depth understanding of this process and the factors that could affect it. This literature review utilizes a welfare state approach to examine macrolevel structural determinants of nursing professionalization, addressing a previously identified gap in this literature, and synthesizes research on the relevance of studying nursing professionalization. The use of a welfare state framework facilitates the understanding that the wider social, economic, and political system exercises significant power over the distribution of resources in a society, providing a glimpse into the complex politics of health and health care. The findings shed light on structural factors outside of nursing, such as country-level education, health, labor market, and gender policies that could impact the process of professionalization and thus could be utilized to strengthen nursing through facilitating increased professionalization levels. Addressing gender inequalities and other structural determinants of nursing professionalization could contribute to achieving health equity and could benefit health systems through enhanced availability, skill-level, and sustainability of nursing human resources, improved and efficient access to care, improved patient outcomes, and cost savings.

Social networks, gender and HIV within marriages in Kenya.

Gender inequalities drive the HIV risk within marriages in Kenya, yet strategies to combat the spread of HIV are limited by their emphasis on the individual or dyadic relationship rather than the wider social-cultural relations that shape gender relations within marriage. This study explores how couples' social networks and spaces of interactions are implicated in the (re)production of gender and gender relations and how this, consequently, shapes HIV risks within marriage. It draws on qualitative data from 14 relatively poor couples from rural eastern Kenya and 13 middle-class couples from the capital city of Nairobi. The data describe couples' networks and address three broad themes: kin relations and gender (re)production; informal financial networks and gender hierarchies; and gender segregation of networks and spaces of interaction. Overall, findings show that much social interaction serves to reinforce gender identities, ideologies and realities that already exist though gender relations might differ among poor rural and middle-class city couples. Therefore, for public health, incorporating couples' wider social and gender relations in HIV interventions in marriage is imperative. Moreover, an intersectional perspective that considers how gender mutually interacts with class, space/geography, religion, age, and other axes of difference to produce particular forms of gender and gender relations in networks is crucial in informing HIV interventions in addressing gender power relationships that shape HIV risk in marriages.

Gender Differences in the Consequences of Divorce: A Study of Multiple Outcomes.

In this study, I examined gender differences in the consequences of divorce by tracing annual change in 20 outcome measures covering four domains: economic, housing and domestic, health and well-being, and social. I used data from the German Socio-Economic Panel Study (SOEP) and fixed-effects panel regression models on a sample of N = 18,030 individuals initially observed in a marital union, N = 1,220 of whom divorced across the observation period (1984-2015). Three main findings emerged from the analysis. First, men were more vulnerable to short-term consequences of divorce for subjective measures of well-being, but postdivorce adaptation alleviated gender differences in these outcomes. Second, a medium-term view on multiple outcomes showed more similarity than differences between women and men. The medium-term consequences of divorce were similar in terms of subjective economic well-being; mental health, physical health, and psychological well-being; residential moves, homeownership, and satisfaction with housework; and chances of repartnering, social integration with friends and relatives, and feelings of loneliness. Third, the key domain in which large and persistent gender differences emerged were women's disproportionate losses in household income and associated increases in their risk of poverty and single parenting. Taken together, these findings suggest that men's disproportionate strain of divorce is transient, whereas women's is chronic.