Research identifies gender bias in estimation of patients' pain

A new study suggests that when men and women express the same amount of pain, women's pain is considered less intense based on gender stereotypes.

UNIVERSITY OF MIAMI

Research News

 

"On a scale of one to 10, how much pain are you in?"

In a recent study published by the Journal of Pain, co-authored by Elizabeth Losin, assistant professor of psychology and director of the Social and Cultural Neuroscience lab at the University of Miami, researchers found that a patient's pain responses may be perceived differently by others based on their gender.

According to "Gender biases in estimation of others' pain," when male and female patients expressed the same amount of pain, observers viewed female patients' pain as less intense and more likely to benefit from psychotherapy versus medication as compared to men's pain, exposing a significant patient gender bias that could lead to disparities in treatments.

The study consisted of two experiments. In the first, 50 participants were asked to view various videos of male and female patients who suffered from shoulder pain performing a series of range of motion exercises using their injured and uninjured shoulders. Researchers pulled the videos from a database that contains videos of actual shoulder injury patients, each experiencing a range of different degrees of pain. The database included patients' self-reported level of discomfort when moving their shoulders.

According to Losin, the study likely provides results more applicable to patients in clinical settings compared to previous studies that used posed actors in their stimuli videos.

"One of the advantages of using these videos of patients who are actually experiencing pain from an injury is that we have the patients' ratings of their own pain," she explained. "We had a ground truth to work with, which we can't have if it's a stimulus with an actor pretending to be in pain."

The patients' facial expressions were also analyzed through the Facial Action Coding System (FACS)--a comprehensive, anatomically based system for describing all visually discernible facial movements. The researchers used these FACS values in a formula to provide an objective score of the intensity of the patients' pain facial expressions. This provided a second ground truth for the researchers to use when analyzing the data.

The study participants were asked to gauge the amount of pain they thought the patients in the videos experienced on a scale from zero, labeled as "absolutely no pain," and 100, labeled as "worst pain possible."

In the second experiment, researchers replicated the first portion of this study with 200 participants. This time, after viewing the videos, perceivers were asked to complete the Gender Role Expectation of Pain questionnaire, which measures gender-related stereotypes about pain sensitivity, the endurance of pain, and willingness to report pain.

Perceivers also shared how much medication and psychotherapy they would prescribe to each patient and which of these treatments they believed would be more effective in treating each patient.

The researchers analyzed the results of the participants' responses to the videos compared to the patient's self-reported level of pain and the facial expression intensity data. The ability to analyze observers' perceptions relative to these two ground truth measures of the patients' pain in the videos allowed the researchers to measure bias more accurately, Losin explained. That is because bias could be defined as different ratings for male and female patients despite the same level of responses.

Overall, the study found that female patients were perceived to be in less pain than the male patients who reported, and exhibited, the same intensity of pain. Additional analyses using participants' responses to the questionnaire about gender-related pain stereotypes allowed researchers to conclude that these perceptions were partially explained by these stereotypes.

"If the stereotype is to think women are more expressive than men, perhaps 'overly' expressive, then the tendency will be to discount women's pain behaviors," Losin said. "The flip side of this stereotype is that men are perceived to be stoic, so when a man makes an intense pain facial expression, you think, 'Oh my, he must be dying!' The result of this gender stereotype about pain expression is that each unit of increased pain expression from a man is thought to represent a higher increase in his pain experience than that same increase in pain expression by a woman."

What's more, psychotherapy was chosen as more effective than medication for a higher proportion of female patients compared to male patients.

Additionally, the study concluded that the gender of the perceivers did not influence pain estimation. Both men and women interpreted women's pain to be less intense.

The idea to study disparities in the perception of pain based on a patient's gender was derived from previous research, Losin said, that found women are often prescribed less treatment than men and wait longer to receive that treatment as well.

"There's a pretty wide literature showing demographic differences in pain report, the prevalence of clinical pain conditions, and then also a demographic difference in pain treatments," Losin pointed out. "These differences manifest as disparities because it seems that some people are getting undertreated for their pain based on their demographics."

Moving forward, Losin and her fellow researchers hope this study is a step in identifying and addressing gender disparities in health care. Co-authors of the study included the study's lead author, Lanlan Zhang, Guangzhou Sport University; Yoni K. Ashar, Weill Cornell Medical College; Leonie Koban, Paris Brain Institute; and senior author Tor D. Wager, Dartmouth College.

"I think one critical piece of information that could be conveyed in medical curricula is that people, even those with medical training in other studies, have been found to have consistent demographic biases in how they assess the pain of male and female patients and that these biases impact treatment decisions," Losin remarked. "Critically, our results demonstrate that these gender biases are not necessarily accurate. Women are not necessarily more expressive than men, and thus their pain expression should not be discounted."

 

Carpal tunnel syndrome is not just an office workers' condition

Researchers find that manufacturing workers experience more incidence of the common hand, wrist injury

HENRY FORD HEALTH SYSTEM

Research News

 

IMAGE: EXECUTIVE VICE CHAIR AND CHIEF OF HAND & UPPER EXTREMITY SURGERY OF HENRY FORD HEALTH SYSTEM'S DEPARTMENT OF ORTHOPEDIC SURGERY AND THE STUDY'S SENIOR INVESTIGATOR. view more 

CREDIT: HENRY FORD HEALTH SYSTEM

DETROIT - Researchers at Henry Ford Health System have found that workers in construction and other manufacturing jobs are more susceptible for developing carpal tunnel syndrome than those who work in office jobs.

In a retrospective study published in the Journal of Occupational and Environmental Medicine, researchers report that manual labor jobs that require lifting, gripping and forceful wrist motion contribute to higher rates of carpal tunnel syndrome.

Injuries related to carpal tunnel have steadily declined from 1.3 million in 2003 to 900,380 in 2018, according to the most recent figures compiled by the U.S. Department of Labor. However, Henry Ford researchers, seeking to clarify conflicting information in previous research studies, found that injuries in labor industry jobs still outpace injuries associated with office jobs.

"This study is an important reminder that carpal tunnel is a primary contributor to hand and upper extremity pain in both the clerical and manufacturing work places, and that ergonomic conditions for workers in both industries should be equally considered," said Charles Day, M.D., Executive Vice Chair and Chief of Hand & Upper Extremity Surgery of Henry Ford's Department of Orthopedic Surgery and the study's senior investigator.

Dr. Day typically consults 10-15 CTS patients and performs 4-5 minimally invasive endoscopic carpal tunnel surgeries each week as part of Henry Ford's Hand and Wrist Care team.

It's estimated that when healthcare costs, reduced productivity, missed work and the potential for lost income due to changing careers are considered, the typical carpal tunnel syndrome case may have an overall cost on society of between $47,000 and $119,000.

The costs to employers, workers, and insurance companies from carpal tunnel and other ergonomic workplace injuries can rack into the billions. Costs for carpal tunnel medical care are estimated to be more than $2 billion annually in the United States, primarily from surgery and nonmedical costs that include mental or psychological health treatment and loss of earnings and productivity.

Dr. Day said a large randomized study of manual labor and office jobs is needed to better assess the association with carpal tunnel, which causes swelling of the ligaments and bones in the wrist, leading to nerve compression. Common symptoms range from mild occasional numbness in the fingers to hand weakness, loss of feeling extreme night pain and loss of hand function.

Workers at risk for carpal tunnel are those who do jobs that involve repetitive finger use. Motions that can place people at risk of developing carpal tunnel syndrome include:

• High-force hammering
• Long-term use
• Extreme wrist motions
• Vibration

While carpal tunnel is one of the most-commonly reported occupational injuries, there are other potential causes or associations for this condition including diabetes, thyroid dysfunction, fluid retention from pregnancy or menopause, autoimmune disorders such as rheumatoid arthritis, fractures or trauma to the wrist, and many other factors.

Dr. Day's recommendation for reducing your risk for developing CTS or worsening existing symptoms is to avoid repetitive motion like lifting, grasping, holding a vibration tool, or typing on a keyboard.

Carpal tunnel surgery is recommended when it does not respond to non-surgical treatments or becomes severe. The surgery enlarges the size of the tunnel which decreases the pressure on the nerves and tendons that pass through the space. This is done by cutting or "releasing" the ligament known as the transverse carpal ligament that covers the carpal tunnel at the base of the palm.

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About Henry Ford Health System

Founded in 1915 by Henry Ford himself, Henry Ford Health System is a non-profit, integrated health system committed to improving people's lives through excellence in the science and art of healthcare and healing. Henry Ford Health System includes Henry Ford Medical Group, with more than 1,900 physicians and researchers practicing in more than 50 specialties at locations throughout Southeast and Central Michigan. Acute care hospitals include Henry Ford Hospital in Detroit, MI and Henry Ford Allegiance Health in Jackson, MI - both Magnet® hospitals; Henry Ford Macomb Hospital; Henry Ford West Bloomfield Hospital; and Henry Ford Wyandotte Hospital.

The largest of these is Henry Ford Hospital in Detroit, a quaternary care research and teaching hospital and Level 1 Trauma Center recognized for clinical excellence in cardiology, cardiovascular surgery, neurology, neurosurgery, and multi-organ transplants. The health system also provides comprehensive, best-in-class care for cancer at the Brigitte Harris Cancer Pavilion, and orthopedics and sports medicine at the William Clay Ford Center for Athletic Medicine - both in Detroit.

As one of the nation's leading academic medical centers, Henry Ford Health System annually trains more than 3,000 medical students, residents, and fellows in more than 50 accredited programs, and has trained nearly 40% of the state's physicians. Our dedication to education and research is supported by nearly $100 million in annual grants from the National Institutes of Health and other public and private foundations.

Henry Ford's not-for-profit health plan, Health Alliance Plan (HAP), provides health coverage for more than 540,000 people.

Henry Ford Health System employs more than 33,000 people, including more than 1,600 physicians, more than 6,600 nurses and 5,000 allied health professionals.

 

How preprints accelerated science communication during the pandemic

PLOS

Research News

 

IMAGE: CAPTION: CARTOON OF THE PLANET WITH A MASK ON view more 

CREDIT: IMAGE BY CROMACONCEPTOVISUAL FROM PIXABAY

During the early phase of the pandemic, approximately 40% of the COVID-19 literature was shared as preprints - freely available manuscripts that are shared prior to peer-review. In a new study publishing in the open access journal PLOS Biology, researchers led by Dr Jonathon Coates (Queen Mary University of London), Dr Nicholas Fraser (Leibniz Information Centre for Economics, Germany) and Dr Liam Brierley (University of Liverpool) explore the crucial role of preprint servers in hosting COVID-19 related science and how these preprints have been used to disseminate knowledge of COVID-19, leading to cultural shifts in journalistic and policy practices.

There has been a rapid and incredible scientific response to the COVID-19 pandemic, with research being shared less than a month after the first reported case, and vaccines being developed in less than a year. The researchers find that this has been matched by a striking change in the way in which research is accessed and communicated; preprints describing COVID-19 research are downloaded and accessed at unprecedented levels (up to 10-fold more than research unrelated to the pandemic) and are being heavily used by reporters and policy makers for the first time.

According to the study's lead author, Dr Jonathon Coates, "The pandemic has shone a light on the benefits of preprints over more traditional publishing and it was clear early in the pandemic that something was happening with preprint usage".

When the researchers explored how preprints were being shared, they found that COVID-19 preprints were being shared across online platforms such as Twitter at a rate of over 7 times that of non-COVID-19 preprints. Although traditionally rarely referenced by official policy documents or reported on by journalists, preprints describing COVID-19 research are frequently being cited in policy and reported in news media, bringing active research closer to policymakers as well as the general public than ever before.

"Prominent public officials, such as Dr Fauci, have stated that preprints have been important in accelerating our understanding of COVID-19. Our data provides evidence to support these statements and reveals a clear cultural shift in the use of preprints by scientists, the general public, journalists and policy makers" says Dr Coates, "What we hope is that the cultural shifts reported in this paper will remain after the pandemic and the biomedical community will continue to turn to preprint servers for disseminating new studies".

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Research article

Peer-reviewed; Observational study; Methodology

In your coverage please use these URLs to provide access to the freely available articles in PLOS Biology:
http://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.3000959

Citation: Fraser N, Brierley L, Dey G, Polka JK, Pálfy M, Nanni F, et al. (2021) The evolving role of preprints in the dissemination of COVID-19 research and their impact on the science communication landscape. PLoS Biol 19(4): e3000959.
https://doi.org/10.1371/journal.pbio.3000959

Funding: NF acknowledges funding from the German Federal Ministry for Education and Research, grant numbers 01PU17005B (OASE) and 01PU17011D (QuaMedFo). LB acknowledges funding from a Medical Research Council Skills Development Fellowship award, grant number MR/T027355/1. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing Interests: I have read the journal's policy and the authors of this manuscript have the following competing interests: JP is the executive director of ASAPbio, a non-profit organization promoting the productive use of preprints in the life sciences. GD is a bioRxiv Affiliate, part of a volunteer group of scientists that screen preprints deposited on the bioRxiv server. MP is the community manager for preLights, a non-profit preprint highlighting service. GD and JAC are contributors to preLights and ASAPBio fellows.

Secure type: consumers say compact logos signal product safety

Large-scale surveys and experiments confirm typography influences consumer preferences

BOSTON COLLEGE

Research News

 

IMAGE: THERE ARE DISTINCT DESIGN FEATURES ORGANIZATIONS CAN INCORPORATE INTO THEIR LOGOS, SUCH AS THIS SAMPLE USED BY RESEARCHERS, IN ORDER TO GENERATE POSITIVE CONSUMER RESPONSES ABOUT PRODUCT SAFETY, ACCORDING TO... view more 

CREDIT: JOURNAL OF CONSUMER RESEARCH

Chestnut Hill, Mass. (4/6/2021) -- Compact logos can encourage favorable brand evaluations by signaling product safety, according to a new study by researchers at Boston College's Carroll School of Management and Indian Institute of Management Udaipur, who reviewed the opinions of 17,000 consumers and conducted additional experiments with a variety of logos.

The findings reveal that typography -- specifically tracking, or the spacing between letters in a word -- can influence consumers' interpretations of brand logos. Further, the interpretation is influenced by cultural factors, the researchers reported in a recent edition of the Journal of Consumer Research.

In addition to the survey data, the results were confirmed in experiments, even during the Covid-19 pandemic, when public health guidance on social or physical distancing put a new emphasis on space, Hagtvedt said.

"We found fairly consistent patterns in these responses, even during the pandemic, when some brands were experimenting with placing the letters of logos farther apart to emulate a social distancing signal," said Boston College Associate Professor of Marketing Henrik Hagtvedt, who co-authored the paper with IIM's Tanvi Gupta.

The researchers analyzed data from 17,000 consumers rating 629 brands. Hagtvedt and Gupta found compact logos, where tight tracking leaves less space, encouraged favorable brand attitudes when compared to loose logos, where loose tracking creates a more spacious appearance. According to consumers, compact logos signaled that the brand was reliable, secure, and trustworthy.

Logos are central to the ways brands communicate with consumers. Logos that appear physically robust imply a brand's products are safe to use, Hagtvedt said. Compact logos were shown to send a message to consumers implying their products were sturdy and secure. This is particularly the case with textual logos, where consumers show sensitivity to the spacing between letters. Tight lettering equates to sturdiness in the minds of most consumers, whereas too much space may imply vulnerability, Hagtvedt said.

Cultural influences are also at play, according to the new report, titled "Safe Together, Vulnerable Apart: How Interstitial Space in Text Logos Impacts Brand Attitudes in Tight versus Loose Cultures." Drawing on the work of anthropologists, the researchers focused on two groups of consumers: those considered culturally "tight" or "loose." Tight cultures are a function of adapting to threats, such as violence or natural disasters. Individuals from this group are likely to favor the appearance of tight structure.

In the US, studies have shown southern states tend to display cultural tightness, while states in the west and northeast reveal looser structure. Factors such as religion, organization, or industry, can influence cultural tightness.

Gupta and Hagtvedt report that consumers tended to favor compact logos over spacious ones, regardless of cultural tightness, under ordinary circumstances. However, when the experiments involved contexts with potential safety concerns (such as products related to pharmaceuticals or mobile financial services), only culturally tight consumers responded more favorably to the compact logos.

The researchers suspect that the latter findings stem from culturally loose individuals associating space with freedom or autonomy, and being especially sensitive to that signal when safety is threatened. Among these individuals, the restrictive associations of compact logos can balance out the positive security signal.

The findings add to the understanding of how people draw meaning from visual communications, a key insight for brand managers and businesses of all sizes, said Hagtvedt. At the same time, they provide practical tips to organizations and individuals seeking to signal safety, depending on the context as well as the relevant culture.

Developing better quantitative standards can help organizations better assess how their designs may be perceived, rather than going on "gut" intuition about what makes a successful logo.

"It is important to know what kind of signal a logo sends," said Hagtvedt. "Businesses spend millions on not just designing their logos, but on using their logos in brand communications. It is arguably the most prominent representation of a brand, wherever that brand operates. It has an enormous influence on consumers. To design and deploy a logo haphazardly is a questionable practice."

 

Helping consumers trade fast fashion for durable, sustainable luxury goods

News from the Journal of Marketing

AMERICAN MARKETING ASSOCIATION

Research News

 

Researchers from Columbia University and Georgetown University published a new paper in the Journal of Marketing that examines how consumers can adopt a sustainable consumption lifestyle by purchasing durable high-end and luxury products.

The study, forthcoming in the Journal of Marketing, is titled "Buy Less, Buy Luxury: Understanding and Overcoming Product Durability Neglect for Sustainable Consumption" and is authored by Jennifer Sun, Silvia Bellezza, and Neeru Paharia.

What do luxury products and sustainable goods have in common? Luxury goods possess a unique, sustainable trait that gives them a longer lifespan than lower-end products.

Sustainable consumption is on the rise with all consumers. However, younger millennial and Gen Z consumers have been more vocal about their desire to embrace sustainability. Several trends have emerged that signal such an inclination, such as "buy less, buy better" and "slow-fashion," as witnessed by the trend of celebrities wearing identical outfits at multiple award ceremonies. Consumers advocating such lifestyles strive to purchase fewer, higher-end products that will last longer rather than many inexpensive products that will be quickly thrown away. However, these trends and movements still represent niche segments because products with expensive price tags do not fit the stereotype of sustainable consumption generally associated with restraint and moderation.

Fast-fashion retailers such as H&M and Zara have enabled consumers to buy disposable clothing and accessories, contributing to a 36% decrease in the average number of times an item is worn compared with 15 years ago. While fast fashion offers consumers access to trendy, albeit short-lived, attire at affordable prices, it also exacts high environmental costs. Indeed, the fashion industry has become one of the largest polluters, contributing 10% of global carbon emissions as well as 20% of global wastewater.

Sun says that "We propose that luxury goods possess a unique, sustainable trait of being durable, which includes being long-lasting and timeless in style, thereby allowing them to have a longer lifespan than lower-end products. Focusing on the clothing and accessories industries, we find that high-end products can be more sustainable than mass-market products."

Yet, why is it that consumers have such a hard time seeing sustainability and luxury as being compatible? Despite the long-lasting nature of high-end goods, sustainable luxury can be a paradoxical concept for consumers because many of them neglect the durability inherent in luxury products. Typical consumers prefer to buy multiple mass-market products instead of fewer, high-end items. "That is due to product durability neglect, a failure to consider how long products will last, even though durability is an important product attribute that consumers genuinely value," explains Bellezza. How can marketers help consumers focus on durability? The researchers say that when the long-lasting nature of high-end products is emphasized, consumers are more likely to overcome their durability neglect and buy fewer, but better high-end products.

While consumers can actively participate in the sustainability movement by selectively purchasing fewer, durable products that last longer, companies can also benefit from emphasizing product durability, an appealing and timely attribute that directly relates to sustainable luxury. In fact, many high-end entrepreneurial brands, such as Pivotte, Everlane, and Cuyana, as well as more established premium and luxury brands, such as Patagonia and Loro Piana, promote the use of high-quality materials and timeless styles that extend the longevity of their products.

Paharia says that "Focusing on the durability aspect of sustainability can be an effective marketing strategy for high-end brands to promote their products while at the same time helping consumers engage in more sustainable consumption practices. That is, emphasizing product durability may shape consumers' actual purchase behavior while promoting an attribute central to luxury brands." In fact, two notable campaigns that directly speak to these findings include Patagonia's "Buy Less, Demand More" advertisement, which posits that purchasing buying fewer, more durable Patagonia products is good for consumers and the environment, as well as Patek Philippe's iconic "Generations" campaign, which proposes that the brand's watches are so durable and timeless that consumers merely look after them for the next generation. Marketers and brand managers of high-end products can emphasize the durability of their products to help consumers overcome product durability neglect and nudge them towards buying fewer, better goods for a more sustainable future.

Full article and author contact information available at: https://doi.org/10.1177/0022242921993172

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About the Journal of Marketing

The Journal of Marketing develops and disseminates knowledge about real-world marketing questions useful to scholars, educators, managers, policy makers, consumers, and other societal stakeholders around the world. Published by the American Marketing Association since its founding in 1936, JM has played a significant role in shaping the content and boundaries of the marketing discipline. Christine Moorman (T. Austin Finch, Sr. Professor of Business Administration at the Fuqua School of Business, Duke University) serves as the current Editor in Chief. https://www.ama.org/jm

About the American Marketing Association (AMA)

As the largest chapter-based marketing association in the world, the AMA is trusted by marketing and sales professionals to help them discover what is coming next in the industry. The AMA has a community of local chapters in more than 70 cities and 350 college campuses throughout North America. The AMA is home to award-winning content, PCM® professional certification, premiere academic journals, and industry-leading training events and conferences. https://www.ama.org

Fossil discovery deepens snakefly mystery

Ancient predatory insects discovered in region once thought uninhabitable

SIMON FRASER UNIVERSITY

Research News

 

IMAGE: MODERN SNAKEFLY PICTURED ABOVE FIFTY-TWO-MILLION-YEAR-OLD FOSSIL SNAKEFLY FROM DRIFTWOOD CANYON IN BRITISH COLUMBIA. view more 

CREDIT: FOSSIL IMAGE COPYRIGHT ZOOTAXA.

Fossil discoveries often help answer long-standing questions about how our modern world came to be. However, sometimes they only deepen the mystery--as a recent discovery of four new species of ancient insects in British Columbia and Washington state is proving.

The fossil species, recently discovered by paleontologists Bruce Archibald of Simon Fraser University and Vladimir Makarkin of the Russian Academy of Sciences, are from a group of insects known as snakeflies, now shown to have lived in the region some 50 million years ago. The findings, published in Zootaxa, raise more questions about the evolutionary history of the distinctly elongated insects and why they live where they do today.

Snakeflies are slender, predatory insects that are native to the Northern Hemisphere and noticeably absent from tropical regions. Scientists have traditionally believed that they require cold winters to trigger development into adults, restricting them almost exclusively to regions that experience winter frost days or colder. However, the fossil sites where the ancient species were found experienced a climate that doesn't fit with this explanation.

"The average yearly climate was moderate like Vancouver or Seattle today, but importantly, with very mild winters of few or no frost days," says Archibald. "We can see this by the presence of frost intolerant plants like palms living in these forests along with more northerly plants like spruce."

The fossil sites where the ancient species were discovered span 1,000 kilometers of an ancient upland from Driftwood Canyon in northwest B.C. to the McAbee fossil site in southern B.C., and all the way to the city of Republic in northern Washington.

According to Archibald, the paleontologists found species of two families of snakeflies in these fossil sites, both of which had previously been thought to require cold winters to survive. Each family appears to have independently adapted to cold winters after these fossil species lived.

"Now we know that earlier in their evolutionary history, snakeflies were living in climates with very mild winters and so the question becomes why didn't they keep their ability to live in such regions? Why aren't snakeflies found in the tropics today?"

Pervious fossil insect discoveries in these sites have shown connections with Europe, Pacific coastal Russia, and even Australia.

Archibald emphasizes that understanding how life adapts to climate by looking deep into the past helps explain why species are distributed across the globe today, and can perhaps help foresee how further change in climate may affect that pattern.

"Such discoveries are coming out of these fossil sites all the time," says Archibald. "They're an important part of our heritage."

CAPTION

Fifty-two-million-year-old fossil snakefly from Driftwood Canyon in British Columbia.

CREDIT

Copyright Zootaxa

CAPTION

Archibald at Driftwood Canyon Provincial Park

CREDIT

Bruce Archibald

We don't know how most mammals will respond to climate change, warn scientists

BRITISH ECOLOGICAL SOCIETY

Research News

 

A new scientific review has found there are significant gaps in our knowledge of how mammal populations are responding to climate change, particularly in regions most sensitive to climate change. The findings are published in the British Ecological Society's Journal of Animal Ecology.

Nearly 25% of mammal species are threatened with extinction, with this risk exacerbated by climate change. But the ways climate change is impacting animals now, and projected to in the future, is known to be complex. Different environmental changes have multiple and potentially contrasting, effects on different aspects of animals' lives, such as reproduction and survival (known as demographic rates).

A new review by a global team of researchers from 15 different institutions has found that most studies on terrestrial mammals only looked at one of these demographic rates at a time, potentially not showing the full picture of climate change impacts.

In a search of 5,728 terrestrial mammal species, the researchers found only 106 studies that looked at both survival and reproduction at the same time. This covered 87 species and constitutes less than 1% of all terrestrial mammals.

"Researchers often publish results on the effects of climate on survival or on reproduction - and not both. But only in rare cases does a climatic variable (say, temperature) consistently negatively or positively affect all studied rates of survival and reproduction." said Dr Maria Paniw from the University of Zurich and lead author of the review.

For example, higher temperatures could decrease the number of offspring, but if the offspring have a better chance of survival because of less competition, the population size won't necessarily be affected. On the other hand, if higher temperatures decrease both reproduction and survival, a study of only one of these could underestimate the effects on a population.

The review also found a mismatch in the regions where studies on climate change impacts on mammals were taking place and regions recognised as being the most vulnerable to climate change, meaning that we know very little about the complex climate impacts in the most climate-vulnerable regions of the globe.

"We were surprised by the lack of data on high-altitude (alpine) mammals. Climate change is expected to be very pronounced in higher elevations." said Dr Paniw. "In our review, we had a few alpine species, such as yellow-bellied marmots and plateau pikas, but I was expecting a study or two on iconic species such as snow leopards.

The review highlights the need for more research on mammal populations that account for multiple demographic responses across entire lifecycles.

"To inform evidence-based conservation, we need to prioritize more holistic approaches in data collection and integration to understand the mechanisms that drive population persistence." said Dr Paniw.

"There are many reasons why this data isn't being captured. An important aspect is that collecting such data requires long-term investment without immediate returns, which has not been favoured by many funding agencies and is also logistically challenging. These challenges are compounded in climate-vulnerable regions, which include many countries with underfunded infrastructure for long-term ecological research."

The review raises concerns that there are even bigger data gaps for animal groups that are less well studied than terrestrial mammals, such as insects and amphibians. This data is urgently needed to inform which species are most vulnerable to climate-driven extinction.

In this study, the researchers performed a literature review, using the species names of 5,728 terrestrial mammal to search databases of scientific papers for studies that quantified the relationship between demographic-rates and climate variables, such as rainfall and temperature.

The researchers only included studies that linked at least two demographic rates, such as survival and reproduction. They also recorded where the studies that did so were distributed globally.

The researchers are now looking to perform similar reviews on less well studied animal groups. Dr Paniw added: "I would like to foster collaborations that will jumpstart new research and 'repurpose' existing data in climate-vulnerable areas of the globe to fill the knowledge gaps we identified in our work".

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Children from poor backgrounds may face educational barriers in low- and middle-income countries

WILEY

Research News

 

New research published in the British Educational Research Journal suggests a very strong association between socio-economic background and educational attainment throughout children's schooling in 4 low- and middle-income countries.

For the study, researchers analyzed data from individuals in Ethiopia, Peru, Vietnam, and India from age 5 to age 22 years to explore the relationship between early schooling opportunities and progression to higher education. Investigators found that students who had high initial learning achievements in primary school, but who were from poor backgrounds, typically fell back in secondary school, or high school.

The results imply that lower socio-economic status continues to be a barrier to educational attainment throughout children's schooling in some countries.

"Our findings, based on the Young Lives study, suggest that even when comparing children with similar levels of prior attainment at ages 8, 12, and 15 years, differences in higher education participation by socio-economic background still remain," said lead author Sonia Ilie, MPhil, PhD, of the University of Cambridge, in the U.K. "This suggests enduring barriers for education progression for the poorest and a need for better evidence about what supports equitable progression."

Poor children are 'failed by system' on road to higher education in lower-income countries

A generation of talented but disadvantaged children are being denied access to higher education because academic success in lower and middle-income countries is continually 'protected by wealth'

UNIVERSITY OF CAMBRIDGE

NEWS RELEASE 7-APR-2021

Research News

 

A generation of talented but disadvantaged children are being denied access to higher education because academic success in lower and middle-income countries is continually 'protected by wealth', a study has found.

The research, which used data from around 3,500 young people in Ethiopia, India, Peru and Vietnam, shows that promising but poorer students 'fall away' during their school years, as challenges associated with their socio-economic circumstances gradually erode their potential. Among children who showed similar levels of ability aged 8, for example, the wealthiest were often over 30 percentage points more likely than the least-wealthy to enter all forms of tertiary education: including university, technical colleges, and teacher training.

Even when they focused only on students who complete secondary school with comparable levels of learning, the researchers found that those from wealthier backgrounds were still more likely to progress to higher education. They describe their findings, reported in the British Education Research Journal, as indicative of the 'protective effect' of wealth in relation to academic advantage.

The study was undertaken by the Research in Equitable Access and Learning (REAL) Centre, Faculty of Education, University of Cambridge. Dr Sonia Ilie, its lead author, said: "In many lower-income countries, low socio-economic status is a continual barrier to young people's attainment. What is clear is that these inequalities in higher education access have nothing to do with ability: this is about systems which are consistently failing poorer children."

The data used in the research was from Young Lives, an international childhood poverty study which is tracking two cohorts of young people from Ethiopia, India, Peru and Vietnam. The Cambridge researchers focused on the group born in 1994/5. Young Lives includes information about education and attainment at ages 8, 12, 15, 19 and 22, and importantly therefore includes the many young people in lower-income countries who may enter higher education after age 19.

The researchers started by comparing basic entry rates into higher education among the poorest 25% and wealthiest 25% of participants. The percentage point gap between these quartiles was 45 in both India and Peru, 41 in Vietnam, and 17 in Ethiopia.

They then analysed higher education progression rates among increasingly comparable groups of students. First, they focused on those with similar demographic characteristics (for example, those specifically from urban settings). They then progressively added more information about their education to examine students who were both in school, and achieving certain attainment levels, aged 8, 12 and 15.

The gap between the poorest and richest students' likelihood of enrolling in higher education narrowed steadily as each level of information was factored in. Given the disparity in the 'raw' wealth gap, this indicates that children from poor backgrounds often fail to progress because they drop out, or under-achieve, throughout primary and secondary school.

Crucially, however, a gap still existed between rich and poor even among students who finished secondary school with comparable levels of learning. The size of the remaining gap reflected the complexities of each country's higher education systems, but showed that at the same level of schooling and learning, wealth played this protective effect.

The study also analysed the progress of 'high-promise' children. The researchers identified all children who had achieved a certain level of literacy at age 8, and then used numeracy and maths scores to compare the educational trajectories of the richest and poorest among this group.

Overall, the attainment gap between high-promise children from the top and bottom wealth quartiles widened during school, even though their test scores were similar at age 8. Ultimately, many more high-promise children from the richest quartile entered higher education compared with the poorest: the percentage point gap between the two groups was 39 in Peru, 32 in India and Vietnam, and 15 in Ethiopia.

"Even among children who do well to begin with, poverty clearly becomes an obstacle to progression," Ilie said. "The reverse also applies: if they are wealthy, even children with initially lower levels of learning catch up with their poorest peers. This is what we mean by the protective effect of wealth."

The study says that the first priority in addressing the higher education wealth gap should be targeted investment in primary education for the very poorest. This is already an emerging policy focus in many lower-income countries, where disadvantaged children, even if they go to school, often have poor learning outcomes. The reasons for this, documented in several other studies, include limited educational resources and support at home, and practical difficulties with school attendance.

The findings also indicate, however, that targeted support should continue during secondary education, where wealth-related barriers persist. In addition, the residual wealth gap even among those who finish secondary school highlights a need for initiatives that will reduce the cost of higher education for disadvantaged students.

The study suggests that means-tested grants may be one viable solution, but further evidence is required. It also warns that at present, taxation-based funding for higher education will essentially 'subsidise a socio-economic elite', while tuition fees will further prohibit access for the poorest.

Professor Pauline Rose, Director of the REAL Centre, said: "If we want to equalise opportunities at the point of entry into higher education, we have to intervene early, when the wealth gaps emerge. This study shows that targeted and sustained interventions and funding are needed for the poorest students not only in their earliest years, but throughout their educational careers."

Comfort care beneficial for hospitalized stroke patients, yet disparities in use persist

Journal of the American Heart Association report

AMERICAN HEART ASSOCIATION

Research News

 

DALLAS, April 7, 2021 — Receiving palliative or hospice care services was found to improve quality of life for hospitalized ischemic stroke patients, however, disparities persist in which patients are prescribed or have access to these holistic comfort care options, according to new research published today in the Journal of the American Heart Association, an open access journal of the American Heart Association.

Prior to the COVID-19 pandemic, stroke ranked No. 5 among all causes of death in the U.S. Nearly 9 in 10 strokes are ischemic strokes caused by a blockage in a blood vessel that carries blood to the brain. Despite advances in acute stroke treatment and management, stroke remains a leading cause of serious long-term disability in the U.S.

“Stroke death rates have declined over the past decade, however, as more people survive stroke, many face lingering consequences including varying levels of disability,” said lead study author Farhaan S. Vahidy, Ph.D., M.B.B.S., M.P.H., FAHA, an associate professor of outcomes research and the associate director of the Center for Outcomes Research at Houston Methodist, in Houston, Texas. “Many stroke patients are candidates for comfort care, including palliative or hospice care, which can improve outcomes and quality of life. It is important that stroke patients who could benefit with better quality of life from comfort care have these options available.”

Palliative care provides holistic support to patients with stroke and other chronic conditions to relieve symptoms and improve quality of life. Hospice care is end-of-life care and is usually reserved for patients among whom most treatment options are no longer feasible. And like palliative care, hospice care also aims to relieve symptoms and improve quality of life.

To better understand comfort care use among ischemic stroke patients in the U.S., researchers examined hospital patient data from 2006 to 2015 from the Agency for Healthcare Research and Quality. They found:

• Of the nearly 4.3 million stroke hospital discharges, 3.8% received hospice or palliative care.
• Prescribing comfort care increased during the 10-year period. Ischemic stroke patients were almost five times more likely to receive a comfort care intervention in 2014 to 2015, compared to 2006 to 2007.
• The increasing trend in patients’ comfort care use was evident even among patients who had acute stroke treatments, including with intravenous clot busting medications, called thrombolytic therapy, and mechanical clot removal, or endovascular thrombectomy.
• Some hospital types, including large hospitals and urban teaching hospitals, had higher rates of comfort care.
• The average length of hospital stays for ischemic stroke patients who received comfort care was longer than stays for patients who did not receive comfort care, yet the average hospitalization costs for patients who received comfort care were lower.
• Although comfort care continues to be associated with higher in-hospital deaths, 10-year outcome trends among patients receiving the services showed a significant decline in in-hospital deaths and a significant increase in the proportion of patients either discharged home or transferred to long term care facilities.

Comfort care use was notably lower among people who identify with non-white racial and ethnic groups. For example, use was 41% lower among Black stroke patients compared to white patients. Other factors independently associated with higher comfort care utilization were older age, female sex, non-Medicare (private) health insurance and higher incomes.

“Disparities in the prescribing of comfort care interventions among ischemic stroke patients was an important finding that needs to be carefully examined. To our knowledge such disparities have not been previously reported,” Vahidy said. “And, while more stroke patients are getting comfort care, overall use is still low, especially among people from underrepresented racial and ethnic groups.”

A limitation of the study is that the investigators examined information that did not differentiate between palliative care and hospice care usage.

“Our work provides a preliminary framework to ensure optimal use of comfort care services among ischemic stroke patients. More work needs to be done to improve access and availability to more stroke patient, to enhance communication with patients and their care providers and to empower patients to make decisions about their care as they recover from and adjust to such a life-altering health event,” Vahidy said.

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Co-authors are Kristie M. Chu, M.D.; Erica M. Jones, M.D.; Jennifer R. Meeks, M.S.; Alan P. Pan, M.S.; Kathryn L. Agarwal, M.D.; and George E. Taffet, M.D. Author disclosures are in the manuscript. The researchers report no direct funding for this study.

Additional Resources:

• Multimedia is available on the right column of release link: https://newsroom.heart.org/news/comfort-care-beneficial-for-hospitalized-stroke-patients-yet-disparities-in-use-persist?preview=7f906dbb47a088b0b529468a9718866e
• After April 7, view the manuscript online.
• Life after stroke
• Stroke Family Warm Line
• Palliative Care and Cardiovascular Disease and Stroke: A Policy Statement From the American Heart Association/American Stroke Association
• Follow AHA/ASA news on Twitter @HeartNews
• Follow news from the Journal of the American Heart Association @JAHA_AHA

Statements and conclusions of studies published in the American Heart Association’s scientific journals are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. The Association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and biotech companies, device manufacturers and health insurance providers are available here, and the Association’s overall financial information is available here. 

About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. We are dedicated to ensuring equitable health in all communities. Through collaboration with numerous organizations, and powered by millions of volunteers, we fund innovative research, advocate for the public’s health and share lifesaving resources. The Dallas-based organization has been a leading source of health information for nearly a century. Connect with us on heart.org, Facebook, Twitter or by calling 1-800-AHA-USA1.