Head injury can blight survival up to 13 years later

A head injury can blight the chances of survival up to 13 years after the event, especially among younger adults, finds research published online in the Journal of Neurology Neurosurgery and Psychiatry.

Injury severity seems to make little difference over the longer term, the findings show.

The research team tracked over 2,000 people, 757 of whom had sustained a head injury that required admission to one of five hospitals in Glasgow between 1995 and 1996.

The rest of the group were split between those who had been admitted to hospital for other reasons, but for the same period as those with a head injury, and healthy people living in the community. The three groups were matched for age, gender, and levels of deprivation.

In all, 40% of people (305) who had sustained a head injury were dead within 13 years of the event. This was higher than the rate among those admitted with other injuries (28%) and those in the community, almost one in five of whom died (19%).

Although the heightened risk of death was highest in the first year after injury, it persisted for at least a further 12 years, when the head-injured were almost three times as likely to die of circulatory, respiratory, digestive, psychiatric and external causes as their community peers.

Those who had sustained other injuries were also more likely to die of these causes, but the risk was not as high.

The annual rate of death from all causes among the head-injured was almost 31 per 1,000 people compared with just under 14 per 1,000 for those living in the community.

As might be expected, those with more serious injuries were more likely to die than those with mild injuries during the critical first year. But those with mild head injury were also twice as likely to die.

And more than a year later, the young and middle aged were far more likely to die than those who were older, when compared with those with no head injury.

Deaths among those aged 15 to 54 were more than six times higher than rates among those without a head injury, irrespective of potentially influential factors, such as gender and level of deprivation.

Lifestyle factors before the injury, such as excessive alcohol intake and living alone or a history of mental health problems do affect survival, say the authors. But these factors also feature among those admitted for other injuries.

There are no clear explanations for the higher death rates among the young and middle aged, say the authors.

"The reason for greater vulnerability in younger adults is unclear, but requires further consideration, especially given the particularly higher risk of head injury in younger adults," they say. Head injury accounts for most trauma deaths in this age group, the evidence shows.


Journal Reference:

  1. T M Mcmillan, G M Teasdale, C J Weir, E Stewart. Death after head injury: the 13 year outcome of a case control study. J Neurol Neurosurg Psychiatry, 31 January 2011 DOI: 10.1136/jnnp.2010.222232

Women in Congress outperform men on some measures, study finds

Congresswomen consistently outperform their male counterparts on several measures of job performance, according to a recent study by University of Chicago scholar Christopher Berry.

The research comes as the 112th Congress is sworn in this month with 89 women, the first decline in female representation since 1978. The study authors argue that because women face difficult odds in reaching Congress — women account for fewer than one in six representatives — the ones who succeed are more capable on average than their male colleagues.

Women in Congress deliver more federal projects to their home districts than men do, even when controlling for such factors as party affiliation and ideology, according to the research by Berry, Assistant Professor in the Harris School of Public Policy Studies, and his former student Sarah Anzia, MPP '07, now a doctoral student at Stanford University. Congresswomen also sponsor and co-sponsor more legislation than their male counterparts, the authors found. The study has recently been accepted for publication at the American Journal of Political Science.

The authors interpret their findings as a by-product of voter discrimination against female candidates. When women confront such bias, only the most talented, politically ambitious females will attempt to run for office, and voters will tend to elect the most highly capable women. Because of one or both of these factors, the women elected will on average be higher performing than their male colleagues.

"Women run for and are elected to public office at lower rates than men. This might be because women perceive themselves as less qualified to run than they actually are, or it might be because bias against women in the electorate produces a barrier to entry for them," Berry said. "In either case, the central implication of sex-based political selection is that the women we observe in office will, on average, outperform the men."

Since there is no direct way to measure legislator capability, the researchers measured performance in two ways. First, using Federal Assistance Award Data, a comprehensive compilation of federal domestic spending programs, the authors examined data from 1984 to 2004 showing the amount of federal program dollars that members of Congress brought to their home districts. The analysis encompassed discretionary spending, including most earmarks, but not entitlement programs or defense spending and other procurement programs.

Berry and Anzia found that congresswomen on average obtain 9 percent more in federal discretionary programs for their home districts — about $49 million per year — than congressmen, even when taking into account variables such as party affiliation, majority party status, seniority, electoral vulnerability, ideology, committee assignments, and district traits.

The authors also compared changes over time in spending within districts, to gauge how much a given district received when represented by a woman rather than a man. This method ensured that the estimated advantage for females was not simply a result of the types of districts they represent.

Second, the researchers examined the policymaking activities of women and men in Congress. They found that women sponsor and co-sponsor significantly more bills than men, and that bills sponsored by women get more co-sponsorship support from their colleagues. More generally, congresswomen score higher on various statistical measures of "network centrality," meaning that they have stronger networks of collaboration than their male counterparts.

"Two fundamental jobs of congressional representatives are constituency service, which includes bringing home federal projects as well as other direct work with constituents, and legislating, which means writing bills and shepherding them through the lawmaking process," said Berry. "The evidence shows that the women in Congress outperform the men on both levels."

In what they dub "the Jackie (and Jill) Robinson Effect," Berry and Anzia relate this "sex-based selection" to the experience of Jackie Robinson, the first African American to play Major League Baseball. It is not surprising that Robinson is widely considered to be one of the best players in the sport's history, argue the authors, because he had to be the best in order to overcome the racial discrimination of the time.

Similarly, women running for Congress must be more motivated and more highly qualified than their male counterparts to win a seat. In fact, the worse the voter discrimination against women, the better women from those districts fare in Congress: the researchers found that congresswomen elected in more conservative districts, where they may face greater sex-based selection, achieve even larger advantages in spending than the average congresswomen.

"We emphasize that we are not arguing that women have more innate political talent than men, nor do we claim that all female candidates outperform their male counterparts," Berry said. He pointed out that widows who enter Congress to fill their deceased husbands' seats do not outperform congressmen, possibly because they bypassed the sex-based selection of elections.

"Our theory simply identifies a connection between the economics of discrimination and models of political agency: when sex discrimination is present among voters, women must be better than their male counterparts to be elected," Berry said.

Women less interested than men in jobs where individual competition determines wages

Men are more likely than women to seek jobs in which competition with coworkers affects pay rates, a preference that might help explain persistent pay differences between men and women, a study at the University of Chicago shows.

The study, which covered most of the nation's largest metropolitan areas, also revealed regional variation in how much women desire jobs in which competition plays a role in determining wages. In cities where local wages are generally lower, women tend to want jobs in which competition determines wages, the study showed.

"We know that women, often working at the same kind of job as men, frequently are not paid as much as men," said John List, professor of economics at UChicago and an author of the paper, "Do Competitive Work Places Deter Female Workers? A Large-Scale Natural Field Experiment on Gender Differences in Job-Entry Decisions," published by the National Bureau of Economic Research.

"Some of the explanations for the differences contend they are caused by discrimination or by women leaving the workforce to have children and then returning," he said. "Other people have suggested that men are more attracted to competition than women, and that accounts for the differences."

To test whether differences between men's and women's interest in competition actually affects their job choices, List and a research team created two advertisements on Internet job boards. They posted jobs for administrative assistants, the most common job in the United States. One ad, which was gender-neutral, described the job responsibilities as preparing reports based on news stories and fulfilling typical office tasks. The second ad, for a sports news assistant, was similar, except that the job would entail writing reports about sports stories.

The advertisements were placed on job boards in 16 of the nation's largest cities between January and April 2010. The team then presented respondents with additional information to describe different forms of compensation.

Some applicants were told the job paid $15 an hour. Others were told the pay was based on individual competition, with a base salary of $13.50, and a $3 bonus depending on how he or she did in comparison to other workers.

Another package offered a $12 hourly base pay with a $6 bonus if the employee outperformed other workers. Still others were told the job had a competition-based wage, but that comparisons would be based on the productivity of people working in teams.

Of the 6,779 people who responded to the ads, 2,702 applied once they knew the wage structure. Those included 1,566 women and 1,136 men. (About 20 of the applicants were actually hired.)

"When the salary potential was most dependent on competition, men were 94 percent more likely to apply than women," List said.

The study found that although women were much less likely to pursue jobs where individual competition was a factor, the deterring effect on women could be overcome by having workers compete in teams, rather than individually.

Women were more deterred by jobs in which competition was a factor in determining pay if the local wages in their city were high. For instance, women were less inclined to pursue jobs with competitive wage situations in San Francisco, Washington, D.C., and Boston, where the median wages for other local administrative assistant jobs were about $13, close to the base pay for the jobs the researchers offered. In cities with lower local wages, the dissuasive effect on women of competition-based pay diminished. For example in Houston, where the local wage was $10, women actually showed slightly more interest in applying to jobs with a competitive pay structure than men.

List said socialization of women and men may play a factor in the gender differences in the way men and women respond to pay incentives based on competition. Boys receive more encouragement growing up to be competitive, particularly in sports, while girls frequently are encouraged to be more cooperative, he said.

Joining List on the study were Jeffrey Flory, a graduate student in economics at the University of Maryland, College Park; and Andreas Leibbrandt, a postdoctoral fellow at the University of Chicago.

Our perceptions of masculinity and femininity swayed by our sense of touch

Gender stereotypes suggest that men are usually tough and women are usually tender. A new study published in Psychological Science, a journal of the Association for Psychological Science, finds these stereotypes have some real bodily truth for our brains; when people look at a gender-neutral face, they are more likely to judge it as male if they're touching something hard and as female if they're touching something soft.

Several studies have found recently that we understand many concepts through our bodies. For example, weight conveys importance; just giving someone a heavy clipboard to hold will make them judge something as more important than someone who holds a light clipboard. Michael Slepian, a graduate student at Tufts University, and his colleagues wanted to know if this was also true for how people think about gender.

For one experiment, people were given either a hard or a soft ball to hold, then told to squeeze it continuously while looking at pictures of faces on a computer. Each face had been made to look exactly gender-neutral, so it was neither male nor female. For each face, the volunteer had to categorize it as male or female. People who were squeezing the soft ball were more likely to judge faces as female, while people who handled the hard ball were more likely to categorize them as male.

The same effect was found in a second experiment in which people wrote their answers on a piece of paper with carbon paper underneath; some were told to press hard, to make two copies, and some were told to press lightly, so the carbon paper could be reused. People who were pressing hard were more likely to categorize faces as male, while the soft writers were more likely to choose female.

"We were really surprised," says Slepian, who cowrote the study with Max Weisbuch of the University of Denver, Nicholas O. Rule at the University of Toronto, and Nalini Ambady of Tufts University. "It's remarkable that the feeling of handling something hard or soft can influence how you visually perceive a face." The results show that knowledge about social categories, such as gender, is like other kinds of knowledge — it's partly carried in the body.


Journal Reference:

  1. M. L. Slepian, M. Weisbuch, N. O. Rule, N. Ambady. Tough and Tender: Embodied Categorization of Gender. Psychological Science, 2010; DOI: 10.1177/0956797610390388

Parents give boys preferential treatment when there is a chronic food shortage

In situations of chronic food shortage, parents are inclined to give boys a preferential treatment, despite the fact that the health of their daughters suffers more from food insecurity. This is shown by research from the Institute of Tropical Medicine in Ethiopia, appearing in the journal Pediatrics.

It is self-evident that food shortages are not healthy, but up to now nobody hat looked if all children in a family suffer equally, or if there are gender differences. In most studies into the effects of food insecurity, parents were questioned, not their children. Scientists of Jimma University (Ethiopia), assisted by American and Flemish scientists, during five years followed two thousand teenagers in as many households, in urban as well as rural communities.

In food insecurity an average of three girls out of ten reported having been ill during the previous month; against two boys out of ten. In food insecure households, girls were twice more likely to report suffering from illness. The girls even reported seven times more often difficulties with activities due to poor health, or feeling tired.

In situations of food insecurity, aid workers should take this into account, the authors say.

In fact, girls should be healthier. Biologically spoken, they are tougher; as teenager they smoke less and show less risk seeking behaviour than boys. But cultural discrimination makes that girls suffer more from situations of shortage.

The teenagers and their family were questioned during the hunger season (the rainy season) and during spring, when there is less food insecurity. The scientists noted, among other things, how much and how varied the ate, their length and weight. They asked for tiredness and lack of energy in the previous month; for problems with activities for school, work or household due to poor health; if they had been ill during the previous month. A quarter of the girls and 16% of the boys were food insecure.

The scientists adjusted for dietary diversity, BMI, place of residence, cooking place (sleeping room, living room, separate kitchen) distance to a garbage disposal site, presence of animals in house, to isolate the effect of gender on illness. Even then, the girls reported seven times as much low energy; and 7.4 times more often problems with activities.

The difference between boys and girls was more intense in rural areas than in cities.

It is known that women rate their health always poorer than men, and that they more often report health problems, being more cautious of their health than men. But in this case that can not be an explanation, because when they were food secure, boys and girls reported no differences.

In many cultures, sons are more valued than daughters. Previous research in the Philippines, Ethiopia, Nepal, India and Guatemala showed that sons receive more and better food. But in Ethiopia at any rate this discrimination only leads to health problems when there is not enough food available.

The researchers conclude that aid workers who provide people with more or better food, need to give extra attention to girls when dealing with food insecurity. They suggest a good way to reduce gender disparities is to remove resource constraints. This might be somewhat easier than shifting population-level norms around gender.


Journal Reference:

  1. T. Belachew, C. Hadley, D. Lindstrom, A. Gebremariam, K. W. Michael, Y. Getachew, C. Lachat, P. Kolsteren. Gender Differences in Food Insecurity and Morbidity Among Adolescents in Southwest Ethiopia. Pediatrics, 2011; DOI: 10.1542/peds.2010-0944