Gender differences in Iceland's education system

This paper describes and compares the performance of boys and girls in the Icelandic education system. The study of gender differences in schools has a long history. An extensive and interesting survey edited by William Hadow in the U.K. in 1923 examined existing evidence from the perspective of medicine, psychology and education studies. The authors found that intra-gender variation in abilities was greater than gender differences. Nevertheless, notable gender differences had to do with girls being more obedient, industrious and respectful while boys were more independent and harder to manage. Recent research in the field of education studies has confirmed many of these differences. In recent decades, the apparent educational underperformance of boys in the Western world has received increased attention. Several books, some of which are controversial, have been written on this topic (such as Kindlon & Thompson, 2000; Palmer, 2009; Sax, 2016; Sommers, 2001). This paper surveys research on gender imbalance in education, which covers the effect of boys having lower non-cognitive skills; boys having a different set of values and attitudes and not valuing educational performance as much as girls; the importance of family background in shaping boys’ attitudes towards education; and teachers viewing boys as being lazier and girls more conscientious. We then use data on comprehensive examinations in 4th, 7th and 10th grade for two cohorts in Iceland. We find that there is no statistically significant difference between the mean grade of boys and girls in mathematics but a significant and sizeable difference in the mean grade in Icelandic, which exists in 4th grade and then becomes larger in 7th grade and in 10th grade. However, the intra-gender variation is much greater than the differences in mean grade. We then look at the tails of the distribution and find that a large majority of those with the 10% lowest grades in Icelandic were boys and a minority of those with the 10% highest grades. The gender differences are also pronounced in the PISA tests and they are larger than the OECD average in reading, mathematics and the natural sciences. Moreover, the gender difference in these examinations has grown since year 2000. Next we describe data on high school graduation rates where 60% are female and the dropout rate is 50% higher for males before moving on to the university level where two thirds of graduates are women. A large majority of students in the health sciences, humanities and social sciences are female but men remain a majority in engineering, mathematics and physics. Within the social sciences, there is gender balance in economics and also to some extent in business studies. Within the humanities, only history and philosophy have a higher proportion of men. Finally, we compare average grades for men and women in the first year of study at the University of Iceland for the school year 2018–2019 and the fall of 2019 (COVID-19 making it impractical to use the spring of 2020 or the following school year) and find that women outperform men by around 0.5 on the 0–10 scale. The gap survives correcting for the high-school GPA. We show that the gap is mainly due to a higher dropout rate of male students. We then draw on the education literature in Iceland to explain the gender gap. Some studies find that girls are more interested in reading and that the choice of reading material suits girls better than boys. Other studies have found that girls place a much greater emphasis on educational performance than boys and this affects their self-image to a larger extent. Girls tend to become more anxious about examinations and this can contribute to anxiety problems that affect their performance. There are studies of the high dropout rate in Iceland, which find that many students who drop out of high school return to school, which explains the high average age of high-school graduates. The overall conclusion is that the underrepresentation of boys among high-school and university graduates is not a consequence of choice but of greater academic failure among the weaker students. Our findings are a call for action in addressing the gender gap

Anticholinergic medicines use among older adults before and after initiating dementia medicines

Publisher's version (útgefin grein)Aims: We investigated anticholinergic medicines use among older adults initiating dementia medicines. Methods: We used Pharmaceutical Benefits Scheme dispensing claims to identify patients who initiated donepezil, rivastigmine, galantamine or memantine between 1 January 2013 and 30 June 2017 (after a period of ≥180 days with no dispensing of these medicines) and remained on therapy for ≥180 days (n = 4393), and dispensed anticholinergic medicines in the 180 days before and after initiating dementia medicines. We further examined anticholinergic medicines prescribed by a prescriber other than the one initiating dementia medicines. Results: One-third of the study cohort (1439/4393) was exposed to anticholinergic medicines up to 180 days before or after initiating dementia medicines. Among patients exposed to anticholinergic medicines, 46% (659/1439) had the same medicine dispensed before and after initiating dementia medicines. The proportion of patients dispensed anticholinergic medicines increased by 2.5% (95% confidence interval [CI]: 1.3–3.7) after initiating dementia medicines. Antipsychotics use increased by 10.1% (95% CI: 7.6–12.7) after initiating dementia medicines; driven by increased risperidone use (7.3%, 95% CI: 5.3–9.3). Nearly half of patients dispensed anticholinergic medicines in the 180 days after (537/1133), were prescribed anticholinergic medicines by a prescriber other than the one initiating dementia medicines. Conclusion: Use of anticholinergic medicines is common among patients initiating dementia medicines and this occurs against a backdrop of widespread campaigns to reduce irrational medicine combinations in this vulnerable population. Decisions about deprescribing medicines with questionable benefit among patients with dementia may be complicated by conflicting recommendations in prescribing guidelines.Australian National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Medicines and Ageing, Grant/Award Number: ID: 1060407; Australian Government Department of Industry, Innovation and Science, Grant/Award Number: ID: CRC‐P‐439. This research is funded by the Australian National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Medicines and Ageing (ID: 1060407), a Cooperative Research Centre Project (CRC‐P) Grant from the Australian Government Department of Industry, Innovation and Science (ID: CRC‐P‐439) and philanthropic support from Mr Ross Brown AM. Dr Zoega is supported by a Scientia Fellowship from the University of New South Wales. The views expressed in this study are those of the authors only. A.J.M. receives funding from GlaxoSmithKline for a postgraduate scholarship for a student under his supervision. S.A.P. is a member of the Drug Utilisation Sub‐Committee of the Pharmaceutical Benefits Advisory Committee. The views expressed in this paper do not represent those of the committee.Peer Reviewe

Antipsychotic drug use in pregnancy: A multinational study from ten countries

Aim: To compare the prevalence and trends of antipsychotic drug use during pregnancy between countries across four continents. Methods: Individually linked health data in Denmark (2000−2012), Finland (2005–2014), Iceland (2004–2017), Norway (2005–2015), Sweden (2006–2015), Germany (2006–2015), Australia (New South Wales, 2004–2012), Hong Kong (2001–2015), UK (2006–2016), and the US (Medicaid, 2000–2013, and IBM MarketScan, 2012–2015) were used. Using a uniformed approach, we estimated the prevalence of antipsychotic use as the proportion of pregnancies where a woman filled at least one antipsychotic prescription within three months before pregnancy until birth. For the Nordic countries, data were meta-analyzed to investigate maternal characteristics associated with the use of antipsychotics. Results: We included 8,394,343 pregnancies. Typical antipsychotic use was highest in the UK (4.4%) whereas atypical antipsychotic use was highest in the US Medicaid (1.5%). Atypical antipsychotic use increased over time in most populations, reaching 2% in Australia (2012) and US Medicaid (2013). In most countries, prochlorperazine was the most commonly used typical antipsychotic and quetiapine the most commonly used atypical antipsychotic. Use of antipsychotics decreased across the trimesters of pregnancy in all populations except Finland. Antipsychotic use was elevated among smokers and those with parity ≥4 in the Nordic countries. Conclusion: Antipsychotic use during pregnancy varied considerably between populations, partly explained by varying use of the typical antipsychotic prochlorperazine, which is often used for nausea and vomiting in early pregnancy. Increasing usage of atypical antipsychotics among pregnant women reflects the pattern that was previously reported for the general population

Sectoral Differences in Wage Freezes and Wage Cuts : Evidence from a New Firm Survey

The paper provides evidence concerning incidence and sources of nominal wage rigidity in services and manufacturing, using a new and large employer survey on wage and price setting behaviour for Germany. We observe that wage freezes are more frequent in services than in manufacturing, whereas wage cuts are less frequent. The significant sector gaps do not vanish after controlling for relevant firm characteristics influencing the incidence of wage freezes and wage cuts, notably coverage by collective agreements and the degree of price competition on the product market. An analysis of firms’ view on the reasons preventing wage cuts suggests that specific fear of excess worker turnover could explain distinct wage setting behaviour in services

Editorial: Observational studies in ADHD: the effects of switching to modified-release methylphenidate preparations on clinical outcomes and adherence

Patients with ADHD may have better adherence to treatment with modified-release methylphenidate (MPH-MR) formulations, which are taken once daily, compared with immediate-release (IR) formulations, which need to be taken several times a day. Data on long-term outcomes such as adherence may be lacking from randomised controlled trials as these are usually only short-term. Observational studies, if performed and reported appropriately, can provide valuable long-term data on such outcomes, as well as additional information on effectiveness and efficiency, from a real-life setting. By reviewing previous observational studies that have investigated switching treatment from MPH-IR to MPH-MR, results from a new, naturalistic observational study, the OBSEER study, are put into context. We conclude that, based on observational trial data, switching from MPH-IR to MPH-MR is a valid clinical approach, with the potential for improved clinical outcome and treatment adherence

Antipsychotic drug use in pregnancy: A multinational study from ten countries

Aim: To compare the prevalence and trends of antipsychotic drug use during pregnancy between countries across four continents

Care of vision and ocular health in diabetic members of a national diabetes organization: A cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Regular examination and early treatment of diabetic retinopathy can prevent visual loss. The aim of the study was to describe the care of vision and ocular health in people with diabetes in Norway.</p> <p>Methods</p> <p>A cross-sectional questionnaire survey of a random sample (n = 1,887) of the Norwegian Diabetic Associations' (NDA) members was carried out in 2005. Questions were asked about care of vision and ocular health, history of ocular disease and visual symptoms, general medical history and diabetes management. The study was approved by the Regional Committee for Medical Research Ethics.</p> <p>Results</p> <p>The response rate was 74%. Forty-four questionnaires with incomplete data regarding gender, age or type of diabetes were excluded, leaving 1352 cases (52% females) for analysis. 451 (33%) had type 1 and 901 (67%) had type 2 diabetes, the mean duration of diabetes was respectively, 22 (sd ± 14) and 10 (sd ± 9) years. In all 1,052 (78%) had their eyes examined according to guidelines and 1,169 (87%) confirmed to have received information about regular eye examinations. One in two recalled to have received such information from their general practitioner. To have received information about the importance of eye examinations (PR 3.1, 95% CI 2.4 to 4.0), and diabetes duration > 10 years (PR 1.2, 95% CI 1.2 to 1.3), were independently associated with reporting regular eye examinations. A history of diabetic retinopathy was reported by 178 (13%) responders, of which 101 (57%) reported a history of laser treatment. Responders who had regular eye examinations reported more frequently a history of diabetic retinopathy (19% vs. 5%, p < 0.001). The frequency of retinopathy was significantly higher in responders with reported HbA1c values above treatment target (23% vs. 13%, p = 0.001). However, in responders who were not regularly examined, there was no difference in reported frequency of retinopathy with regard to HbA1c level.</p> <p>Conclusion</p> <p>Eight out of ten diabetic members of the NDA had their eyes examined according to current guidelines and the majority was well informed about the risk of vision loss due to diabetes. The results indicate that the reported history of diabetic retinopathy likely underestimates the prevalence of retinopathy.</p

TFOS European Ambassador meeting: Unmet needs and future scientific and clinical solutions for ocular surface diseases

The mission of the Tear Film & Ocular Surface Society (TFOS) is to advance the research, literacy, and educational aspects of the scientific field of the tear film and ocular surface. Fundamental to fulfilling this mission is the TFOS Global Ambassador program. TFOS Ambassadors are dynamic and proactive experts, who help promote TFOS initiatives, such as presenting the conclusions and recommendations of the recent TFOS DEWS II™, throughout the world. They also identify unmet needs, and propose future clinical and scientific solutions, for management of ocular surface diseases in their countries. This meeting report addresses such needs and solutions for 25 European countries, as detailed in the TFOS European Ambassador meeting in Rome, Italy, in September 2019

Long-term outcome after anterior cervical discectomy without fusion

To retrospectively study the long-term outcome of patients after anterior cervical discectomy without fusion (ACD) compared to results published on the long-term outcome after ACD with fusion (ACDF). We reviewed the charts of all patients receiving ACD surgery between 1985 and 2000 to analyze the direct post-operative results as well as complications of the surgery. Moreover, 102 patients, randomly selected, were interviewed with the neck disability index to study possible persisting complaints up to 18 years after ACD surgery. A total of 551 Patients were identified. Two months post-operative follow up at the outpatient clinic revealed that 90.1% of patients were satisfied with the result of ACD surgery. At the time of the survey, this percentage had dropped to 67.6%. In addition, 20.6% and 11.8% had obtained moderate to severe complaints, respectively, in daily-life activities. Complaints were mainly localized in the neck region and occasionally provoked radiating pain in the arm. On the short term, ACD leads to a satisfied outcome. Over the longer term, patients report increasing complaints. The increase in complaints at the time of the survey may be the result of ongoing degenerative effects. Compared to published data on ACDF, there is no superiority of any fusion technique compared to ACD alone