Sex differences in stress responses: Focus on ovarian hormones

Women in the reproductive age are more vulnerable to develop affective disorders than men. This difference may attribute to anatomical differences, hormonal influences and environmental factors such as stress. However, the higher prevalence in women normalizes once menopause is established, suggesting that ovarian hormones may play an important role in the development of depression in women. Ovarian hormones such as estrogen can pass the brain-blood barrier and bind to cytoplasmatic estrogen receptor (ER)-alpha and ER-beta in different areas of the limbic system. During stress, estrogen can modulate the behavioral and neurobiological response depending on the concentrations of estrogen. In this review we present evidence for disparate effects of chronic stress on neuroplasticity and brain activity in male and female rats. Furthermore, we will demonstrate that effects of social support on coping with stress can be mimicked by social housing of rats and that this model can be used for identification of underlying neurobiological mechanisms, including behavior, phosphorylation of CREB and ERK1/2, and brain activity changes as measured with fos expression. Using cyclic administration of estrogen in ovariectomized female rats we could specifically address effects of different plasma estrogen levels and antidepressants on stress-induced neuroplasticity and activity changes. In this model we also studied effects of estrogen on recovery after chronic stress. We conclude that the female brain has a different innate strategy to handle stress than the male brain and that female animal models are necessary for studying the underlying mechanisms and options for treatment.     

Yoga for anxiety: A systematic review and meta-analysis of randomized controlled trials

Yoga has become a popular approach to improve emotional health. The aim of this review was to systematically assess and meta-analyze the effectiveness and safety of yoga for anxiety. Medline/PubMed, Scopus, the Cochrane Library, PsycINFO, and IndMED were searched through October 2016 for randomized controlled trials (RCTs) of yoga for individuals with anxiety disorders or elevated levels of anxiety. The primary outcomes were anxiety and remission rates, and secondary outcomes were depression, quality of life, and safety. Risk of bias was assessed using the Cochrane tool. Eight RCTs with 319 participants (mean age: 30.0–38.5 years) were included. Risk of selection bias was unclear for most RCTs. Meta-analyses revealed evidence for small short-term effects of yoga on anxiety compared to no treatment (standardized mean difference [SMD] = −0.43; 95% confidence interval [CI] = −0.74, −0.11; P = .008), and large effects compared to active comparators (SMD = −0.86; 95% CI = −1.56, −0.15; P = .02). Small effects on depression were found compared to no treatment (SMD = −0.35; 95% CI = −0.66, −0.04; P = .03). Effects were robust against potential methodological bias. No effects were found for patients with anxiety disorders diagnosed by Diagnostic and Statistical Manual criteria, only for patients diagnosed by other methods, and for individuals with elevated levels of anxiety without a formal diagnosis. Only three RCTs reported safety-related data but these indicated that yoga was not associated with increased injuries. In conclusion, yoga might be an effective and safe intervention for individuals with elevated levels of anxiety. There was inconclusive evidence for effects of yoga in anxiety disorders. More high-quality studies are needed and are warranted given these preliminary findings and plausible mechanisms of action.     

Epidemiological situation of malaria in Madagascar: Baseline data for monitoring the impact of malaria control programmes using serological markers

The aim of this study was to provide baseline information of the epidemiological situation of malaria in Madagascar using serological markers. We carried out cross-sectional studies in schoolchildren from eight sites in the four different malarious epidemiological strata of Madagascar. We studied the prevalence of anti-MSP1 antibodies to assess the burden, and anti-CSP antibodies to estimate the transmission intensity, of malaria. The overall prevalence of each antibody tested was 46.1% for anti-PfMSP-1, 15.2% for anti-PvMSP-1, 14.9% for anti-PfCSP, 4.9% for anti-PvCSP and 2.4% for anti-PmCSP. The prevalence of the five antibodies varied significantly between the sites (P < 10⁻⁶). We also found significant effects of ethnic origin on the prevalence of anti-PfMSP1 antibodies. With regular testing in the same target populations, this data will be particularly useful for managing the elimination strategy supported by the Malagasy Government.     

Gender contributes to personal research funding success in The Netherlands

We examined the application and review materials of three calls (n = 2,823) of a prestigious grant for personal research funding in a national full population of early career scientists awarded by the Netherlands Organization for Scientific Research (NWO). Results showed evidence of gender bias in application evaluations and success rates, as well as in language use in instructions and evaluation sheets. Male applicants received significantly more competitive “quality of researcher” evaluations (but not “quality of proposal” evaluations) and had significantly higher application success rates than female applicants. Gender disparities were most prevalent in scientific disciplines with the highest number of applications and with equal gender distribution among the applicants (i.e., life sciences and social sciences). Moreover, content analyses of the instructional and evaluation materials revealed the use of gendered language favoring male applicants. Overall, our data reveal a 4% “loss” of women during the grant review procedure, and illustrate the perpetuation of the funding gap, which contributes to the underrepresentation of women in academia.Women are still underrepresented in academia today. Despite various attempts to promote gender equality (e.g., affirmative action initiatives, quotas), female scientists are less likely to get offered tenure, are judged to be less competent, receive less payment and research facilities, and are less likely to be awarded research grants compared with male scientists (1–3). Over time, this type of bias accumulates and contributes to the attrition of women from academia (4); the academic pipeline leaks. Here we report evidence of gender bias in personal research funding for early career scientists.The importance of equal gender representation is widely acknowledged, for several reasons. First, it can resolve historic inequalities and provide equal opportunities (the “moral case for diversity”) (5, 6). Second, research has demonstrated that gender diversity in organizations can boost innovation and creativity, expand target groups, and increase productivity (the “business case for diversity”) (7, 8), either directly or indirectly through decision making processes or reputation, and provided that the organizational culture is open to change (9–12). This is true for academia as well. Gender-diverse research teams facilitate innovation and excellence in research and policy, address different research questions and methods, and facilitate wider application of research findings (13), thereby contributing to scientific progress.Relevant statistics, however, show a persistent leadership gap, salary gap, and funding gap for women in academia (3). To illustrate, The Netherlands—generally considered a high-equity nation—had only 16% female full professors in 2012 (14). Leadership is stereotyped as masculine and consequently associated more strongly with stereotypical male traits rather than female traits. Although women are equally effective in, and equally likely to use optimal leadership styles, as men (15, 16), women continue to be devalued as leaders due to the influence of gender stereotypes on judgment (17). Overall, science also is more implicitly associated with men than with women, because gender stereotypes characterize women as lacking the masculine traits associated with ability and success in science (18, 19). For instance, a recent study linked the level of women’s underrepresentation across academic disciplines to the magnitude of the stereotype-based assumption that innate talent is associated with male traits and considered necessary for academic career success (20). Moreover, women still earn on average 18% less than their male colleagues for the same work with similar responsibilities (3). Although the salary gap seems to narrow for early career researchers, women in top academic positions are still substantially underpaid compared with men. Finally, across different career phases, success rates for female scientists applying for research funding tend to be lower than for male scientists (3, 21, 22). Even when overall success rates for men and women are equal, women receive less research funding than men, and are less often listed as principal investigators (23–25). Closing the funding gap is of particular importance, because this may help retain women in academia and foster the closing of other gaps by facilitating negotiations about salaries, research facilities, and promotion opportunities.     

Pain in people living with HIV/AIDS: a systematic review

Introduction

Pain is one of the most commonly reported symptoms in people living with HIV/AIDS (PLWHA). However, wide ranges of pain prevalence have been reported, making it difficult to determine the relative impact of pain in PLWHA. A systematic review of the literature was conducted to establish the prevalence and characteristics of pain and to explore pain management in PLWHA.

Methods

Studies that included cross-sectional data were included in the search, which was conducted in April 2012. Databases searched using a time limit of March 1982 to March 2012 included PubMed, Scopus, Africa-wide: NIPAD, CINAHL, PsychARTICLES, PSYCINFO, PSYCHIATRYONLINE, ScienceDirect and Web of Science. Search terms selected were “pain” and “HIV” or “acquired immune deficiency syndrome.” Two reviewers independently screened all citation abstracts for inclusion. Methodological quality was evaluated using a standardized 11-item critical appraisal tool.

Results

After full text review, 61 studies fulfilled the inclusion criteria. Prevalence of pain ranged from a point prevalence of 54% (95%CI 51.14–56.09) to 83% (95%CI 76–88) using a three-month recall period. The reported pain was of moderate-to-severe intensity, and pain was reported in one to two and a half different anatomical sites. Moderate levels of pain interference with function were reported. All nine studies reporting on the adequacy of pain management recorded marked under-treatment of pain.

Discussion

The studies reviewed reported that pain commonly presents at multiple pain sites with a range of severity suggesting that there are several differing pathological processes contributing to pain at one time. The interplay of variables associated with pain suggests that the biopsychosocial model of pain is an appropriate paradigm from which to view pain in PLWHA and from which to approach the problem, explore causes and establish effective treatment.

Conclusions

The results highlight that pain is common in PLWHA at all stages of the disease. The prevalence rates for pain in PLWHA do not appear to have diminished over the 30 years spanning the studies reviewed. The body of work available in the literature thus far, while emphasizing the problem of pain, has not had an impact on its management.