Search

Research on educational gender segregation has been mostly concerned with the lack of women in male-dominated educational fields, and only to a lesser degree with the shortage of men in female-dominated subjects. This article addresses the latter issue and introduces new theoretical tools to the research field of educational gender segregation. Building on in-depth interviews with male and female nursing students in Norway, the article illuminates processes that may contribute to gender inclusion and exclusion. Combining theory on cultural beliefs on gender, symbolic boundaries and repertoire theory, the article shows how the valued nursing competence of being caring -- together with an operative cultural belief that women are more caring than men -- provides the female students with an asset both when accounting for their educational choice and in demonstrating their suitability to be nurses. The article demonstrates the situational relevance of gender and the value of analysing accounts of gender within particular contexts.

Magnetic resonance imaging is integral to the care of patients with high-grade gliomas. Anatomic detail can be acquired with conventional structural imaging, but newer approaches also add capabilities to interrogate image-derived physiologic and molecular characteristics of central nervous system neoplasms. These advanced imaging techniques are increasingly employed to generate biomarkers that better reflect tumor burden and therapy response. The following is an overview of current strategies based on advanced magnetic resonance imaging that are used in the assessment of high-grade glioma patients with an emphasis on how novel imaging biomarkers can potentially advance patient care.

BackgroundThe United States is in the midst of an opioid epidemic, and opioid use disorder often begins with a prescription for acute pain. The perioperative period represents an important opportunity to prevent chronic opioid use, and recently there has been a paradigm shift toward implementation of enhanced recovery after surgery (ERAS) protocols that promote opioid-free and multimodal analgesia. The objective of this study was to assess the impact of an ERAS intervention for colorectal surgery on discharge opioid prescribing practices.MethodsWe conducted a historical-prospective quality improvement study of an ERAS protocol implemented for patients undergoing colorectal surgery with a focus on the opioid-free and multimodal analgesia components of the pathway. We compared patients undergoing colorectal surgery 1 year before implementation (June 15, 2015, to June 14, 2016) and 1 year after implementation (June 15, 2016, to June 14, 2017).ResultsBefore the ERAS intervention, opioids at discharge were not significantly increasing (1% per month; 95% confidence interval [CI], -1% to 3%; P = .199). Immediately after the ERAS intervention, opioid prescriptions were not significantly lower (13%; 95% CI, -30% to 3%; P = .110). After the intervention, the rate of opioid prescriptions at discharge did not decrease significantly 1% (95% CI, -3% to 1%) compared to the pre-period rate (P = .399). Subgroup analysis showed that in patients with a combination of low discharge pain scores, no preoperative opioid use, and low morphine milligram equivalents consumption before discharge, the rate of discharge opioid prescription was 72% (95% CI, 61%-83%).ConclusionsThis study is the first to report discharge opioid prescribing practices in an ERAS setting. Although an ERAS intervention for colorectal surgery led to an increase in opioid-free anesthesia and multimodal analgesia, we did not observe an impact on discharge opioid prescribing practices. The majority of patients were discharged with an opioid prescription, including those with a combination of low discharge pain scores, no preoperative opioid use, and low morphine milligram equivalents consumption before discharge. This observation in the setting of an ERAS pathway that promotes multimodal analgesia suggests that our findings are very likely to also be observed in non-ERAS settings and offers an opportunity to modify opioid prescribing practices on discharge after surgery. For opioid-free anesthesia and multimodal analgesia to influence the opioid epidemic, the dose and quantity of the opioids prescribed should be modified based on the information gathered by in-hospital pain scores and opioid use as well as pain history before admission.

This article compares educational choice narratives and assessments of ideal competence within and across female-dominated nursing studies and male-dominated nautical science studies. By use of this comparative approach, the article offers new understandings of gendered educational choices and what promotes gender inclusion and exclusion in educational settings. The article finds that previous experience from the field was instrumental in the choice of education made by the gender minority. However, the different valuations of such experience in the two study programmes had implications for the social and academic position of gender minority students.

Given the ambition to decrease gender segregation in higher education, it is essential to understand the considerations made by the gender minority in segregated fields of study. This article interprets the resistance met by girls choosing gender-untypical paths, and analyses how they explain and justify such choices. The context of Norway provided both the framework for the study and a lens for understanding the girls' experiences. Interview data show how the girls understand their own and others' educational choices in light of ideas of gender equality. Arguably, claiming to be 'one who dares', and anchoring their choices in egalitarian ideals, strengthened their motivation in the face of resistance. Furthermore, the resistance was not rooted in stereotypes around competence but based on gender role expectations. This suggests that cultural beliefs about women as primarily caretakers, and the notion that appearance relates to educational choices, are more resistant to change than stereotypes about women and technical competence.

Glioblastoma (GBM), the most aggressive form of brain cancer, is characterized by a high level of molecular heterogeneity, and infiltration by various immune and stromal cell populations. Important advances have been made in deciphering the microenvironment of GBMs, but its association with existing molecular subtypes and its potential prognostic role remain elusive. We have investigated the abundance of infiltrating immune and stromal cells in silico, from gene expression profiles. Two cohorts, including in‐house normal brain and glioma samples (n = 70) and a large sample set from TCGA (n = 393), were combined into a single exploratory dataset. A third independent cohort (n = 124) was used for validation. Tumors were clustered based on their microenvironment infiltration profiles, and associations with known GBM molecular subtypes and patient outcome were tested a posteriori in a multivariable setting. We identified a subset of GBM samples with significantly higher abundances of most immune and stromal cell populations. This subset showed increased expression of both immune suppressor and immune effector genes compared to other GBMs and was enriched for the mesenchymal molecular subtype. Survival analyses suggested that tumor microenvironment infiltration pattern was an independent prognostic factor for GBM patients. Among all, patients with the mesenchymal subtype with low immune and stromal infiltration had the poorest survival. By combining molecular subtyping with gene expression measures of tumor infiltration, the present work contributes with improving prognostic models in GBM. [ABSTRACT FROM AUTHOR]