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Background Conflicting results exist regarding the impact of gender on early survival after sudden cardiac arrest (SCA). We aimed to assess the association between female gender and early SCA survival. Methods We searched Embase, MEDLINE, EBM Reviews, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews (between 1948 and January 2014) for studies evaluating the association between gender and survival after SCA. Two independent reviewers selected studies of any design or language. Pooled odds-ratios (OR) and 95% confidence intervals (CIs) were estimated using a random-effects model. Additional sensitivity analyses and meta-regression were carried out to explore heterogeneity. Results Thirteen studies were included involving 409,323 patients. Women were more likely to present with SCA at home, less likely to have witnessed SCA, had a lower frequency of initial shockable rhythm but were more likely to receive bystander CPR. After adjustment for these differences, women were more likely to survive at hospital discharge (OR 1.1, 95% CI 1.03–1.20, p =0.006, I 2 =61%). This association persisted in multiple sensitivity analyses. Conclusion This meta-analysis of observational studies demonstrates that women have increased odds of survival after SCA. Further studies are needed to address mechanisms explaining this discrepancy.

Introduction: Conflicting results exist regarding the impact of gender on survival after Sudden Cardiac Arrest (SCA). Hypothesis: Assess association between female gender and survival after SCA Methods: An electronic search of Embase, Ovid MEDLINE In-Process & Non-Indexed Citations and EBM Reviews - Cochrane Register of Controlled Trials, EBM Reviews - Cochrane Database of Systematic Reviews and Google was conducted (January 1948 to January 2014) for studies of any study design and language, examining the gender effect on survival at hospital discharge after a SCA. Two independent reviewers selected studies and extracted data. The inter-rater agreements kappa were measured at the first and second selection steps. Moreover, the pooled OR and 95% CI, concerning women vs. men survival at hospital discharge after an OHCA were calculated with a random effect model. Subgroups analyses were performed, according to the cardiac origin of OHCAs and according to the study quality. Study quality criteria were based on the New Castle Ottawa Scale. Results: After a detailed screening of 556 citations, 12 studies were identified involving 404 621 patients. The inter-rater agreements kappa was high for the 2 study selection steps (0.91 and 1). In most studies, women were older and had less favorable baseline characteristics including a lower prevalence of witnessed-OHCA, OHCA in a public location, bystander cardio-pulmonary resuscitation and shockable rhythms compared to men. However and after adjustment for these differences, women were more likely to survive at hospital discharge (N=12; OR: 1.11 [1.02-1.21]; p=0.013). This result remains in studies analyzing OHCA of presumed cardiac origin (N=7; OR: 1.17 [1.03-1.34]; p=0.017) and in studies of high quality (N=7; OR: 1.11 [1.02-1.21]; p=0.017). Conclusion: Despite less favorable baseline characteristics, women are more likely to survive at hospital discharge after an OHCA. Further studies are needed to explain this paradox.

Aim. This study aims to investigate self-understanding in young males with high-functioning autism spectrum disorders (ASD) and to determine whether self-understanding is related to social functioning and theory of mind (ToM). In addition, this study aims to examine the characteristics and abilities of young males with high-functioning autism (HFA) and Asperger’s disorder (AD) to determine whether there are significant differences in selfunderstanding and whether self-understanding is related to social functioning and ToM between these two groups. The results have important implications for social skills interventions for young people with ASD. Method. Forty three young males diagnosed with one of the ASD (25 diagnosed with HFA and 18 diagnosed with AD) were compared with 38 TD males. Participants were assessed using the Autism Diagnostic Interview- Revised (ADI-R), the Kaufman Brief Intelligence Test (KBIT), the Vineland Adaptive Behavior Scales (VABS), the Peabody Picture Vocabulary Test- Third Edition (PPVT-III), Damon and Hart’s Self-understanding Interview, and two false-belief ToM tasks. Results. Children with ASD had difficulties recognising and attributing their own mental states and failed to integrate various aspects of the self. Specifically, the ASD group produced fewer self-statements that reflected agency (the awareness and understanding that one is in control of their actions), social aspects of self (such as personality characteristics and group membership) and psychological aspects of self (such as emotions, thoughts and cognitive processes). Instead, children with ASD produced more concrete physical self-statements (such as body characteristics and material possessions). A significant positive relationship was found between selfunderstanding and social functioning for the ASD group. Within the ASD group, the relationship held for the HFA group only. In terms of ToM, children with ASD were less able to correctly answer the second-order false-belief ToM question compared to the TD group. For the ASD group, there was a significant positive correlation between self-understanding and ToM. Within the ASD group, the relationship held for the HFA group only. Conclusions. The results show young males with high-functioning ASD are less aware of their own and others’ mental states perhaps reflecting a general delay in the development of self-understanding and ToM. Furthermore, a more developed self-understanding may translate to improved social functioning and ToM ability for young males with high-functioning ASD. For young males with HFA, self-understanding and ToM may stem from a common underlying cognitive framework. Consequently, treatments aimed at improving self-understanding may simultaneously improve ToM, or vice versa. For individuals with AD there may be a separate cognitive mechanism responsible for self-understanding and another for ToM. Therefore, different interventions may be required; one to improve self-understanding and another to improve the understanding of others’ minds. Overall, these results may assist in the development of practice parameters for social skills training for those with ASD.