Adequate Representation Of Women Research Articles

Sex Differences in Cardiovascular Management: A Call for Better Acknowledgment-Part 1 Pharmacological Differences in Women and Men; How Relevant Are They?

Sex differences (SDs) in pharmacology of cardiovascular (CV) drugs have been described previously; however, paradoxically, there are scarce recommendations in therapy based on these differences. It is of utmost importance to identify whether these SDs determine a modified clinical response and the potential practical implications for this, to provide a base for personalized medicine. The aim of this article was to outline the most important pharmacological drivers of cardiovascular drugs that differ between women and men, along with their implications and challenges in clinical practice. A detailed assessment of English-written resources reflecting SDs impact in CV drug pharmacology was performed using PubMed and Embase databases. Despite large variations in CV drug pharmacokinetics and pharmacodynamics in individuals, correcting for height, weight, surface area, and body composition compensate for most "sex-dependent" differences. In addition, individual, cultural, and social factors significantly impact disease management in women versus men. Gender-biased prescribing patterns and gender-dependent adherence to therapy also influence outcomes. The development of sex-specific guidelines requires that they should reflect the SDs implications for the management of a disease and that the evidence should be carefully evaluated as to whether there is an adequate representation of both sexes and whether sex-disaggregated data are reported. Pharmacological drivers are under the influence of an impressive number of differences between women and men. However, to establish their significance in clinical practice, an adequate representation of women in studies and the reporting of distinct results is mandatory.

Metrics, baseline scores, and a tool to improve sponsor performance on clinical trial diversity: retrospective cross sectional study

ObjectiveTo develop a measure for fair inclusion in pivotal trials by assessing transparency and representation of enrolled women, older adults (aged 65 years and older), and racially and ethnically minoritized...

A Study on Analyzing the Status of Women's Skill Development on Digital Platforms

The growing engagement of women in all fields has ushered in a new era for women's socioeconomic advancement. Increased exposure to digital media has resulted, the adequate representation of women in the digital era. The growing engagement of women in all fields has ushered in a new era for women's socioeconomic advancement. This paper examines the status of women's skill development after enormous digital innovation; a survey was conducted amongst the digitally educated women of rural and urban areas, those who are performing through digital forums for obtaining information relevant to a specific study. Though the findings show that though the involvement of women on digital platforms is growing, they must walk on a long road to leave an impression. Thus, this paper clearly highlights challenges being faced by women and enhancement of their socioeconomic condition after digital advancement.

Trends in female representation in clinical practice guidelines (CPGs) among major cancer organizations.

11006 Background: While women representation and sex disparities in National Comprehensive Cancer Network (NCCN) and European Society of Medical Oncology (ESMO) has been studied in a limited set of CPGs, the sex representation and disparity trend over time among all NCCN and ESMO CPG panelists has not been studied. Our study evaluates the current sex disparities and female representation for all NCCN and ESMO CPGs as of 2020 and compared it to the 2010 CPGs of both organizations. Methods: The 2010 and 2020 version of NCCN and ESMO CPGs were examined from their respective websites and archives. We catalogued the number of female versus male panelist for each CPG. We discerned the sex of the panelists based on google search and the panelists’ affiliated institutional websites. Results: 60 NCCN (2020), 51 NCCN (2010), 78 ESMO (2020) and 55 ESMO (2010) CPGs inclusive of all cancers by site, detection prevention and risk reduction, supportive care, and guidelines for specific population were reviewed. NCCN 2020 CPGs had 55.5% female representation. 35 (58%) NCCN CPGs had predominant female representation (>50% of the members being female) whereas 24 CPG (40%) were male predominant (>50% of the members being male). Solid tumors had 24 CPGs with male predominance and hematological malignancies had 14 CPGs with female predominance. Cancers specific to women had higher proportion of female panelist. NCCN 2010 CPGs had 27.1% female representation. Both solid tumors and hematological malignancies had male predominance (82% and 75% respectively). Breast cancer screening, palliative care and older adult oncology CPGs were female predominant. ESMO 2020 had 27.8% female representation. Both solid tumors (37 CPGs) and hematological malignancies (17 CPGs) had predominant male representation (72% and 85% respectively). Breast and ovarian cancer CPGs were female predominant. ESMO 2010 had 23.2% female representation. Male representation was predominant in both solid tumors (35 CPGs) and hematological malignancies (9 CPGs). Breast, cervical and ovarian cancer CPGs were female predominant. Conclusions: Over the last decade, proportion of female panelists in NCCN CPGs has doubled with more than 50% representation among its 60 CPGs, indicating adequate representation of women. In ESMO, although there has been a significant improvement in female representation in hematological malignancies over time, it continues to have overall female underrepresentation (<30%).[Table: see text]

Sex Representation in Clinical Trials Associated with FDA Cancer Drug Approvals Differs Between Solid and Hematologic Malignancies.

Proportionate female representation in health research is necessary for scientific rigor and health equity. We aimed to assess the representation of women in clinical trials leading to U.S. Food and Drug Administration (FDA) cancer drug approvals. Trials supporting FDA cancer drug approvals between July 2008 and June 2018 were sourced from PubMed and ClinicalTrials.gov. The ratio of female to male trial enrollment was compared with cancer incidence and mortality in the U.S. using International Agency for Research on Cancer data. Reproductive tract and breast cancers were excluded. Odds ratios (ORs) and 95% confidence intervals (CIs) comparing trial enrollment with population incidence and mortality were calculated. A total of 186 trials leading to 170 FDA cancer drug approvals showed slight female underrepresentation compared with overall cancer incidence in the U.S. (OR, 0.97; 95% CI, 0.95-0.98, p < .0001). Female enrollment for drugs approved between 2008-2013 and 2014-2018 was unchanged (OR, 1.02; 95% CI, 0.99-1.05, p = .25). There was slight female underrepresentation in hematological trials (OR, 0.95; 95% CI, 0.91-0.998; p = .040 for leukemia; OR, 0.95; 95% CI, 0.90-0.997; p = .040 for lymphoma) and significant female underrepresentation in colorectal (OR, 0.72; 95% CI, 0.69-0.76; p < .0001), pancreas (OR, 0.85; 95% CI, 0.78-0.93; p = .0004), lung (OR, 0.77; 95% CI, 0.75-0.80; p < .0001), kidney (OR, 0.63; 95% CI, 0.60-0.67; p < .0001), and thyroid cancer trials (OR, 0.26; 95% CI, 0.23-0.28; p < .0001) compared with U.S. incidence. Female underrepresentation has persisted within solid organ tumor trials but is less notable in hematologic trials. Additional work is required to identify drivers of such disparity. Adequate gender representation in clinical trials is a matter of health equity. This study demonstrates that women remain underrepresented in trials across hematological and solid organ trials compared with cancer incidence and mortality in women, with the disparity worse in a number of solid organ tumor types. There are thus still significant improvements to be made regarding adequate representation of women in trials. Studies exploring the reasons for ongoing disparity in gender representation are warranted to help clinicians to rectify this.

Gender equity in scientific publishing: Analysis of publications in the Journal of Health Monitoring

Abstract Background The importance of gender- and sex-sensitive reporting and communication in science has been widely acknowledged in the past years. At the same time, a 'gendered system' of scientific publishing is increasingly discussed, given the underrepresentation of women as first and last authors, reviewers, on editorial boards and in editorial key positions. Against this background, the Journal of Health Monitoring (JoHM) - a scientific online journal published by the Federal Health Reporting at the Robert Koch Institute, Germany's national public health institute - took stock of the proportion of women among authors and reviewers. Methods Articles published in the JoHM between its founding in 2016 and the last issue in 2019 were included. Descriptive analysis was performed on the proportion of women in first and last authorship, stratified by publication format, and the proportion of peer reviews performed by women. Results A total of 145 articles were included in the analysis, comprising the categories Focus, Fact sheet, Concepts &amp; Methods, Proceedings, Abstract and Editorial. The percentage of articles with first authorship by women was 66% (95/145), ranging from 53% for Focus articles (n = 16/30) to all of the Editorials (n = 6/6). 49% of last authors were female (n = 66/135). Overall, 42% of all reviews were performed by women (n = 96/233). Conclusions With almost two third of the publications analysed, first authorship of women in the JoHM is high. However, the proportion of female last authors and reviewers is lower in comparison. Next to professional qualification, gender should be taken into account when editors select reviewers. Overall, discussion should be stimulated on adequate representation of women in all areas of scientific publishing, given the relevance of visible merits in publishing for the building of scientific careers. Key messages Publications in the Journal of Health Monitoring have a high percentage of female first authors; in comparison, the percentage of last authorship and peer reviews by women is lower. An adequate representation of women in all areas of scientific publishing is essential, given the significance of publishing for merit in science and research.

Gender Parity in Parliament: A Panacea for the Promotion and Protection of Women's Rights in Nigeria

Women’s rights are part of the fundamental human rights that are recognised in international human rights treaties. While Nigeria has acceded to a number of international instruments on the promotion and protection of women’s rights, women in this country have yet to realise their rights. The Nigerian Constitution requires that international treaties be domesticated before they apply in the country. Most of the international instruments on the promotion and protection of women’s rights have not been domesticated. One of the reasons for non domestication of international human rights treaties accentuating women’s rights in Nigeria is the lack of adequate representation of women in the country’s parliament. This is despite the fact that the right of women to participate in decision making process at all levels is guaranteed in both international and domestic instruments. This paper examined why Nigerian women are not adequately represented in parliament and the implications for the promotion and protection of women’s rights. It concluded that gender parity in the legislative houses is essential to agitate for and promote women’s rights in this country.

Influences for Gender Disparity in Academic Psychiatry in the United States.

IntroductionAcademic undertakings, including research, lead to career progression. However, the career paths of female psychiatrists appear to diverge significantly from that of their male counterparts. This article reviews the pervasiveness of the trend of women being less likely to pursue active research in psychiatry. In addition, we examine the correlation between academic rank and research productivity.MethodsWe searched the American Medical Association’s (AMA) Fellowship and Residency Electronic Interactive Database (FREIDA) to identify training programs for psychiatry. A total of 5234 psychiatrists met our inclusion criteria. The gender, academic rank, research work, and h-index of faculty members were compared. The ratio of women reaching senior ranks as compared to men was also calculated. The Scopus database was used to determine the h-index of the individuals included in this study. Data analysis was done with SPSS 22.0 Release 2013 (IBM SPSS Statistics for Windows, IBM, Armonk, NY, USA). Kruskal–Wallis and Mann–Whitney U tests were used where required, with the P-value set at less than 0.05.ResultsIn our study sample, 2181 (42%) of the psychiatrists were women. However, according to the information obtained from the websites of 23 programs, few women reached higher ranks, full professorship, or positions such as the chairperson of a program, and only 9% of women achieved the designation of chairperson of the psychiatry department, with men representing the other 91%. Higher academic rank correlated with higher h-index. A statistically-significant difference between the genders in terms of h-index was found for the assistant professor rank as well. However, this difference was not observed at the level of an associate professor.ConclusionsDespite adequate representation of women in the academic workforce in psychiatry, there appears to be a discrepancy in the research productivity of the two genders. This study highlights the need for targeted interventions to address gender disparities in academic psychiatry.

La violencia de la publicidad contra la mujer

La cultura oficial masculina no ha sabido establecer una representación femenina adecuada y en el siglo XXI se siguen perpetuando los estereotipos sobre la mujer especialimente en la publicidad mediática. A pesar de las teorías feministas en torno a la imagen de la mujer, no se han encontrado vías para erradicar la violencia simbólica que genera un efecto que permea oda la sociedad. En este trabajo se presenta y analiza un caso ilustrativo, cuyo tratamiento publicitario (verbal e icónico) no favorece la igualdad, mientras que incrementa la discriminación y el sexismo.

A Prediction Model for the Presence of Axillary Lymph Node Involvement in Women with Invasive Breast Cancer: A Focus on Older Women

Axillary lymph node (ALN) status at diagnosis is the most powerful prognostic indicator for patients with breast cancer. Our aim is to examine the contribution of variables that lead to ALN metastases in a large dataset with a high proportion of patients greater than 70 years old. Using the data from two multicenter prospective studies, a retrospective review was performed on 2,812 patients diagnosed with clinically node-negative invasive breast cancer from 1996 to 2005 and who underwent ALN sampling. Univariate and multivariate logistic regression were used to identify variables that were strongly associated with axillary metastases, and an equation was developed to estimate risk of ALN metastases. Of the 2,812 patients with invasive breast cancer, 18% had ALN metastases at diagnosis. Based on univariate analysis, tumor size, lymphovascular invasion (LVI), tumor grade, age at diagnosis, menopausal status, race, tumor location, tumor type, and estrogen and progesterone receptor status were statistically significant. The relationship between age and involvement of axillary metastases was nonlinear. In multivariate analysis, LVI, tumor size and menopausal status were the most significant factors associated with ALN metastases. Age, however, was not a significant contributing factor for axillary metastases. Tumor size, LVI, and menopausal status are strongly associated with ALN metastases. We believe that age may have been a strong factor in previous analyses because there was not an adequate representation of women in older age groups and because of the violation of the assumption of linearity in their multivariate analyses.

Mechanizmy zwiększania partycypacji kobiet w wyborach

The degree to which women are represented in the organs of national authorities stirs considerable emotions. Proposals for legal regulations providing guarantees for the adequate representation of women in parliament are presented more and more often. The paper analyzes the means and methods for increasing women’s participation in politics, with particular attention placed on how this is provided for in electoral law. The paper places particular attention on the situation in Poland.

Gender-based distributional skewness of the United Republic of Tanzania's health workforce cadres: a cross-sectional health facility survey.

BackgroundWhile severe shortages, inadequate skills and a geographical imbalance of health personnel have been consistently documented over the years as long term critical challenges in the health sector of the United Republic of Tanzania, there is limited evidence on the gender-based distribution of the health workforce and its likely implications. Extant evidence shows that some people may not seek healthcare unless they have access to a provider of their gender. This paper, therefore, assesses the gender-based distribution of the United Republic of Tanzania’s health workforce cadres.MethodsThis is a secondary analysis of data collected in a cross-sectional health facility survey on health system strengthening in the United Republic of Tanzania in 2008. During the survey, 88 health facilities, selected randomly from 8 regions, yielded 815 health workers (HWs) eligible for the current analysis. While Chi-square was used for testing associations in the bivariate analysis, multivariate analysis was conducted using logistic regression to assess the relationship between gender and each of the cadres involved in the analysis.ResultsThe mean age of the HWs was 39.7, ranging from 15 to 63 years. Overall, 75% of the HWs were women. The proportion of women among maternal and child health aides or medical attendants (MCHA/MA), nurses and midwives was 86%, 86% and 91%, respectively, while their proportion among clinical officers (COs) and medical doctors (MDs) was 28% and 21%, respectively. Multivariate analysis revealed that the odds ratio (OR) and 95% confidence interval (CI) that a HW was a female (baseline category is “male”) for each cadre was: MCHA/MA, OR = 3.70, 95% CI 2.16-6.33; nurse, OR = 5.61, 95% CI 3.22-9.78; midwife, OR = 2.74, 95% CI 1.44-5.20; CO, OR = 0.08, 95% CI 0.04-0.17 and MD, OR = 0.04, 95% CI 0.02-0.09.ConclusionThe distribution of the United Republic of Tanzania’s health cadres is dramatically gender-skewed, a reflection of gender inequality in health career choices. MCHA/MA, nursing and midwifery cadres are large and female-dominant, whereas COs and MDs are fewer in absolute numbers and male-dominant. While a need for more staff is necessary for an effective delivery of quality health services, adequate representation of women in highly trained cadres is imperative to enhance responses to some gender-specific roles and needs.

Gender Diversity in the Boardroom and Firm Performance of Malaysian Public Listed Companies

The lack of women representation on boards become an important issue recently that need to be addressed due to the benefits driven from gender diversity in the boardrooms. This study intends to examine the association between gender diversity in the board of directors and firm performance. The discovery on content analysis is used to collect the data. The population of the study comprises of the companies listed in Bursa Malaysia for both Main and ACE market for the year 2008 and 2009. Quota and simple random sampling techniques were used in order to get an adequate representation of women. The data is analyzed using ordinary least square regression method to determine the association of the variables. The finding indicates that a positive association exists between gender diversity and firm performance. This suggests that women directorship may influence firm performance.

WOMEN, REPRESENTATION AND DEMOCRACY IN POST-SADDAM IRAQ, 2003–10

Activists in post-Saddam Iraq (2003–10) were in the process of forging a new discourse. They rejected what Dahlerup and Freidenvall (2005) termed the ‘incremental track’ in favour of a ‘fast track’ discourse. Development, of the country and/or women, was no longer accepted as a prerequisite for democratic rights. Rather, activists believed that immediate measures must be taken to ensure women's inclusion for the simple reason that there can be no democracy without adequate representation of women. Yet, realities in Iraq undermined this discourse; ‘representation as presence’ did not result in the subsequent ‘representation of ideas’ hoped for by these activists. Moreover, the rising tide of communal politics threatened not only to sweep away past hard-won advances but to de-prioritise women's concerns—again.

Working mothers in the boardroom

PurposeThis paper aims to focus on the importance of ensuring that enough women take their place on boards of directors.Design/methodology/approachThe paper provides statistics to underline the under‐representation of women in the higher echelons of companies. It looks at how the problem is being confronted in a number of countries. It examines what governments and companies could and should be doing to ensure adequate representation of women on boards of directors, and the advantages that flow from this.FindingsThe paper stresses the importance of career crunch points – particularly around childbirth – when women have to make the decision about how best to balance their home and working lives. It urges companies to support women through these periods through coaching.Practical implicationsThe paper reveals that companies with strong representation of women on the boards of directors tend to perform better than those with all‐male boards.Social implicationsThe paper highlights the cost to society of the under‐representation of women at the top of companies.Originality/valueThe paper examines, from an international perspective, the problem of under‐representation of women on boards of directors.

Heart Failure in Women: Epidemiology, Biology and Treatment

Although women account for a significant proportion of the growing heart failure epidemic, they have been poorly represented in clinical trials. As emerging epidemiologic data reveal a growing prevalence and burden of disease among women, it is increasingly important that treating physicians and researchers recognize sex-based differences. Despite the overall incidence of heart failure being lower in women compared with men, the magnitude of improvement in survival over the last several decades has been less apparent in women. Women with heart failure are more likely to be older, have preserved systolic function and nonischemic cardiomyopathy. While clinical trials have demonstrated improved outcomes among heart failure patients, they have predominantly included men, yielding results that are sometimes inadequately powered to detect a benefit for women. Without adequate representation of women in clinical trials, one cannot assume that the same level of therapeutic evidence also applies to women. Nonetheless, it appears that beta-blockers and angiotensin-converting enzyme inhibitors provide the same survival benefits in women with systolic dysfunction as in men. In addition, some studies suggest that angiotensin-receptor blockers may lead to a better survival in women when compared with angiotensin-converting enzyme inhibitors. Focused research is needed to understand and guide the management of women with heart failure.

Under‐representation of women in high‐impact published clinical cancer research

Adequate representation of women in research has been deemed essential. Cancer research published in 8 journals in 2006 was reviewed. The percentage of women among study participants was compared with the proportion expected from population-based estimates of sex-specific cancer incidence, using binomial tests. Differences were assessed in sex distribution of participants by funding source, author sex, and focus of research with the Student t test, and in a linear regression model controlling for cancer type. A total of 1534 cancer research articles were identified, of which 661 (representing 1,096,098 participants) were prospective clinical studies and were analyzed further. For all 7 non-sex-specific cancer types assessed, the majority of studies analyzed included a lower proportion of women than the proportion of women among patients having cancer of that type in the general population. Among studies focusing on cancer treatment, women constituted a significantly lower overall proportion of the participants in the analyzed studies than expected for 6 of 7 non-sex-specific cancer types (P < .001). Among non-sex-specific studies, the mean percentage of participants who were women was 38.8%. Non-sex-specific studies reporting government funding had a higher percentage of female participants (mean 41.3% vs 36.9%; P = .005). In a regression model controlling for cancer type, lack of government funding (P = .03) and focus on cancer treatment (P = .03) were found to be independent significant predictors of a lower percentage of female participants. Women were under-represented as participants in recently published, high-impact studies of non-sex-specific cancers. Studies that received government funding included a higher proportion of female subjects.

Association between researcher gender and sex of participants in clinical cancer research

6607 Background: The National Institutes of Health prioritize adequate representation of women in medical research. Methods: We collected data on researchers & participants from clinical oncology s...

Women and willingness to participate in clinical trials: results from a hypothetical randomized control trial

Purpose The U.S. Congress, the Institute of Medicine, and the National Institutes of Health have all expressed great concern about insufficient representation of women in medical research, particularly within large-scale cohort and clinical safety and efficacy trials. Despite federal mandates requiring adequate representation and enrollment of women in such healthcare research, gender-related participation disparities often persist. We asked whether underrepresentation of women in clinical trials could be due to a lesser willingness to participate (WTP) on the part of women relative to men. Methods We randomly approached patients from 13 Maryland outpatient clinics to self-complete a survey of their WTP in a hypothetical cardiovascular chemoprevention randomized control trial (RCT). After participants rated their WTP on a five-point Likert scale (+WTP = very likely, likely), impact of gender on WTP was analyzed from logistic regressions, adjusted for potential sociodemographic and clinical confounders. Interactions between gender and covariates were also evaluated. Results Of 1132 eligible individuals, 70% responded. By gender, 31% of women were WTP in the hypothetical RCT, compared with 38% of men. In crude analysis, women were marginally less willing to participate in the trial (odds ratio OR = 0.74, 95% confidence interval CI = 0.55–1.00, P = 0.049). In the adjusted model, women indicated a significantly lower WTP than men (OR = 0.61, 95% CI = 0.49–0.77, P P = 0.001), having a sick family member ( P = 0.03), being current smoker ( P = 0.08), Caucasian race ( P = 0.10), having greater income (>$30,000/yr; P = 0.09), and rating religion as being less important in their lives ( P = 0.04). Conclusion Women appear less willing to participate in randomized control trials than men. This gender disparity in trial participation may be an obstacle to federal mandates requiring adequate representation of women in cohorts and clinical trials.