Recruitment Bias Research Articles

Research protocol for the validation of a new portable technology for real-time continuous monitoring of Early Warning Score (EWS) in hospital practice and for an early-stage multistakeholder assessment

IntroductionThe real-time continuous monitoring of vital parameters in patients affected by multiple chronic conditions and/or COVID-19 can lead to several benefits to the Italian National Healthcare System (IT-NHS). The UBiquitous...

Gender Bias in Academic Recruitment? Evidence from a Survey Experiment in the Nordic Region

Abstract Gender disparities in top-level academic positions are persistent. However, whether bias in recruitment plays a role in producing these disparities remains unclear. This study examines the role of bias in academic recruitment by conducting a large-scale survey experiment among faculty in Economics, Law, Physics, Political Science, Psychology, and Sociology from universities in Iceland, Norway, and Sweden. The faculty respondents rated CVs of hypothetical candidates—who were randomly assigned either a male or a female name—for a permanent position as an Associate Professor in their discipline. The results show that, despite the underrepresentation of women in all fields, the female candidates were viewed as both more competent and more hireable compared to their male counterparts. Having children or a stronger CV do not change the overall result. Consequently, biased evaluations of equally qualified candidates to Associate Professor positions do not seem to be the key explanation of the persistent gender gap in academia in the Nordic region.

In vitro and in vivo pharmacological activity of minor cannabinoids isolated from Cannabis sativa

The Cannabis sativa plant contains more than 120 cannabinoids. With the exceptions of ∆9-tetrahydrocannabinol (∆9-THC) and cannabidiol (CBD), comparatively little is known about the pharmacology of the less-abundant plant-derived (phyto) cannabinoids. The best-studied transducers of cannabinoid-dependent effects are type 1 and type 2 cannabinoid receptors (CB1R, CB2R). Partial agonism of CB1R by ∆9-THC is known to bring about the ‘high’ associated with Cannabis use, as well as the pain-, appetite-, and anxiety-modulating effects that are potentially therapeutic. CB2R activation by certain cannabinoids has been associated with anti-inflammatory activities. We assessed the activity of 8 phytocannabinoids at human CB1R, and CB2R in Chinese hamster ovary (CHO) cells stably expressing these receptors and in C57BL/6 mice in an attempt to better understand their pharmacodynamics. Specifically, ∆9-THC, ∆9-tetrahydrocannabinolic acid (∆9-THCa), ∆9-tetrahydrocannabivarin (THCV), CBD, cannabidiolic acid (CBDa), cannabidivarin (CBDV), cannabigerol (CBG), and cannabichromene (CBC) were evaluated. Compounds were assessed for their affinity to receptors, ability to inhibit cAMP accumulation, βarrestin2 recruitment, receptor selectivity, and ligand bias in cell culture; and cataleptic, hypothermic, anti-nociceptive, hypolocomotive, and anxiolytic effects in mice. Our data reveal partial agonist activity for many phytocannabinoids tested at CB1R and/or CB2R, as well as in vivo responses often associated with activation of CB1R. These data build on the growing body of literature showing cannabinoid receptor-dependent pharmacology for these less-abundant phytocannabinoids and are critical in understanding the complex and interactive pharmacology of Cannabis-derived molecules.

Spontaneous coronary artery dissection (SCAD) in men: an observational study

Abstract Background/Introduction SCAD is a rare cause of acute coronary syndrome. Approximately 90% of SCAD patients are women, and factors such as the hormonal changes of the menstrual cycle are thought to be relevant. It is therefore interesting to consider why patients without such hormonal exposure may be affected. SCAD in men remains poorly understood. Purpose To study the clinical features and natural history of SCAD in men and to see how it differs from SCAD in women. Methods Patients with SCAD were recruited by self-referral and clinician referral from across the UK. Angiograms are reviewed by two experienced cardiologists and other data is obtained from patient questionnaires and from medical records. Results 53 male SCAD patients were identified from the registry. Mean age at SCAD was 47±5.4 (SD). 1 presented with cardiac arrest, 2 as chronic dissections without a clear acute event, 15 as STEMI and 32 as NSTEMI; admission ECGs were not available for 3 patients. The vessel affected was the circumflex in 15 patients, RCA in 4, LAD in 27 and multi vessel in 7. SCAD type was 1 in seven patients, 2a in 21, 2b in 16, 3 in 7 and 4 in 2. LV function post SCAD was normal in 37 out of 50 patients with data available and mean EF was 52.4%. Of 37 with cardiac MRI data, 11 had no visible late gadolinium enhancement. 23 patients had been screened for fibromuscular dysplasia and only 1/23 had this diagnosis. 2 other patients had a non-FMD aortopathy (dilated ascending aorta) and 1 had a very small cerebral aneurysm that was not thought to represent FMD. Mean follow up from the first SCAD event was 3 years (SD 2 years); over this time period 10/51 patients had recurrent SCAD (2 patients presented as chronic dissections on elective angiography and it was not possible to date the index event). Conclusions This is the largest study so far reported of SCAD in men. The mean age was similar to that seen in women, though with a narrower age range, and the proportions of STEMI and NSTEMI are also similar. The most frequently affected vessel was the LAD. Type 2 SCAD was by far the commonest angiographic appearance. The majority of patients had preserved LV systolic function and a significant proportion had no measurable scar. These findings suggest that the presenting features of SCAD in men are very similar to those in women. The incidence of FMD appears to be far lower than in women, however; studies in female SCAD patients suggest that FMD is present in 11–86% (depending on methods used for screening). Finally, rate of recurrent SCAD in men appears significant. The largest series so far reported in SCAD (327 patients, 90.5% women, followed prospectively) showed a recurrence rate of 10.4% over 3 years. We saw a recurrence rate of 19.6%. This may simply represent the play of chance in a small population, or recruitment bias as our study is primarily retrospective, however it is an intriguing observation worthy of further investigation. Funding Acknowledgement Type of funding source: Other. Main funding source(s): BeatSCAD

Games and Fieldwork in Agriculture: A Systematic Review of the 21st Century in Economics and Social Science

Games are particularly relevant for field research in agriculture, where alternative experimental designs can be costly and unfeasible. Games are also popular for non-experimental purposes such as recreating learning experiences and facilitating dialogue with local communities. After a systematic review of the literature, we found that the volume of published studies employing coordination and cooperation games increased during the 2000–2020 period. In recent years, more attention has been given to the areas of natural resource management, conservation, and ecology, particularly in regions important to agricultural sustainability. Other games, such as trust and risk games, have come to be regarded as standards of artefactual and framed field experiments in agriculture. Regardless of their scope, most games’ results are subject to criticism for their internal and external validity. In particular, a significant portion of the games reviewed here reveal recruitment biases towards women and provide few opportunities for continued impact assessment. However, games’ validity should be judged on a case-by-case basis. Specific cultural aspects of games might reflect the real context, and generalizing games’ conclusions to different settings is often constrained by cost and utility. Overall, games in agriculture could benefit from more significant, frequent, and inclusive experiments and data—all possibilities offered by digital technology. Present-day physical distance restrictions may accelerate this shift. New technologies and engaging mediums to approach farmers might present a turning point for integrating experimental and non-experimental games for agriculture in the 21st century.

Developing and validating subjective and objective risk-assessment measures for predicting mortality after major surgery: An international prospective cohort study

Preoperative risk prediction is important for guiding clinical decision-making and resource allocation. Clinicians frequently rely solely on their own clinical judgement for risk prediction rather than objective measures. We aimed to compare the accuracy of freely available objective surgical risk tools with subjective clinical assessment in predicting 30-day mortality. We conducted a prospective observational study in 274 hospitals in the United Kingdom (UK), Australia, and New Zealand. For 1 week in 2017, prospective risk, surgical, and outcome data were collected on all adults aged 18 years and over undergoing surgery requiring at least a 1-night stay in hospital. Recruitment bias was avoided through an ethical waiver to patient consent; a mixture of rural, urban, district, and university hospitals participated. We compared subjective assessment with 3 previously published, open-access objective risk tools for predicting 30-day mortality: the Portsmouth-Physiology and Operative Severity Score for the enUmeration of Mortality (P-POSSUM), Surgical Risk Scale (SRS), and Surgical Outcome Risk Tool (SORT). We then developed a logistic regression model combining subjective assessment and the best objective tool and compared its performance to each constituent method alone. We included 22,631 patients in the study: 52.8% were female, median age was 62 years (interquartile range [IQR] 46 to 73 years), median postoperative length of stay was 3 days (IQR 1 to 6), and inpatient 30-day mortality was 1.4%. Clinicians used subjective assessment alone in 88.7% of cases. All methods overpredicted risk, but visual inspection of plots showed the SORT to have the best calibration. The SORT demonstrated the best discrimination of the objective tools (SORT Area Under Receiver Operating Characteristic curve [AUROC] = 0.90, 95% confidence interval [CI]: 0.88-0.92; P-POSSUM = 0.89, 95% CI 0.88-0.91; SRS = 0.85, 95% CI 0.82-0.87). Subjective assessment demonstrated good discrimination (AUROC = 0.89, 95% CI: 0.86-0.91) that was not different from the SORT (p = 0.309). Combining subjective assessment and the SORT improved discrimination (bootstrap optimism-corrected AUROC = 0.92, 95% CI: 0.90-0.94) and demonstrated continuous Net Reclassification Improvement (NRI = 0.13, 95% CI: 0.06-0.20, p < 0.001) compared with subjective assessment alone. Decision-curve analysis (DCA) confirmed the superiority of the SORT over other previously published models, and the SORT-clinical judgement model again performed best overall. Our study is limited by the low mortality rate, by the lack of blinding in the 'subjective' risk assessments, and because we only compared the performance of clinical risk scores as opposed to other prediction tools such as exercise testing or frailty assessment. In this study, we observed that the combination of subjective assessment with a parsimonious risk model improved perioperative risk estimation. This may be of value in helping clinicians allocate finite resources such as critical care and to support patient involvement in clinical decision-making.

Factors that influence Australian early career nurse employment outcomes and settings: A prospective cohort study.

To identify the factors influencing employment outcomes and settings for early career nurses. A shortage of nurses attracted to work in out-of-hospital settings exists. Despite this, not all nursing graduates can secure work as a nurse. Information on the factors that impact wider graduate employment is available. However, a nursing perspective is missing, especially for hard to recruit to areas. A prospective cohort study was conducted. Participants were 293 final-year undergraduate nursing students, recruited from two universities. Data were collected over 12months, commencing November 2016. English as a first language was the greatest predictor of employment for graduates. Previous health care experience and workplace preferences predicted employment in the out-of-hospital setting. Misalignment between English language requirements and industry expectations about language may lead to bias in recruitment of graduate nurses with English as their second language. Recruitment to out-of-hospital settings may be promoted by having health care experience and targeting those with a preference. Reviewing current employment policies to ensure they reflect the need for cultural diversity in the nursing workforce is critical. Additionally, research that aims to understand how preferences for out-of-hospital settings are developed will help target graduate employment strategies.

Gender bias in the recruitment of entry-level B2B salespeople

PurposeIn response to calls to reduce the gender gap in the salesforce, this study aims to examine the effect of candidate gender, manager gender and industry to explain gender bias in salesperson recruitment during screening and skill assessment.Design/methodology/approachThis paper tested the hypotheses using observational data from a national sales competition in the USA, where managers evaluated student candidates for entry-level sales positions.FindingsThis research finds gender bias during screening using the dyadic perspective. Specifically, female managers evaluate male candidates more favorably than male managers do during screening. Further, managers of service companies evaluate female candidates more favorably than managers of goods companies during screening. However, this paper finds no such effects during candidates’ skill assessment.Research limitations/implicationsThe findings indicate the importance of using dyadic research techniques to assess gender bias.Practical implicationsManagers should not use short interactions to screen candidates.Social implicationsImplicit bias exists when candidates and managers interact during screening. To reduce gender bias in recruitment the candidates and managers should interact for a longer duration.Originality/valueThis study draws upon a unique setting, where the candidates interact with the managers for screening and skill assessment. Implicit bias exists when candidates and managers interact for screening under time pressure. This paper finds no evidence of gender bias in skill assessment. This study finds that female managers are more prone to bias when evaluating male candidates than male managers. Prior work has not examined industry-based bias; this paper provides evidence of such bias in candidate screening.

Arrestin Recruitment to C-C Chemokine Receptor 5: Potent C-C Chemokine Ligand 5 Analogs Reveal Differences in Dependence on Receptor Phosphorylation and Isoform-Specific Recruitment Bias.

C-C chemokine receptor 5 (CCR5) is a chemokine receptor belonging to the G protein-coupled receptor (GPCR) superfamily. An established anti-human immunodeficiency virus drug target, CCR5 is attracting significant additional interest in both cancer and neuroinflammation. Several N-terminally engineered analogs of C-C chemokine ligand 5 (CCL5), a natural ligand of CCR5, are highly potent CCR5 inhibitors. The inhibitory mechanisms of certain analogs relate to modulation of receptor desensitization, but the cellular and molecular mechanisms have not been fully elucidated. Here we made use of a collection of CCR5 phosphorylation mutants and arrestin variants to investigate how CCL5 analogs differ from CCL5 in their capacity to elicit both CCR5 phosphorylation and arrestin recruitment, with reference to the current "core" and "tail" interaction model for arrestin-GPCR interaction. We showed that CCL5 recruits both arrestin 2 and arrestin 3 to CCR5 with recruitment, particularly of arrestin 2, strongly dependent on the arrestin tail interaction. 5P12-RANTES does not elicit receptor phosphorylation or arrestin recruitment. In contrast, PSC-RANTES induces CCR5 hyperphosphorylation, driving enhanced arrestin recruitment with lower dependence on the arrestin tail interaction. 5P14-RANTES induces comparable levels of receptor phosphorylation to CCL5, but arrestin recruitment is absolutely dependent on the arrestin tail interaction, and in one of the cellular backgrounds used, recruitment showed isoform bias toward arrestin 3 versus arrestin 2. No evidence for ligand-specific differences in receptor phosphorylation patterns across the four implicated serine residues was observed. Our results improve understanding of the molecular pharmacology of CCR5 and help further elucidate the inhibitory mechanisms of a group of potent inhibitors. SIGNIFICANCE STATEMENT: C-C chemokine receptor 5 (CCR5) is a key drug target for human immunodeficiency virus, cancer, and inflammation. Highly potent chemokine analog inhibitors act via the modulation of receptor desensitization, a process initiated by the recruitment of arrestin proteins. This study shows that potent C-C chemokine ligand 5 analogs differ from each other and from the parent chemokine in the extent and quality of CCR5-arrestin association that they elicit, providing valuable insights into CCR5 pharmacology and cell biology that will facilitate the development of new medicines targeting this important receptor.

Abstract PO-057: Cancer center support for understanding statewide COVID-19 prevalence and early detection

Abstract NCI-funded cancer centers are committed to serving the needs of their catchment area—at no other time have these needs been greater or more explicit. To this end many cancer institutes are redirecting the efforts of Community Outreach and Engagement (COE) programs to address COVID-19 related needs. The Knight Cancer Institute, recognizing the substantial resources they bring in community engagement and population science, has taken a lead role in establishing a statewide study of the prevalence of COVID-19 related symptoms and active disease. The Knight team has developed and implemented a syndromic and active surveillance system that allows monitoring of COVID-19 related symptoms as early indicators of COVID-19 accompanied by symptomatic and asymptomatic testing. The Key to Oregon study, started with state funding, will create a cohort of up to 100,000 individuals. Participants are identified with household statewide random sampling with stratification and oversampling for geography (rural/urban) and race/ethnicity. A secure, HIPAA-compliant web-based data entry portal was developed and individuals are consented to provide daily information of symptoms related to COVID-19 and a series of additional surveys addressing issues such as financial impact, mental health impact, and physical impacts (including cancer screening behaviors) of the COVID-19 pandemic. Individuals meeting symptom thresholds consistent with potential coronavirus infections are offered a mailed, home-based COVID-19 testing kit. Additionally, asymptomatic testing of randomly selected individuals will be conducted at regular intervals. In the first 2 weeks of recruitment, nearly 10,000 individuals have enrolled. Weekly review of data assesses for recruitment bias and provides focus for community engagement efforts. The Knight COE team leverages their existing relationships and infrastructure to support engagement in communities of color, Native American, Latin X, and rural groups. Listening sessions have been held and Knight will direct resources to support community organizations committed to assisting with outreach for the Key to Oregon study. The value of this study as a mechanism for informing public health policy and health care resource distribution is immense. Further, the impact, while not immediate, on cancer research and cancer care is substantial, from building community-level trust that will long outlast the pandemic, to providing early indicators of infection hot spots that allow susceptible individuals to make potentially life-saving decisions, to establishing a statewide cohort of individuals who may be re-approached for future cancer-related studies. The ability of an NCI-designated cancer center to rapidly and effectively redirect and repurpose resources has allowed for the development of this innovative statewide resource. Citation Format: Jackilen Shannon, David Bangsberg, Paul Spellman, Bridget Barnes, Jenny Lee Berry, Kim Brown, Derick DuVivier, Kathryn Goforth, Peter Graven, Christopher Peters, Kathryn Schuff, Brian Druker. Cancer center support for understanding statewide COVID-19 prevalence and early detection [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr PO-057.

Does preoperative dipyridamole-thallium scanning reduce 90-day cardiac complications and 1-year mortality in patients with femoral neck fractures undergoing hemiarthroplasty?

BackgroundThis study aimed to evaluate the effect of dipyridamole-thallium scanning (DTS) on the rates of 90-day cardiac complications and 1-year mortality in patients with a femoral neck fracture treated with hemiarthroplasty.MethodsBetween 2008 and 2015, 844 consecutive patients who underwent cemented or cementless hemiarthroplasty were identified from the database of a single level-one medical center. One-hundred and thirteen patients (13%) underwent DTS prior to surgery, and 731 patients (87%) did not. Patient characteristics, comorbidities, surgical variables, and length of the delay until surgery were recorded. A propensity score-matched cohort was utilized to reduce recruitment bias in a 1:3 ratio of DTS group to control group, and multivariate logistic regression was performed to control confounding variables.ResultsThe incidence of 90-day cardiac complications was 19.5% in the DTS group and 15.6% in the control group (p = 0.343) among 452 patients after propensity score-matching. The 1-year mortality rate (10.6% vs 13.3%, p = 0.462) was similar in the two groups. In the propensity score-matched patients, utilization of DTS was not associated with a reduction in the rate of 90-day cardiac complications (matched cohort, adjusted odds ratio [aOR] = 1.32; 95% confidence interval [CI] 0.75–2.33, p = 0.332) or the 1-year mortality rate (aOR = 0.62; 95% CI 0.27–1.42, p = 0.259). Risk factors for cardiac complications included an American Society of Anesthesiologists grade ≥ 3 (OR 3.19, 95% CI 1.44–7.08, p = 0.004) and pre-existing cardiac comorbidities (OR 5.56, 95% CI 3.35–9.25, p < 0.001). Risk factors for 1-year mortality were a long time to surgery (aOR 1.15, 95% CI 1.06–1.25, p = 0.001), a greater age (aOR 1.05, 95% CI 1.00 to 1.10, p = 0.040), a low body mass index (BMI; aOR 0.89, 95% CI 0.81–0.98, p = 0.015), and the presence of renal disease (aOR 4.43, 95% CI 1.71–11.46, p = 0.002).DiscussionPreoperative DTS was not associated with reductions in the rates of 90-day cardiac complications or 1-year mortality in patients with a femoral neck fracture undergoing hemiarthroplasty. The necessity for DTS should be re-evaluated in elderly patients with femoral neck fractures, given that this increases the length of the delay until surgery.Level of evidencePrognostic level III

Program Directors Survey on Diversity in Cardiovascular Training Programs

BackgroundWomen and minorities are under-represented in cardiovascular disease (CVD) specialties. It remains unknown how characteristics of the CVD learning environment affect diversity and how program directors (PDs) approach these critical issues. ObjectivesThe second annual Cardiovascular PD Survey aimed to investigate characteristics of the CVD learning environment that may affect diversity and strategies PDs use to approach these issues. MethodsThe survey contained 20 questions examining U.S.-based CVD PD perceptions of diversity in CVD and related characteristics of the CVD fellowship learning environment. ResultsIn total, 58% of PDs completed the survey. Responding programs demonstrated geographic diversity. The majority were university-based or -affiliated. A total of 86% of PDs felt diversity in CVD as a field needs to increase, and 70% agreed that training programs could play a significant role in this. In total, 89% of PDs have attempted to increase diversity in fellowship recruitment. The specific strategies used were associated with PD sex and the presence of under-represented minority trainees in the program. PDs identified lack of qualified candidates and overall culture of cardiology as the 2 most significant barriers to augmenting diversity. A majority of programs have support systems in place for minority fellows or specific gender groups, including procedures to report issues of harassment or an unsafe learning environment. PDs identified shared best practices for recruitment and implicit bias training, among others, as important resources in their efforts to support diversity in CVD training. ConclusionsDiversity is important to CVD PDs. They are striving to increase it in their programs through recruitment and strategies directed toward the fellowship learning environment. The CVD community has opportunities to standardize strategies and provide national resources to support PDs in these critical efforts.

Patient distrust in pharmaceutical companies: an explanation for women under-representation in respiratory clinical trials?

BackgroundPatient skepticism concerning medical innovations can have major consequences for current public health and may threaten future progress, which greatly relies on clinical research.The primary objective of this study is to determine the variables associated with patient acceptation or refusal to participate in clinical research. Specifically, we sought to evaluate if distrust in pharmaceutical companies and associated psychosocial factors could represent a recruitment bias in clinical trials and thus threaten the applicability of their results.MethodsThis prospective, multicenter survey consisted in the administration of a self-questionnaire to patients during a pulmonology consultation. The 1025 questionnaires distributed collected demographics, socio-professional and basic health literacy characteristics. Patients were asked to rank their level of trust for pharmaceutical companies and indicate their willingness to participate in different categories of research (pre or post marketing, sponsored by an academic institution or pharmaceutical company).Logistic regression was used to determine factors contributing to “trust” versus “distrust” group membership and willingness to participate in each category of research.ResultsOne thousand patients completed the survey, corresponding to a response rate of 97.5%. Data from 838 patients were analyzed in this study.48.3% of respondents declared that they trusted pharmaceutical companies, while 35.5% declared distrust. Being female (p = 0.042), inactive in the employment market(p = 0.007), and not-knowing the name of one’s disease(p = 0.010) are factors related to declared distrust. Distrust-group membership is associated with unwillingness to participate in certain categories of trials such as pre-marketing and industry-sponsored trials.ConclusionDistrust in pharmaceutical companies is associated with a specific patient profile and with refusal to participate in certain subcategories of trials. This potential recruitment bias may explain the under-representation of certain categories of patients such as women in pre-marketing drug trials.

Assessment of Sex Differences in Recovery of Motor and Sensory Impairments Poststroke

Background. Understanding potential sex differences in stroke recovery is important for prognosis, ensuring appropriate allocation of health care resources, and for stratification in research studies. Previously, functional measures have shown poorer outcomes for females, however, little is known about sex differences that may exist in specific motor and sensory impairments. Objective. The aim of this study was to utilize robotic assessments of motor and sensory impairments to determine if there are sex differences at the impairment level in stroke recovery over the first 6 months poststroke. Methods. We used robotic and clinical assessments of motor and sensory impairments at 1, 6, 12, and 26 weeks poststroke in 108 males and 52 females. Linear mixed models were used to examine the effect of sex on recovery poststroke, controlling for age and lesion volume. Results. In general, we did not find significant sex differences across a range of assessments. The exception to this was a sex × age interaction for the Purdue Pegboard Assessment, where we found that females had better performance than males at younger ages (<62 years), but males had better performance at older ages. Conclusions. While recruitment biases need to be acknowledged when generalizing our results to stroke recovery at-large, our results suggest that sex differences do not exist at the impairment level poststroke.

Discriminatory job advertisements for English language teachers in Colombia: An analysis of recruitment biases

AbstractNumerous studies have explored the persistence of discrimination against nonnative‐English‐speaking teachers (NNESTs) of English as a foreign or second language in various contexts. However, the author of this article could find no study that explores the prevalence of “native‐speakerism” and other forms of discrimination in English language teacher recruitment in South America. The current study thus investigated the extent to which online postings for English language teachers in Colombia expressed a preference for native‐English‐speaking teachers (NESTs) and how this discrimination intersects with other inequitable hiring practices. The author conducted content analysis on job ads found on two prominent Facebook groups for English language teachers in Colombia. The findings reveal evidence of discrimination in nearly half of the 95 job ads analysed. These ads discriminate based on age, gender, nationality, variety of English, the location where a prospective teacher gained their qualifications, and “nativeness.” The study tentatively concludes that this discrimination has several dimensions, with those further from the colonial “centre” facing greater degrees of discrimination. The mutually reinforcing constructs of coloniality and native‐speakerism help account for the persistence of such discrimination, which is also reflected in the Colombian governments’ linguistic policies.

The Relationship of Residency and Fellowship Sites to Academic Faculty and Leadership Positions.

After completion of training, a physician's training institution has a lasting and meaningful impact on career trajectory. Training program influence on first job placement and academic promotions remain uncertain in academic plastic surgery. The aim of this study was to determine the impact of training and internal bias in academic plastic surgery employment and promotion. Academic plastic surgery faculty were identified through an internet search of all Accreditation Council for Graduate Medical Education-accredited residency training programs. Faculty demographics, training background, employment, and leadership status were gathered. The analysis examined the impact of internal recruitment bias on first job employment, the impact of training history on institutional leadership promotion (chair/chief, residency director, or fellowship director), and the impact of alumni effect on academic employment. A significant proportion of recent graduates (38.6%) are practicing at the same institution as where they received residency or fellowship training. Of the 229 institutional leaders, 31.5% of chairs/chiefs, 39.6% of residency directors, and 37.5% of fellowship directors were internal hires. Overall, 34% of plastic surgery faculty in the United States share a common training program with at least 1 colleague. The top 5 programs that have the most faculty who trained at their hiring institution are Harvard (30 faculty), University of Southern California (15 faculty), University of California Los Angeles (12 faculty), University of Michigan (12 faculty), and Albert Einstein (12 faculty). Overall, 54% of plastic surgery departments employ 2 or more faculty who share a common external training program. The top 5 programs that have the most faculty who share an external training program are (1) Methodist Houston, 8 faculty who trained at Baylor; (2) Hofstra, 7 faculty who trained at New York University; (3) Stanford, 6 faculty who trained at University of California, Los Angeles; (4) Wisconsin, 5 faculty who trained at University of Pittsburgh Medical Center; and (5) University of Southern California, 4 faculty who trained at New York University. The study highlights that an internal bias exists in the recruitment for first jobs and leadership promotions. However, a clear bias of internal hiring exists at several institutions. In addition, an alumni effect was identified, where some programs have a bias of hiring faculty who trained at the same external institution.

The impact of implicit bias in the pandemic age: Protecting our pediatric patients.

The impact of implicit bias in the pandemic age: Protecting our pediatric patients.

Advances and challenges in conducting ethical trials involving populations lacking capacity to consent: A decade in review

Informed consent is an essential requirement prior to clinical trial participation, however some ‘vulnerable’ groups, such as people with cognitive impairments and those in medical emergency situations, may lack decisional capacity to consent. This raises ethical and practical challenges when designing and conducting clinical trials involving these populations, who are frequently excluded as a result. Despite recent advances in improving informed consent processes, there has been far less attention paid to the enrolment of adults lacking capacity.Exclusion criteria are an important determinant of the external validity of clinical trial results. The exclusion of these populations, and consent-based recruitment biases which arise from the challenges of identifying and involving surrogate decision-makers, leads to trials which are not representative of the clinical population.This article discusses the involvement of adults who lack decisional capacity to consent in clinical trials and presents the advances over the previous decade and the remaining ethical challenges for the inclusion of this under-represented population in research.

Density and diameter distributions of saplings in naturally regenerated and planted coniferous stands in Québec after various approaches of commercial thinning

A model describing species composition, density and diameter distribution of saplings was developed from operational inventory data. It could be used as an input into growth models calibrated exclusively with merchantable trees to correct some recruitment bias. Important differences in distributions were found between plantations and naturally regenerated stands. Longer-term monitoring would be required to observe the effects of thinning treatments on saplings. Saplings play important ecological and structural roles in forest stands. They also constitute the pool of candidate trees that are responsible for recruitment of merchantable sized trees. However, sapling information is often absent from regular inventory measurements (e.g. where no saplings are measured) even though they could be used as inputs in predicting recruitment in merchantable trees. The objectives were to develop models describing density and diameter distribution of saplings from operational inventories, e.g. having only merchantable tree inventory, and to evaluate how stand type (naturally regenerated stands and plantations) and various thinning treatments influence these distributions. Using data from both white spruce (Picea glauca [Moench] Voss) plantations and naturally regenerated balsam fir (Abies balsamea (L.) Mill.) stands having been commercially thinned, a zero-inflated poisson regression was used to model the stand density and a gamma regression to predict the two parameters of the Weibull used to characterize the diameter distribution. Despite the fact that the operational inventory data is often limited (e.g. species, dbh, height), the accuracy of the models was good and unbiased. It could be integrated into growth models to complete missing sapling distributions and help to correct some recruitment bias. Important differences in species composition, density and diameter distribution were found between plantations and naturally regenerated stands, but only a moderate response in diameter distribution was observed with thinning treatments. These models will enable managers to estimate saplings in intermediate aged softwood forests of eastern Quebec using harvesting inventories or National Forest Inventory. Characterization of differences between plantations and naturally regenerated stands will be useful for integrating intensive plantation silviculture with ecosystem-based management. Longer-term follow-up would be needed to better evaluate the effects of thinning treatments.

Generalizability of Results From Dyadic Data: Participation of One Versus Two Members of a Romantic Couple Is Associated With Breakup Likelihood.

With a growing body of relationship research relying on dyadic data (i.e., in which both members of a couple are participants), researchers have raised questions about whether such samples are representative of the population or unique in important ways. In this research, we used two large data sets (Study 1: n = 5,118; Study 2: n = 5,194) that included participants with and without a romantic partner participating to examine if co-participation status has substantive relationship implications. Results showed that co-participation status predicted breakup even after controlling for other known predictors such as satisfaction, although the effect weakened over time (Study 2). There was also tentative evidence that factors such as conflict may be differentially related to breakup among couples in which one versus both partners participated. These findings raise caution in interpreting effects found in dyadic studies and highlight the need to be mindful of potential bias in recruitment.