Difference In Proportion Of Women Research Articles

Workforce diversity in cardiothoracic surgery: An examination of recent demographic changes and the training pathway

IntroductionThe purpose of our study was to examine changes in the demographic makeup of resident physicians in integrated 6-year cardiothoracic surgery and traditional thoracic surgery residency programs from 2013 to 2022 compared with other surgical subspecialties and determine potential leaks in the training pathway. MethodsData from US Graduate Medical Education reports from 2013 to 2022 and medical student enrollment data from the Association of American Medical Colleges were obtained. Average percentages of women and underrepresented minorities were calculated in 2 5-year intervals: 2013 to 2017 and 2018 to 2022. Average percentages of women, Black, and Hispanic medical students and residents were calculated for the 2019 to 2022 period. Pearson χ2 tests were conducted to determine significant differences in proportions of women, Black/African American, and Hispanic trainees across time (α = 0.05). ResultsThoracic surgery and I6 residents saw a significant increase in the proportion of women trainees across the 2 time periods (19.9% (210 out of 1055) to 24.6% (287 out of 1169) (P < .01) and 24.1% (143 out of 592) to 28.9% (330 out of 1142) (P < .05)), respectively. There was no significant change in the proportion of Black and Hispanic trainees in thoracic surgery fellowship or integrated 6-year cardiothoracic residency programs. Hispanic trainees were the only group whose proportion of cardiothoracic surgery trainees was not significantly lower than their medical school proportion. Women and Black trainees had significantly lower proportions of thoracic surgery residents and integrated 6-year cardiothoracic residency program residents than their proportions in medical school (P < .01). ConclusionsCardiothoracic surgery has not significantly increased the number of Black and Hispanic trainees during the past decade. The lower proportion of Blacks and women in thoracic surgery residency and fellowship programs compared with their proportion in medical schools is concerning and is an opportunity for intervention.

Sex differences and occupational choice Theorizing for policy informed by behavioral science✰

Occupations are segregated with respect to sex, even in modern, egalitarian societies. There are strong pressures to eliminate segregation and therefore strong reasons to correctly theorize why segregation persists. The dominant view underpinning most public policies is essentially that environmental factors nudge women and men into different occupational paths. Nudging, however, ignores research suggesting that psychological traits that influence occupational choice differs between women and men, on average.Some of the most well-documented and persistent average sex differences between men and women suggest that the taken-for-granted assumption that an egalitarian society would exhibit a more or less equal distribution of men and women across the occupational landscape may be mistaken. Rather, models of occupational choice informed by individual differences in preferences, broadly understood, would help us better explain how men and women behave in the labor market. Differences in occupational preferences will affect choices. Therefore, differences in proportions of women and men across professions may be in line with an egalitarian society and the well-being and best interest of both men and women in society.

MP10-13 AUTHORSHIP IN UROLOGY: A GENDER REVEAL

You have accessJournal of UrologyCME1 May 2022MP10-13 AUTHORSHIP IN UROLOGY: A GENDER REVEAL Leah Beland, Ginnie Jeng, Tareq Aro, and Jessica Kreshover Leah BelandLeah Beland More articles by this author , Ginnie JengGinnie Jeng More articles by this author , Tareq AroTareq Aro More articles by this author , and Jessica KreshoverJessica Kreshover More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002532.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: According to the American Urological Association (AUA) 2019 census, the percentage of women practicing urologists is 9.9% of the workforce in the USA, making urology one of the least gender-diverse specialties recognized by the Accreditation Council for Graduate Medical Education.The purpose of this study is to identify the proportion of urologic studies published in 5 major urologic journals by women in 2019 in the USA. We also aim to determine if any significant difference exists in the types of urologic studies authored by women as compared to those by men. METHODS: A cross-sectional study was designed to analyze trends in women authorship of urology publications in 2019 compared to AUA 2019 census data. All studies published by authors from USA institutions between January and April of 2019 in Journal of Urology, BJU International, Journal of Endourology, European Urology, and Prostate Cancer and Prostatic Diseases were evaluated. The gender of first and senior authors were collected. Studies were categorized as basic science, clinical medicine, economics/practice management, review/meta-analysis, editorial, and case report/technique. Chi-squared test was used for statistical analyses and p values <0.05 were considered statistically significant. RESULTS: 184 publications were included in this study. The proportion of women first authors was significantly higher than would be expected based on population proportions, X2 (1, N=178)=9.65, p=0.002. There was no significant difference in proportion of women senior authors compared to expected, X2 (1, N=165)=2.18, p=0.14. The proportion of women with basic science publications was significantly higher than expected, X2 (1, N=18)=6.45, p=0.011. There were no differences in proportion of women compared to men in all other types of studies, including case report/technique, X2 (1, N=14)=1.54, p=0.215, clinical medicine, X2 (1, N=178)=3.43, p=0.064, economics/practice management, X2 (1, N=40)=1.17, p=0.28, editorial, X2 (1, N=70)=0, p=0.978, and review/meta-analysis, X2 (1, N=42)=2.16, p=0.142. CONCLUSIONS: A recent study showed that amongst physicians, women were less likely than men to be promoted in academic medicine. This gender gap exists despite the high productivity of women as first authors in this study. This may reflect the growing number of women in urology training programs. As one of the least gender-diverse specialties, it is imperative that urologic institutions not only encourage productivity amongst women trainees and urologists but ultimately take actions to promote the advancement of women urologists within the ranks of academic leadership. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e151 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Leah Beland More articles by this author Ginnie Jeng More articles by this author Tareq Aro More articles by this author Jessica Kreshover More articles by this author Expand All Advertisement PDF DownloadLoading ...

Effect of a community-based intervention to increase participation in cervical cancer screening among Pakistani and Somali women in Norway

BackgroundNorway implemented a regular cervical cancer screening program based on triennial screening in 1995, recommending participation of all women between 25 and 69 years of age. Somali and Pakistani women have the lowest participation in cervical cancer screening in Norway. This study evaluates the effect of a community-based intervention aimed at increasing participation in the screening program among women from these two groups.MethodsThe intervention consisted of an oral 20–25 min presentation in Urdu and Somali on cervical cancer and screening and practical information on how to make an appointment and payment for the test. The participants were invited to pose questions related to the topic after the presentation. This study was carried out in four geographical areas surrounding the capital Oslo between February and October 2017, among women aged 25–69 years from Pakistan and Somalia. We recruited women in the intervention group directly from different community institutions, households, and religious sites. Women from Pakistan and Somalia residing in Oslo were the controls. The absolute intervention effect was measured as difference in absolute proportion of women screened and estimated as the interaction between time and group allocation in a generalized estimation equation model with binomial distribution and identity link function.ResultsThe percentage of women screened in the intervention group increased, from 46 to 51%. The corresponding increase in proportion in the control group was from 44 to 45.5%. After adjustment for potential confounders the intervention group showed a significant larger increase in participation in the screening program as compared to the control group with an absolute difference in change in proportion screened of 0.03 (95% CI; 0.02- 0.06).ConclusionsOur findings suggest that theory-based, culturally and linguistically sensitive educational interventions can raise awareness and motivate immigrant women to participate in cervical cancer screening program. In addition, approaching health professionals as well as immigrant women, might improve participation even more.Trial registrationNCT03155581. Retrospectively registered, on 16 May 2017.

Phosphatidylethanol as Blood Biomarker of Alcohol Consumption in Early Pregnancy: An Observational Study in 4,067 Pregnant Women.

The teratogenic effects of alcohol are well documented, but there is a lack of screening methods to detect alcohol use during pregnancy. Phosphatidylethanol 16:0/18:1 (PEth) is a specific and sensitive biomarker reflecting alcohol intake up to several weeks after consumption. The aim of this study was to investigate the prevalence of positive PEth values as an indicator of early prenatal alcohol exposure in a general population of pregnant women. Rhesus typing is routinely performed in Norway in all pregnancies around gestational week 12. Rhesus-negative women have an additional test taken around week 24. Blood samples submitted to St. Olav University Hospital in Trøndelag, Norway, for Rhesus typing during the period September 2017 to October 2018 were collected. A total of 4,533 whole blood samples from 4,067 women were analyzed for PEth (limit of quantification of 0.003µM). Fifty-eight women had a positive PEth sample. Of these, 50 women were positive around gestational week 12, 3 women were positive around week 24, and in 5 cases, the timing was unknown. There were no significant differences in proportions of women with positive PEth values related to age, or rural versus urban residency. In an unselected pregnant population in Norway, 1.4% had a positive PEth sample around gestational week 12, whereas 0.4% had a positive sample around week 24. The use of PEth as an alcohol biomarker should be further investigated as a diagnostic tool in the antenatal setting.

Delayed breast cancer diagnosis after repeated recall at biennial screening mammography: an observational follow-up study from the Netherlands

BackgroundDelay in detection of breast cancer may worsen tumour characteristics, with progression of tumour size and a higher risk of metastatic lymph nodes. The purpose of this study was to investigate delayed breast cancer diagnosis after repeated recall for the same mammographic abnormality at screening.MethodsThis was a retrospective study performed in two cohorts of women enrolled in a mammography screening programme in the Netherlands. All women aged 50−75 who underwent biennial screening mammography either between January 1, 1997 and December 31, 2006 (cohort 1) or between January 1, 2007 and December 31, 2016 (cohort 2) were included.ResultsThe cohorts showed no difference in proportions of women with delayed breast cancer diagnosis of at least 2 years (2.2% versus 2.8%, P = 0.29). Most delays were caused by incorrect BI-RADS classifications after recall (74.2%). An increase in mean tumour size was seen when comparing sizes at initial false-negative recall and at diagnosis of breast cancer (P < 0.001).ConclusionsThe proportion of women with a long delay in breast cancer confirmation following repeated recall at screening mammography has not decreased during 20 years of screening. These delays lead to larger tumour size at detection and may negatively influence prognosis.

Trends in women’s authorship in pharmacy literature

ObjectivesThe purpose of this evaluation was to determine whether the percentage of women as first authors in pharmacy journals has continued to increase over the past decade. MethodsKey pharmacy practice journals were identified from the American Association of Colleges of Pharmacy Core List of Journals for Pharmacy Education. Articles were analyzed from January 2007 through December 2017. The outcome of interest was the proportion of articles having feminine names as the first author. Femininity was determined for first authors by matching the first name to data from the U.S. Social Security Administration or genderize.io. The Cochran–Armitage trend test was used to determine differences in proportion of women as first authors over time. ResultsThe listed first authors over the past decade were 52.7% female for all studied journals from 2007 through 2017. All but 1 journal demonstrated a significant increase in the proportion of female first authors over the time period studied. Subanalyses of journals (1) containing more than 90% gender-identifiable articles, (2) focused predominantly on contemporary drug therapy or pharmacy practice and not typically including pharmaceutical- or pharmacokinetics-related topics, and (3) that did not focus predominantly on contemporary therapy or practice and included pharmaceutical- or pharmacokinetics-related topics were each significant. ConclusionFemale first authorship in pharmacy practice journals appears to have increased in the past decade but may potentially be reaching a plateau. The proportion of female first authorship is close to reaching that of women in the U.S. pharmacy workforce when compared over the same time period.

Sex-related inequalities in management of patients with acute coronary syndrome-results from the EURHOBOP study.

Real-world data from different levels of hospital specialisation would help to understand if differences in management between women and men with acute coronary syndrome (ACS) are still a priority target. We aimed to identify sex inequalities in management of patients with different types of ACS. We analysed 1757 patients with a non-ST-elevation ACS (NSTEACS) and 1184 with ST elevation myocardial infarction (STEMI) or left bundle branch block (non-classifiable (NC) ACS (STEMI/NC ACS group), consecutively discharged from ten Portuguese hospitals with different specialisation levels, between 2008 and 2010. We estimated odds ratios (OR) and 95% confidence intervals (95% CI) for the association between sex and the performance of coronary angiography, reperfusion and revascularisation. Among STEMI/NC ACS, men had higher probability of performing coronary angiography than women (adjusted OR=1.64, 95% CI: 1.11-2.44), while among NSTEACS patients there was no significant difference by sex (adjusted OR=1.26, 95% CI: 0.99-1.62). In patients who underwent coronary angiography, there was no difference in proportion of women and men submitted to revascularisation, regardless of the ACS type. Although men with STEMI/NC ACS were more likely to undergo reperfusion (crude OR=2.17, 95% CI: 1.68-2.81), the effect became not significant after multivariable adjustment (adjusted OR=1.33, 95% CI: 0.96-1.84). Women diagnosed with STEMI/NC, but not NSTEACS, had lower probability when compared with men to be submitted to coronary angiography. There was no difference in performance of reperfusion and revascularisation by sex.

Evaluation of a bespoke training to increase uptake by midwifery teams of NICE Guidance for membrane sweeping to reduce induction of labour: a stepped wedge cluster randomised design

BackgroundNational guidance recommends pregnant women are offered membrane sweeping at term to reduce induction of labour. Local audit suggested this was not being undertaken routinely across two maternity units in the West Midlands, UK between March and November 2012.MethodsBespoke training session for midwifery teams (nine community and one antenatal clinic) was developed to address identified barriers to encourage offer of membrane sweeping, together with an information leaflet for women and appointment of a champion within each team.The timing of training session on membrane sweeping to ten midwifery teams was randomly allocated using a stepped wedge cluster randomised design. All women who gave birth in the Trusts after 39 + 3/40 weeks gestation within the study time period were eligible. Relevant anonymised data were extracted from maternity notes for three months before and after training. Data were analysed using a generalised linear mixed model, allowing for clustering and adjusting for temporal effects.Primary outcomes were number of women offered and accepting membrane sweeping and average number of sweeps per woman. Sub-group comparisons were undertaken for adherence to Trust guidance and potential influence of pre-specified maternal characteristics. Data included whether sweeping was offered but declined and no record of membrane sweeping.ResultsTraining was given to all teams as planned. Analyses included data from 2787 of the 2864 (97%) eligible low-risk women over 39 + 4 weeks pregnant. Characteristics of the women were similar before and after training. No evidence of difference in proportion of women being offered and accepting membrane sweeping (44.4% before training versus 46.8% after training (adjusted relative risk [aRR] = 0.90, 95% confidence interval [CI] = 0.71–1.13), nor in average number of sweeps per woman (0.603 versus 0.627, aRR = 0.83, 95% CI = 0.67–1.01). No differences in any secondary outcomes nor influence of maternal characteristics were demonstrated. The midwives evaluated training positively.ConclusionsThis stepped wedge cluster trial enabled randomised evaluation within a natural roll-out and demonstrates the importance of robust evaluation in circumstances in which it is rarely undertaken. While the midwives evaluated the training positively, it did not appear to change practice.Trials registrationISRCTN14300475. Registered on 23 August 2016.

Influence of a targeted performance measure for brief intervention on gender differences in receipt of brief intervention among patients with unhealthy alcohol use in the Veterans Health Administration

AimsWomen are less likely than men to receive brief intervention (BI) for unhealthy alcohol use. In 2007, the U.S. Veterans Health Administration (VA) used a national performance measure to implement BI. Although AUDIT-C scores ≥3 for women and ≥4 for men optimize sensitivity and specificity for identifying unhealthy alcohol use, VA's performance measure required BI only among a targeted subgroup defined by a non-gender-specific score threshold (AUDIT-C ≥5). This may have influenced gender differences in receipt of BI among those optimally eligible for BI. Therefore, we evaluate differences in proportions of women and men offered BI before and after BI implementation. MethodsNational secondary chart review data (7/06-6/10) identified all outpatients with unhealthy alcohol use for whom BI would be indicated (AUDIT-C ≥3 women, ≥4 men). Logistic regression, including a time-by-gender interaction, estimated the prevalence and 95% confidence interval (CI) of BI for women and men pre- and post-implementation. FindingsAmong patients optimally eligible for BI (n=51,272, 8206 women and 43,066 men), the prevalence of BI increased more steeply for men than women after implementation (interaction p-value <0.0001). Pre-implementation rates of BI were 21% (95% CI, 18–24) for women and 26% (95% CI, 24–29) for men, and post-implementation rates were 32% (95% CI, 30–34) for women and 47% (95% CI, 45–49) for men. ConclusionsHealthcare systems implementing BI with performance measures may wish to consider that specifying a single alcohol screening threshold for men and women may increase gender differences in receipt of BI among patients likely to benefit.

Longitudinal changes in menopausal symptoms comparing women randomized to low-dose oral conjugated estrogens or transdermal estradiol plus micronized progesterone versus placebo: the Kronos Early Estrogen Prevention Study.

The objective of the present study was to compare the efficacy of two forms of menopausal hormone therapy in alleviating vasomotor symptoms, insomnia, and irritability in early postmenopausal women during 4 years. A total of 727 women, aged 42 to 58, within 3 years of their final menstrual period, were randomized to receive oral conjugated estrogens (o-CEE) 0.45 mg (n = 230) or transdermal estradiol (t-E2) 50 μg (n = 225; both with micronized progesterone 200 mg for 12 d each mo), or placebos (PBOs; n = 275). Menopausal symptoms were recorded at screening and at 6, 12, 24, 36, and 48 months postrandomization. Differences in proportions of women with symptoms at baseline and at each follow-up time point were compared by treatment arm using exact χ tests in an intent-to-treat analysis. Differences in treatment effect by race/ethnicity and body mass index were tested using generalized linear mixed effects modeling. Moderate to severe hot flashes (from 44% at baseline to 28.3% for PBO, 7.4% for t-E2, and 4.2% for o-CEE) and night sweats (from 35% at baseline to 19% for PBO, 5.3% for t-E2, and 4.7% for o-CEE) were reduced significantly by 6 months in women randomized to either active hormone compared with PBO (P < 0.001 for both symptoms), with no significant differences between the active treatment arms. Insomnia and irritability decreased from baseline to 6 months postrandomization in all groups. There was an intermittent reduction in insomnia in both active treatment arms versus PBO, with o-CEE being more effective than PBO at 36 and 48 months (P = 0.002 and 0.05) and t-E2 being more effective than PBO at 48 months (P = 0.004). Neither hormone treatment significantly affected irritability compared with PBO. Symptom relief for active treatment versus PBO was not significantly modified by body mass index or race/ethnicity. Recently postmenopausal women had similar and substantial reductions in hot flashes and night sweats with lower-than-conventional doses of oral or transdermal estrogen. These reductions were sustained during 4 years. Insomnia was intermittently reduced compared with PBO for both hormone regimens.

Invitation to cervical cancer screening does increase participation in Germany: Results from the MARZY study.

The effect of different invitation models on participation in cervical cancer screening (CCS) was investigated in a randomized population-based cohort study in Germany. Participants were randomly selected via population registries and randomized into intervention Arm A (invitation letter) and Arm B (invitation letter and information brochure) or control Arm C (no invitation). The intervention and control arms were compared with regard to 3-year participation and the two invitation models were compared between intervention arms. Of the 7,758 eligible women aged 30-65 years, living in the city of Mainz and in the rural region of Mainz-Bingen, 5,265 were included in the analysis. Differences in proportions of women attending CCS were investigated and logistic regression was performed to analyze various factors influencing participation. In the intervention group, 91.8% participated in CCS compared to 85.3% in the control group (p < 0.0001), with a 6.6 percentage point increase in participation [95% confidence interval (CI) 4.6-8.6] and an adjusted odds ratio (OR) of 2.69 (95% CI 2.15-3.37). Effect estimators increased to 21.9 percentage points (95% CI 16.7-27.1) and an OR of 3.64 (95% CI 2.74-4.82), respectively, when women who participated in screening annually were excluded from the analysis. The invitation letter was particularly effective among women with lower school education, migrant women and older women. No difference in participation was found between the intervention Arm A and Arm B. An accompanying information brochure did not motivate more women to undergo CCS. However, a written invitation statistically significantly increased participation in CCS in Germany.

Impact of a multi-component antenatal vaccine promotion package on improving knowledge, attitudes and beliefs about influenza and Tdap vaccination during pregnancy

ABSTRACTObjective: Understanding whether interventions designed to improve antenatal vaccine uptake also change women's knowledge about vaccination is critical for improving vaccine coverage. This exploratory study evaluates the effectiveness of a multi-component influenza and tetanus, diphtheria, and acellular pertussis (Tdap) vaccine promotion package on improving women's knowledge, attitudes and beliefs toward antenatal vaccination. Study Design: In 2012/2013 a cluster-randomized trial was conducted to test the effectiveness of a vaccine promotion package on improving antenatal vaccine coverage. Participants included 325 unvaccinated pregnant women from 11 obstetric practices in Georgia. Eleven health beliefs measures were assessed at baseline and 2–3 months post-partum. Outcomes were differences in proportions of women citing favorable responses to each measure between study groups at follow-up. Results: Women enrolled in their third trimester had a higher probability of asking family members to vaccinate to protect the infant if they were in the intervention group versus the control group (36% vs. 22%; risk ratio [RR] = 1.65, 95% confidence interval [CI]: 1.21, 2.26). A similar association was not observed among women enrolled before their third trimester (39% vs. 44%; RR = 0.93, 95% CI: 0.50, 1.73). There were no other significant differences at follow-up between study groups. Conclusions: While exposure to the intervention package may have raised awareness that vaccinating close contacts can protect an infant, there is little evidence that the package changed women's attitudes and beliefs toward antenatal vaccination. Future research should ensure adequate exposure to the intervention and consider study design aspects including power to assess changes in secondary outcomes, discriminatory power of response options, and social desirability bias. This study is registered with clinicaltrials.gov, study ID NCT01761799.

Effective approaches to persuading pregnant women to quit smoking: a meta-analysis of intervention evaluation studies.

The study aimed to: (1) assess the effectiveness of prenatal smoking cessation interventions, (2) clarify whether the psychological changes targeted by interventions are related to their effectiveness, (3) identify specific intervention components associated with greater effectiveness, and (4) establish whether aspects of evaluation methodology are associated with a greater effectiveness. Differences in proportions of women quitting and odds ratios were calculated for the intervention and control groups. Interventions were categorized in relation to the main intervention target (i.e. cognitive preparation versus increased threat perception), use of follow-up contact, use of individual cessation counselling and other characteristics. Methodological approaches to evaluation were also categorized. A systematic literature review generated 36 controlled evaluations, including one unpublished study. A meta-analysis was used to relate study classifications to effectiveness. This involved univariate analyses and a multivariate model of the relationship between observed univariate effects. A weighted mean odds ratio of 1.93 indicated a good overall effectiveness. Cognitive preparation interventions achieved higher quit rates (6.5%) compared to interventions focusing on threat perception (2.2%). However, this effect was not maintained in the multivariate analysis. Interventions should employ follow-up, but further research is required to assess the impact of one-to-one counselling. Clarification of the psychological change processes underlying the observed effectiveness of these interventions is required. Future research should seek to identify the active ingredients and cognitive mediators of successful interventions.

Comparison of body mass indexes and cutoff points for estimating the prevalence of overweight on Hispanic women

The anthropometric standards used for estimating the prevalence of overweight among Hispanic groups are generally developed in other populations. Our purpose was to identify appropriate anthropometric indicators and cutoff points for Hispanic women. Data from the Hispanic Health and Nutrition Examination Survey HHANES (1982-1984) included 1,784 Mexican American, 479 Cuban American, and 750 Puerto Rico women aged 25 to 74 years. The body mass indexes examined were weight/ standing height1.5, weight/standing height2, weight/sitting height1.5, and weight/sitting height2. Appropriateness was based on correlation of the index with triceps and subscapular skinfold measurements and lack of association with standing or sitting height. The most appropriate indicator was weight/standing height2. To estimate overweight, the 85th percentiles for weight/standing height2 were obtained from the 20- to 29-year-olds in HHANES and the second National Health and Nutrition Examination Survey (NHANES II). For 10-year age intervals, the differences in proportions of women above those cutoff points were compared with a modified t test. The mean estimated prevalences of overweight were significantly higher with the NHANES II standard compared with the HHANES cutoff points (P<.05) for Mexican American women (43% vs 29%) and Puerto Rican women (40% vs 28%). They were slightly lower for the Cuban American women (36% vs 39%). Cutoff points are relative, not absolute, standards that must have biologic meaning. Before our results are used for assessing populations, the cutoff points should be tested for predictive validity with chronic disease rates.