Higher Percentage Of Women Research Articles

Comparison of Health Status and Nutrient Intake by Household Type in the Elderly Population.

BackgroundThe health condition of old age is affected by various factors such as economic level, disease condition, and nutrition. With the aging population in Korea, the ratio of single-person households increased rapidly. Research on the health status and nutrition of the elderly in the single-person household is very insufficient. In this study, we compared the health and nutritional status of the elderly by the household type.MethodsData from the 2013 to 2014 Korea National Health and Nutrition Examination Survey were used. A total of 2,730 patients were classified into 2 groups (single-person, with family), and general, chronic disease, health behavior, nutrient intake, and food insecurity status were compared by the statistical analysis.ResultsSingle-person households had a low economic and educational level and a higher percentage of women. In addition, obesity, hypertension, dyslipidemia, stroke, myocardial infarction disease rate was significantly higher. Sing-person households answered that their subjective health status was bad, and their quality of life was low. As a result of analysis of the quality of the diet in the single-person, the intake of protein, calcium, iron, vitamin B2, niacin, and vitamin C was significantly lower. In particular, the intake of calcium was the most insufficient. Food insecurity has also been observed, including the inability to consume diverse and sufficient foods due to economic difficulties.ConclusionsMore attention should be paid to the health of single-person households in elderly population and various policies should be prepared.

Oral Health Literacy and Oral Health Knowledge among 2,263 First-time Pregnant Urban Women: A Cross-sectional Questionnaire Study

The present study aimed to see the oral health literacy rate among first-time pregnant women across 12 corporate hospital setups in the city of Pune, India. For the survey, the REALD 30 questionnaires were used to assess the adult literacy rate (with 0 being least score and 30 being the highest score) and the knowledge of the participants related to oral health was assessed using a set of 6 questions. The study was carried out for a period of 1 year from January 2018 to December 2018. The total participants at the end of the study were 2,263. All the women were pregnant for the first time, in their 1st trimester of pregnancy. Written consent was taken from all the participants. Epi Info was used to carry out the statistical analysis. All the p values less than 0.05 was considered to be statistically significant. The mean REALD 30 score was 23.8 ± 8.34. The REALD score was higher for those with a postgraduate degree; this could be due to more number of participants in the group. There were higher percentages of women with correct answers to all the knowledge-based questions. We observed that there was a positive correlation with the REALD total scores and the correct answers provided to the questions on oral health (r = 0.76). There was a positive correlationship between the REALD scores and the oral health knowledge of the participants. The educated pregnant women had a high oral health literacy rate. There was a positive correlation of literacy with the REALD 30 score. Healthcare providers should focus on clearing the myths and misconceptions that are still prevalent in a small portion of the urban population.

Epidemiological characteristics of breast cancer patients attending a tertiary health-care institute in the National Capital Territory of India.

Limited data are available on the epidemiology of breast cancer (BC) in India. To study the epidemiological characteristics of BC patients attending a tertiary care hospital in National Capital Territory of India. A cross-sectional study was conducted and information from 320 women with confirmed BC was collected on a questionnaire for demographic profile, socioeconomic status (SES), reproductive risk factors, and family history of BC. Information on clinical presentation and staging of BC was recorded. Anthropometric assessment for body mass index (BMI) was done. Data were analyzed and presented as mean ± standard deviation and frequency tables. The mean age at diagnosis of BC was 47 ± 10 years. Fifty-three percent of patients were illiterate or only primary school education. About 74% of patients were from urban areas. Only 11% of patients were from upper SES and 26% from lower SES. Forty-seven percent of patients had stage II followed by 36% with stage III BC. About 15% patients had experienced early menarche (<13 years of age) and 15% of women had attained late menopause (>51 years of age). About 42% of patients had <3 children and 15% patients had a family history of BC. About 38% patients were overweight and 21% were obese. Other than the established risk factors, other factors such as lack of education, SES, and higher BMI were present in our study. A higher percentage of women were diagnosed with BC at later stages. There is a need for educating women about BC, self-examination of breast, and screening programs for early detection of BC.

Assessment of Women's Psychological Health with Hysterectomy at Maternity Hospitals in Baghdad City

Hysterectomy is one of the most common gynecological surgeries performed worldwide. However, women undergoing this surgery often experience negative emotional reactions. Controversy regarding psychological or psychiatric outcomes following hysterectomy still exists. The purpose of this study was to investigate the risk of postoperative psychiatric disorders in women with hysterectomy. This study was conducted to assess psychological Health of women with Hysterectomy at Maternity Hospitals in Baghdad City. This study was conducted at maternity hospitals in Baghdad city to assess the psychological health of women with hysterectomy. This study was started in January 2018 to January 2019, The data regarding was achieved from the patient's charts that recorded in the Statistical Department in the hospitals, the study consist of (100) women with hysterectomy which were selected according to inclusion criteria Women who had undergone hysterectomy, Postoperative duration for hysterectomies from 6weeks to 6 month, Women in reproductive age only. The data are analyzed through the use of descriptive statistical analysis and inferential statistical analysis procedures were employed for the data analysis. The findings of the study shows moderate levels of psychological health (50%), the highest percentage of women with hysterectomy were suffering from psychological problem.

Demographic and socio-economic factors affecting birth preparation and complication readiness (BPCR) practices in Nepal

BPCR practices by women in Nepal are still low. Still a relatively high percentage of women do not make BPCR to its fullest extent. Researches in developing countries show that various demographic, social and economic factors influence the BPCR practices by pregnant women. This paper examines the likelihood of BPCR practices based on women’s demographic, social and economic status in Nepal. NDHS 2011 data set has been utilized by applying bivariate logistics regression analysis technique to examine the effects of these variables on BPCR practices in Nepal. The analysis result shows high variations and gaps in BPCR practice based on demographic, social and economic status of women. Against this finding the study recommends implementation of appropriate policy and program measures by the government and other agencies to address the existing variations and gaps in BPCR practices among subgroups of women in Nepal. Further research studies focusing on the existing barriers on BPCR practice need to be conducted in Nepal especially among the women who are disadvantaged and marginalized.

808: Oxytocin regimen for induction of labor and pregnancy outcomes

Uncertainty exists regarding the optimal oxytocin dose regimen for induction of labor (IOL). We evaluated the association of oxytocin regimen for IOL with cesarean delivery and with adverse perinatal composite outcome in low-risk nulliparous women. Secondary analysis of a multi-center randomized control trial of IOL at 39 weeks compared with expectant management in low-risk nulliparous women. Women in either group who underwent IOL with a mid-to high-dose oxytocin (MHD) regimen were compared with those induced with a low-dose oxytocin (LD) regimen. The primary outcomes were cesarean delivery and a composite of perinatal death or severe neonatal complications (Table 1). M ultivariable regression was used to estimate relative risks (RR) controlling for related covariates, although site could not be adjusted for given collinearity with oxytocin regimen. Interaction between oxytocin regimen and modified Bishop score, induction indication and treatment group were also evaluated. Of 6,106 women enrolled in the primary trial, 3,034 women underwent induction with oxytocin; 889 in the MHD group and 2145 in the LD group. There was a shorter duration from start of oxytocin to delivery (median 11.7 hours vs. 13.4 hours) and higher percentage of women in the lowest quartile for time to delivery in the MHD group compared with the LD group (p<0.001 for both). The lower frequency of cesarean delivery in the MHD group (20.9% vs. 25.0%) was not significant after adjustment (Table 1). There was an increase in operative vaginal delivery in the MHD group (9.7% vs. 6.8%, P=0.007). The adverse perinatal composite outcome was significantly more frequent in the MHD group (6.6% vs. 4.3%, adjusted RR 1.59, 95% CI (1.15-2.21)) compared with LD group; this association was most notable among those with an elective induction (p=0.03 for interaction). The higher frequency of the adverse perinatal outcome in the MHD group was mostly due to a higher frequency of continuous positive airway pressure or high-flow nasal cannula (Table 2). Compared with LD regimen, MHD regimen for induction was associated with a similar chance of spontaneous vaginal delivery as well as a higher risk of an adverse perinatal composite outcome, particularly for elective induction. It remains uncertain if this finding is related to the actual regimen or other confounding variables such as site of use.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Disability Prior to Death Among the Oldest-Old in China.

Background To estimate the prevalence of disability during the last 3 years prior to death among the oldest-old (≥80 years) in China. Methods We used data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), a nationally representative study of the oldest-old in China. The analytic sample included 23,934 decedents who died between 1998 and 2014 and had at least one interview within the last 3 years of life. Disability was defined as being incontinent or needing assistance in performing one or more of five other essential activities (bathing, transferring, dressing, eating, and toileting). Results About 57.8% (weighted) of the study decedents were female. The prevalence of disability increased modestly from 36 months to 24 months prior to death (20% to 23%), more rapidly from 24-months to 12-months before death (23% to 31%), and substantially from 12 months before death to the last month of life (31% to 48%). The disability rates were lowest for participants who died between 80 and 89 years, intermediate for those who died between 90 and 99 years, and highest for those who died at age 100 or older, although the patterns over the 3-year period were comparable for the three age groups. At each time point prior to death, a higher percentage of women was disabled than men. Conclusions In this large nationally representative sample of the oldest-old in China, the prevalence of disability during the 3 years prior to death is high and is greater in women than men and those who die at the oldest ages.

Women Do the Job: The Reasons to Set Quota for Women on Boards

In 2012 Italy introduced quota to increase the number of women on corporate boards. The aim of our research is to shed more lights on how women on boards, after the enforcement of quota law, improve the board functions and the board structure. Our study focuses on all Italian FTSE MIB companies from 2008 to 2015. Italy is a country where the percentage of female directors was very low before quota. Female directors, when present, were linked through a family connection to the controlling shareholder. Our research demonstrates that a higher percentage of women on boards, after the quota, leads to a higher board members attendance and more board meetings, thus a better board monitoring. We document that, after quota, one more women to the board results in increasing the board involvement in strategy and the independence of audit committee. Our findings provide empirical support on the effectiveness of female directors, suggesting important implications of the quota legislation on the &amp;ldquo;type&amp;rdquo; of women elected.

Reasons undergraduate students majored in geology across six universities: The importance of gender and department

Only 40% of geoscience undergraduate degrees are conferred on women. Little research has examined why more men tend to pursue and persist in geology degrees compared to women. We examined the reasons why undergraduate geology students chose to major in geology, with a particular emphasis on women. We collected data from 391 undergraduate students (46.4% women) enrolled in six geology departments at public, four-year institutions across the United States. Students reported six reasons they were attracted to geology: interest, career opportunities, liking the outdoors, liking the department, being encouraged by someone, and other. Interest was the most frequent reason female and male students reported for being attracted to geology. After interest, liking the geology department (including liking classes, faculty, and the department overall) was the next most frequent reason female students reported for selecting a geology major. It was the second to least frequent reason for male students. Both female and male students in departments graduating a higher percentage of women more frequently reported liking the department as a reason for being attracted to geology than did students in departments graduating lower percentages of women. Geology departments have the potential to impact the recruitment and retention of students, particularly women, into their programs. Future research is needed to identify the specific department practices that attract female students and provide a more welcoming climate to students.

Mobile Mammography in Lower-Middle–Income Country, Jordan Experience

Background: Breast cancer is the most common malignancy among adults in Jordan accounting for 39.4% of all newly diagnosed cancers. Jordan is a lower-middle–income country that lacks national screening program. King Hussein Cancer Foundation/Center (KHCF/KHCC) and Jordan Breast Cancer Program had put significant efforts over past years to increase awareness about breast cancer and improve mammography services. They have introduced two mobile mammography units aiming at reaching women in their local communities, in underserved and underprivileged regions. Aim: Describe the experience of making mammography accessible and free of charge to women in rural and remote areas with limited access to mammography services. Methods: Local health educators were trained to recruit women aged 40 years and above to get free screening mammogram in mobile mammography unit. Data collected from five rural areas in Jordan from 2012 until 2017. Total number is 13570 women. Recall was performed at the fixed mammography unit at KHCC and was free of charge until the diagnosis of cancer affirmed or deferred. Results: The highest percentage of women 55.2% (N: 7733) aged 41-50 years. Women aged less than 40 years were recruited due to their breast-related symptoms. It was ethically difficult to refrain imaging symptomatic women in van in remote areas. However, in areas closer to KHCC symptomatic women with no medical insurance were directly referred to KHCC with voucher for free mammogram and workup. Total number of women referred for screening was 13058 (96.2%) and those referred as diagnostic was 512 (3.8%); their mean age was 48.8 and 45 years respectively. Overall recall rate was 29.3% (N: 3822) among screening cases. Cancer detection rate was 0.85% (N: 112) among screened women and 6.8% (N: 35) among diagnostic cases. Number of women who failed to adhere to follow-up procedures was N=1191 (8.8%). It was noticed that family history of cancer correlated with better adherence to complete follow-up procedures. Conclusion: Mobile mammography unit enabled access to screening mammography in rural areas and also encouraged symptomatic women to seek medical advice early. Ensuring financial coverage may have been an additional motivational factor. Follow-up studies may be conducted to compare tumor size differences between screening and diagnostic cases, prognosis and quality of life.

Variations in the referral patterns to pharmacologic and exercise myocardial perfusion imaging

BackgroundMyocardial perfusion imaging (MPI) is commonly utilized for the non-invasive evaluation of patients with suspected coronary artery disease (CAD). It is either performed with exercise or pharmacologic stress. The objective of this study is to compare the referral patterns and diagnostic findings in patients referred for pharmacologic vs exercise MPI. Methods and ResultsThis was a prospective study of 429 consecutive patients who were referred for MPI at the American University of Beirut Medical Center (23% had pharmacologic stress with dipyridamole and 77% had exercise stress testing). Patients referred to pharmacologic stress were older, had a higher percentage of women, and a higher prevalence of diabetes and hypertension. There were more abnormal scans in the pharmacologic stress group (38% vs 20%, P < 0.001), as well as a higher prevalence of ischemia (21% vs 13%, P < 0.001) and impaired left ventricular function with an ejection fraction < 50% (19% vs 7.9%, P < 0.001). The significant predictors for referral to pharmacologic stress by multivariable logistic regression analysis were older age (OR = 2.01 (1.57–2.57), P < 0.001) and diabetes (OR = 2.04 (1.19–3.49), P = 0.009). ConclusionPatients referred for pharmacologic stress MPI are at a higher risk than those referred for exercise stress MPI with more CAD risk factors, older age, and a higher prevalence of abnormal MPI findings.

Alcohol Consumption and Binge Drinking Among Young Adults Aged 20-30 Years in Lisbon, Portugal.

Over the past decade, the changes to the pattern of alcohol consumption in Portugal, in particular among young people with heavy episodic drinking (binge drinking), are well documented. However, there are limited studies in individuals aged between 20 and 30 years, which is an important period of transition into adulthood where binge drinking can negatively influence the resolution of developmental tasks. Therefore, this study aims at analyzing the pattern of alcohol consumption and binge drinking among young adults aged between 20 and 30 years living in the municipality of Lisbon. This is a quantitative, descriptive correlational study using a convenience sample composed of 259 individuals. We used the Alcohol Use Disorders Identification Test for data collection. Among the sampled subjects, 19.3% of them reported being nondrinkers. Among the alcohol-drinking subjects (N = 209), 61.3% reported binge drinking behaviors. We found a higher percentage of binge drinkers among vocational training students than among university students, as well as a relatively higher percentage of women. In both cases, we found no statistically significant differences. Within the total sample, 10.8% reported hazardous or harmful consumption, with men showing greater hazardous consumption. Although approximately one fifth of the sampled subjects reported being nondrinkers, the percentage of binge drinkers in this study was significantly higher than that reported in other studies. We also found that binge drinking is more common among vocational training students, although this difference was not statistically significant. Further studies are needed on this age group and in nonacademic settings.

Does breast size affect how women participate in physical activity?

ObjectivesResearch has shown that women with large breasts experience increased breast motion, which can act as a barrier to participating in physical activity. Despite this evidence, limited research has investigated the effect of breast size on physical activity participation. DesignCross-sectional study. Methods355 Australian women (aged 18–75years) who volunteered as participants were divided into four breast size groups (small, medium, large and hypertrophic). All participants completed the Active Australia Survey to assess their participation in physical activity in the previous week, and were asked to indicate whether they agreed or disagreed that their breast size affected their participation in physical activity. Participant responses to time spent in each type of activity were compared across the four breast size groups using an ANCOVA design, controlling for age. ResultsParticipants with hypertrophic breasts participated in significantly less total physical activity per week, particularly less vigorous-intensity physical activity, compared to their counterparts with smaller breasts. Participants with large breasts also participated in less vigorous-intensity physical activity compared to participants with small and with medium breasts, and a high percentage of women with large and with hypertrophic breasts perceived their breast size to affect the amount and intensity of physical activity they performed. ConclusionsBreast size should be acknowledged as a potential barrier to women participating in physical activity. Strategies to assist women with large and hypertrophic breasts participate in all types and intensities of physical activity are needed so women can enjoy the health benefits associated with an active lifestyle.

Women with compulsive buying or gambling disorder: Similar profiles for different behavioural addictions

The aim of the present study was to examine the differences in sociodemographic and clinical characteristics of 104 women diagnosed with compulsive buying behaviour (CBB = 55) or gambling disorder (GD = 49) treated at three public hospitals unit specialized in behavioural addictions from January 2004 to December 2015. Significant between-group differences in sociodemographic variables were observed for cohabitation status (living with a partner or not) and educational level, with a higher percentage of women in the GD group cohabiting (х2 (1), p = .029). By contrast, the CBB group had a significantly higher educational level (х2 (1) = 7.4, p = .007). There were no significant differences between the groups in age of onset, age at treatment initiation, age at the onset of behavioural problems, or in the years elapsed until presenting addiction problems. However, there were significant between-group differences in the amount of money spent weekly (F (1.100) = 4.9, p = .028), with women in the CBB group spending on average €289.4/week (SD, 412.4) versus €151/week (SD, 141.23) in the GD group. The CBB group had significantly more depressive disorders compared to the GD group (х2(1) = 5.4, p = .020). In contrast, the GD group presented significantly more tobacco use than the CBB group (х2(1) = 1.19, p = .000). This study suggests that women with CBB or GD share more characteristics than differences and the treatment approaches must take into account gender related factors.

Elevated serum adiponectin and tumor necrosis factor-α and decreased transthyretin in Japanese elderly women with low grip strength and preserved muscle mass and insulin sensitivity

ObjectiveTo determine if adiponectin levels are associated with low grip strength among the elderly independently of insulin resistance and inflammation.Research design and methodsCross-sectional associations were analyzed by logistic regression between...

Absent and Discordant Electronic Health Record Documentation of Complementary and Alternative Medicine in Cancer Care.

Many patients with cancer use complementary and alternative medicine (CAM), but the quality of CAM documentation in their electronic health records (EHRs) is unknown. The authors aimed to describe (i) the prevalence and types of CAM used after cancer diagnosis and the influence of oncologists on CAM use, as per patients' self-report, and (ii) the prevalence of CAM documentation in the EHR and its consistency with self-reported usage. Patient and provider surveys and chart review. Medical oncology practices at one institution. Patients with cancer at oncologist visits. Patient self-reported rate of 3-month postvisit CAM use; provider EHR documentation of CAM use or discussion and its concordance with patient self-report. Among 327 patients enrolled, 248 responded to the 3-month postvisit survey. Of these, 158 reported CAM use after diagnosis (63.7%). CAM users were younger (p < 0.001) and had a higher percentage of women (p = 0.03) than nonusers. Modalities most commonly used were supplements (62.6%), special diets (38.6%), chiropractor (28.4%), and massage (28.4%). CAM was used to improve well-being (68.7%), manage adverse effects (35.5%), and fight cancer (22.9%). Oncologists suggested CAM in 22.5% of instances of use. CAM use/discussion was documented for 58.2% of self-reported CAM users. Of the documented modalities, EHR and self-report were concordant for only 8.2%. CAM documentation was associated with physician provider (p = 0.03), older patients (p = 0.01), and treatment with radiation (p = 0.03) or surgery (p = 0.001). After adjusting for other factors, patients with breast cancer or "other" tumor category were four times more likely than patients with gastrointestinal cancer to have CAM use documentation (odds ratio [95% confidence interval]: 4.41 [1.48-13.10]; 3.76 [1.42-9.99], respectively). Most patients with cancer use CAM after diagnosis, yet EHR documentation is complete for very few. Oncologists should inquire about, document, and discuss CAM benefits and harm or refer patients to CAM specialists.

Automedicación en estudiantes de Odontología de la Universidad Católica de Cuenca, Ecuador

Objetivo: Determinar el índice de automedicación en los estudiantes universitarios de la carrera de Odontología de la Universidad Católica de Cuenca. Materiales y Métodos: Se realizó un estudio descriptivo, retrospectivo, de campo con análisis cuantitativo, se aplicó un encuesta a 452 estudiantes de la carrera de Odontología, en donde se indago datos socioeconómicos, frecuencia de automedicación, razones para automedicarse, tipos de medicamentos, y conocimientos sobre los peligros de esta práctica. Resultados: Un 84.3% de estudiantes se automedican, con respecto al género se encontró un predominio del género femenino en un 86.74%, mientras que el género masculino se encontró en un 81.28%, a su vez se puede señalar que la principal razón que conlleva a los estudiantes universitarios a auto medicarse es el hecho de que creen que no siempre es necesario ir al médico en un 57%. El grupo de medicamentos más utilizados ha sido los analgésicos-antiinflamatorios con un 44%, seguidos de los antigripales y antibióticos con un 39% y13% respectivamente. Un 86% de los encuestados consideran que la automedicación es una práctica peligrosa, conociendo las complicaciones que esta conlleva. Conclusión: La frecuencia de automedicación en la población universitaria estudiada es elevada, los medicamentos usados requieren por lo general prescripción médica, los factores influyentes de esta práctica son los conocimientos en el área de la salud que tiene los estudiantes, pues consideran que no siempre es necesario acudir al médico.

Gender and access to professorships in academic medical settings in France.

Previous studies, mainly originating from North America, suggest that women are less likely than men to obtain professorships in academic medical settings. However, research providing a comprehensive picture of such gender disparities in other national contexts and addressing associated contextual factors is lacking. Our objectives were to assess gender differences in access to professorships in academic medical settings in France, to determine their evolution across regions and medical specialties and over time, and to identify the factors associated with the likelihood of a professor being a woman. We carried out a national administrative cohort study of all new professors appointed during 1989-2015 in all medical specialties in the whole of France. We first conducted a descriptive analysis of the percentage of professorships awarded to women and its variations by time, region and specialty. We then ran a logistic regression model to determine factors significantly associated with the likelihood of a professor being a woman. Between 1989 and 2015, 3950 professors were appointed, of whom fewer than one in five were women. Female professors consistently represented a minority in all French regions and specialties over the study period. Although a small increase was observed over the years, women never represented more than 29% of newly appointed professors. After adjustments for other factors, the likelihood of a professor being a woman was significantly higher in specialties with a higher percentage of women among hospital practitioners, in regions with higher numbers of appointed professors and in recent years. Gender inequalities in career evolution exist in academic medical settings in France and have continued over time despite moderate improvements. Increased awareness based on scientific evidence is a first step towards reducing such inequalities.

Gender: Women-led tech startups on the rise in Africa

On the surface, sub-Saharan Africa boasts the world’s highest rate of women entrepreneurs, at 27%. The MasterCard Index of Women Entrepreneurs 2017 listed two African countries, Uganda (34.8%) and Botswana (34.6%), as having the highest percentage of women entrepreneurs globally.

Hospital Leadership Diversity and Strategies to Advance Health Equity

BackgroundDiversity in hospital leadership is often valued as important for achieving clinical excellence. The American Hospital Association surveyed hospitals about their actions to identify and address health disparities. The survey asked about the degree of representation of racial and ethnic minorities and women among executives and board members. MethodsThe survey contained 78 items in four domains: Leadership and Strategic Planning, Workforce, Data Collection, and Reducing Disparities. All items were standardized and pooled within each domain to construct four variables. Logistic regression models were used to assess the difference in domain scores, for each domain, between hospitals with (a) high and low representation of people of color in the C-suite, (b) high and low representation of women in the corporate (C-) suite, (c) high and low representation of people of color on the board, and (d) high and low representation of women on the board. ResultsHospitals with more diverse boards with respect to race and ethnicity had significantly higher scores for all domains, indicating that these hospitals were pursuing substantially more strategies in all domains. In contrast, more racially and ethnically diverse executive suites were associated only with the Data Collection domain, while hospitals with a higher percentage of women in executive positions had lower scores for all domains except Data Collection. ConclusionHospitals with greater representation of racial and ethnic minorities in leadership positions had greater commitments to diversity initiatives. However, hospitals with women—particularly white women—in leadership positions reported fewer diversity initiatives. Future research is needed to examine the mechanisms and causality behind these associations.