Higher Proportion Of Women Research Articles

Impact of diagnosis and treatment of uterine fibroids on quality of life and labor productivity: The Japanese online survey for uterine fibroids and quality of life (JOYFUL survey).

To investigate the impact of uterine fibroid diagnosis/treatment status on quality of life (QOL) and work productivity in women living in Japan. Women aged 20-49 years who registered on Macromill were recruited via the opt-in method. They completed an online survey on demographic and uterine fibroid diagnosis/treatment status, 36-Item Short-Form Health Survey, Uterine Fibroid Symptom and Health-Related Quality of Life questionnaire (UFS-QOL), and World Health Organization Health and Work Performance Questionnaire. There were 4120 respondents: 1362 untreated, 249 with ongoing treatment, 449 with past treatment, 1030 with no uterine fibroids, and 1030 with unknown uterine fibroid status. A high proportion of women with ongoing treatment had moderate to severe uterine fibroid-like symptoms (symptom severity score of UFS-QOL ≥40 points), accompanied by reduced QOL. QOL was improved in women with past treatment. Uterine fibroids had a significant impact on physical and psychosocial aspects in the ongoing treatment group versus other groups. Using classification and regression tree analysis, anemia was identified as a plausible predictor of reduced QOL in the ongoing treatment group. Approximately 20% of women-even in groups other than the ongoing treatment group-experienced moderate to severe uterine fibroid-like symptoms. However, the diagnosis and treatment status of uterine fibroids had no clear impact on work productivity. Uterine fibroids, especially in association with anemia, were related to reduced QOL. Given that uterine fibroid-related reduced QOL is likely improved by appropriate treatment, women with uterine fibroid-like symptoms, such as menorrhagia, should be examined and treated.

Housework and earnings: intrahousehold evidence from Latin America

ABSTRACT This paper analyzes the intrahousehold allocation of housework and paid work in five Latin American countries. Prior work has consistently shown that income plays a major role in the region’s large gender gaps in the distribution of unpaid work at the aggregate level. However, the extent to which earnings shape intrahousehold decisions regarding the allocation of unpaid work remains unexplored. Using harmonized time-use surveys for Chile, Colombia, Mexico, Peru, and Uruguay, we analyze the relationship between earnings and housework drawing on the framework of the dependency, gender deviance neutralization, and autonomy. We find that in Latin America, increases in women's absolute earnings are related to decreases in the hours women devote to housework. At the same time, the allocation of men’s time into housework does not seem to be related to their own or their partners’ earnings. Against our expectations, differences in contextual gender inequality across countries does not seem to be relevant. These findings help us assess how well existing theories, formulated to account for phenomena of the developed world, apply to more unequal contexts that have higher levels of gender inequality and where a high proportion of women are excluded from paid work.

Vaginal microbiome community state types and high-risk human papillomaviruses in cervical precancer and cancer in North-central Nigeria

BackgroundHigh risk human papillomaviruses (HR-HPV) have a causal role in cervical oncogenesis, and HIV-mediated immune suppression allows HR-HPV to persist. We studied whether vaginal microbiome community state types (CSTs) are associated with high-grade precancer and/or invasive cervical cancer (HSIL/ICC).MethodsThis was a cross-sectional study of adult women with cervical cancer screening (CCS) at the Jos University Teaching Hospital (JUTH) in Jos, Nigeria, between January 2020 and February 2022. Cervical swabs underwent HPV genotyping (Anyplex™ II HPV28). Cervico-vaginal lavage (CVL) sample was collected for 16 S rRNA gene amplicon sequencing. We used multivariable logistic regression modelling to assess associations between CSTs and other factors associated with HSIL/ICC.ResultsWe enrolled 155 eligible participants, 151 with microbiome data for this analysis. Women were median age 52 (IQR:43–58), 47.7% HIV positive, and 58.1% with HSIL/ICC. Of the 138 with HPV data, 40.6% were negative for HPV, 10.1% had low-risk HPV, 26.8% had single HR-HPV, and 22.5% had multiple HR-HPV types. The overall prevalence of any HR-HPV type (single and multiple) was 49.3%, with a higher proportion in women with HSIL/ICC (NILM 31.6%, LSIL 46.5%, HSIL 40.8%, and 81.5% ICC; p = 0.007). Women with HIV were more likely to have HSIL/ICC (70.3% vs. 29.7% among women without HIV). In crude and multivariable analysis CST was not associated with cervical pathology (CST-III aOR = 1.13, CST-IV aOR = 1.31). However, in the presence of HR-HPV CST-III (aOR = 6.7) and CST-IV (aOR = 3.6) showed positive association with HSIL/ICC.ConclusionVaginal microbiome CSTs were not significantly associated with HSIL/ICC. Our findings suggest however, that CST could be helpful in identifying women with HSIL/ICC and particularly those with HR-HPV. Characterization of CSTs using point-of-care molecular testing in women with HR-HPV should be studied as an approach to improve early detection and cervical cancer prevention. Future longitudinal research will improve our understanding of the temporal effect of non-optimal CST, HR-HPV, and other factors in cervical cancer development, prevention, and control.

Intra-racial disaggregation reveals associations between nativity and overall survival in women with endometrial cancer

ObjectivePrior studies have demonstrated survival differences between Black women with endometrial cancer (EC) born in the US and Caribbean. Our objective was to determine if country of birth influences EC overall survival (OS) in disaggregated subpopulations of Black women. MethodsUsing the Florida Cancer Data System, women with EC diagnosed from 1981 to 2017 were identified. Demographic and clinical information were abstracted. Women who self-identified as Black and born in the US (USB), Jamaica (JBB), or Haiti (HBB) were included. Statistical analyses were performed using chi-square, Cox proportional hazards models, and Kaplan-Meier methods with significance set at p < 0.05. Results3817 women met the inclusion criteria. Compared to USB, JBB and HBB had more high-grade histologies, more advanced stage disease, had a greater proportion of uninsured or Medicaid insured, and had a higher proportion of women who received chemotherapy (all p < 0.05). In multivariate analyses, age (HR 1.03 [1.02–1.05]), regional stage (HR 1.52 [1.22–1.89]), distant stage (HR 3.73 [2.84–4.89]), lymphovascular space invasion (HR 1.96 [1.61–2.39]), receipt of surgery (HR 0.47 [0.29–0.75]), and receipt of chemotherapy (HR 0.77 [0.62–0.95]) were independently associated with OS. Compared to USB, Haitian nativity was an independent negative predictor of OS when evaluating all histologies together (HR 1.54 [1.18–2.00]) and for endometrioid EC specifically (HR 1.77 [1.10–2.83]). Among women with serous EC, HBB had markedly worse median OS (18.5 months [13.4–46.5]) relative to USB (29.9 months [26.3–35.9]) and JBB (41.0 months, [34.1–82.6], p = 0.013). ConclusionCountry of birth is associated with endometrial cancer survival in Black women, with HBB demonstrating worse outcomes.

Gender disparity in prestigious speaking roles: A study of 10 years of international conference programming in the field of gambling studies.

The objective of this study was to examine the distribution of prestigious speaking roles by gender at gambling studies conferences to better understand the state of gender representation within the field. Keyword searches were conducted in the fall of 2019. A total of 16 conferences that occurred between 2010-2019 and comprising 882 prestigious speaking opportunities were included. Quantitative analysis (i.e., t-tests, chi-squared posthoc tests) was undertaken to evaluate the representation of women speakers and if proportions were the same across genders for speakers. There were significantly less women than men within prestigious speaking roles at gambling studies conferences with only 30.2% of speakers being women (p < .001). This underrepresentation of women was consistent across conference location, speaker continent, speaker role, time, and across the majority of conferences. Women held prestigious speaking roles less frequently than men (M = 1.48 vs. 1.76; p < .001). A 9 to 1 (p < .001) ratio of men to women was found among top 10 most frequent prestigious speakers. While there was a higher proportion of women than men among student speakers and there was no significant gender disparity among early career researchers, there was a significantly lower proportion of women than men among speakers who hold more senior academic positions. There is an issue of gender disparity in prestigious speaking roles at conferences within the gambling studies field. This study highlights the need to counteract gender disparities and make room for diversity within the field.

Association Between the Autonomy of Peruvian Women and the Choice of the Place of Delivery: Analysis of a National Survey, 2019.

To determine the association between Peruvian women's autonomy and place of delivery. An analytical cross-sectional study of secondary data from the Demographic and Family Health Survey 2019 was carried out. The dependent variable was institutionalized childbirth, and the independent variable was women's autonomy. Likewise, the association between women's autonomy and institutionalized childbirth was evaluated using Poisson family generalized linear models with logarithmic link function, and crude (PR) and adjusted prevalence ratios (aPR) with their respective 95% confidence interval (CI) were estimated. The analysis included 15,334 women aged 15-49 years. It was found that a high proportion of women had a low level of autonomy (42.6%; 95% CI: 41.5-43.7), while 92.1% (95% CI: 91.3-92.9) had institutionalized childbirth. Moderate (PR: 1.10; 95% CI: 1.08-1.12) and high (PR: 1.13; 95% CI: 1.12-1.15) levels of women's autonomy were found to be associated with institutionalized childbirth, and the same association was found in the adjusted analysis. Being a woman with a higher level of autonomy was related to a higher prevalence of institutionalized childbirth. Therefore, as decision-making is a multifactorial characteristic, it is necessary to study in depth the determinants of non-institutionalized childbirth in women with less autonomy.

Http://www.pertanika.upm.edu.my/pjssh/browse/regular-issue?article=JSSH-8608-2022

Ensuring gender equality and empowering women is crucial, as they play a significant role in driving economic and societal development. This study examines women’s empowerment levels in Malaysia and Indonesia, two neighbouring countries with a predominantly Muslim population. Data were obtained from the Fifth Malaysian Population and Family Survey 2014 and the Indonesia Demographic and Health Survey 2017. A total of 5,175 Malaysian and 34,467 Indonesian married women aged 15–49 were selected for this study. The variables used include women’s autonomy in household decision-making (a proxy for women’s empowerment), educational level, work status, place of residence, number of children, and women’s age. Findings reveal that Malaysia has a higher proportion of women with tertiary education than Indonesia (25.2% versus 14.7%). However, the proportion of women who were employed was lower in Malaysia than in Indonesia (45.4% versus 57.0%). Concerning household decision-making participation, approximately 46% of Malaysian women participated in all household decisions, as compared to 73% among Indonesian women. Binary logistic regression analysis indicates that all selected independent variables, except the place of residence, were significantly associated with women’s autonomy in household decision-making in both countries at the multivariate level. Women’s socio-economic characteristics greatly influence their status in the household and decision-making autonomy. Enhancing women’s education and employability can empower them and strengthen their decision-making autonomy.

Award Recipients for Pediatric Gastroenterology: A Descriptive Analysis of Gender Distribution.

Society awards are an important component of recognition in medicine and for career advancement such as promotion. Multiple studies conducted in pediatrics and gastroenterology have shown underrepresentation of women awardees even in fields with a higher proportion of women than men. To our knowledge, no such studies have been conducted in pediatric gastroenterology. We hypothesized that among all recipients, women would be underrepresented when compared to men and that women were more likely to be given teaching awards compared to other career achievement awards. We collected data on recipients of major recognition award presented by The North American Society for Pediatric Gastroenterology, Hepatology and Nutrition from 1987 to 2022. We found that 80.90% of the awards had been given to men and that most nominators were men. This study highlights inequities in women recipients for major awards and presents an opportunity for a call for action to examine and address the factors contributing to this gender inequity.

#3669 EFFECT OF DAPAGLIFLOZIN IN PATIENTS WITH CKD ACROSS THE SPECTRUM OF AGE AND BY SEX

Abstract Background and Aims The SGLT2 inhibitor dapagliflozin reduces the risk of progressive kidney disease and cardiovascular events in patients with and without type 2 diabetes. Among patients with CKD, baseline risks of cardiovascular disease and CKD progression vary based on age and sex. Whether the effects of dapagliflozin are uniform among patients across the spectrum of age and among men and women is unknown. Therefore, we performed a pre-specified analysis from the DAPA-CKD trial to evaluate efficacy and safety of dapagliflozin according to baseline age and sex. Method We randomized 4304 adults with baseline estimated glomerular filtration rate (eGFR) 25–75 mL/min/1.73m2 and urinary albumin-to-creatinine ratio 200–5000 mg/g to dapagliflozin 10 mg or placebo once daily. The primary endpoint was a composite of ≥50% eGFR decline, end-stage kidney disease, and kidney or cardiovascular death. Secondary endpoints included a kidney composite endpoint (primary composite endpoint without cardiovascular death), a cardiovascular composite endpoint (hospitalized heart failure or cardiovascular death), and all-cause mortality. Study participants were categorized based on decades of age (&amp;lt;50, 50-59, 60-69, 70-79, and ≥80 years). Sex was based on self-report. We conducted time-to-event analyses using a proportional hazards (Cox) regression stratified by randomization factors (diabetes status and UACR), adjusting for baseline eGFR, and analyzed the effects of dapagliflozin on total and chronic eGFR slopes using a mixed effects linear spline model. Results Median follow-up was 2.4 years. 671 (15.6%), 935 (21.7%), 1501 (34.9%), 999 (23.2%), and 198 (4.6%) participants were &amp;lt;50, 50-59, 60-69, 70-79, and ≥80 years of age, respectively; 1425 (33.1%) were women and 2879 (66.9%) were men. Racial composition varied by age and sex; older patients were more likely to be white, younger patients were more likely to be Asian, and a higher proportion of women were black. As expected, absolute risks of the cardiovascular composite endpoint and all-cause mortality were higher in older patients; absolute risks of the kidney composite endpoint were highest in patients &amp;lt;50 (10.7 and 6.2 per 100 patient-years in the placebo and dapagliflozin groups, respectively) and lowest in patients ≥80 years (3.0 and 1.2 per 100 patient-years in the placebo and dapagliflozin groups, respectively). There was no evidence of heterogeneity of the relative effects of dapagliflozin on the primary composite or secondary endpoints based on age or sex. Neither age nor sex modified the effects of dapagliflozin on total or chronic eGFR slope (Figure 1). Conclusion Benefits of dapagliflozin were evident across the spectrum of age and among women and men. Although younger trial participants with CKD and albuminuria were more likely to experience CKD progression, dapagliflozin reduced the risks of mortality, cardiovascular events, and CKD progression in older patients, including in more than 25% septuagenarians and octogenarians. Ageism and/or therapeutic nihilism should not diminish the use of dapagliflozin in older patients who are likely to experience considerable benefit.

Part of the gender gap in voting for Democrats arises because a higher proportion of women than men voters are Black

Women voted for the Democratic candidate more than men did in each US presidential election since 1980. We show that part of the gender gap stems from the fact that a higher proportion of women than men voters are Black, and Black voters overwhelmingly choose Democratic candidates. Past research shows that Black men have especially high rates of death, incarceration, and disenfranchisement due to criminal convictions. These disparities reduce the share of men voters who are Black. We show that the gender difference in racial composition explains 24% of the gender gap in voting Democratic. The gender gap in voting Democratic is especially large among those who are never-married, and, among them, the differing racial composition of men and women voters is more impactful than in the population at large, explaining 43% of the gender gap. We consider an alternative hypothesis that income differences between single men and women explain the gender gap in voting, but our analysis leads us to reject it. Although unmarried women are poorer than unmarried men, and lower-income voters vote slightly more Democratic, the latter difference is too small for income to explain much of the gender gap in voting. In short, the large gender gap among unmarried voters is not a reflection of the lower incomes of women's households but does reflect the fact that women voters are disproportionately Black. We used the General Social Survey as the data source for the analysis, then replicated results with the American National Election Survey data.

Exploring Diversity in Otolaryngology-Head and Neck Surgery Journal Editorial Boards.

Despite increasing diversity in medical school entrants, disparities exist in academic leadership. This study sought to examine the proportion of women and visible minorities (VMs) among editorial board members (EBMs) of otolaryngology journals. Two reviewers collected journal, editorial board, and editor-in-chief characteristics using journal mastheads or official websites. Gender and VM representation on editorial boards and factors associated with increased representation were investigated. Forty-one journals were explored, from January to April 2022. Of 2128 EBMs, 663 (31.3%) were VMs and 551 (25.9%) were women. Editor-in-chief roles were held by 12 (25%) VM individuals and 3 (6.2%) women. Gender differences in the distribution of editorial board positions were found (P < .001); women had higher representation as associate editors (24.5%, n = 551 vs 15.4, n = 1577%) and deputy/managing editors (2.2%, n = 551 vs 0.4%, n = 1577), while men were more represented as editor-in-chief (2.9%, n = 1577 vs 0.5%, n = 551). Similar VM representation existed between genders (31.0% male; 31.6% women) (P = .80). Journal impact factor quartile and gender were significantly correlated (P < .001); a higher proportion of women were represented in the first (27.0% vs 24.5%) and fourth (12.0% vs 4.9%) quartile. No significant factors were identified for higher women's editorial board representation. Larger editorial board size (P = .002) and Asian/South American journals (P = .003 to P < .001) had significantly higher representation of VMs. Women and VMs are underrepresented in high-ranking editorial positions. Diversity in editorial boards is needed to ensure fair and balanced journal reviews and equity within otolaryngology.

Attitude of postpartum women towards multiple postnatal clinic schedule in south-west Nigeria.

The postnatal period is a critical in the lives of mothers and babies due to the risk of maternal and perinatal morbidity and mortality. According to the Nigeria Demographic Health Survey 2018, only 38% of women and 42;% of newborns received a postnatal check in the first 2 days after birth. The World Health Organisation (WHO) recommends that postpartum women should have contact with healthcare providers within 24h, at day 3, days 10-14 and 6 weeks post-delivery. Multiple postnatal clinic (PNC) visits will allow assessment and prompt treatment of complications arising from delivery. This study assessed the attitude of postpartum women towards multiple PNC schedule. This descriptive cross-sectional study assessed the attitude of postpartum women towards multiple PNC schedules. A total of 167 respondents participated in the study and data was collected using a semi-structured interviewer administered questionnaire. Information on awareness, knowledge and purpose of postnatal care, preference for multiple schedules and the timing of postnatal care visits were obtained. Data was analysed using IBM SPSS version 23; and the level of significance was set at p<0.05. Of the respondents, 71.9% had poor or incorrect knowledge. About 87.4% perceived PNC as beneficial; and that mothers and newborns should be seen at least three times (47.9%) in the postnatal period. A high proportion of women were willing to come for PNC on day 3 (74.3%), days 10-14 (86.2%) and six weeks postpartum (91.6%). Also, 69.5% were willing to come for multiple PNC visits. Parity was significantly associated with willingness to attend multiple PNC visits. Despite suboptimal knowledge of the components of postnatal care services, postpartum women have a good attitude to postnatal care and are willing to attend scheduled and multiple PNC schedules. However, fewer women wanted the multiple PNC schedules. Health education and quality postnatal care will enhance postpartum surveillance with prompt detection and treatment of maternal and neonatal complications to forestall life-threatening complications or mortality.

Social determinants influencing cervical cancer diagnosis: an ecological study

BackgroundBarriers to accessing health care result in advanced cervical cancer. In Sao Paulo, Brazil, the Index of Social Responsibility (ISR) synthesizes the situation of each town concerning wealth, education, and longevity. This study aimed to evaluate in 645 municipalities the relation of the ISR with stage, age, and morphology in cervical cancer diagnosis.MethodsAn ecological study that used data from Sao Paulo, Brazil, from 2010 to 2017. The ISR was identified through government platforms and data on cancer through the Hospital Cancer Registry. The subjects were the 9,095 women aged 30 years or older. The ISR summarizes municipalities into five levels: dynamic (ISR5), unequal (ISR4), equitable (ISR3), in transition (ISR2), and vulnerable (ISR1). It was used the chi2 tests and logistic regression.ResultsThe proportion of stage 1 increased significantly with ISR level, ranging from 24.9% in ISR1 to 30.0% in ISR5 (p = 0.040). To every increase in ISR level, the chance of a woman being diagnosed in stage I was at least 30% higher. Woman living where ISR2 had a 1.4 times higher chance of being diagnosed in stage 1 than those living in ISR1 (OR 1.40, 95% CI 1.07–1.84). Squamous tumors frequency decreased when ISR level increased (p = 0.117). A higher proportion of women under 50 years were observed when they lived in wealthier cities (ISR4 and ISR5) (42.2% vs. 44.6%, p = 0.016).ConclusionThe ISR was a good health indicator for understanding and predicting the social determinants in cervical cancer diagnosis. The proportion of stage I increased significantly in more favorable social conditions.

The role of sex differences in depression in pathologically defined Alzheimer's disease.

Sex differences in Alzheimer's disease (AD) may contribute to disease heterogeneity and affect prevalence, risk factors, disease trajectories and outcomes. Depression impacts a large number of patients with AD and has been reported to be more prevalent in women. We aimed to better understand the interaction between sex, depression and AD neuropathology, which could have implications for detection of symptoms, earlier diagnosis, therapeutic management, and enhanced quality of life. We compared 338 cases with clinicopathologically confirmed AD (46% women) to 258 control cases (50% women), without dementia, parkinsonism or a significant pathological diagnosis. Depression was assessed both, using the Hamilton Depression Scale (HAM-D), and as being reported in their medical history combined with treatment with antidepressant medication. In the control group, women showed a higher depression severity, and a higher proportion of women were found to meet the cut-off score for depression on the HAM-D (32 vs. 16%) and having an history of depression (33 vs. 21%), while these sex differences were not observed in AD. Further, in both groups, female sex independently predicted the presence of depression, with covariates for age and cognitive status. AD subjects had higher mean HAM-D scores, were more likely to meet cutoff scores for depression (41 vs. 24%) and have a history of depression than controls (47 vs. 27%). When comparing the increase in frequency of depression in controls versus AD, the difference was significantly greater in men (AD men - control men: 24%) than in women (AD women - control women: 9%). Although subjects with depression were more likely to have higher levels of AD neuropathology, these differences were not observed when investigating the control or AD group separately. Control women had a higher likelihood and severity of depression than control men, but this sex difference was not noted when considering only those with pathologically defined AD, emphasizing the importance of considering sex in aging studies. AD was associated with higher rates of depression and men may be more likely to report or be diagnosed with depression once they develop AD indicating the importance of more frequent depression screenings in men.

MS Rehabilitation Research During the COVID Pandemic: Participant and Therapist Satisfaction with Remote Delivery (P12-8.004)

<h3>Objective:</h3> To understand participant and physical therapist (PT) satisfaction with virtual delivery of a multiple sclerosis (MS) rehabilitation research intervention. <h3>Background:</h3> Rehabilitation interventions in people with MS are usually in-person, although virtual delivery can improve access and relevance to patient’s daily lives. We planned a randomized controlled trial of a standardized physical therapy intervention for walking aid selection, fitting and training, (Assistive Device Selection, Training and Education Program [ADSTEP]), to prevent falls in MS. Due to the COVID-19 pandemic we transitioned to virtual delivery by video-teleconference. <h3>Design/Methods:</h3> ADSTEP, piloted as an in-person in-clinic program, consists of six 40-minute one-on-one sessions with a PT. We transitioned to virtual delivery to patients’ homes at the beginning of our full-scale randomized controlled trial. At intervention completion for each subject, we examined subject and PT satisfaction with virtual delivery using a nine-question survey. We analyzed survey responses and associations. <h3>Results:</h3> Forty-eight subjects completed ADSTEP delivered by four therapists; 46 subjects and all therapists completed the survey. For almost all session, subjects and therapists reported no difficulties seeing each other or following instructions, and all found the platform secure and private. 63% of subjects, a higher proportion of women than men (71% vs 50%) and more so for those with fewer falls in the past year (median 5 vs 12 falls), found the virtual visits as good as in-person sessions. 59% of subjects, a higher proportion of women than men (64% vs 50%) and more so for those with fewer falls in the past year (median 5 vs 8), preferred the virtual visits. <h3>Conclusions:</h3> This study supports that PTs and people with MS find virtual delivery of a rehabilitation research intervention feasible and acceptable, with women and those who fall less often being more likely to find virtual visits as good as or preferable to in-person visits. <b>Disclosure:</b> Dr. Cameron has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Greenwich Biosciences/Jazz . Dr. Cameron has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Adamas Pharmaceuticals. Dr. Cameron has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer. The institution of Dr. Cameron has received research support from National MS Society. The institution of Dr. Cameron has received research support from Department of Veterans Affairs. Dr. Cameron has received publishing royalties from a publication relating to health care. The institution of Ms. Hildebrand has received research support from National MS Society. Ms. Serdar has nothing to disclose. Mr. Schlimgen has nothing to disclose. Ms. Hugos has received personal compensation in the range of $500-$4,999 for serving as a Consultant for GW Pharmaceuticals. Ms. Hugos has received personal compensation in the range of $0-$499 for serving as a Consultant for Evidera, Inc.. Ms. Hugos has received personal compensation in the range of $0-$499 for serving as a Consultant for Techspert.io Ltd.. Ms. Hugos has received research support from Portland VA. Ms. Hugos has received research support from Oregon Health &amp; Science University. Ms. Hugos has received research support from Oregon Health &amp; Science University. Ms. Hugos has received publishing royalties from a publication relating to health care.

Individual and contextual-level factors associated with iron-folic acid supplement intake during pregnancy in Ethiopia: a multi-level analysis

BackgroundAnemia is still one of the major public health problems in many developing countries including Ethiopia. Thus, this study aimed to assess individual and contextual-level factors associated with iron-folic acid supplement intake during pregnancy in Ethiopia.MethodsA secondary analysis was done on the 2019 mini-Ethiopian Demographic and Health Survey (EDHS) dataset. A total of 3,927 pregnant women who gave birth five years before the survey were included in the analysis. Multi-level mixed-effect logistic regression analysis was done by STATA/SE version 14.0 to identify individual and contextual-level factors. Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was used to show the strength and direction of the association. The level of statistical significance was declared at a P value less than 0.05.ResultsThose primary educated [AOR = 1.83, 95% CI: (1.24, 2.74)], secondary educated [AOR = 2.75, 95% CI: (1.57, 4.824)], women who had greater than 5 living children [AOR = 2.02, 95% CI: (1.25, 3.27)], women who had ANC visit [AOR = 21.26, 95% CI: (13.56, 33.32)] and women who lived in a cluster with high proportion of women had ANC visit [AOR = 1.72, 95% CI: (1.17, 2.54)] and women who lived in Somali [AOR = 0.44 0.73, 95% CI: (0.22, 0.87)] were significantly associated with iron-folic acid intake during pregnancy.ConclusionsBoth individual and contextual-level factors were significantly associated with iron-folic acid intake during pregnancy. From individual-level factors: education status of women, the total numbers of living children, and ANC follow-up are significant and from contextual-level factors: region and living in a high proportion of women who had ANC follow-up were found to have a statistically significant association. Promoting women’s education and maternal health services like ANC and intervention targeting the Somali region would be the recalled area of the government.

Who benefits from (Human Resource Management) professionalization? The moderating role of gender on professionalization effects in organisations

AbstractProfessionalization aims at closure, that is, having the monopoly protection of expertise for an occupation on the labour market and in organizations. Role congruity theory suggests that the translation of professionalization into organizational closure and reaching board membership is likely to be moderated by gender at the individual and the occupational level. We test this proposition focusing on Human Resource Management (HRM), an occupation with a long history of professionalization attempts. Using a sample of 3276 organizations embedded in 34 countries with varying professionalization levels between countries, results show that professionalization of HRM at the country level is positively related to closure in organizations. The positive relationship is weaker for female HR directors and high proportions of women in the HRM occupation in a country. Organizational closure, in contrast, is negatively related to board representation but increases the likelihood of board membership in countries with high proportions of women in the HRM occupation.

A series of patients with refractory myasthenia gravis

IntroductionAdvances in the treatment of myasthenia gravis (MG) have improved quality of life and prognosis for the majority of patients. However, 10%–20% of patients present refractory MG, with frequent relapses and significant functional limitations. Patients and methodsPatients with refractory MG were selected from a cohort of patients diagnosed with MG between January 2008 and June 2019. Refractory MG was defined as lack of response to treatment with prednisone and at least 2 immunosuppressants, inability to withdraw treatment without relapse in the last 12 months, or intolerance to treatment with severe adverse reactions. ResultsWe identified 84 patients with MG, 11 of whom (13%) met criteria for refractory MG. Mean (standard deviation) age was 47 (18) years; 64% of patients with refractory MG had early-onset generalised myasthenia (as compared to 22% in the group of patients with MG; P < .01), with a higher proportion of women in this group (P < .01). Disease severity at diagnosis and at the time of data analysis was higher among patients with refractory MG, who presented more relapses during follow-up. Logistic regression analysis revealed an independent association between refractory MG and the number of severe relapses. ConclusionsThe percentage of patients with refractory MG in our series (13%) is similar to those reported in previous studies; these patients were often women and presented early onset, severe forms of onset, and repeated relapses requiring hospital admission during follow-up.

Future of Gender Equity in Healthcare

Globally there is an increasing participation of women in the general workforce, but the healthcare workforce has always had a higher proportion of women. It is estimated that the majority of the 75% of women who constitute the global health workforce mostly occupy the lower ranks. Among doctors, women are under-represented in positions of power and influence. This article aims to increase awareness of factors that impede the potential of women doctors, and considers initiatives that could be implemented in the healthcare sector to address the gender inequality, including a fair representation in positions of leadership and influence. Although this article will focus primarily on issues related to gender equality, the author recognises the impact of intersectionality of the factors that contribute to differential attainment. Diverse workforces tend to perform better in productivity, innovation, balanced decision-making and job satisfaction. There is research suggesting that women doctors have better communication skills, spend more time with patients, adhere better to guidelines and may even have better outcomes in healthcare decision-making. Women tend to anchor their leadership in purpose and impact rather than personal ambitions or power; demonstrate emotional intelligence in inspiring their teams, and promote collaborative working in the interest of the organisations they lead. There is an opportunity to learn from initiatives that promote women in leadership roles, as well as published reviews that encourage organisations to address gender disparity in pay and positions of influence. Now is the time to add the multiple dimensions of diversity and intersectionality to this initiative for gender equality and justice in the medical workforce. Keywords: Equity, leadership, woman doctor

Women Representation in Anesthesiology Society Leadership Positions.

Although the number of women in medicine has increased, women remain underrepresented in leadership positions, specifically in medical societies. Specialty societies in medicine are influential in networking, career advancement, research and education opportunities, and providing awards and recognition. The goals of this study are to examine the representation of women in leadership positions in anesthesiology societies compared to women society members and women anesthesiologists and to analyze the trend in women society presidents over time. A list of anesthesiology societies was obtained from the American Society of Anesthesiology (ASA) website. Society leadership positions were obtained via the societies' websites. Gender was determined by images on the society website and images or pronouns on hospital websites and research databases. The percentage of women presidents, vice presidents/presidents-elect, secretaries/treasurers, board of directors/council members, and committee chairs was calculated. The percentage of women in society leadership positions was compared to the percentage of women society members when available, and the percentage of women anesthesiologists in the workforce (26%) using binomial difference of unpaired proportions tests. The trend of women presidents from 1980 to 2020 was analyzed using a Cochran-Armitage trend test. A total of 13 societies were included in this study. Overall, women held 32.6% (189/580) of leadership positions. 38.5% (5/13) of presidents, 17.6% (3/17) of presidents-elect/vice presidents, and 45% (9/20) of secretaries/treasurers were women. In addition, 30.0% (91/303) of board of directors/council members and 34.2% (90/263) of committee chairs were women. The percentage of women holding society leadership positions was significantly greater than the percentage of women anesthesiologists in the workforce ( P < .001), as was the percentage of women as committee chairs ( P = .003). The percentage of women society members was available for 9 of 13 societies (69%), and the percentage of women leaders was similar to the percentage of women society members ( P = .10). There was a significant difference in the percentage of women leaders between society size categories. Small societies had 32.9% (49/149) women leaders, medium had 39.4% (74/188) women leaders, and the single large society had 27.2% (66/243) ( P = .03). There were also significantly more women leaders in the Society of Cardiovascular Anesthesiologists (SCA) than there are women members ( P = .02). This study suggests that anesthesia societies may be more inclusive of women in leadership positions compared to other specialty societies. Although in anesthesiology, women remain underrepresented in academic leadership roles, there is a higher proportion of women in leadership roles in anesthesiology societies than proportion of women in the anesthesia workforce.