On-site Child Care Research Articles

People-centred health services at HIV clinics across Europe: findings from the EuroSIDA clinic survey

Introduction : An important dimension of people-centred health systems is the organisation of services around patients’ heterogeneous medical and psychosocial needs rather than around biomedical disease categorisations. This approach may potentially contribute to better treatment outcomes in the field of HIV, since many factors not directly related to HIV, such as the availability of opioid substitution therapy, may determine the extent to which patients benefit from HIV clinical care. Methods : The EuroSIDA study is a prospective observational cohort study that began enrolling patients in 1994. In early 2014, we conducted a 59-item survey of the 98 EuroSIDA clinics. The survey included 10 items relating to various aspects of people-centred health care. Responses from the EuroSIDA East Europe study region (Belarus, Estonia, Lithuania, the Russian Federation and Ukraine [n=12 centres from 5 countries]) were compared to responses from a “non-East Europe” study region comprised of all other EuroSIDA countries (n=70 centres from 26 countries). Differences in responses were assessed using Fisher’s exact test and statistical significance was defined as p Results : Drug/alcohol treatment services and opioid substitution therapy (OST) were not available at many EuroSIDA study clinics, with the East Europe group reporting non-significantly lower levels of these services than the non-East Europe group (33% versus 50% and 25% versus 44% respectively) (Figure 1). The East Europe group lagged further behind the non-East Europe group in regard to levels of mental health treatment and/or referral (42% versus 74%, p=0.039), as well as levels of family planning counselling (33% versus 69%, p=0.026). On-site childcare was available at less than two-thirds of clinics in both East Europe and non-East Europe (50% versus 35%). High proportions of clinics in both regions were found to have on-site pharmacies (92% East Europe versus 93% non-East Europe). Significantly lower levels of East Europe clinics reported having foreign-language interpreters available compared to non-East Europe clinics (25% versus 59%, p=0.038). High levels of both East Europe clinics and non-East Europe clinics reported providing the following services to HIV-positive patients for free: clinic visits (83% versus 77%), antiretroviral therapy (ART) (100% versus 83%), CD4 cell count testing (100% versus 78%) and viral load testing (100% versus 83%) (Figure 2).Drugs for opportunistic infections were provided for free at somewhat smaller proportions of clinics (58% East Europe versus 62% non-East Europe). Discussion : Although neither alcohol and drug treatment services nor OST were available at many EuroSIDA clinics within or outside of the East Europe countries, it is not known whether or not this is problematic, since it is common in some settings to have separate narcological facilities located in close proximity to clinics that provide ART. A question warranting further research, particularly in East Europe EuroSIDA clinics, is whether patients with alcohol and drug addiction have sufficient access to treatment and to OST, either on the premises or elsewhere. The HIV literature has identified health service fees as a major barrier to treatment and care, with one potential consequence being loss to follow-up. In our study, the proportions of clinics providing four types of free services were high for both of the regions being compared. At the same time, East Europe clinics responding to the survey reported having higher loss to follow-up than the comparison region (data not shown). Further research should examine these variables on a clinic-by-clinic basis and in relation to patient socioeconomic status to determine how fees might affect patient outcomes in this regard. The regional difference in the provision of foreign-language interpreters may be due to a lower need in the East Europe group of clinics since most people in those study countries, regardless of nationality, speak Russian. On the other hand, a lack of foreign language interpreters in more than 40% of non-East clinics may be indicative of a service access barrier with greater consequences in some of those countries. Again, a closer examination of key variables on a clinic-by-clinic basis is warranted. Conclusion : This investigation of patient-centred health services at EuroSIDA study clinics has identified some service gaps in the East Europe group of clinics and other service gaps in the full cohort of EuroSIDA study clinics across Europe. Further research is needed to determine the potential impact of these gaps on patient outcomes. Figure 1. Availability of people-centred health services (see figure by following link below) P-values from Fishers exact test for comparing proportions. 1N=81 responses: 11 from East and 70 from non-East. 2N=81 responses: 12 from East and 69 from non-East. 3N=80 responses: 12 from East and 68 from non-East. Figure 2. Availability of free services (see figure by following the link below) P-values from Fishers exact test for comparing proportions. ART = antiretroviral therapy; CD4 = CD4 cell count; VL = viral load; OIs = opportunistic infections. All questions had 81 responses: 12 from East and 69 from non-East.

People-centred health services at HIV clinics across Europe: findings from the EuroSIDA clinic survey

Introduction: An important dimension of people-centred health systems is the organisation of services around patients’ heterogeneous medical and psychosocial needs rather than around biomedical disease categorisations. This approach may potentially contribute to better treatment outcomes in the field of HIV, since many factors not directly related to HIV, such as the availability of opioid substitution therapy, may determine the extent to which patients benefit from HIV clinical care. Methods: The EuroSIDA study is a prospective observational cohort study that began enrolling patients in 1994. In early 2014, we conducted a 59-item survey of the 98 EuroSIDA clinics. The survey included 10 items relating to various aspects of people-centred health care. Responses from the EuroSIDA East Europe study region (Belarus, Estonia, Lithuania, the Russian Federation and Ukraine [n=12 centres from 5 countries]) were compared to responses from a “non-East Europe” study region comprised of all other EuroSIDA countries (n=70 centres from 26 countries). Differences in responses were assessed using Fisher’s exact test and statistical significance was defined as p Results: Drug/alcohol treatment services and opioid substitution therapy (OST) were not available at many EuroSIDA study clinics, with the East Europe group reporting non-significantly lower levels of these services than the non-East Europe group (33% versus 50% and 25% versus 44% respectively) (Figure 1). The East Europe group lagged further behind the non-East Europe group in regard to levels of mental health treatment and/or referral (42% versus 74%, p=0.039), as well as levels of family planning counselling (33% versus 69%, p=0.026). On-site childcare was available at less than two-thirds of clinics in both East Europe and non-East Europe (50% versus 35%). High proportions of clinics in both regions were found to have on-site pharmacies (92% East Europe versus 93% non-East Europe). Significantly lower levels of East Europe clinics reported having foreign-language interpreters available compared to non-East Europe clinics (25% versus 59%, p=0.038). High levels of both East Europe clinics and non-East Europe clinics reported providing the following services to HIV-positive patients for free: clinic visits (83% versus 77%), antiretroviral therapy (ART) (100% versus 83%), CD4 cell count testing (100% versus 78%) and viral load testing (100% versus 83%) (Figure 2).Drugs for opportunistic infections were provided for free at somewhat smaller proportions of clinics (58% East Europe versus 62% non-East Europe). Discussion: Although neither alcohol and drug treatment services nor OST were available at many EuroSIDA clinics within or outside of the East Europe countries, it is not known whether or not this is problematic, since it is common in some settings to have separate narcological facilities located in close proximity to clinics that provide ART. A question warranting further research, particularly in East Europe EuroSIDA clinics, is whether patients with alcohol and drug addiction have sufficient access to treatment and to OST, either on the premises or elsewhere. The HIV literature has identified health service fees as a major barrier to treatment and care, with one potential consequence being loss to follow-up. In our study, the proportions of clinics providing four types of free services were high for both of the regions being compared. At the same time, East Europe clinics responding to the survey reported having higher loss to follow-up than the comparison region (data not shown). Further research should examine these variables on a clinic-by-clinic basis and in relation to patient socioeconomic status to determine how fees might affect patient outcomes in this regard. The regional difference in the provision of foreign-language interpreters may be due to a lower need in the East Europe group of clinics since most people in those study countries, regardless of nationality, speak Russian. On the other hand, a lack of foreign language interpreters in more than 40% of non-East clinics may be indicative of a service access barrier with greater consequences in some of those countries. Again, a closer examination of key variables on a clinic-by-clinic basis is warranted. Conclusion: This investigation of patient-centred health services at EuroSIDA study clinics has identified some service gaps in the East Europe group of clinics and other service gaps in the full cohort of EuroSIDA study clinics across Europe. Further research is needed to determine the potential impact of these gaps on patient outcomes. Figure 1. Availability of people-centred health services (see figure by following link below) P-values from Fishers exact test for comparing proportions. 1N=81 responses: 11 from East and 70 from non-East. 2N=81 responses: 12 from East and 69 from non-East. 3N=80 responses: 12 from East and 68 from non-East. Figure 2. Availability of free services (see figure by following the link below) P-values from Fishers exact test for comparing proportions. ART = antiretroviral therapy; CD4 = CD4 cell count; VL = viral load; OIs = opportunistic infections. All questions had 81 responses: 12 from East and 69 from non-East.

A Review of Worksite Lactation Accommodations.

The purpose of this review was to examine workplace lactation accommodations, and their association with breastfeeding duration, and identify strategies occupational health professionals can use to promote lactation improvements. This study included literature published from 1985 through 2015 and listed in PubMed and CINAHL. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), 11 articles were identified for review. Presence of a corporate lactation program, on-site child care, and return to work/telephone lactation consultation were consistently associated with breastfeeding at 6 months. Other breastfeeding accommodations (i.e., lactation spaces, lactation breaks, worksite lactation policies, and supervisor/coworker support) were not consistently associated with breastfeeding duration. Occupational health professionals can play key roles in improving the effectiveness of lactation accommodations. Assuring adequate implementation of accommodations, increasing communication and marketing of accommodations, and promoting supervisor and coworker support are areas that occupational health professionals should explore for improving lactation duration.

Workload, generic and work–family specific social supports and job stress

Purpose The present study aims to investigate the mediating role of work–family conflict (WFC) and family–work conflict (FWC) on the effects of workload and the generic and specific work–family social support in job stress. Design/methodology/approach Using AMOS 20 through bootstrap analysis for indirect effect, the study assessed the abovementioned relationships based on data collected from 258 respondents in the hospitality industry in Quebec. Findings The findings indicate that workload increases job stress via WFC and FWC. Both generic and specific work–family social support decrease job stress through WFC and FWC. Organizational support for reconciling work and family life is more significant than generic supervisor support. Family support reduces job stress via WFC but not via FWC. Research limitations/implications In future studies, it would be interesting to explore the effects of variables such as gender, marital status, hotel category and the job category, as well as cultural origin. Practical implications The results of this research should alert employers in the hospitality industry to engage in family-friendly policies that include not only practices such as working time arrangements, family leave and onsite child care services, but also to be committed to create a family-friendly culture and to adopt the best forms of supportive policies at work. Originality/value By emphasizing cross-domain effects, the present research contributes to the existing knowledge by testing the mediating role of WFC and FWC in the effects of workload and various resources of social support on job stress.

Pregnancy and Parenthood among Surgery Residents: Results of the First Nationwide Survey of General Surgery Residency Program Directors

Although family and lifestyle are known to be important factors for medical students choosing a specialty, there is a lack of research about general surgery residency program policies regarding pregnancy and parenthood. Similarly, little is known about program director attitudes about these issues. We performed a cross-sectional survey of United States (US) general surgery residency program directors. Sixty-six respondents completed the survey: 70% male, 59% from university-based programs, and 76% between 40 and 59 years of age. Two-thirds (67%) reported having a maternity leave policy. Less than half (48%) reported having a leave policy for the non-childbearing parent (paternity leave). Leave duration was most frequently reported as 6 weeks for maternity leave (58%) and 1 week for paternity leave (45%). Thirty-eight percent of general surgery residency program directors (PDs) reported availability of on-site childcare, 58% reported availability of lactation facilities. Forty-six percent of university PDs said that the research years are the best time to have a child during residency; 52% of independent PDs said that no particular time during residency is best. Sixty-one percent of PDs reported that becoming a parent negatively affects female trainees' work, including placing an increased burden on fellow residents (33%). Respondents perceived children as decreasing female trainees' well-being more often than male trainees' (32% vs 9%, p < 0.001). Program director reports indicated a lack of national uniformity in surgical residency policies regarding parental leave, length of leave, as well as inconsistency in access to childcare and availability of spaces to express and store breast milk. Program directors perceived parenthood to affect the training and well-being of female residents more adversely than that of male residents.

Differences in palliative care needs among cancer survivors in an inner city academic facility versus a suburban community facility.

61 Background: To determine differences in palliative care (PC) needs in newly diagnosed cancer patients from an inner-city academic facility compared to a suburban, community facility. Also, to identify ways to improve PC for cancer patients in these locations. Methods: 270 subjects with cancer were prospectively identified, 85 from an inner city academic facility (Site A), and 185 from a suburban community facility in the same metropolitan area. (Site B) All patients received treatment from board-certified oncologists. Master’s level Social Workers asked all subjects to complete a standardized, validated questionnaire to determine their palliative care needs prior to treatment. Completed questionnaires were collected and data was depersonalized and analyzed by the authors. Statistical differences were assessed using standard methods. Results: Site A patients were younger (56.3 vs 61.5years) less likely to be caucasian (35/85, 41.2% vs 114/185, 61.6%) and less likely to have private insurance (28/85, 32.9% vs 187/185, 47%). Site B patients were more likely to express a fear of pain, (112/185, 60.5% vs 28/85,32.9%) dying, (112/185, 60.5% vs 18/85, 21.2%) being alone, (112/185(60.5% vs 15/85, 17.7%) or nausea (117/185, 63.2% vs 10/85, 11.8%). Site A patients were more likely to express fear of not having transportation, (35/85, 41.2% vs 42/185, 22.1%) inability to pay for prescriptions, (28/85, 32.9% vs 40/185, 21.6%) or child care (13/85, 15.3% vs 9/185, 4.9%). All differences were significant at a p &lt; 0.05. Conclusions: There are major differences in the PC needs of patients presenting to an inner-city academic vs suburban community facility. To be most effective, PC programs must be tailored to the community. Interventions proposed for the suburban community facility include early access to: 1) grief counseling, 2) support groups, 3) Nurse-Navigators. Interventions proposed for the inner city academic facility include early access to: 1) Medication cost assistance programs (local philanthropies, facility-based pharmacy discounts) 2) travel services (cab vouchers, coordination with public transportation schedules) 3) on-site child care facilities.

Family Friendly Policies in Stem Departments: Awareness and Determinants

Focused on academic departments in science, technology, engineering, and mathematics (STEM) fields in the United States, we attempt to map department chairs’ awareness of family friendly policies and investigate the possible determinants of their knowledge levels. We propose that department chairs’ knowledge of family friendly policies is shaped by their working contexts and incentives. Based on a representative sample of STEM department chairs in American research universities, we find that chairs’ knowledge of family friendly policies is at least worrisome. Nevertheless, chairs prove more committed to family friendly policies if departments have a diversity strategy. Those aspiring to move up in the administrative rank possess more knowledge on the policies of unpaid family leave, spousal employment assistance and workload reduction for family reasons. Female chairs demonstrate greater knowledge of family leave policies and onsite childcare. We conclude the study by discussing research implications and developing policy recommendations.

Relationship of residency program characteristics with pass rate of the American Board of Internal Medicine certifying exam

ObjectivesTo evaluate the relationship between the pass rate of the American Board of Internal Medicine (ABIM) certifying exam and the characteristics of residency programs.MethodsThe study used a retrospective, cross-sectional design with publicly available data from the ABIM and the Fellowship and Residency Electronic Interactive Database. All categorical residency programs with reported pass rates were included. Using univariate and multivariate, linear regression analyses, I analyzed how 69 factors (e.g., location, general information, number of faculty and trainees, work schedule, educational environment) are related to the pass rate.ResultsOf 371 programs, only one region had a significantly different pass rate from the other regions; however, as no other characteristics were reported in this region, I excluded program location from further analysis. In the multivariate analysis, pass rate was significantly associated with four program characteristics: ratio of full-time equivalent paid faculty to positions, percentage of osteopathic doctors, formal mentoring program, and on-site child care (OCC). Numerous factors were not associated at all, including minimum exam scores, salary, vacation days, and average hours per week.ConclusionsAs shown through the ratio of full-time equivalent paid faculty to positions and whether there was a formal mentoring program, a highly supervised training experience was strongly associated with the pass rate. In contrast, percentage of osteopathic doctors was inversely related to the pass rate. Programs with OCC significantly outperformed programs without OCC. This study suggested that enhancing supervision of training programs and offering parental support may help attract and produce competitive residents.

The Professional, the Personal, and the Ideal Worker: Pressures and Objectives Shaping the Boundary between Life Domains

Both scholarly literature and popular accounts suggest that modern organizational practices have moved toward encouraging employees to “integrate” or blur the boundary between their personal and professional domains, for example, through self-disclosure at work, company-sponsored social activities or providing on-site child care. Concurrently, an ideology underlying U.S. professional norms discourages integration practices such as referencing non-work roles during workplace interactions, expressing emotions in the workplace, and/or displaying non-work-related items in workspaces. In this review, we posit that these two norms firmly coexist because they differentially serve two objectives corresponding to the parallel bodies of research we examine: one addressing boundary management as a tool for handling role responsibilities, and the other considering boundary management as a tool for shaping workplace identity and relationships. Specifically, we posit that segmenting personal and professional domains facilitates the management of role responsibilities, whereas integration is more beneficial for managing workplace identity and relationships. Furthermore, both objectives serve the “ideal worker” imperative of work primacy. We identify key contingencies that help us to further understand existing research findings, and prompt future research directions informing theories for understanding the attractiveness and efficacy of different personal–professional boundary management strategies for both organizations and individuals.

Vouching for childcare assistance with two quasi-experimental studies

Purpose– Human resource management (HRM) practices are implemented to improve outcomes, such as reducing turnover, absenteeism, and improving performance. Using social exchange theory (SET), the purpose of this paper is to examine one HRM practice that has received less attention by researchers: employer-sponsored childcare assistance programs.Design/methodology/approach– Study 1 – a field study compared three groups of hospital employees’ (n=148) attitudes and behaviors using MANCOVA/ANOVA over two time periods. Study 2 – using a field study, on-site and voucher childcare assistance programs were evaluated in terms of the cost to the organization and the relationship to attitudinal variables.Findings– Study 1 – results indicated that employee performance was higher and absenteeism lower for employees using the on-site childcare center than employees using an off-site center or with no children. Although the attitudinal results did not align with hypotheses, they were not inconsistent with SET. Study 2 – results indicate that childcare assistance programs may be a beneficial HRM practice for organizations to implement.Research limitations/implications– One limitation of Study 1 is the small sample size. Future research should continue to examine how employee benefits like childcare programs affect employees, as well as examine how such benefits differentially employees who value and do not value the benefits. In Study 2, although the authors randomly selected the sample of on-site and voucher programs, the health care facilities self-selected themselves to participate in the program and selected the type of childcare program, a potential source of bias. Future research should examine childcare assistance programs and their impact on work-family balance and strain-based conflict in a wider variety of samples.Practical implications– Implications for research and practice: Both studies offer researchers a “next step” in the evaluation of childcare assistance research. Additionally, these studies are of practical value to administrators/researchers in organizations who may be considering vouchers or on-site programs as they relate such programs to organizational outcomes.Originality/value– The first study is one of the few studies on this topic to use a field design with two time points and with multiple behaviors and attitudes. The second study provides a descriptive comparison of two types of childcare assistance programs, a comparison made by few studies to date.

Hope in a Freezer: The 21st Century Pandora’s Box

Hope in a Freezer: The 21st Century Pandora’s Box

Differences in palliative care needs among women with gynecologic cancers in an inner city, academic facility versus a suburban, community facility

Objectives: The aim of this study was to determine differences in palliative care needs inwomenwith gynecologic cancers from anurban, inner city, academic facility compared to a suburban, community facility and also, to identify interventions that could improve palliative care for gynecologic cancer patients in varying locations. Methods: 71 women with gynecologic cancer were prospectively identified, 54 from an urban, inner city academic cancer center, and 17 from a suburban community cancer center in the same metropolitan area. All subjects were asked to complete a standardized, validated questionnaire intended to determine their palliative care needs after diagnosis but prior to treatment. Palliative care trained, Master's level social workers introduced themselves and the questionnaire to patients, and offered to help with additional needs. Completed questionnaires were collected and appropriate data was extracted. The data was depersonalized and analyzed by the authors. Statistical differences were assessed with SigmaStat V.2.0. Results: All patients were treated by board-certified gyn oncologists. The types of cancers seen and treatments offered (all of which met NCCN guidelines) were similar. Inner city academic patients were less likely to complete the questionnaire than the suburban community patients (64% vs 100% of those offered, p b 0.001). Patients from the inner city academic group were younger (54 years old vs 61 years old, p b 0.05) and more likely to be African–American (77% vs 29%, p b 0.05) than those from the suburban community group. The ratio of Medicaid to private/Medicare insurance coverage was higher in inner city academic patients than suburban community patients (58% vs 22%, p b 0.05). The most common palliative care concerns identified by suburban community patientswere: 1) pain, 2) anxiety, 3) depression, 4) nausea/vomiting. In comparison, the most common concerns identified by inner city academic patients were: 1) paying for medications, 2) travel to the treatment facility, 3) pain, and 4) child care. Conclusion: There are major differences in the palliative care needs of patients from an inner city academic facility compared to a suburban community facility. Interventions proposed for the suburban community facility were early access to: 1) grief counseling, 2) patient support groups, and 3) Nurse–Navigator services. Interventions proposed for the inner city academic facility include early access to: 1) programs for assistance with medication costs (local philanthropies, facility-based pharmacy discounts), 2) travel services (cab vouchers, coordination of treatments with public transportation schedules), and 3) on-site child care facilities. Further, inner city academic patients should be encouraged to voice their palliative care concerns. More specific determinations of patient concerns are needed to help structure palliative care services in different types of facilities.

The role of tumor associated macrophages in ovarian cancer

Objectives: The aim of this study was to determine differences in palliative care needs inwomenwith gynecologic cancers from anurban, inner city, academic facility compared to a suburban, community facility and also, to identify interventions that could improve palliative care for gynecologic cancer patients in varying locations. Methods: 71 women with gynecologic cancer were prospectively identified, 54 from an urban, inner city academic cancer center, and 17 from a suburban community cancer center in the same metropolitan area. All subjects were asked to complete a standardized, validated questionnaire intended to determine their palliative care needs after diagnosis but prior to treatment. Palliative care trained, Master's level social workers introduced themselves and the questionnaire to patients, and offered to help with additional needs. Completed questionnaires were collected and appropriate data was extracted. The data was depersonalized and analyzed by the authors. Statistical differences were assessed with SigmaStat V.2.0. Results: All patients were treated by board-certified gyn oncologists. The types of cancers seen and treatments offered (all of which met NCCN guidelines) were similar. Inner city academic patients were less likely to complete the questionnaire than the suburban community patients (64% vs 100% of those offered, p b 0.001). Patients from the inner city academic group were younger (54 years old vs 61 years old, p b 0.05) and more likely to be African–American (77% vs 29%, p b 0.05) than those from the suburban community group. The ratio of Medicaid to private/Medicare insurance coverage was higher in inner city academic patients than suburban community patients (58% vs 22%, p b 0.05). The most common palliative care concerns identified by suburban community patientswere: 1) pain, 2) anxiety, 3) depression, 4) nausea/vomiting. In comparison, the most common concerns identified by inner city academic patients were: 1) paying for medications, 2) travel to the treatment facility, 3) pain, and 4) child care. Conclusion: There are major differences in the palliative care needs of patients from an inner city academic facility compared to a suburban community facility. Interventions proposed for the suburban community facility were early access to: 1) grief counseling, 2) patient support groups, and 3) Nurse–Navigator services. Interventions proposed for the inner city academic facility include early access to: 1) programs for assistance with medication costs (local philanthropies, facility-based pharmacy discounts), 2) travel services (cab vouchers, coordination of treatments with public transportation schedules), and 3) on-site child care facilities. Further, inner city academic patients should be encouraged to voice their palliative care concerns. More specific determinations of patient concerns are needed to help structure palliative care services in different types of facilities.

The Women in Medicine and Health Science Program

Although more female physicians and scientists are choosing careers in academic medicine, women continue to be underrepresented as medical school faculty, particularly at the level of full professor and in leadership positions. Effective interventions to support women in academic medicine exist, but the nature and content of such programs varies widely. Women in medicine programs can play a critical role in supporting women's careers and can improve recruitment and retention of women by providing opportunities for networking, sponsorship, mentorship, and career development. The University of California Davis School of Medicine established the Women in Medicine and Health Science (WIMHS) program in 2000 to ensure the full participation and success of women in all roles within academic medicine. The authors describe the components and evolution of the WIMHS program. A steady increase in the number and percentage of female faculty and department chairs, as well as a relatively low departure rate for female faculty, strong and growing internal partnerships, and enthusiastic support from faculty and the school of medicine leadership, suggest that the WIMHS program has had a positive influence on recruitment and retention, career satisfaction, and institutional climate to provide a more inclusive and supportive culture for women. Going forward, the WIMHS program will continue to advocate for broader institutional change to support female faculty, like creating an on-site child care program. Other institutions seeking to address the challenges facing female faculty may consider using the WIMHS program as a model to guide their efforts.

Treasurer's Report for Financial Year (FY) 2013

Society’s total assets as of May 31, 2014, are as follows: $2,933,887.35 • Cash accounts (community checking + money market business): $2,749,480.42 • Total CDs: $184,406.93 This report covers the period of June 1, 2013–May 31, 2014. Due to the ongoing success of Molecular Biology and Evolution (MBE) and Genome Biology and Evolution (GBE), whose revenues continue to increase, the society remains in outstanding financial health. Society membership decreased marginally during financial year 2013: Membership-only subscriptions decreased from 732 in 2012 to 332 in 2013, whereas Society membership + journal subscriptions increased from 313 in 2012 to 687 in 2013. The society used its income to publish its two journals, MBE and GBE, and to support its annual meeting, in 2013, held in Chicago, IL. This included providing increased graduate and postdoctoral travel awards, funding the Walter Fitch Prize Symposium (a cash prize for the winner and travel funds for all eight contestants), running the Undergraduate Diversity Mentoring Program (UDMP), subsidizing the provision of on-site childcare, supporting the travel and accommodation of Council members, and providing travel incentives for associate editors of MBE and GBE. We also supported three satellite meetings on important, focused and timely topics related to molecular evolutionary biology. We continue to receive an annual donation of $2,000USD from Masatoshi Nei to support an honorarium for publication in MBE of the annual Nei Lecture given by the President of Society for MBE (SMBE) during the annual meeting. The 2013 Nei Lecture is to be the first lecture published under this scheme. The total value of the honorarium is to be $4,000USD. Expense Category June 1, 2013– May 31, 2014 (USD) Interest income 532.23 OUP signing bonus (new contract negotiation) 125,000.00 OUP journal revenue (MBE) 585,510.00 OUP journal revenue (GBE) 131,224.00 Society fees collected by OUP 9,817.00 Annual meeting reimbursement 0.00 Nei Lecture fund donation (Masatoshi Nei) 2,000.00 Total inflows 854,083.23 2013 annual meeting 146,120.00 SMBE satellite meetings 54,796.50 Support for diversity programs (e.g., UDMP, childcare subsidy) 27,685.84 Nei Lecture publication honorarium 0.00 Bank charges 295.00 Accounting 1,750.00 Consultancy and professional society management 3,620.00 Corporation fee 40.00 Fitch prize 1,500.00 SMBE council and editors-in-chief travel 26,915.29 MBE/GBE associate editors travel incentive 110,001.07 SMBE travel awards (Fitch, graduate, postdoc) 46,969.00 SMBE website maintenance 514.81 SMBE treasurer expenses 0.00 MBE editorial office expenses 65,356.66 MBE editor expenses 66,000.00 MBE highlights and press releases 6,370.00 GBE editor expenses 0.00 GBE “Highlight” honoraria 10,090.50 Postage 0.00 Total outflows 568,024.67 Overall total 286,058.56 View it in a separate window

Enabling work? Family-friendly policies and academic productivity for men and women scientists

Universities throughout the USA have adopted family-friendly policies to enable life and career balance and to encourage the attraction and retention of women scientists. Although family-leave policies are designed to provide job protection for parents and ensure that faculty can remain productive scholars, it is unclear whether or not formal family-leave policies have played a positive role in areas of academic productivity such as publishing and teaching. This research investigates the relationships between university family-leave policies and productivity among faculty in six fields of science using responses from a national survey of 1,598 faculty at 150 research universities and data from status of women reports and faculty handbooks. The hierarchical multi-level analysis indicates that generous formal family-leave policies, on-site childcare, and spousal hiring policies differently affect the productivity of women and men academic scientists.

An overview of nursing in Saudi Arabia

Achieving and maintaining a stable nursing workforce is an important issue for the well-being of the rapidly growing population of Saudi Arabia. However, high turnover of expatriate staff and low recruitment of Saudi nationals have led to a serious staff shortage in the professions, particularly of well-qualified and experienced nurses. Nursing leaders need to work to improve the image of nurses and facilitate the recruitment of women into the nursing profession. Reduced working hours and part-time contracts with increased salaries and benefits could attract more young women to the profession, as might the provision of facilities such as private transportation and on-site childcare. Furthermore, establishing a national association for nurses would advance the nursing profession and help to ensure that all nurses undertake fully comprehensive training before entering the workforce.

The Case for On-Site Child Care in Residency Training and Afterward

Individuals in residency and fellowship training work long, often unpredictable hours, including nights and weekends, and residency training typically occurs during individuals' childbearing and child-rearing years. However, it is unclear how residents with children arrange child care that accommodates the 80-hour resident work week. Additionally, during the past 40 years, the proportion of women in medicine in the United States has increased dramatically. Historically, parental leave and child care have been considered women's issues, but they affect both men and women, especially for dual-professional and dual-physician couples. Additionally, residents often face repayment of educational debt while earning a limited salary, which can limit the affordability of child care options. The lack of child care options for residents may have a broader impact on the training and growth of the physician workforce. Due to many factors, including the growth of an aging population and the limited number of entry positions into graduate medical education, a shortage of physicians (both generalists and specialists) is predicted for the United States within the next 10 years.1 Compounding this, a significant proportion of the physician population is working part-time. According to a national survey of 5704 physicians, 13% of US physicians work part-time, including 22% of female physicians and 9% of male physicians.2 Female physicians working part-time are more likely to be married and have young children.2 Similar trends in part-time employment are noted internationally as well. A study from Switzerland reported that the most prevalent career arrangement for a male physician with young children is full-time employment with a spouse unemployed or working less than half-time.3 However, the most common arrangement for a female physician with young children is 50% to 69% part-time employment with a full-time working partner.3 The authors suggest that in the era of physician shortages, availability of child care facilities in hospitals could encourage a higher work participation of physician mothers.3 A study of dual-physician marriages reported that as many as 87% of women and 59% of men arrange their work schedule to accommodate child care responsibilities.4 Among male and female surgeons married or partnered to another physician, nearly 40% reported that their career advancement had been slowed owing to child-rearing responsibilities. In addition, surgeons with a physician partner were twice as likely to miss work for sick-child care as surgeons with a nonphysician partner.5

Using mPINC data to measure breastfeeding support for hospital employees.

Employer support is important for mothers, as returning to work is a common reason for discontinuing breastfeeding. This article explores support available to breastfeeding employees of hospitals that provide maternity care. This study aimed to describe the prevalence of 7 different types of worksite support and changes in these supports available to breastfeeding employees at hospitals that provide maternity care from 2007 to 2011. Hospital data from the 2007, 2009, and 2011 Centers for Disease Control and Prevention Survey on Maternity Practices in Infant Nutrition and Care (mPINC) were analyzed. Survey respondents were asked if the hospital provides any of the following supports to hospital staff: (1) a designated room to express milk, (2) on-site child care, (3) an electric breast pump, (4) permission to use existing work breaks to express milk, (5) a breastfeeding support group, (6) lactation consultant/specialist available for consult, and (7) paid maternity leave other than accrued vacation or sick leave. This study was exempt from ethical approval because it was a secondary analysis of a publicly available dataset. Of the 7 worksite supports in hospitals measured, 6 increased and 1 decreased from 2007 to 2011. Across all survey years, more than 70% of hospitals provided supports for expressing breast milk, whereas less than 15% provided direct access to the breastfeeding child through on-site child care, and less than 35% offered paid maternity leave. Results differed by region and hospital size and type. In 2011, only 2% of maternity hospitals provided all 7 worksite supports; 40% provided 5 or more. The majority of maternity care hospitals (> 70%) offer breastfeeding supports that allow employees to express breast milk. Supports that provide direct access to the breastfeeding child, which would allow employees to breastfeed at the breast, and access to breastfeeding support groups are much less frequent than other supports, suggesting opportunities for improvement.

Chest Physicians Recommend CT Screening for Lung Cancer Only for Older Smokers

the risk factors for women,” Tsai said. Trauma in general may be a factor. Tsai and colleagues studied 581 homeless women veterans at 11 VA Homeless Women Veterans Program sites and found that women in the group had experienced a diverse array of trauma. For example, 82% said someone close to them had experienced a serious or lifethreatening illness, 67% reported having been raped, 61% had experienced a natural or manmade disaster, 53% had a friend or family member who was killed, 52% had been injured by a family member hitting or pushing them, and 27.7% had engaged in prostitution. Tsai said much of the trauma occurred before the women joined the military, and many remained at elevated risk of trauma after they returned home. He noted that some researchers theorize that people who have been traumatized may be at increased risk of further trauma in part because they may put themselves into potentially threatening situations. Homeless female veterans sometimes have a different set of needs than their male counterparts. Many have children and need to find housing that is suitable for children, explained Stephen Peck, MSW, of the nonprofit US Veterans Initiative. The majority of homeless female veterans have also experienced sexual trauma, which may make them less comfortable with participating in programs in which they are greatly outnumbered by men. Peck said his group found that many female homeless veterans declined to participate in their substance abuse program until the group developed a program specifically for women that allows women to attend day treatment as a cohort. Peck noted that his organization also offers on-site child care and a school with kindergarten through grade 8 to provide care and access to education for children whose mothers are seeking treatment. Tailoring interventions to the specific needs of subgroups of homeless vets may be crucial for both men and women, Tsai said. “Some individuals need more intensive services; some are able to do well on their own once they get housing,” he explained. Tsai recommended that physicians refer veterans at risk of homelessness to the VA, which he said is better equipped to handle issues surrounding homelessness and which is often free for veterans. The VA tries to make care as accessible as possible, not just at hospitals but also at outpatient clinics. The US Department of Housing and Urban Development–Veterans Affairs Supportive Housing (HUD-VASH) program provides vouchers to help homeless veterans find rental housing and also provides them with case management and clinical services (http://1.usa .gov/h52lnU).