201
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Hemphill ME, Maher Z, Ross HM. Addressing Gender-Related Implicit Bias in Surgical Resident Physician Education: A Set of Guidelines. J Surg Educ 2020; 77:491-494. [PMID: 31954662 DOI: 10.1016/j.jsurg.2019.12.014] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 12/21/2019] [Accepted: 12/27/2019] [Indexed: 05/18/2023]
Abstract
While it is the goal of academic institutions to train male and female resident physicians equally, gender-related implicit bias may play a role in resident training, thus impacting the quality and fairness of education. Implicit bias may be one of the reasons for the discrepancies that exist in resident training, specifically in learning style, evaluations by faculty members, and treatment of female residents by other clinicians. Patterns of systemic gender-related implicit bias, we argue, remain pervasive in the healthcare system and affect medical education. This review identifies areas of surgical education that are susceptible to gender-related bias and provides recommendations to safeguard gender equity in resident education. We believe behavioral change can help maintain an inclusive learning environment. Using evidence from existing data, we generated guidelines to provide surgical educators in academic centers with information to further understanding of, training in, and steps toward overcoming gender-related implicit bias in resident education. Our guidelines include specific recommendations for educators to require training modules, remove bias from teaching resources, use formal introductory titles, maintain comparable evaluations, encourage women in surgery, adjust instructional methods, and caution self-reporting.
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Affiliation(s)
- Margaret E Hemphill
- Department of Surgery, Temple University Lewis Katz School of Medicine, Phladelphia, Pennsylvania.
| | - Zoe Maher
- Department of Surgery, Temple University Lewis Katz School of Medicine, Phladelphia, Pennsylvania
| | - Howard M Ross
- Department of Surgery, Temple University Lewis Katz School of Medicine, Phladelphia, Pennsylvania
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202
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Duma N. Gender differences in publication rates in oncology: Looking at the past, present, and future. Cancer 2020; 126:2759-2761. [PMID: 32212332 DOI: 10.1002/cncr.32819] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 02/15/2020] [Accepted: 02/17/2020] [Indexed: 01/15/2023]
Affiliation(s)
- Narjust Duma
- Division of Hematology, Medical Oncology and Palliative Care, University of Wisconsin, Madison, Wisconsin
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203
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Tiwari T, Randall CL, Cohen L, Holtzmann J, Webster-Cyriaque J, Ajiboye S, Schou L, Wandera M, Ikeda K, Fidela de Lima Navarro M, Feres M, Abdellatif H, Al-Madi E, Tubert-Jeannin S, Fox CH, Ioannidou E, D'Souza RN. Gender Inequalities in the Dental Workforce: Global Perspectives. Adv Dent Res 2020; 30:60-68. [PMID: 31746651 DOI: 10.1177/0022034519877398] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aim of this review is to investigate the growth of diversity and inclusion in global academic dental research with a focus on gender equality. A diverse range of research methodologies were used to conduct this review, including an extensive review of the literature, engagement of key informants in dental academic leadership positions around the world, and review of current data from a variety of national and international organizations. Results provide evidence of gender inequalities that currently persist in dental academics and research. Although the gender gap among graduating dental students in North America and the two most populous countries in Europe (the United Kingdom and France) has been narrowed, women make up 30% to 40% of registered dentists in countries throughout Europe, Oceania, Asia, and Africa. In academic dentistry around the globe, greater gender inequality was found to correlate with higher ranking academic and leadership positions in the United States, United Kingdom, several countries in European Union, Japan, and Saudi Arabia. Further disparities are noted in the dental research sector, where women make up 33% of dental researchers in the European Union, 35% in North America, 55% in Brazil, and 25% in Japan. Family and societal pressures, limited access to research funding, and lack of mentoring and leadership training opportunities are reported as also contributing to gender inequalities. To continue advancing gender equality in dental academia and research, efforts should be geared toward the collection and public dissemination of data on gender-specific distributions. Such evidence-driven information will guide the selection of future strategies and best practices for promoting gender equity in the dental workforce, which provides a major pipeline of researchers and scholars for the dental profession.
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Affiliation(s)
- T Tiwari
- School of Dental Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - C L Randall
- School of Dentistry, University of Washington, Seattle, WA, USA
| | - L Cohen
- National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
| | - J Holtzmann
- School of Dental Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | | | - S Ajiboye
- International Association for Dental Research, Alexandria, VA, USA
| | - L Schou
- National University Health System, Singapore, Singapore
| | - M Wandera
- Uganda Dental Association, Kampala, Uganda
| | - K Ikeda
- School of Dental Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | | | - M Feres
- Guarulhos University, Guarulhos, Brazil
| | - H Abdellatif
- Princess Nourah bint AbdulRahman University, Riyadh, Saudi Arabia
| | - E Al-Madi
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | | | - C H Fox
- International Association for Dental Research, Alexandria, VA, USA
| | - E Ioannidou
- School of Dental Medicine, UConn Health, Farmington, CT, USA
| | - R N D'Souza
- University of Utah Health Sciences, Salt Lake City, UT, USA
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Abstract
This commentary integrates and expands on the preceding articles in this issue that document and celebrate a century of women's achievements in the International Association for Dental Research (IADR). The increasing participation and leadership of women in dental and craniofacial research and within the IADR were viewed from the perspective of a changing culture of science. The steps that have been taken by the IADR to develop greater inclusiveness are acknowledged, and some of the challenges that remain are discussed in terms of obstacles that are most often social or cultural in origin. Comparisons are made across countries, and the social determinants that lead to differences in women's participation are described. Recommendations are made for developing strategies to change elements of our institutional cultures that have provided advantages to some groups of researchers more than to others. The unconscious biases and a lack of commitment to diversity, equity, and inclusion that limit the participation of members of some groups limit the progress and achievements of science in general.
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Affiliation(s)
- J Albino
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Community Dentistry and Population Health, School of Dental Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - F Teles
- Department of Microbiology, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
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205
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Ibrahim H, Anglade P, Abdel-Razig S. The Use of Social Media by Female Physicians in an International Setting: A Mixed Methods Study of a Group WhatsApp Chat. Womens Health Rep (New Rochelle) 2020; 1:60-64. [PMID: 33786474 PMCID: PMC7784792 DOI: 10.1089/whr.2019.0015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Background: The past decade has witnessed an increase in informal and bottom up driven "she-for-she" efforts, often using social media, to promote the advancement of women in medicine. Yet, this area of research is nascent with limited information on the use of social media platforms by female physicians, especially in the international medical arena. The purpose of this study was to investigate the use of a social media platform by a diverse group of female physicians in an international setting. Materials and Methods: The study used a mixed methods approach, including quantitative descriptive statistics and qualitative thematic analysis of the content of posts of a women physicians WhatsApp group during a 1-year time period (June 1, 2018-May 31, 2019). Results: The group consisted of 122 members with 4897 posts during the 1-year time period. Nine themes were identified including requests for medical information, logistics, personal recommendations, promotion, celebration, community engagement, education, women's empowerment, and employment inquiries. Engagement was high with 72% of members posting during the last 30 days of analysis and 92% of questions posted receiving a response, often within minutes. There were no instances of unprofessional social media behavior. Conclusions: The social media platform was effective in enabling female physicians to expand networks, exchange ideas, share scientific information, celebrate accomplishments, and provide support to colleagues. Creating a social media forum for women physicians may be an effective tool to foster a network of support and community.
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Affiliation(s)
- Halah Ibrahim
- Department of Medicine, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | - Pascale Anglade
- Digestive Disease Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
- Department of Medicine, Lerner College of Medicine, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Sawsan Abdel-Razig
- Department of Medicine, Lerner College of Medicine, Cleveland Clinic Foundation, Cleveland, Ohio
- Department of Medicine, Langone School of Medicine, New York University, New York, New York
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206
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Cardel MI, Dhurandhar E, Yarar-Fisher C, Foster M, Hidalgo B, McClure LA, Pagoto S, Brown N, Pekmezi D, Sharafeldin N, Willig AL, Angelini C. Turning Chutes into Ladders for Women Faculty: A Review and Roadmap for Equity in Academia. J Womens Health (Larchmt) 2020; 29:721-733. [PMID: 32043918 DOI: 10.1089/jwh.2019.8027] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Despite significant progress in recent decades, the recruitment, advancement, and promotion of women in academia remain low. Women represent a large portion of the talent pool in academia, and receive >50% of all PhDs, but this has not yet translated into sustained representation in faculty and leadership positions. Research indicates that women encounter numerous "chutes" that remove them from academia or provide setbacks to promotion at all stages of their careers. These include the perception that women are less competent and their outputs of lesser quality, implicit bias in teaching evaluations and grant funding decisions, and lower citation rates. This review aims to (1) synthesize the "chutes" that impede the careers of women faculty, and (2) provide feasible recommendations, or "ladders" for addressing these issues at all career levels. Enacting policies that function as "ladders" rather than "chutes" for academic women is essential to even the playing field, achieve gender equity, and foster economic, societal, and cultural benefits of academia.
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Affiliation(s)
- Michelle I Cardel
- Department of Health Outcomes and Biomedical Informatics and Pediatrics, University of Florida, Gainesville, Florida
| | - Emily Dhurandhar
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas
| | - Ceren Yarar-Fisher
- Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, Alabama
| | - Monica Foster
- Department of Nutrition Sciences, University of Florida, Gainesville, Florida
| | - Bertha Hidalgo
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Leslie A McClure
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Sherry Pagoto
- Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut
| | - Nathanial Brown
- Department of Mathematics, Penn State University, State College, Pennsylvania
| | - Dori Pekmezi
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, Alabama
| | - Noha Sharafeldin
- Institute for Cancer Outcomes and Survivorship, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Amanda L Willig
- Department of Medicine, Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham, Alabama
| | - Christine Angelini
- Department of Environmental Engineering Sciences, Environmental School for Sustainable Infrastructure and the Environment (ESSIE), University of Florida, Gainesville, Florida
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207
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Zdravkovic M, Osinova D, Brull SJ, Prielipp RC, Simões CM, Berger-Estilita J. Perceptions of gender equity in departmental leadership, research opportunities, and clinical work attitudes: an international survey of 11 781 anaesthesiologists. Br J Anaesth 2020; 124:e160-e170. [PMID: 32005515 DOI: 10.1016/j.bja.2019.12.022] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 12/08/2019] [Accepted: 12/20/2019] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Women make up an increasing proportion of the physician workforce in anaesthesia, but they are consistently under-represented in leadership and governance. METHODS We performed an internet-based survey to investigate career opportunities in leadership and research amongst anaesthesiologists. We also explored gender bias attributable to workplace attitudes and economic factors. The survey instrument was piloted, translated into seven languages, and uploaded to the SurveyMonkey® platform. We aimed to collect between 7800 and 13 700 responses from at least 100 countries. Participant consent and ethical approval were obtained. A quantitative analysis was done with χ2 and Cramer's V as a measure of strength of associations. We used an inductive approach and a thematic content analysis for qualitative data on current barriers to leadership and research. RESULTS The 11 746 respondents, 51.3% women and 48.7% men, represented 148 countries; 35 respondents identified their gender as non-binary. Women were less driven to achieve leadership positions (P<0.001; Cramer's V: 0.11). Being a woman was reported as a disadvantage for leadership and research (P<0.001 for both; Cramer's V: 0.47 and 0.34, respectively). Women were also more likely to be mistreated in the workplace (odds ratio: 10.6; 95% confidence interval: 9.4-11.9; P<0.001), most commonly by surgeons. Several personal, departmental, institutional, and societal barriers in leadership and research were identified, and strategies to overcome them were suggested. Lower-income countries were associated with a significantly smaller gender gap (P<0.001). CONCLUSIONS Whilst certain trends suggest improvements in the workplace, barriers to promotion of women in key leadership and research positions continue within anaesthesiology internationally.
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Affiliation(s)
- Marko Zdravkovic
- Department of Anaesthesiology, Intensive Care and Pain Management, University Medical Centre Maribor, Maribor, Slovenia; Faculty of Medicine, University of Maribor, Maribor, Slovenia
| | - Denisa Osinova
- Department of Anaesthesiology and Intensive Care, Jessenius Faculty of Medicine in Martin, Comenius University Bratislava, University Hospital Martin, Martin, Slovak Republic
| | - Sorin J Brull
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic College of Medicine and Science, Jacksonville, FL, USA
| | | | - Claudia M Simões
- Department of Anaesthesiology, Instituto Do Câncer Do Estado de São Paulo, Faculdade de Medicina da Universidade de São Paulo, Hospital Sírio Libanês, São Paulo, Brazil
| | - Joana Berger-Estilita
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, Bern, Switzerland.
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208
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Bosco L, Lorello GR, Flexman AM, Hastie MJ. Women in anaesthesia: a scoping review. Br J Anaesth 2020; 124:e134-e147. [PMID: 31983412 DOI: 10.1016/j.bja.2019.12.021] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 12/16/2019] [Accepted: 12/18/2019] [Indexed: 10/25/2022] Open
Abstract
Despite an increase in the proportion of women anaesthesiologists over time, women remain under-represented in academic and leadership positions, honour awards, and academic promotion. Current literature has identified several reasons for the observed gender disparity in anaesthesiology leadership and faculty positions, including unsupportive work environments, lack of mentorship, personal choices, childcare responsibilities, and active discrimination against women. A scoping review design was selected to examine the nature and extent of available research. Our review provides an overview of the literature that explores gender issues in anaesthesiology, identifies gaps in the literature, and appraises effective strategies to improve gender equity in anaesthesiology. We searched PubMed, MEDLINE, and EMBASE up to July 2019, and included 30 studies for analysis. Most reports used retrospective or survey methodologies. The review shows that women anaesthesiologists face gender biases in the work environment, are under-represented in various positions of leadership or influence, and as authors. Work-life demands may impose a challenge. Motivation and interest in career advancement of women anaesthesiologists have not been well studied. Several strategies have been proposed, ranging from an individual to administrative level, which may help anaesthesiologists achieve equal representation of women in the field.
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Affiliation(s)
- Laura Bosco
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Postgraduate Medical Education, Toronto, ON, Canada
| | - Gianni R Lorello
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada; Department of Anesthesiology and Pain Medicine, Toronto Western Hospital - University Health Network, Toronto, ON, Canada; The Wilson Centre, University Health Network, Toronto, ON, Canada.
| | - Alana M Flexman
- Department of Anesthesiology and Perioperative Care, Vancouver General Hospital, Vancouver, BC, Canada; Department of Anesthesiology, Pharmacology, and Therapeutics, University of British Columbia, Vancouver, BC, Canada
| | - Maya J Hastie
- Department of Anesthesiology, Columbia University, New York, NY, USA
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209
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Patel R, Moonesinghe SR. A seat at the table is no longer enough: practical implementable changes to address gender imbalance in the anaesthesia workplace. Br J Anaesth 2020; 124:e49-e52. [PMID: 31973828 DOI: 10.1016/j.bja.2019.12.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 12/17/2019] [Accepted: 12/19/2019] [Indexed: 10/25/2022] Open
Affiliation(s)
- Reshma Patel
- Surgical Outcomes Research Centre, Centre for Perioperative Medicine, University College London, London, UK.
| | - S Ramani Moonesinghe
- Surgical Outcomes Research Centre, Centre for Perioperative Medicine, University College London, London, UK; National Institute Academic Anaesthesia, Health Services Research Centre, Royal College Anaesthetists, London, UK; Department of Anaesthesia, UCL Hospitals, London, UK
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210
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Abstract
Background: Understanding the work habits, attitudes, and experiences of women physicians is critical for optimal patient care. In a gendered work environment, obstacles faced hinder women physicians from contributing to their full ability. This study investigated how women physicians' work habits are viewed, in the context of women's attitudes and experiences. Methods: An analysis of the medical literature (1990-2017) was undertaken. Published studies were located using search engines, article references, consultation with experts, and relevant Mesh terms. Of 1185 listings, 354 studies were evaluated and 44 articles, selected by three reviewers, were analyzed in detail. Results: Four themes emerged-practice styles, productivity, prevailing attitudes, and the workplace environment. Comparing women physicians to male colleagues as a standard for evaluating performance, for example, undervalues distinctive characteristics women bring to medical practice. Productivity models that focus on work hours, procedures, and publications do not encompass the full scope of patient care. Conclusions: Solutions offered mainly have been designed to help women physicians fit into existing workplace environments, but traditionally available "adapt or exit" options in response to challenges faced appear insufficient. A gender equity perspective helps to explain findings and suggests ways to reshape the health care workplace to better understand, utilize, and retain women physicians.
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Affiliation(s)
- Linda P Rouse
- Department of Sociology and Anthropology, The University of Texas at Arlington, Arlington, Texas
| | | | - Roberta E Gebhard
- Gender Equity Task Force, The American Medical Women's Association, Reston, Virginia
| | - Wendy K Bernstein
- Department of Anesthesiology and Perioperative Medicine, University of Rochester Medical Center, Rochester, New York
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211
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Wolfson L, Stinson J, Poole N. Gender Informed or Gender Ignored? Opportunities for Gender Transformative Approaches in Brief Alcohol Interventions on College Campuses. Int J Environ Res Public Health 2020; 17:E396. [PMID: 31936091 DOI: 10.3390/ijerph17020396] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 01/04/2020] [Accepted: 01/06/2020] [Indexed: 11/17/2022]
Abstract
Brief alcohol interventions are an effective strategy for reducing harmful and risky alcohol use and misuse. Many effective brief alcohol interventions include information and advice about an individual’s alcohol use, changing their use, and assistance in developing strategies and goals to help reduce their use. Emerging research suggests that brief interventions can also be expanded to address multiple health outcomes; recognizing that the flexible nature of these approaches can be helpful in tailoring information to specific population groups. This scoping review synthesizes evidence on the inclusion of sex and gender in brief alcohol interventions on college campuses, highlighting available evidence on gender responsiveness in these interventions. Furthermore, this scoping review offers strategies on how brief alcohol interventions can be gender transformative, thereby enhancing the effectiveness of brief alcohol interventions as harm reduction and prevention strategies, and in promoting gender equity.
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212
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Affiliation(s)
- R N D'Souza
- Schools of Dentistry and Medicine, University of Utah Health, Salt Lake City, UT, USA
| | - E Ioannidou
- School of Dental Medicine, UCONN Health, Farmington, CT, USA
| | - T Tiwari
- Department of Community Dentistry and Population Health, School of Dental Medicine, University of Colorado, Aurora, CO, USA
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213
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Larson AR, Sharkey KM, Poorman JA, Kan CK, Moeschler SM, Chandrabose R, Marquez CM, Dodge DG, Silver JK, Nazarian RM. Representation of Women Among Invited Speakers at Medical Specialty Conferences. J Womens Health (Larchmt) 2019; 29:550-560. [PMID: 31687866 DOI: 10.1089/jwh.2019.7723] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Gender-related differences have been found among invited speakers in select professional and medical societies. We examined whether similar disparities existed among keynote speakers, plenary speakers, and invited lecturers in a broad range of medical specialty conferences from 2013 to 2017. Materials and Methods: A cross-sectional study was performed on 27 U.S. medical specialty conferences for which data were available on plenary speakers, keynote speakers, and/or invited lecturers. For each speaker, gender and degree(s) were determined. Fisher's exact test was performed to compare proportions of women among speakers to Association of American Medical Colleges' (AAMC) physician workforce data on gender distribution. Results: In aggregate, we identified 246 women among 984 speakers, significantly lower than expected when compared with 2015 AAMC data (25.0% vs. 34.0%; p < 0.00001). Compared with AAMC data reported in 2013, 2015, and 2017, women were significantly underrepresented in 2013 (p = 0.0064) and 2015 (p = 0.00004). In 2017, the proportion of women among invited speakers trended lower than AAMC active women physicians but did not reach significance (p = 0.309). Analysis of individual conference data stratified by year indicated that, while the representation of women among all speakers improved between 2015 and 2017, the representation of women among keynote speakers, plenary speakers, and invited lectureships was variable (including zero levels some years during the study period) and remained lower than expected as compared with workforce data for specific medical specialties. Conclusions: Evaluating for and improving disparities is recommended to ensure gender equity among invited speakers across all medical specialty conferences.
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Affiliation(s)
- Allison R Larson
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts
| | - Katherine M Sharkey
- Department of Medicine, Alpert Medical School of Brown University, Providence, Rhode Island.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Julie A Poorman
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts
| | - Carolyn K Kan
- Boston University School of Medicine, Boston, Massachusetts
| | - Susan M Moeschler
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic School of Medicine, Rochester, Minnesota
| | - Rekha Chandrabose
- Department of Anesthesiology, University of California San Diego School of Medicine, San Diego, California
| | - Carol M Marquez
- Department of Radiation Oncology, Stanford University, San Jose, California
| | - Daleela G Dodge
- Department of Surgery, Pennsylvania State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Julie K Silver
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts
| | - Rosalynn M Nazarian
- Dermatopathology Unit, Department of Pathology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts
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214
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Santoso MV, Kerr RB, Hoddinott J, Garigipati P, Olmos S, Young SL. Role of Women's Empowerment in Child Nutrition Outcomes: A Systematic Review. Adv Nutr 2019; 10:1138-1151. [PMID: 31298299 PMCID: PMC6855975 DOI: 10.1093/advances/nmz056] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 03/26/2019] [Indexed: 01/20/2023] Open
Abstract
Women's empowerment has gained attention as critical for child nutrition during the first 1000 days of life. However, the ways in which various women's empowerment measures are applied and the evidence for how they are differentially related to child nutrition is unclear. In this systematic review, therefore, we 1) systematically parse the many ways in which women's empowerment has been quantitatively measured in the context of child nutrition through the use of a theoretically driven application of dimensions and domains of empowerment; 2) summarize evidence for each of the various pathways between women's empowerment and child nutrition, based on dimensions and domains of empowerment; and 3) offer suggestions for future research to better articulate the relationship between women's empowerment and child nutrition. A search of evidence yielded 62 quantitative studies that used 200 unique indicators of women's empowerment, tested in 1316 associations with various child nutrition outcomes. Despite the large number of unique indicators, indicators for time resource allocation and reproductive decisions and indicators for men's engagement in child care and nutrition, all pertinent to child nutrition, were missing. Overall, the findings indicated an inconclusive relationship between women's empowerment and child nutrition: 379 out of 461 (82% weighted) and 217 out of 258 (84% weighted) associations found with stunting and wasting outcomes, respectively, were not significant. The current lack of evidence is likely not due to the absence of an underlying relationship between women's empowerment and child nutrition, but rather limitations in study design. Future research should carefully select women's empowerment indicators in context-specific ways, aggregate them meaningfully, and use a longitudinal study design to conduct pathway and lifecycle analysis in appropriate populations to clarify the relationship between women's empowerment and child nutrition.
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Affiliation(s)
| | - Rachel Bezner Kerr
- Department of Development Sociology, Cornell University, Ithaca, NY, USA
| | - John Hoddinott
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | - Priya Garigipati
- Department of Anthropology, Northwestern University, Evanston, IL, USA
| | - Sophia Olmos
- Department of Anthropology, Northwestern University, Evanston, IL, USA
| | - Sera L Young
- Department of Anthropology, Northwestern University, Evanston, IL, USA,Institute of Policy Research, Northwestern University, Evanston, IL, USA,Address correspondence to SLY (e-mail: )
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215
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Puccetti M, Greville H, Robinson M, White D, Papertalk L, Thompson SC. Exploring Readiness for Change: Knowledge and Attitudes towards Family Violence among Community Members and Service Providers Engaged in Primary Prevention in Regional Australia. Int J Environ Res Public Health 2019; 16:E4215. [PMID: 31671688 DOI: 10.3390/ijerph16214215] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 10/22/2019] [Accepted: 10/26/2019] [Indexed: 11/17/2022]
Abstract
Community efforts at the primary prevention of family violence (FV) involve changing values, structures and norms that support gender inequality. This study examines the attitudes of a group of highly engaged community leaders and service providers involved in FV primary prevention in Geraldton, a small city in regional Western Australia. The outcomes of focus group discussions were mapped against a readiness for change model. Despite considerable involvement in discussions of FV prevention over time, the readiness level of these engaged community members for taking leadership roles in the prevention strategy were between pre-planning and preparation stages, although some individuals' understanding of the drivers of FV and readiness for implementing change was higher. Key areas for further education are the role of gender inequality as the primary driver of FV, particularly rigid gender roles and men's control of decision making, and the role of alcohol and drugs as reinforcers but not primary drivers of FV.
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Boxer R, Norman M, Abadir P, Beizer JL, Dierich M, Lau S, Linnebur SA, Lundebjerg NE, Naik AD, Schreiber R, Unroe K, Mikhailovich AL, Goldstein AC. When Women Rise, We All Rise: American Geriatrics Society Position Statement on Achieving Gender Equity in Geriatrics. J Am Geriatr Soc 2019; 67:2447-2454. [PMID: 31573074 DOI: 10.1111/jgs.16195] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 09/02/2019] [Indexed: 11/28/2022]
Abstract
Supporting gender equity for women working in geriatrics is important to the growth of geriatrics across disciplines and is critical in achieving our vision for a future in which we are all able to contribute to our communities and maintain our health, safety, and independence as we age. Discrimination can have a negative impact on public health, particularly with regard to those who care for the health of older Americans and other vulnerable older people. Women working in the field of geriatrics have experienced implicit and explicit discriminatory practices that mirror available data on the entire workforce. In this position article, we outline strategic objectives and accompanying practical recommendations for how geriatrics, as a field, can work together to achieve a future in which the rights of women are guaranteed and women in geriatrics have the opportunity to achieve their full potential. This article represents the official positions of the American Geriatrics Society. J Am Geriatr Soc 67:2447-2454, 2019.
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Affiliation(s)
- Rebecca Boxer
- Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado
| | | | - Peter Abadir
- Division of Geriatrics Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Judith L Beizer
- St John's University College of Pharmacy and Health Science, Queens, New York
| | - Mary Dierich
- University of Minnesota School of Nursing, Minneapolis, Minnesota
| | - Samantha Lau
- Icahn School of Medicine at Mount Sinai, New York, New York
| | - Sunny A Linnebur
- University of Colorado Skaggs School of Pharmacy, Aurora, Colorado
| | | | - Aanand D Naik
- DeBakey VA Medical Center, Baylor College of Medicine, Houston, Texas
| | | | - Kathleen Unroe
- Indiana University School of Medicine, Indianapolis, Indiana
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217
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James A, Chisnall R, Plank MJ. Gender and societies: a grassroots approach to women in science. R Soc Open Sci 2019; 6:190633. [PMID: 31598298 PMCID: PMC6774970 DOI: 10.1098/rsos.190633] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 07/26/2019] [Indexed: 05/29/2023]
Abstract
Women are under-represented in science. We show that the extent of the gender gap varies depending on the status of the position in question and there are simple steps that can be taken to improve diversity. We analyse data on the activities of over 30 science societies spanning four countries and five distinct discipline areas. Our results show that women tend to be equally represented in lower status roles and awards, e.g. student prizes and editorships, but under-represented in higher status roles, e.g. late-career awards and chief editorships. We develop a simple mathematical model to explore the role of homophily in decision making and quantify the effect of simple steps that can be taken to improve diversity. We conclude that, when the stakes are low, efforts to tackle historic gender bias towards men have been at least partially successful, but when the stakes are higher male dominance is often still the norm.
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Affiliation(s)
- Alex James
- School of Maths and Stats, University of Canterbury, Christchurch 8140, New Zealand
- Te Pūnaha Matatini, a New Zealand Centre of Research Excellence, Christchurch, New Zealand
| | - Rose Chisnall
- School of Maths and Stats, University of Canterbury, Christchurch 8140, New Zealand
| | - Michael J. Plank
- School of Maths and Stats, University of Canterbury, Christchurch 8140, New Zealand
- Te Pūnaha Matatini, a New Zealand Centre of Research Excellence, Christchurch, New Zealand
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218
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Nair S, Dixit A, Ghule M, Battala M, Gajanan V, Dasgupta A, Begum S, Averbach S, Donta B, Silverman J, Saggurti N, Raj A. Health care providers' perspectives on delivering gender equity focused family planning program for young married couples in a cluster randomized controlled trial in rural Maharashtra, India. Gates Open Res 2019; 3:1508. [PMID: 32266327 PMCID: PMC7100659 DOI: 10.12688/gatesopenres.13026.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2019] [Indexed: 11/20/2022] Open
Abstract
Background: There is increasing programming and research on male engagement and gender-equity (GE) counselling in family planning (FP) services. However, there is a lack of data on healthcare provider’s perspectives on delivering these interventions. The objective of the paper is to present providers’ perspectives on delivering a GE-focused FP intervention, CHARM, to married couples in rural India. Methods: In-depth interviews were carried out with 22 male village health care providers who were delivering a GE-focused FP intervention, CHARM, to 428 husbands (247 couples) rural Maharashtra, India. Providers were interviewed on their experiences and perspectives during delivery of CHARM. Major domains were identified during a thematic analysis. Results: Local male health providers are interested and can be engaged in delivering a GE-focused FP intervention. Providers believed that the CHARM intervention improves couples’ communication, contraceptive use and strengthened their own capacity to provide FP services in accordance with national FP programmatic efforts. Providers found the low-tech flipchart including pictures and information helpful in supporting their service provision. Providers reported some challenges including lack of privacy and space for counselling, limited access to contraceptive options beyond pill and condom, numerous myths and misconceptions about contraceptives. Providers also reported persistent social norms related to expectancy of pregnancy early in marriage, and son preference. Conclusions: Providers in rural areas with high fertility and related maternal health complications are interested in and can successfully implement a GE-focused FP intervention. Future efforts using this approach may benefit from greater focus to support broader array of spacing contraceptives particularly among first time parents, none or one child parents. There is a need to better support engagement of wives possibly through female provider led sessions parallel to male programs, i.e. gender synchronized rather than couples’ sessions. Trialregistration: ClinicalTrials.gov
NCT01593943, May 8, 2012.
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Affiliation(s)
- Saritha Nair
- ICMR-National Institute of Medical Statistics (NIMS), New Delhi, Delhi, 110029, India
| | - Anvita Dixit
- Center on Gender Equity and Health, School of Medicine, University of California San Diego, 9500 Gilman Drive #0507, La Jolla, CA, 92093-0507, USA.,Joint Doctoral Program in Public Health (Global Health), University of California San Diego and San Diego State University, San Diego, CA, 92093, USA
| | - Mohan Ghule
- Center on Gender Equity and Health, School of Medicine, University of California San Diego, 9500 Gilman Drive #0507, La Jolla, CA, 92093-0507, USA
| | | | - Velhal Gajanan
- Seth G S Medical College & KEM Hospital, Mumbai, Maharashtra, 400012, India
| | - Anindita Dasgupta
- School of Social Work, Columbia University, New York, NY, 10027, USA
| | - Shahina Begum
- ICMR-National Institute for Research in Reproductive Health, J.M Street, Parel, Mumbai, 400012, India
| | - Sarah Averbach
- Center on Gender Equity and Health, School of Medicine, University of California San Diego, 9500 Gilman Drive #0507, La Jolla, CA, 92093-0507, USA.,Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, University of California San Diego, La Jolla, CA, 92093, USA
| | - Balaiah Donta
- ICMR-National Institute for Research in Reproductive Health, J.M Street, Parel, Mumbai, 400012, India
| | - Jay Silverman
- Center on Gender Equity and Health, School of Medicine, University of California San Diego, 9500 Gilman Drive #0507, La Jolla, CA, 92093-0507, USA
| | | | - Anita Raj
- Center on Gender Equity and Health, School of Medicine, University of California San Diego, 9500 Gilman Drive #0507, La Jolla, CA, 92093-0507, USA.,Department of Education Studies, Division of Social Sciences, University of California San Diego, San Diego, CA, 92093, USA
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219
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Chawla S, Sharma RR. Enhancing Women's Well-Being: The Role of Psychological Capital and Perceived Gender Equity, With Social Support as a Moderator and Commitment as a Mediator. Front Psychol 2019; 10:1377. [PMID: 31275203 PMCID: PMC6593049 DOI: 10.3389/fpsyg.2019.01377] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 05/27/2019] [Indexed: 01/07/2023] Open
Abstract
The study aims to determine the role of psychological capital and perceived gender equity on employee well-being, particularly women, and assess if commitment mediates and social support moderates the relationships between psychological capital, perceived gender equity, and well-being. A personal survey method was employed for data collection using standardized measures from a representative sample of 433 managers (201 women and 233 men) from private sector companies in India. The findings revealed that perceived gender equity in the workplace positively impacts employee well-being for both men and women, with the greater impact being on women's well-being. To Facilitate employee well-being, organizations can leverage the strengths of psychological capital through training interventions and can promote perceived gender equity through appropriate policies and practices. This bridges the knowledge gap in developing and utilizing psychological capital to enhance employee well-being, especially for women, who are under pressure due to their demanding multiple roles at work and home.
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Affiliation(s)
- Sonam Chawla
- Organizational Behavior, Management Development Institute, Gurgaon, India
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220
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Shillcutt SK, Parangi S, Diekman S, Ghalib R, Schoenthaler R, Girgis LM, Parekh R, Bhargava H, Silver JK. Survey of Women Physicians' Experience with Elected Leadership Positions. Health Equity 2019; 3:162-168. [PMID: 31289775 PMCID: PMC6608691 DOI: 10.1089/heq.2018.0101] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: Women physicians do not advance in academic promotion or leadership at the same rate as their male counterparts. One factor contributing to academic promotion and advancement is the experience of serving in elected leadership positions. Although >400 women are running for political office in 2018, fewer than a handful are physicians and there has never been a woman physician elected to the Congress. Yet, little is known about women physicians who run for elected positions within their institutions, medical/professional societies, or government. This study sought to examine how women physicians experience elections using a cross-sectional survey of women physicians to gain insight into patterns of reported experiences and perceived barriers to elected leadership positions. Methods: A cross-sectional survey study of 1221 women physicians. Results: 43.8% (N=535) of women physicians ran for an elected office from high school through medical school graduation, in contrast to only 16.7% (N=204) after graduating from medical school. Only 8.5% of women physicians surveyed reported a boss or supervisor encouraged them to run for an elected position. Conclusion: Women physicians are less likely to run for elected positions and for those with previous election experience, the most common barriers cited were lack of institutional time and support, experience, and mentorship.
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Affiliation(s)
- Sasha K Shillcutt
- Department of Anesthesiology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Sareh Parangi
- Department of Surgery, Harvard Medical School, Boston, Massachusetts.,Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Sarah Diekman
- College of Law, Florida Agricultural and Mechanical University, Orlando, Florida
| | - Reem Ghalib
- Texas Clinical Research Institute, Arlington, Texas
| | - Robin Schoenthaler
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
| | - Linda M Girgis
- Department of Family Medicine, Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey
| | - Ranna Parekh
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.,American Psychiatric Association, Washington, DC.,Morehouse School of Medicine, Atlanta, Georgia
| | - Hansa Bhargava
- Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Julie K Silver
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.,Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts.,Brigham and Women's Hospital, Boston, Massachusetts.,Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts
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221
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Bellini MI, Graham Y, Hayes C, Zakeri R, Parks R, Papalois V. A woman's place is in theatre: women's perceptions and experiences of working in surgery from the Association of Surgeons of Great Britain and Ireland women in surgery working group. BMJ Open 2019; 9:e024349. [PMID: 30617103 PMCID: PMC6326292 DOI: 10.1136/bmjopen-2018-024349] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE Surgery remains an inherently male-dominated profession. The aim of this study was to survey women working within the discipline, to understand their current perceptions, providing insight into their practical day-to-day lives, supporting an action-oriented change. DESIGN AND SETTING The link to a confidential, online survey was distributed through the Association of Surgeons of Great Britain and Ireland (ASGBI) social media platforms on Facebook and Twitter over a 2-week period in October 2017. PARTICIPANTS Women working in surgical specialties and actively responding to the link shared through the ASGBI social media platforms. No patients were involved in the study. PRIMARY AND SECONDARY OUTCOME MEASURES Data were analysed through a mixed-methods approach. The quantitative data were analysed through descriptive statistics and qualitative analysis was undertaken using a constant comparative analysis of the participants' comments, to identify salient patterns (themes). RESULTS A total of 81 female participants replied (42% response rate based on the Facebook group members), with 88% (n=71) perceiving surgery as a male-dominated field. Over half had experienced discrimination (59%, n=47), while 22% (n=18) perceived a 'glass ceiling' in surgical training. Orthopaedics was reported as the most sexist surgical specialty by 53% (n=43). Accounts of gendered language in the workplace were reported by 59% (n=47), with 32% (n=25) of surveys participants having used it. Overall, a lack of formal mentorship, inflexibility towards part-time careers, gender stereotypes and poor work-life balance were the main perceived barriers for women in surgical careers. CONCLUSION These findings highlight the implicit nature of the perceived discrimination that women report in their surgical careers. The ASGBI acknowledges these perceptual issues and relative implications as the first of many steps to create an action-oriented change by allowing all staff, regardless of gender, to reflect on their own behaviour, perceptions and the culture in which they work.
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Affiliation(s)
- Maria Irene Bellini
- Renal Transplant Directorate, Imperial College Healthcare NHS Trust, London, UK
| | - Yitka Graham
- Science Complex, Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, Sunderland, UK
- Directorate of General Surgery, Bariatric Surgical Unit, Sunderland Royal Hospital, Sunderland, Sunderland, UK
| | - Catherine Hayes
- Science Complex, Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, Sunderland, UK
| | - Roxanna Zakeri
- Department of General Surgery, University College London Hospital NHS Foundation Trust, London, UK
| | - Rowan Parks
- Directorate of General Surgery, Hepatobiliary-Pancreatic Surgical Services Royal Infirmary of Edinburgh, Edinburgh, UK
- Department of Clinical Surgery, University of Edinburgh, Edinburgh, UK
| | - Vassilios Papalois
- Renal Transplant Directorate, Imperial College Healthcare NHS Trust, London, UK
- Department of Surgery and Cancer, Imperial College London, London, UK
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222
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Abstract
Pressure to ban prenatal sex-selection has grown with rising sex ratios at birth in some countries. Governments feel pressured to act, and bans seem an immediate step they can take. However, such bans have been in place for some time in South Korea, China, and India and the available evidence suggests they are difficult to implement and have limited impact. This is indicated most clearly in the Chinese census data, which throw light on the mixed effects of a very intensive effort to implement the ban. Studies show that bans on sex-selection have negative consequences for unwanted girls and their mothers. By contrast, studies show that other policies - including mass messaging and measures to increase gender equity - show fairly quick impact in reducing son preference and increasing parental investment in girls. Such policies can permanently lower son preference and sex-selection, while also improving girls' life-chances.
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223
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Abstract
We analyzed 2898 scientific papers published between 1995 and 2017 in which two or more authors shared the first author position. For papers in which the first and second authors made equal contributions, mixed-gender combinations were most frequent, followed by male-male and then female-female author combinations. For mixed-gender combinations, more male authors were in the first position, although the disparity decreased over time. For papers in which three or more authors made equal contributions, there were more male authors than female authors in the first position and more all-male than all-female author combinations. The gender inequalities observed among authors who made equal contributions are not consistent with random or alphabetical ordering of authors. These results raise concerns about female authors not receiving proper credit for publications and suggest a need for journals to request clarity on the method used to decide author order among those who contributed equally.
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Affiliation(s)
- Nichole A Broderick
- Department of Molecular & Cell BiologyUniversity of ConnecticutStorrsUnited States
| | - Arturo Casadevall
- Department of Molecular Microbiology and ImmunologyJohns Hopkins School of Public HealthBaltimoreUnited States
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224
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Cardoso LF, Clark CJ, Rivers K, Ferguson G, Shrestha B, Gupta J. Menstrual restriction prevalence and association with intimate partner violence among Nepali women. BMJ Sex Reprod Health 2018; 45:bmjsrh-2017-101908. [PMID: 30266716 PMCID: PMC6352404 DOI: 10.1136/bmjsrh-2017-101908] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 06/27/2018] [Accepted: 08/24/2018] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Emerging research has linked women's sanitation and menstrual hygiene experiences with increased vulnerability to violence outside the home. Few studies, however, have investigated the relationship between menstruation and violence perpetrated by family members. This type of violence may be linked specifically to restrictions placed on women during menstruation, which are common in some regions of Nepal owing to shared power differentials that disfavour women, and societal norms that stigmatise menstruation. OBJECTIVE To record the prevalence of menstrual restrictions experienced by married women and examine potential associations between intimate partner violence (IPV) in the past year and menstrual restrictions imposed by husbands and/or in-laws among women in three districts of Nepal: Nawalparasi, Kapilvastu and Chitwan. METHODS Baseline data from a larger randomised control trial aiming to reduce IPV in three districts of the Terai region of Nepal (n=1800) were used to assess the prevalence of menstrual restrictions and the association with IPV. RESULTS Nearlythree out of four women (72.3%) reported experiencing high menstrual restriction, or two or more types of menstrual restriction. When controlling for demographic variables and IPV, no type of IPV was associated with high menstrual restrictions. CONCLUSION The experience of menstrual restriction was widespread in this sample of women in Nepal. Future research should seek to identify how best to capture menstrual stigma and deviations around such norms. The global health and development community should prioritise integration with existing water and sanitation programmes to reduce stigma and ensure the well-being of menstruating women and girls. TRIAL REGISTRATION NUMBER NCT02942433.
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Affiliation(s)
- Lauren F Cardoso
- School of Social Policy and Practice, University of Pennsylvania, Philadelphia, USA
| | - Cari Jo Clark
- Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Kelsey Rivers
- Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, Virginia, USA
| | - Gemma Ferguson
- Equal Access International, San Francisco, California, USA
| | | | - Jhumka Gupta
- Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, Virginia, USA
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225
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Nowling TK, McClure E, Simpson A, Sheidow AJ, Shaw D, Feghali-Bostwick C. A Focused Career Development Program for Women Faculty at an Academic Medical Center. J Womens Health (Larchmt) 2018; 27:1474-1481. [PMID: 30251910 DOI: 10.1089/jwh.2018.6937] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Within free-standing academic medical centers, women continue to be underrepresented at upper faculty ranks and in leadership positions. A career development program (CDP) at the Medical University of South Carolina (MUSC) was implemented with the goal of improving the number of women in the upper ranks and in leadership positions. The CDP was initiated in 2013 as a 2-day program. Beginning in 2015, a half-day promotion-focused program was offered alternating with the 2-day program. Materials and Methods: The CDP has served ∼200 women from 2013 to 2017 and was evaluated for reaction and learning through postprogram surveys. Promotion success of ∼160 women who attended at least one of the programs through 2016 was assessed through an additional survey. Promotion information for ∼3000 faculty members during the same 2013-2016 period (post-CDP), as well as a 4-year time period before implementation of the CDP (pre-CDP), was collected using university-level personnel data. Results: The majority of CDP attendees (94%) indicated overall satisfaction with the program and would recommend the program to a colleague. Of the 137 CDP attendees still employed at MUSC in 2017, 50 had applied for promotion and 42 (84%) were successfully promoted. Among all the MUSC faculty, overall and rank-sepcific promotion rates for women and men were similar during the post-CDP time period and there was a significant increase in the promotion rate of women to Full Professor from pre-CDP to post-CDP time periods. Conclusions: CDP attendees were overwhelmingly satisfied with the program and were highly successful in being promoted. Since the overall university promotion rates of women and men were similar during the post-CDP time period and women are currently underrepresented at the upper faculty ranks, parity between men and women will likely not be achievable without additional programs to retain and/or recruit women in the upper ranks.
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Affiliation(s)
- Tamara K Nowling
- Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Erin McClure
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - Annie Simpson
- Department of Healthcare Leadership and Management, Medical University of South Carolina, Charleston, South Carolina
| | - Ashli J Sheidow
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - Darlene Shaw
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - Carol Feghali-Bostwick
- Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
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Kattari SK, Walls NE, Speer SR. Differences in Experiences of Discrimination in Accessing Social Services Among Transgender/Gender Nonconforming Individuals by (Dis)Ability. ACTA ACUST UNITED AC 2018; 16:116-140. [PMID: 28447917 DOI: 10.1080/1536710x.2017.1299661] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Transgender and gender nonconforming (GNC) individuals frequently experience discrimination and potentially a lack of respect from service providers, suggesting they have decreased access to professionals with cultural competency. Similarly, people with disabilities experience higher levels of discrimination in social services than their nondisabled counterparts. From an intersectional perspective, this study examines rates of discrimination in accessing social services faced by transgender and GNC people, comparing across ability. Data indicate that although transgender and GNC individuals of all abilities experience gender-based discrimination when accessing social services, those with disabilities experience higher levels of antitransgender discrimination in mental health centers, rape crisis centers, and domestic violence shelters.
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Affiliation(s)
- Shanna K Kattari
- a Graduate School of Social Work , University of Denver , Denver , Colorado , USA
| | - N Eugene Walls
- a Graduate School of Social Work , University of Denver , Denver , Colorado , USA
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227
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Kvach E, Yesehak B, Abebaw H, Conniff J, Busse H, Haq C. Perspectives of female medical faculty in Ethiopia on a leadership fellowship program. Int J Med Educ 2017; 8:314-323. [PMID: 28869749 PMCID: PMC5694698 DOI: 10.5116/ijme.5985.f644] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 08/05/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES This study aims to evaluate a leadership fellowship program through perspectives of Ethiopian women medical faculty participants. METHODS An intensive two-week leadership development fellowship was designed for women faculty from Ethiopian medical schools and conducted from 2011-2015 at the University of Wisconsin-School of Medicine and Public Health in Madison, Wisconsin. Nine Ethiopian women working in early- or mid-level academic positions were selected. Semi-structured interviews were conducted with the fellows. Transcripts were reviewed through qualitative analysis to assess the perceived impact of the training on their careers. Three male academic leaders were interviewed to solicit feedback on the program. RESULTS Eight of 9 fellows were interviewed. Themes describing the benefits of the fellowship included: increased awareness of gender inequities; enhanced motivation for career advancement; increased personal confidence; and improved leadership skills. Fellows provided suggestions for future training and scaling up efforts to promote gender equity. Male leaders described the benefits of men promoting gender equity within academic health centers. CONCLUSIONS This paper provides evidence that targeted brief training programs can enhance women's motivation and skills to become effective leaders in academic medicine in Ethiopia. Promoting gender equity in academic medicine is an important strategy to address health workforce shortages and to provide professional role models for female students in the health professions.
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Affiliation(s)
- Elizabeth Kvach
- Department of Family Medicine, Denver Health/ University of Colorado-Denver, USA
| | - Bethlehem Yesehak
- School of Medicine, Addis Ababa University, College of Health Sciences, Ethiopia
| | - Hiwot Abebaw
- School of Medicine, Addis Ababa University, College of Health Sciences, Ethiopia
| | - James Conniff
- Department of Family Medicine, University of Minnesota-Duluth, USA
| | - Heidi Busse
- School of Human Ecology, University of Wisconsin-Madison, USA
| | - Cynthia Haq
- Department of Family Medicine and Community Health, University of Wisconsin-Madison, USA
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228
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Abstract
Introduction Female managers in the Polish health care system are seldom a subject of scientific investigation. Material and Methods This study describes the share and profile of women in health care management positions and explores how and why Polish female health care managers add value to the leadership of health care organizations. Three data collection methods were used including: scoping review, analysis of data from governmental information bases and in-depth interviews with female health care managers. Results Men comprise nearly twice the number of hospital directors in Poland as compared to women, or 67% of the total representation. Traits often attributed to women including strength, perseverance, multi-tasking, empathy, emotional intelligence and intuition add value in leadership roles. Polish women managers value the complementarity of genders in professional roles and their contribution to constructive collaboration. Conclusion The study contributes to the scarce literature on Polish female health care managers.
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Affiliation(s)
- Katarzyna Czabanowska
- Department of International Health, CAPHRI, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands & Department of Health Policy and Management, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University, Medical College, Krakow, Poland
| | - Alicja Domagała
- Department of Health Policy and Management, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University, Medical College, Krakow, Poland
| | - Stavroula Kalaitzi
- Department of International Health, CAPHRI, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | | | - Genc Burazeri
- Department of International Health, CAPHRI, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands & Faculty of Medicine, University of Medicine, Tirana, Albania
| | - Suzanne Babich
- Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, Indiana, USA and Department of International Health, Faculty of Health, Medicine and Life Sciences, CAPHRI, Maastricht University, Maastricht, the Netherlands
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229
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Abstract
Background Over the past decade, gender equality and women's empowerment have been explicitly recognized as key not only to the health of nations but also to social and economic development. The aim of the present study was to assess the effectiveness of a mixed methods' participatory group education approach to introduce gender equity to adolescent school children. It also assessed baseline and postintervention knowledge, attitudes, and practices regarding gender equity, sexual and reproductive health among adolescent students in government-aided schools, and finally, compare the pre- and post-intervention gender equitable (GE) attitudes among the study participants. Methodology A government-aided school was selected by nonprobalistic intentional sampling. On 5 predesignated days, willing students were included in the intervention which included a pretest, a group of educational-based participatory mixed methods' intervention followed by a posttest assessment. A total of 186 students participated in the study. Results Girls had better baseline GE scores as compared to boys and they also improvised more on the baseline scores following the intervention. Conclusion The present mixed method approach to introduce gender equity to adolescent school children through a group education-based interventional approach proved to be effective in initiating dialog and sensitizing adolescents on gender equity and violence within a school setting.
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Affiliation(s)
- Saba Syed
- Department of Community Medicine, Apollo Institute of Medical Sciences and Research, Hyderabad, Telangana, India
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230
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Abstract
OBJECTIVES Gender inequity has persisted in academic medicine. Yet equity is vital for countries to achieve their full potential in terms of translational research and patient benefit. This study sought to understand how the gender equity programme, Athena SWAN, can be enabled and constrained by interactions between the programme and the context it is implemented into, and whether these interactions might produce unintended consequences. DESIGN Multimethod qualitative case studies using a realist evaluation approach. SETTING 5 departments from a university medical school hosting a Translational Research Organisation. PARTICIPANTS 25 hours of observations of gender equality committee meetings, 16 in-depth interviews with Heads of Departments, Committee Leads and key personnel involved in the initiative. 4 focus groups with 15 postdoctoral researchers, lecturers and senior lecturers. RESULTS The implementation of Athena SWAN principles was reported to have created social space to address gender inequity and to have highlighted problematic practices to staff. However, a number of factors reduced the programme's potential to impact gender inequity. Gender inequity was reproduced in the programme's enactment as female staff was undertaking a disproportionate amount of Athena SWAN work, with potential negative impacts on individual women's career progression. Early career researchers experienced problems accessing Athena SWAN initiatives. Furthermore, the impact of the programme was perceived to be undermined by wider institutional practices, national policies and societal norms, which are beyond the programme's remit. CONCLUSIONS Gender equity programmes have the potential to address inequity. However, paradoxically, they can also unintentionally reproduce and reinforce gender inequity through their enactment. Potential programme impacts may be undermined by barriers to staff availing of career development and training initiatives, and by wider institutional practices, national policies and societal norms.
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Affiliation(s)
- Louise Caffrey
- Faculty of Life Sciences & Medicine, Division of Health & Social Care Research, King's College London, London, UK
- NIHR Biomedical Research Centre at Guy's and St. Thomas’ NHS Foundation Trust and King's College London, UK
| | - David Wyatt
- Faculty of Life Sciences & Medicine, Division of Health & Social Care Research, King's College London, London, UK
- NIHR Biomedical Research Centre at Guy's and St. Thomas’ NHS Foundation Trust and King's College London, UK
| | - Nina Fudge
- Faculty of Life Sciences & Medicine, Division of Health & Social Care Research, King's College London, London, UK
- NIHR Biomedical Research Centre at Guy's and St. Thomas’ NHS Foundation Trust and King's College London, UK
| | | | - Catherine Williamson
- NIHR Biomedical Research Centre at Guy's and St. Thomas’ NHS Foundation Trust and King's College London, UK
- Women's Health Academic Centre, King's College London, Guy's Hospital, London, UK
| | - Christopher McKevitt
- Faculty of Life Sciences & Medicine, Division of Health & Social Care Research, King's College London, London, UK
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231
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Anzai Y, Meltzer CC, DeStigter KK, Destounis S, Pawley BK, Oates ME. Entrepreneurial Women in Radiology: Role Models of Success. J Am Coll Radiol 2016; 13:1378-82. [PMID: 27570131 DOI: 10.1016/j.jacr.2016.06.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2015] [Revised: 06/06/2016] [Accepted: 06/13/2016] [Indexed: 11/23/2022]
Abstract
Radiology is undeniably male dominated. Alongside surgery and orthopedic surgery, academic radiology ranks near the bottom in having the lowest proportion of full-time female faculty members. Despite many efforts to recruit talented women, the pipeline entering the radiologic disciplines continues to flow at a trickle. One factor is the relative lack of role models for female medical students. Entrepreneurial women in radiology can lead the field with their innovation and creativity, courage, and commitment. In this article, the authors highlight two entrepreneurial female radiologists who shared their success stories at the American Association for Women Radiologists' session at the 2015 ACR annual meeting. Their successes underscore the potential for such women to serve as role models to female medical students and even college undergraduates. Despite the gender gap in radiology, the field has yielded some exceptional women who can take on challenges, overcome barriers and assume risks, create strategies and processes to operationalize their visions, secure funding, and expand their enterprises to make sustainable impacts both at home and abroad. As we move toward more patient- and family-centered care models and become increasingly visible to diverse populations, there is no better time for female leaders in radiology to inspire the next generation to join our essential and rewarding specialty.
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232
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Affiliation(s)
- A T Dennis
- Royal Women's Hospital, Parkville, Australia. .,University of Melbourne, Victoria, Australia.
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233
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Abstract
Despite concerns about health disparities among women with intellectual disabilities, little is known about substance abuse treatment access in this population. Using standardized performance measures, treatment initiation and engagement were examined retrospectively for women aged 18 to 64 (N = 3,752), men with (N = 5,732) and women without intellectual disability (N = 493,446). Logistic regression models of utilization were conducted. Women in the sample were less likely than men in the sample or women without intellectual disability to utilize treatment, suggesting both gender-related and disability-related barriers. Policy and practice implications for improving the health and welfare of women with intellectual disabilities are discussed.
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Affiliation(s)
- Elspeth Slayter
- a Graduate School of Social Work , Salem State University , Salem , Massachusetts , USA
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234
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Arkell C, MacPhail C, Abdalla S, Grant E, Ashaba S, Biii LC, Bienempaka F, Pemba S, Kollmann T, Bortolussi R, MacDonald NE. MicroResearch in East Africa: Opportunities for Addressing Gender Inequity. J Obstet Gynaecol Can 2016; 37:897-8. [PMID: 26606704 DOI: 10.1016/s1701-2163(16)30025-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | | | | | | | - Scholastic Ashaba
- Mbarara University of Science and Technology and Healthy Child Uganda, Mbarara, Unganda
| | | | - Florence Bienempaka
- Mbarara University of Science and Technology and Healthy Child Uganda, Mbarara, Unganda
| | - Senga Pemba
- Tanzanian Training Centre for International Health, Ifakara, Tanzania
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235
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Fernbrant C, Essén B, Esscher A, Östergren PO, Cantor-Graae E. Increased Risk of Mortality Due to Interpersonal Violence in Foreign-Born Women of Reproductive Age: A Swedish Register-Based Study. Violence Against Women 2016; 22:1287-304. [PMID: 26746826 DOI: 10.1177/1077801215623380] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Violence against women is an increasing public health concern, with assault leading to death as the most extreme outcome. Previous findings indicate that foreign-born women living in Sweden are more exposed to interpersonal violence than Swedish-born women. The current study investigates mortality due to interpersonal violence in comparison with other external causes of death among women of reproductive age in Sweden, with focus on country of birth. Foreign-born women and especially those from countries with low and very low gender equity levels had increased risk of mortality due to interpersonal violence, thus implicating lack of empowerment as a contributing factor.
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Affiliation(s)
| | - Birgitta Essén
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Annika Esscher
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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236
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Sharma RR, Sharma NP. Opening the gender diversity black box: causality of perceived gender equity and locus of control and mediation of work engagement in employee well-being. Front Psychol 2015; 6:1371. [PMID: 26500566 PMCID: PMC4599315 DOI: 10.3389/fpsyg.2015.01371] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 08/26/2015] [Indexed: 11/24/2022] Open
Abstract
The study is aimed at assessing the role of perceived gender equity and locus of control in employee well-being at the workplace and ascertaining if work engagement mediates between perceived gender equity, locus of control, and employee well-being (measured through optimism, general satisfaction with life and work, and executive burnout). Adopting a personal survey method data was collected from 373 managers (both males and females) from the public and private sectors representing manufacturing and service industry in India. The study bridges the knowledge gap by operationalizing the construct of perceived gender equity and studying its role in the work engagement and employee well-being. Conceptualization of the well-being in an unconventional way covering both the positive and the negative aspects extends the understanding of the emerging concept of well-being. It has practical implications for talent management and work engagement besides promoting gender equity at the workplace for employee well-being. It opens vistas for the gender based theory and cross cultural research on gender equity.
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Affiliation(s)
- Radha R Sharma
- Raman Munjal (Hero MotoCorp) Chair Professor and Professor, Organizational Behavior and HRD, Management Development Institute Gurgaon, India
| | - Neha P Sharma
- Research Scholar, Management Development Institute Gurgaon, India
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237
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Ghule M, Raj A, Palaye P, Dasgupta A, Nair S, Saggurti N, Battala M, Balaiah D. Barriers to use contraceptive methods among rural young married couples in Maharashtra, India: Qualitative findings. ACTA ACUST UNITED AC 2015; 5:18-33. [PMID: 29430437 DOI: 10.5958/2249-7315.2015.00132.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Introduction In rural India contraceptive use remains uncommon among newly married couples. non-use in rural young couples contributes to higher fertility rates. Objectives To identify barriers of spacing contraceptive use among young married couples in rural Maharashtra. Methods In-depth interviews were conducted with husbands (N=30), wives (N=20), and village health providers (N=12); additionally, 3 focus groups were conducted with mothers of husbands (N= 42 focused on understanding contraceptive use and barriers. Interviews and focus groups ranged in length from 90-120 minutes. Detailed notes taken during interviews were analysed using a grounded theory approach and the data was analysed using atlas-ti software. Results Major barriers to spacing contraception are: pro-natal social norms, pregnancy expectations early in marriage, to produce multiple sons, limited access to modern spacing contraceptives, family resistance to adopt contraceptives, lack of husband's involvement on family planning issues, myths, misconceptions, perceived side effects and negative attitudes toward specific contraceptives. Conclusion Findings highlight the intersection of norms against spacing contraception, traditional gender ideologies and lack of male involvement as major barriers to the use of contraception. Male oriented outreach programmes on family planning. Promoting gender equity should be made through health programme deliveries with special focus in rural areas.
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Affiliation(s)
- Mohan Ghule
- National Institute for Research in Reproductive Health, Mumbai, India
| | - Anita Raj
- Division of Global Public Health, Department of Medicine, University of California, San Diego, USA.,Center on Gender Equity and Health, University of California, San Diego, USA
| | - Prajakta Palaye
- National Institute for Research in Reproductive Health, Mumbai, India
| | - Anindita Dasgupta
- Division of Global Public Health, Department of Medicine, University of California, San Diego, USA
| | | | | | | | - Donta Balaiah
- National Institute for Research in Reproductive Health, Mumbai, India
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238
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239
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Abstract
Estimating the characteristics of the "disabled" population is necessary for some governments and of interest to health researchers concerned with producing disability prevalence rates. Because generating easy-to-understand estimates of disability in the population is important, this article provides U.S. population estimates for two disability-related measures by using the 2009 to 2011 American Community Survey Public Use Microdata Sample file. The number of people who have "independent living" and "ambulatory" difficulties is calculated from a sample of 9,204,437 (representing >309 million people). The percentage for "disabled" is found to vary by racial and ethnic category, sex, age, citizenship status, educational attainment, and state-level regions divided by weather.
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Affiliation(s)
- Carlos Siordia
- a Department of Epidemiology, Graduate School of Public Health , University of Pittsburgh , Pittsburgh , Pennsylvania , USA
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240
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Oschwald M, Lund EM, Latorre A, Shelton R, Hughes RB, Liston B, Flaherty MC, Powers LE. An Exploratory Study of a Computer-Assisted Abuse Awareness and Safety Planning Program for Men With Disabilities: The Men's Safer and Stronger Program. J Soc Work Disabil Rehabil 2015; 14:88-109. [PMID: 25671458 DOI: 10.1080/1536710x.2015.1014533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Interpersonal violence (IPV) is a serious and often unrecognized problem for men with disabilities (MWD). However, abuse awareness programs and outcome measures have not been systematically evaluated in MWD. This article reports findings from an exploratory study (n = 31) of the Safer and Stronger Program for Men with Disabilities (Men's SSP), an audio computer-assisted self-interview (ACASI) abuse awareness program. Preliminary findings suggest it is sensitive toward detecting abuse and it allows MWD to privately and independently self-identify IPV experiences. Preliminary psychometric data on a battery of abuse and safety awareness outcome measures suggest that they are reliable in this population.
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Affiliation(s)
- Mary Oschwald
- a The Regional Research Institute for Human Services , Portland State University , Portland , Oregon , USA
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241
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Abstract
As health care reform promises to change the landscape of health care delivery, its potential impact on women's health looms large. Whereas health and mental health systems have historically been fragmented, the Affordable Care Act (ACA) mandates integrated health care as the strategy for reform. Current systems fragment women's health not only in their primary care, mental health, obstetrical, and gynecological needs, but also in their roles as the primary caregivers for parents, spouses, and children. Changes in reimbursement, and in restructuring financing and care coordination systems through accountable care organizations and medical homes, will potentially improve women's health care.
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Affiliation(s)
- Jean Lau Chin
- a Derner Institute for Advanced Psychological Studies , Adelphi University , Garden City , New York , USA
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242
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Abstract
This study aimed to explore the communication in consultations between patients and health care staff from a gender perspective. We used 23 tape-recorded consultations between patients with Atrial Fibrillation and 5 nurses and 5 physicians at cardiac outpatient clinics at 6 different hospitals in southern Sweden during autumn 2009 to explore the verbal gendered constructions of patients. Through critical discourse analysis, we revealed that the male patients tended to describe their ailments with performance-oriented statements, whereas the female patients usually used emotional-oriented statements. The staff downplayed the male patients' questions and statements, while they acknowledged concern toward the female patients. Both the patients and the staff made conclusions according to a mutual construction. Male patients were constructed as competent, and female patients as fragile through gender-stereotypical communication. Open-ended statements and questions enabled consultations to be less limited by gender stereotypes.
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Affiliation(s)
- Joel Hedegaard
- a School of Education and Communication , Jönköping University , Jönköping , Sweden
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243
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Gavriilidis G, Gavriilidou NN, Pettersson E, Renhammar E, Balkfors A, Östergren PO. Empowerment evaluation of a Swedish gender equity plan. Glob Health Action 2014; 7:23710. [PMID: 24993349 PMCID: PMC4082192 DOI: 10.3402/gha.v7.23710] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Revised: 05/10/2014] [Accepted: 05/12/2014] [Indexed: 12/05/2022] Open
Abstract
Background Empowerment is essential for gender equity and health. The city of Malmö, Sweden, has formulated a development plan for gender equity integration (GEIDP). A ‘Policy Empowerment Index’ (PEI) was previously developed to assess the empowerment potential of policies. Objectives To pilot-evaluate the GEIDP’s potential for empowerment and to test the PEI for future policy evaluations. Design The GEIDP was analyzed and scored according to electronically retrieved evidence on constituent opinion, participation, capacity development, evaluation–adaptation, and impact. Results The plan’s PEI score was 64% (CI: 48–78) and was classified as ‘enabling’, ranging between ‘enabling’ and ‘supportive’. The plan’s strengths were: 1) constituent knowledge and concern; 2) peripheral implementation; 3) protection of vulnerable groups; and 4) evaluation/adaptation procedures. It scored average on: 1) policy agenda setting; 2) planning; 3) provisions for education; 4) network formation; 5) resource mobilization. The weakest point was regarding promotion of employment and entrepreneurship. Conclusions The PEI evaluation highlighted the plan’s potential of constituency empowerment and proposed how it could be augmented.
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Affiliation(s)
- Georgios Gavriilidis
- Division of Social Medicine and Global Health, Social Medicine and Global Health, Lund University (LU), Malmö, Sweden;
| | - Nivetha Natarajan Gavriilidou
- Division of Social Medicine and Global Health, Social Medicine and Global Health, Lund University (LU), Malmö, Sweden
| | - Erika Pettersson
- City of Malmö, Commission of a Socially Sustainable Malmö, Malmö, Sweden
| | - Eva Renhammar
- City of Malmö, Commission of a Socially Sustainable Malmö, Malmö, Sweden
| | - Anna Balkfors
- City of Malmö, Commission of a Socially Sustainable Malmö, Malmö, Sweden
| | - Per-Olof Östergren
- Division of Social Medicine and Global Health, Social Medicine and Global Health, Lund University (LU), Malmö, Sweden
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244
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MacPherson EE, Richards E, Namakhoma I, Theobald S. Gender equity and sexual and reproductive health in Eastern and Southern Africa: a critical overview of the literature. Glob Health Action 2014; 7:23717. [PMID: 24972916 PMCID: PMC4074359 DOI: 10.3402/gha.v7.23717] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Revised: 04/24/2014] [Accepted: 05/13/2014] [Indexed: 11/28/2022] Open
Abstract
Background Gender inequalities are important social determinants of health. We set out to critically review the literature relating to gender equity and sexual and reproductive health (SRH) in Eastern and Southern Africa with the aim of identifying priorities for action. Design During November 2011, we identified studies relating to SRH and gender equity through a comprehensive literature search. Results We found gender inequalities to be common across a range of health issues relating to SRH with women being particularly disadvantaged. Social and biological determinants combined to increase women's vulnerability to maternal mortality, HIV, and gender-based violence. Health systems significantly disadvantaged women in terms of access to care. Men fared worse in relation to HIV testing and care with social norms leading to men presenting later for treatment. Conclusions Gender inequity in SRH requires multiple complementary approaches to address the structural drivers of unequal health outcomes. These could include interventions that alter the structural environment in which ill-health is created. Interventions are required both within and beyond the health system.
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Affiliation(s)
- Eleanor E MacPherson
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom;
| | - Esther Richards
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Ireen Namakhoma
- Research for Equity and Community Health Trust, Lilongwe, Malawi
| | - Sally Theobald
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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245
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Abstract
In this paper we draw attention to the difficulty of accessing reproductive rights in the absence of effective state and legal guarantees for gender equity and citizenship, and argue that if reproductive rights are to be meaningful interventions on the ground, they must be reframed in terms of reproductive justice. Drawing on multi-sited ethnographic fieldwork conducted in Rajasthan, Northwest India, we track two dynamic legal aid interventions on reproductive health rights in India, concerned with domestic violence and maternal mortality respectively, that have sought to fill this existing gap between ineffective state policies and the rhetoric on reproductive rights. Through an analysis of these interventions, we propose that requirements of reproductive justice cannot be met through discrete or private, albeit creative legal initiatives, pursued by individuals or civil society organisations but must involve comprehensive policies as well as strategies and alliances between state, non-state, transnational organisations and progressive political groups.
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Affiliation(s)
- Sumi Madhok
- a Gender Institute, London School of Economics , London , UK
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246
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Abstract
BACKGROUND The benefits of exclusive breastfeeding, including public health cost savings, are widely recognized, but breastfeeding requires maternal time investments. OBJECTIVE This study investigates the time taken to exclusively breastfeed at 6 months compared with not exclusively breastfeeding. METHODS Time use data were examined from an Australian survey of new mothers conducted during 2005-2006. Data from 139 mothers with infants age 6 months were analyzed using chi-square tests of independence to examine socioeconomic and demographic characteristics and 2-sided t tests to compare average weekly hours spent on milk feeding, feeding solids, preparing feeds, and the total of these. The comparison was of exclusively breastfeeding mothers with other mothers. We also compared exclusively breastfeeding with partially breastfeeding and formula feeding mothers using a 1-way between-groups analysis of variance (ANOVA). RESULTS The exclusively breastfeeding (vs other) mothers spent 7 hours extra weekly on milk feeding their infants but 2 hours less feeding solids. These differences were statistically significant. ANOVA revealed significant differences between exclusively breastfeeding mothers, breastfeeding mothers who had introduced solids, and mothers who fed any formula, in time spent feeding milk, and solids, and preparing feeds. CONCLUSION Exclusive breastfeeding is time intensive, which is economically costly to women. This may contribute to premature weaning for women who are time-stressed, lack household help from family, or cannot afford paid help. Gaining public health benefits of exclusive breastfeeding requires strategies to share maternal lactation costs more widely, such as additional help with housework or caring for children, enhanced leave, and workplace lactation breaks and suitable child care.
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Affiliation(s)
- J P Smith
- 1Australian Centre for Economic Research on Health, College of Medicine, Biology and Environment, Australian National University, Canberra, Australia
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247
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Bond JC, Roberts SC, Greenfield TK, Korcha R, Ye Y, Nayak MB. Gender differences in public and private drinking contexts: a multi-level GENACIS analysis. Int J Environ Res Public Health 2010; 7:2136-60. [PMID: 20623016 PMCID: PMC2898041 DOI: 10.3390/ijerph7052136] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2010] [Revised: 04/26/2010] [Accepted: 04/27/2010] [Indexed: 01/22/2023]
Abstract
This multi-national study hypothesized that higher levels of country-level gender equality would predict smaller differences in the frequency of women's compared to men's drinking in public (like bars and restaurants) settings and possibly private (home or party) settings. GENACIS project survey data with drinking contexts included 22 countries in Europe (8); the Americas (7); Asia (3); Australasia (2), and Africa (2), analyzed using hierarchical linear models (individuals nested within country). Age, gender and marital status were individual predictors; country-level gender equality as well as equality in economic participation, education, and political participation, and reproductive autonomy and context of violence against women measures were country-level variables. In separate models, more reproductive autonomy, economic participation, and educational attainment and less violence against women predicted smaller differences in drinking in public settings. Once controlling for country-level economic status, only equality in economic participation predicted the size of the gender difference. Most country-level variables did not explain the gender difference in frequency of drinking in private settings. Where gender equality predicted this difference, the direction of the findings was opposite from the direction in public settings, with more equality predicting a larger gender difference, although this relationship was no longer significant after controlling for country-level economic status. Findings suggest that country-level gender equality may influence gender differences in drinking. However, the effects of gender equality on drinking may depend on the specific alcohol measure, in this case drinking context, as well as on the aspect of gender equality considered. Similar studies that use only global measures of gender equality may miss key relationships. We consider potential implications for alcohol related consequences, policy and public health.
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Affiliation(s)
- Jason C. Bond
- Alcohol Research Group, 6475 Christie Avenue, Suite 400, Emeryville, CA 94608, USA; E-Mails:
(T.G.);
(S.R.);
(Y.Y.);
(M.N.)
| | - Sarah C.M. Roberts
- Alcohol Research Group, 6475 Christie Avenue, Suite 400, Emeryville, CA 94608, USA; E-Mails:
(T.G.);
(S.R.);
(Y.Y.);
(M.N.)
- NIAAA Training Program, School of Public Health, University of California Berkeley, Berkeley, CA 94709, USA
| | - Thomas K. Greenfield
- Alcohol Research Group, 6475 Christie Avenue, Suite 400, Emeryville, CA 94608, USA; E-Mails:
(T.G.);
(S.R.);
(Y.Y.);
(M.N.)
- Clinical Services Research Training Program, Department of Psychiatry, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA 94143, USA
| | - Rachael Korcha
- Alcohol Research Group, 6475 Christie Avenue, Suite 400, Emeryville, CA 94608, USA; E-Mails:
(T.G.);
(S.R.);
(Y.Y.);
(M.N.)
| | - Yu Ye
- Alcohol Research Group, 6475 Christie Avenue, Suite 400, Emeryville, CA 94608, USA; E-Mails:
(T.G.);
(S.R.);
(Y.Y.);
(M.N.)
| | - Madhabika B. Nayak
- Alcohol Research Group, 6475 Christie Avenue, Suite 400, Emeryville, CA 94608, USA; E-Mails:
(T.G.);
(S.R.);
(Y.Y.);
(M.N.)
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Abbuhl S, Bristol MN, Ashfaq H, Scott P, Tuton LW, Cappola AR, Sonnad SS. Examining faculty awards for gender equity and evolving values. J Gen Intern Med 2010; 25:57-60. [PMID: 19727968 DOI: 10.1007/s11606-009-1092-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2008] [Revised: 06/26/2009] [Accepted: 08/07/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND Awards given to medical school faculty are one important mechanism for recognizing what is valued in academic medicine. There have been concerns expressed about the gender distribution of awards, and there is also a growing appreciation for the evolving accomplishments and talents that define academic excellence in the 21st century and that should be considered worthy of award recognition. OBJECTIVE Examine faculty awards at our institution for gender equity and evolving values. METHODS Recipient data were collected on awards from 1996 to 2007 inclusively at the University of Pennsylvania School of Medicine (SOM). Descriptions of each award also were collected. The female-to-male ratio of award recipients over the time span was reviewed for changes and trends. The title and text of each award announcement were reviewed to determine if the award represented a traditional or a newer concept of excellence in academic medicine. MAIN RESULTS There were 21 annual awards given to a total of 59 clinical award recipients, 60 research award recipients, and 154 teaching award recipients. Women received 28% of research awards, 29% of teaching awards and 10% of clinical awards. Gender distribution of total awards was similar to that of SOM full-time faculty except in the clinical awards category. Only one award reflected a shift in the culture of individual achievement to one of collaboration and team performance. CONCLUSION Examining both the recipients and content of awards is important to assure they reflect the current composition of diverse faculty and the evolving ideals of leadership and excellence in academic medicine.
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