Gender disparities in high-quality dermatology research: a descriptive bibliometric study on scientific authorships

Gender disparities in high-quality dermatology research over the past 15 years

Background

In the last 15 years, an increase in U.S. female dermatologists from 41 to 52.2% and a surge in female authorship (FAP) have been noted. Authorship is a pivotal objective measurement of academic productivity and, contribution as first or senior author, plays a major role in the promotion process of active physicians and faculty members.

Objective

To validate, analyze, and clarify trends in FAP in high-quality dermatology research in the last 15 years.

Methods

The Thomson Reuters Web of Science Journal Citation Reports 2021 was used to retrieve the 100 most-cited original articles from the top 5 dermatology journals (determined by 2021 impact factors) in 5 consecutive 3-year intervals between 2009 and 2023. Gender application programming interface, a gender algorithm, was used to identify FAP according to country of origin and first name. Monotonic trend test significance level was set at 5%.

Results

In total, 14,187 articles were retrieved and subdivided into the 100 most-cited in 3-year intervals. A total of 418 first and 447 senior authors' gender were identified. FAP was found in 43%, 31%, and 37% of the first, last, and total authors. Trend analysis revealed a decrease in the last 15 years (S = -4610, P = .068) in senior FAP. Similarly, the trend persists in the United States (S = -1606, P = .052).

Limitations

Due to the usage of a binary gender identification algorithm, Nonbinary gender could not be identified in this analysis.

Conclusion

The last 15 years show an inverse relationship, with an increase in female dermatologists and a decrease in senior FAP in high-quality journals in the general dermatology community.

Characterizing Gender and Leadership Trends Among Mohs Micrographic Surgery Fellowship Directors

BACKGROUND

Fellowship directors (FDs) play a key role in shaping Mohs micrographic surgery (MMS). Studies characterizing director trends are lacking and may provide a framework for improving gender diversity.

OBJECTIVE

To explore characteristics of FDs and trends in gender of both fellows and FDs over time.

MATERIALS AND METHODS

The authors compiled a comprehensive list of FDs and fellows for all Accreditation Council for Graduate Medical Education-accredited Micrographic Surgery & Dermatologic Oncology programs from 1996 to 2023. Publicly available data from various internet sources from February 1, 2023 to May 30, 2023 were used to assess characteristics of MMS FDs.

RESULTS

The percentage of female FDs increased from 6% to 25% from 1996 to 2023. Female directors were more likely to select female fellows than male directors ( p = .0002) and had fewer years between fellowship completion and FD appointment (9.1 ± 4.7 years) compared with male directors (13.6 ± 8.8 years; p = .036). H-index, program type, and academic rank were similar between male and female directors.

CONCLUSION

Although gender parity among MMS trainees has been achieved, discrepancies remain in the gender composition of FDs. Further studies are required to determine why women are underrepresented as FDs.

Molecular basis for the transcriptional regulation of an epoxide-based virulence circuit in Pseudomonas aeruginosa

The opportunistic pathogen Pseudomonas aeruginosa infects cystic fibrosis (CF) patient airways and produces a virulence factor Cif that is associated with worse outcomes. Cif is an epoxide hydrolase that reduces cell-surface abundance of the cystic fibrosis transmembrane conductance regulator (CFTR) and sabotages pro-resolving signals. Its expression is regulated by a divergently transcribed TetR family transcriptional repressor. CifR represents the first reported epoxide-sensing bacterial transcriptional regulator, but neither its interaction with cognate operator sequences nor the mechanism of activation has been investigated. Using biochemical and structural approaches, we uncovered the molecular mechanisms controlling this complex virulence operon. We present here the first molecular structures of CifR alone and in complex with operator DNA, resolved in a single crystal lattice. Significant conformational changes between these two structures suggest how CifR regulates the expression of the virulence gene cif. Interactions between the N-terminal extension of CifR with the DNA minor groove of the operator play a significant role in the operator recognition of CifR. We also determined that cysteine residue Cys107 is critical for epoxide sensing and DNA release. These results offer new insights into the stereochemical regulation of an epoxide-based virulence circuit in a critically important clinical pathogen.

Safety implications of remote assessments for suspected COVID-19: qualitative study in UK primary care

BACKGROUND

The introduction of remote triage and assessment early in the pandemic raised questions about patient safety. We sought to capture patients and clinicians' experiences of the management of suspected acute COVID-19 and generate wider lessons to inform safer care.

SETTING AND SAMPLE

UK primary healthcare. A subset of relevant data was drawn from five linked in-pandemic qualitative studies. The data set, on a total of 87 participants recruited via social media, patient groups and snowballing, comprised free text excerpts from narrative interviews (10 survivors of acute COVID-19), online focus groups (20 patients and 30 clinicians), contributions to a Delphi panel (12 clinicians) and fieldnotes from an online workshop (15 patients, clinicians and stakeholders).

METHODS

Data were uploaded onto NVivo. Coding was initially deductive and informed by WHO and Institute of Medicine frameworks of quality and safety. Further inductive analysis refined our theorisation using a wider range of theories-including those of risk, resilience, crisis management and social justice.

RESULTS

In the early weeks of the pandemic, patient safety was compromised by the driving logic of 'stay home' and 'protect the NHS', in which both patients and clinicians were encouraged to act in a way that helped reduce pressure on an overloaded system facing a novel pathogen with insufficient staff, tools, processes and systems. Furthermore, patients and clinicians observed a shift to a more transactional approach characterised by overuse of algorithms and decision support tools, limited empathy and lack of holistic assessment.

CONCLUSION

Lessons from the pandemic suggest three key strategies are needed to prevent avoidable deaths and inequalities in the next crisis: (1) strengthen system resilience (including improved resourcing and staffing; support of new tools and processes; and recognising primary care's role as the 'risk sink' of the healthcare system); (2) develop evidence-based triage and scoring systems; and (3) address social vulnerability.

Gender equity of authorship in pulmonary medicine over the past decade

BACKGROUND

Gender disparity in authorship broadly persists in medical literature, little is known about female authorship within pulmonary medicine.

METHODS

A bibliometric analysis of publications from 2012 to 2021 in 12 journals with the highest impact in pulmonary medicine was conducted. Only original research and review articles were included. Names of the first and last authors were extracted and their genders were identified using the Gender-API web. Female authorship was described by overall distribution and distribution by country/region/continent and journal. We compared the article citations by gender combinations, evaluated the trend in female authorship, and forecasted when parity for first and last authorship would be reached. We also conducted a systematic review of female authorship in clinical medicine.

RESULTS

14,875 articles were included, and the overall percentage of female first authors was higher than last authors (37.0% vs 22.2%, p<0.001). Asia had the lowest percentage of female first (27.6%) and last (15.2%) authors. The percentages of female first and last authors increased slightly over time, except for a rapid increase in the COVID-19 pandemic periods. Parity was predicted in 2046 for the first authors and 2059 for the last authors. Articles with male authors were cited more than articles with female authors. However, male-male collaborations significantly decreased, whereas female-female collaborations significantly increased.

CONCLUSIONS

Despite the slow improvement in female authorship over the past decade, there is still a substantial gender disparity in female first and last authorship in high-impact medical journals in pulmonary medicine.

Antithrombotic drugs for cardiovascular risk reduction in patients with lower limb peripheral arterial disease: protocol for a systematic review and network meta-analysis of randomised controlled trials

INTRODUCTION

The optimal antithrombotic regimen to reduce the risk of vascular events in patients with peripheral arterial disease (PAD) is contentious. This systematic review and network meta-analysis (NMA) aims to define the relative efficacy and risks of previously investigated antithrombotic medication regimens in preventing major cardiovascular events, vascular limb events and mortality in patients with PAD.

METHODS AND ANALYSIS

A peer-reviewed, systematic search will be executed in English on Medline, Embase, Cochrane (CENTRAL), Web of Science and Google Scholar databases in late 2022. The WHO International Clinical Trials Registry platform will also be searched for ongoing trials. Abstracts will be screened independently by two researchers for randomised controlled trials meeting the review criteria. All associated publications including the study protocol will be sought and evaluated together against prespecified inclusion/exclusion criteria. Two researchers will extract the data into a prepiloted extraction form. Risk-of-bias assessments will be performed using the Cochrane 'Risk-of-Bias V.2' criteria by individuals with domain expertise. All differences will be resolved by consensus or a third individual for ties.Included trials will be summarised. An NMA will be performed, subject to checks of assumptions. Both primary and secondary outcomes will be analysed on a whole network basis. Pairwise comparisons and league tables will be produced. Prespecified subgroup analyses will include sex, ethnicity, disease status, conservative versus interventional management and key comorbidities. The findings will be evaluated using the Grading of Recommendation Assessment, Development and Evaluation, informed by patient and public involvement work.

ETHICS AND DISSEMINATION

This is a systematic review of data in the public domain and does not require ethical approval. Dissemination will include presentations to key vascular and patient organisations, publication in a peer-reviewed journal and an open-access repository of the study data.

PROSPERO REGISTRATION NUMBER

CRD42023389262.

Dermatology Journals' Editorial Boards Require Improved Gender Equity: JMIR Dermatology's Future Directions

Gender disparities exist across all facets of academic medicine including within the editorial boards of dermatology journals. Only 22% of these editorial boards comprised women, even though 51% of full-time, faculty dermatologists are female. When inviting academic dermatologists to our editorial board at JMIR Dermatology, we invited 50% women to represent the gender distribution of academic dermatologists; however, we have not sufficiently reached gender equity among accepted editorial board members. We will continue to strive toward the goal of gender equity on our editorial board and invite other dermatology journals to do the same.

Gender Equity in Medicine and Dermatology in the United States: The Long Road Traveled and the Journey ahead

Over the past 50 years there has been an increase in the representation of women in medicine with similar rates of men and women graduating from medical training today. Nevertheless, gender gaps in leadership, research publications, and compensation persist. Herein, we review trends in gender differences among leadership positions in academic medicine with a particular focus on dermatology, evaluate the roles of mentorship, motherhood, and gender bias on gender equity, and discuss constructive solutions for addressing gender inequities that persist in academic medicine today.

Validity of the ROX index in predicting invasive mechanical ventilation requirement in pneumonia

Background

The ROX index (Respiratory rate-OXygenation) has been described as a prediction tool to identify the need for invasive mechanical ventilation (IMV) in community-acquired pneumonia (CAP) with acute hypoxaemic respiratory failure treated with high-flow nasal cannula in order to avoid delay of a necessary intubation. However, its use in predicting the need for ventilatory support in hospitalised patients with CAP has not been validated.

Methods

This is a retrospective cohort study including subjects with CAP treated in the general ward, emergency service or intensive care unit of a third-level centre in Cundinamarca, Colombia, between January 2001 and February 2020. The ROX index was estimated as the ratio of oxygen saturation/fraction of inspired oxygen to respiratory rate.

Results

A total of 895 patients were included, of whom 93 (10%) required IMV. The ROX index proved to be a good predictor, presenting an area under the curve of receiver operating characteristics (AUROC) of 0.733 (95% CI 0.671 to 0.795, p<0.001) when determined by pulse oximetry and an AUROC of 0.779 (95% CI 0.699 to 0.859, p<0.001) when estimated by arterial blood gas (ABG) parameters, with an intraclass correlation of 0.894. The estimated cut-off point was 14.8; a score less than 14.8 indicates high risk of requiring IMV.

Conclusion

The ROX index is a good predictor of IMV in hospitalised patients with CAP. It presents good performance when calculated through pulse oximetry and can replace the one calculated by ABG.

Fragmentation of ambulatory care among older adults: an exhaustive database study in an ageing city in Japan

OBJECTIVES

Continuity of care is a core dimension of primary care, and better continuity is associated with better patient outcomes. Therefore, care fragmentation can be an indicator to assess the quality of primary care, especially in countries without formal gatekeeping system, such as Japan. Thus, this study aimed to describe care fragmentation among older adults in an ageing city in Japan.

DESIGN

Cross-sectional study.

SETTING

The most populated basic municipality in Japan.

PARTICIPANTS

Older adults aged 75 years and older.

INTERVENTIONS

This study used a health claims database, including older adults who visited medical facilities at least four times a year in an urban city in Japan. The Fragmentation of Care Index (FCI) was used as an indicator of fragmentation. The FCI was developed from the Continuity of Care Index and is based on the total number of visits, different institutions visited and proportion of visits to each institution. We employed Tobit regression analysis to examine the association between the FCI and age, sex, type of insurance and most frequently visited facility.

RESULTS

The total number of participants was 413 600. The median age of the study population was 81 years, and 41.6% were men. The study population visited an average of 3.42 clinics/hospitals, and the maximum number of visited institutions was 20. The proportion of patients with FCI >0 was 85.0%, with a mean of 0.583. Multivariable analysis showed that patients receiving public assistance had a lower FCI compared with patients not receiving public assistance, with a coefficient of 0.137.

CONCLUSIONS

To our knowledge, this is the first study to demonstrate care fragmentation in Japan. Over 80% of the participants visited two or more medical facilities, and their mean FCI was 0.583. The FCI could be a basic indicator for assessing the quality of primary care.

Supporting families managing childhood eczema: developing and optimising eczema care online using qualitative research

BACKGROUND

Childhood eczema is often poorly controlled owing to underuse of emollients and topical corticosteroids (TCS). Parents/carers report practical and psychosocial barriers to managing their child's eczema, including child resistance. Online interventions could potentially support parents/carers; however, rigorous research developing such interventions has been limited.

AIM

To develop an online behavioural intervention to help parents/carers manage and co-manage their child's eczema.

DESIGN AND SETTING

Intervention development using a theory-, evidence-, and person-based approach (PBA) with qualitative research.

METHOD

A systematic review and qualitative synthesis of studies (n = 32) and interviews with parents/carers (n = 30) were used to identify barriers and facilitators to effective eczema management, and a prototype intervention was developed. Think-aloud interviews with parents/carers (n = 25) were then used to optimise the intervention to increase its acceptability and feasibility.

RESULTS

Qualitative research identified that parents/carers had concerns about using emollients and TCS, incomplete knowledge and skills around managing eczema, and reluctance to transitioning to co-managing eczema with their child. Think-aloud interviews highlighted that, while experienced parents/carers felt they knew how to manage eczema, some information about how to use treatments was still new. Techniques for addressing barriers included providing a rationale explaining how emollients and TCS work, demonstrating how to use treatments, and highlighting that the intervention provided new, up-to-date information.

CONCLUSION

Parents/carers need support in effectively managing and co-managing their child's eczema. The key output of this research is Eczema Care Online for Families, an online intervention for parents/carers of children with eczema, which is being evaluated in a randomised trial.

Impact of a Psychotherapy Protocol on Women with a History of Intimate Partner Violence in Brazil

Violence against women is a public health problem, and it causes psychological damage that should be the focus of psychological treatment. Psychological symptoms include anxiety, depression, and trauma-related stress. Scientific, evidence-based practices are recommended for a high-quality outcome. This study aimed to evaluate the impact of a 16-session Cognitive Behavioral Psychotherapy protocol for women with a history of intimate partner violence (IPV). The final sample included 26 women. The participants were evaluated before the intervention and after the end of it. The study results indicate an increase in the level of life satisfaction, as well as a reduction in anxiety, depression, and trauma-related symptoms. Patients with different histories of violence have benefited from the intervention. Despite the limitations of this study, for example, sample size and the absence of a control group, the results provide initial evidence of the effectiveness of the protocol. This study contributes to stimulating evidence-based practices for treatment for this population in Brazil. Future experimental and follow-up studies are necessary to produce evidence of the effectiveness of the protocol.

Gender-based violence, psychological distress, sexual behaviours and binge drinking among female entertainment workers in Cambodia: a cross-sectional study

OBJECTIVE

To examine the relationship between gender-based violence, HIV risks, psychological distress and binge drinking among female entertainment workers (FEWs) in Cambodia.

DESIGN

Cross-sectional study.

SETTING

Phnom Penh and three other provinces in Cambodia.

PARTICIPANTS

We recruited 600 FEWs from entertainment venues using a stratified random sampling method. Participants were eligible if they were at least 18 years old, working in the selected entertainment venues and self-identified as a FEW.

PRIMARY OUTCOME MEASURE

Binge drinking was defined as drinking more than five units of alcoholic drinks in 24 hours on at least one occasion in the past 3 months.

RESULTS

The prevalence of binge drinking was 76.7%. Adjusted odds of binge drinking were significantly higher among FEWs who earned >US$250 per month than those who earned ≤US$120 per month (adjusted OR (AOR) 2.96, 95% CI: 1.40 to 6.24), had been forced to drink more than once per month in the past 3 months than those who had never been forced to drink (AOR 5.66, 95% CI: 2.19 to 14.65), worked at karaoke bars than those working at a restaurants/café (AOR 1.85, 95% CI: 1.19 to 2.88) and experienced emotional abuse in the past 6 months than those who did not experience it (AOR 2.71, 95% CI: 1.22 to 6.02). The odds of binge drinking were significantly higher among FEWs with lower psychological distress than those with higher psychological distress (AOR 1.65, 95% CI: 1.09 to 2.49).

CONCLUSIONS

This study highlights a high prevalence of binge drinking among FEWs and its associations with working environments, conditions and contexts. Our findings suggest that individual-based behavioural intervention may not effectively reduce binge drinking among FEWs. Structural and occupational health policy interventions may be needed to change the working environment.

Small female citation advantages for US journal articles in medicine

Female under-representation continues in senior roles within academic medicine, potentially influenced by a perception that female research has less citation impact. This article provides systematic evidence of (a) female participation rates from the perspective of published journal articles in 46 Scopus medical subject categories 1996–2018 and (b) gender differences in citation rates 1996–2014. The results show female proportion increases 1996–2018 in all fields and a female majority of first-authored articles in two-fifths of categories, but substantial differences between fields. A paper is 7.3 times more likely to have a female first author in Obstetrics and Gynaecology than in Orthopaedics and Sports Medicine. Only three fields had a female last author majority by 2018, a probable side effect of ongoing problems with appointing female leaders. Female first-authored research tended to be more cited than male first-authored research in most fields (59%), although with a maximum difference of only 5.1% (log-transformed normalised citations). In contrast, male last-authored research tends to be more cited than female last-authored research, perhaps due to cases where a senior male has attracted substantial funding for a project. These differences increase if team sizes are not accounted for in the calculations. Since female first-authored research is cited slightly more than male first-authored research, properly analysed bibliometric data considering career gaps should not disadvantage female candidates for senior roles.

Continuity of GP care for patients with dementia: impact on prescribing and the health of patients

Background

Higher continuity of GP care (CGPC), that is, consulting the same doctor consistently, can improve doctor–patient relationships and increase quality of care; however, its effects on patients with dementia are mostly unknown.

Aim

To estimate the associations between CGPC and potentially inappropriate prescribing (PIP), and with the incidence of adverse health outcomes (AHOs) in patients with dementia.

Design and setting

A retrospective cohort study with 1 year of follow-up anonymised medical records from 9324 patients with dementia, aged ≥65 years living in England in 2016.

Method

CGPC measures include the Usual Provider of Care (UPC), Bice–Boxerman Continuity of Care (BB), and Sequential Continuity (SECON) indices. Regression models estimated associations with PIPs and survival analysis with incidence of AHOs during the follow-up adjusted for age, sex, deprivation level, 14 comorbidities, and frailty.

Results

The highest quartile (HQ) of UPC (highest continuity) had 34.8% less risk of delirium (odds ratio [OR] 0.65, 95% confidence interval [CI] = 0.51 to 0.84), 57.9% less risk of incontinence (OR 0.42, 95% CI = 0.31 to 0.58), and 9.7% less risk of emergency admissions to hospital (OR 0.90, 95% CI = 0.82 to 0.99) compared with the lowest quartile. Polypharmacy and PIP were identified in 81.6% (n = 7612) and 75.4% (n = 7027) of patients, respectively. The HQ had fewer prescribed medications (HQ: mean 8.5, lowest quartile (LQ): mean 9.7, P<0.01) and had fewer PIPs (HQ: mean 2.1, LQ: mean 2.5, P<0.01), including fewer loop diuretics in patients with incontinence, drugs that can cause constipation, and benzodiazepines with high fall risk. The BB and SECON measures produced similar findings.

Conclusion

Higher CGPC for patients with dementia was associated with safer prescribing and lower rates of major adverse events. Increasing continuity of care for patients with dementia may help improve treatment and outcomes.

Role of primary care physician factors on diagnostic testing and referral decisions for symptoms of possible cancer: a systematic review

BACKGROUND

Missed opportunities for diagnosing cancer cause patients harm and have been attributed to suboptimal use of tests and referral pathways in primary care. Primary care physician (PCP) factors have been suggested to affect decisions to investigate cancer, but their influence is poorly understood.

OBJECTIVE

To synthesise evidence evaluating the influence of PCP factors on decisions to investigate symptoms of possible cancer.

METHODS

We searched MEDLINE, Embase, Scopus, CINAHL and PsycINFO between January 1990 and March 2021 for relevant citations. Studies examining the effect or perceptions and experiences of PCP factors on use of tests and referrals for symptomatic patients with any cancer were included. PCP factors comprised personal characteristics and attributes of physicians in clinical practice.

DATA EXTRACTION AND SYNTHESIS

Critical appraisal and data extraction were undertaken independently by two authors. Due to study heterogeneity, data could not be statistically pooled. We, therefore, performed a narrative synthesis.

RESULTS

29 studies were included. Most studies were conducted in European countries. A total of 11 PCP factors were identified comprising modifiable and non-modifiable factors. Clinical judgement of symptoms as suspicious or 'alarm' prompted more investigations than non-alarm symptoms. 'Gut feeling' predicted a subsequent cancer diagnosis and was perceived to facilitate decisions to investigate non-specific symptoms as PCP experience increased. Female PCPs investigated cancer more than male PCPs. The effect of PCP age and years of experience on testing and referral decisions was inconclusive.

CONCLUSIONS

PCP interpretation of symptoms as higher risk facilitated testing and referral decisions for possible cancer. However, in the absence of 'alarm' symptoms or 'gut feeling', PCPs may not investigate cancer. PCPs require strategies for identifying patients with non-alarm and non-specific symptoms who need testing or referral.

PROSPERO REGISTRATION NUMBER

CRD420191560515.

Diversity in high-impact psychiatric publishing: gender parity within reach?

Gender parity and authorship diversity are declared goals in the publishing world. This study assessed the progress of authorship gender distribution over a quarter of a century and geographic diversity over the last 15 years in high-impact psychiatric journals. All articles published in 2019 in the American Journal of Psychiatry, the British Journal of Psychiatry, and JAMA Psychiatry were included and compared with data from three points in time starting in 1994. Descriptive statistics were gathered, and chi-square tests were performed. All tests were conducted as two-tailed, and p-values < 0.05 were considered to be statistically significant. Inter-rater reliability was calculated via Cohen's kappa. In 2019 a total of 473 articles were published. Forty percent of all authors, 42.3% of first authors, and 29.4% of senior authors were female. Counting original research articles only, female first authorship reached 50.4%. In the 25-year period between 1994 and 2019, female first (p < .001), female senior (p < .001), and female overall (p < .001) authorship has increased. In the specific period between 2014 and 2019, overall female senior authorship in all articles (p = .940) as well as first (p = .101) and senior (p = .157) in original research plateaued. In non-original research articles, female first authorship was higher in 2019 compared to 2014 (p = .014), whilst female senior authorship plateaued (p = .154). Geographic diversity was low and did not change over time. Gender parity in the subcategory original research articles was reached for the first time in 2019. Senior female authorship and geographic diversity remain areas of concern that need further investigation and specific interventions.

Gender disparities in pediatric research: a descriptive bibliometric study on scientific authorships

BACKGROUND

The proportion of women in medicine, especially in pediatrics, is noticeably increasing. Yet, leadership positions are predominantly occupied by men.

METHODS

Academic authorships of 156,642 pediatric original research articles were analyzed with regard to gender disparities. The evaluation included the proportion of female authorships (FAP), distributions over first-, co- and last-authorships, gender-related citation rates, a productivity analysis and investigations on journals, countries and pediatric sub-disciplines.

RESULTS

In all, 46.6% of all authorships in pediatric research were held by female authors. Women held relatively more first-authorships (FAP = 52%) and had higher odds for first- (OR = 1.3) and co- (OR = 1.11) authorships, compared to men. The Prestige Index of -0.13 indicated an underrepresentation of female authors at prestigious first- and last-authorships. Citation rates were not affected by the gender of the key authors. At the country-level pronounced gender-related differences were detected. The time trend showed increasing female prospects forecasting a female-dominated Prestige Index of 0.05 in 2023.

CONCLUSION

The integration of women in pediatric research has advanced. Opportunities for female authors differ at the country-level, but overall women are lacking in leadership positions. Improving career opportunities for women in pediatric research can be expected in the coming years.

IMPACT

There is a measurable progress in the integration of female scientists. Gender-neutrality is partially achieved in pediatric research with yet a female underrepresentation in leading positions. Our descriptive study presents gender-related dynamics in pediatric research that forecast improving career opportunities for female scientists.

Health and well-being of rotation workers in the mining, offshore oil and gas, and construction industry: a systematic review

Introduction

Rotation work, characterised by travelling long distances to work in isolated areas where workers typically rotate consecutive days working and living on-site with periods at home, is increasingly used in the resources and construction sectors globally. Such employment practices may have an impact on workers’ health and well-being. This systematic review explores the impact rotation work has on mental and physical outcomes in rotation workers in the resources and construction sectors.

Method

The PubMed, Medline, EMBASE, CINAHL, PsycINFO, and Scopus databases were systematically searched on 1 May 2020 to identify quantitative, qualitative and mixed-method studies addressing the health of rotation workers published in peer-reviewed journals. Findings from the studies were summarised narratively.

Results

Of 6268 studies retrieved, 90 studies were included in the review. Studies suggested higher prevalence of psychological distress in onshore rotation workers and higher overweight/obesity rates among rotation workers as compared with the general population. We found more sleep problems and higher levels of smoking during work periods compared with off-site days; and higher alcohol intake during off-site days compared with on-site days. Workers generally perceived their physical health status as good. High-perceived job demands (such as workload, repetitive work) were associated with mental distress and exhaustion, sleep problems and perceived poor physical health status, while high-perceived job resources (such as job clarity/control, support) were associated with low mental distress and exhaustion, less smoking and alcohol intake, and better sleep.

Conclusion

Rotation work is associated with several poorer health behaviours and outcomes, such as sleep problems, smoking, alcohol consumption and overweight/obesity. Interventions needed to improve rotation workers’ health should include maximising available job resources and reducing job demands. Further longitudinal studies are needed to explore the long-term health effects of rotation work and the short-term contextual effects of the different aspects of rotation work.

Performance of gender detection tools: a comparative study of name-to-gender inference services

Objective:

To evaluate the performance of gender detection tools that allow the uploading of files (e.g., Excel or CSV files) containing first names, are usable by researchers without advanced computer skills, and are at least partially free of charge.

Methods:

The study was conducted using four physician datasets (total number of physicians: 6,131; 50.3% female) from Switzerland, a multilingual country. Four gender detection tools met the inclusion criteria: three partially free (Gender API, NamSor, and genderize.io) and one completely free (Wiki-Gendersort). For each tool, we recorded the number of correct classifications (i.e., correct gender assigned to a name), misclassifications (i.e., wrong gender assigned to a name), and nonclassifications (i.e., no gender assigned). We computed three metrics: the proportion of misclassifications excluding nonclassifications (errorCodedWithoutNA), the proportion of nonclassifications (naCoded), and the proportion of misclassifications and nonclassifications (errorCoded).

Results:

The proportion of misclassifications was low for all four gender detection tools (errorCodedWithoutNA between 1.5 and 2.2%). By contrast, the proportion of unrecognized names (naCoded) varied: 0% for NamSor, 0.3% for Gender API, 4.5% for Wiki-Gendersort, and 16.4% for genderize.io. Using errorCoded, which penalizes both types of error equally, we obtained the following results: Gender API 1.8%, NamSor 2.0%, Wiki-Gendersort 6.6%, and genderize.io 17.7%.

Conclusions:

Gender API and NamSor were the most accurate tools. Genderize.io led to a high number of nonclassifications. Wiki-Gendersort may be a good compromise for researchers wishing to use a completely free tool. Other studies would be useful to evaluate the performance of these tools in other populations (e.g., Asian).

Untangling the inter-relatedness within integrated care programmes for community-dwelling frail older people: a rapid realist review

OBJECTIVE

To identify the relationships between the context in which integrated care programmes (ICPs) for community-dwelling frail older people are applied, the mechanisms by which the programmes do (not) work and the outcomes resulting from this interaction by establishing a programme theory.

DESIGN

Rapid realist review.

INCLUSION CRITERIA

Reviews and meta-analyses (January 2013-January 2019) and non-peer-reviewed literature (January 2013-December 2019) reporting on integrated care for community-dwelling frail older people (≥60 years).

ANALYSIS

Selection and appraisal of documents was based on relevance and rigour according to the Realist And Meta-narrative Evidence Syntheses: Evolving Standards criteria. Data on context, mechanisms, programme activities and outcomes were extracted. Factors were categorised into the five strategies of the WHO framework of integrated people-centred health services (IPCHS).

RESULTS

27 papers were included. The following programme theory was developed: it is essential to establish multidisciplinary teams of competent healthcare providers (HCPs) providing person-centred care, closely working together and communicating effectively with other stakeholders. Older people and informal caregivers should be involved in the care process. Financial support, efficient use of information technology and organisational alignment are also essential. ICPs demonstrate positive effects on the functionality of older people, satisfaction of older people, informal caregivers and HCPs, and a delayed placement in a nursing home. Heterogeneous effects were found for hospital-related outcomes, quality of life, healthcare costs and use of healthcare services. The two most prevalent WHO-IPCHS strategies as part of ICPs are 'creating an enabling environment', followed by 'strengthening governance and accountability'.

CONCLUSION

Currently, most ICPs do not address all WHO-IPCHS strategies. In order to optimise ICPs for frail older people the interaction between context items, mechanisms, programme activities and the outcomes should be taken into account from different perspectives (system, organisation, service delivery, HCP and patient).

"Would You Rather Jump Out of a Perfectly Good Airplane or Develop Cardiovascular Disease?" Validity and Reliability of the Cardiovascular Risk Perception Survey Among Military Personnel

BACKGROUND AND PURPOSE

Cardiovascular disease (CVD) is a major cause of death in the United States. The military are viewed as fit, ready to fight and that jumping out of perfectly good airplane or going to war is a greater risk than CVD. The purpose of this study was to determine reliability and validity of the Cardiovascular Risk Perception Survey (CRPS).

METHODS

A cross-sectional descriptive design was performed, supported by the Health Belief Model. Internal consistency reliability (Cronbach's alpha) and validity (principal component analysis) were examined.

RESULTS

Fifty-five participants were included in this study. Construct validity of the CRPS was supported by principal component analysis; indicating one scale that measured cardiovascular risk perception. The Cronbach's alpha is reported .865.

CONCLUSION

Initial psychometric testing of the CRPS provides evidence for construct validity and internal consistency reliability.

Gender parity in scientific authorship in a National Institute for Health Research Biomedical Research Centre: a bibliometric analysis

OBJECTIVE

Scientific authorship is a vital marker of achievement in academic careers and gender equity is a key performance metric in research. However, there is little understanding of gender equity in publications in biomedical research centres funded by the National Institute for Health Research (NIHR). This study assesses the gender parity in scientific authorship of biomedical research.

DESIGN

Descriptive, cross-sectional, retrospective bibliometric study.

SETTING

NIHR Oxford Biomedical Research Centre (BRC).

DATA

Data comprised 2409 publications that were either accepted or published between April 2012 and March 2017. The publications were classified as basic science studies, clinical studies (both trial and non-trial studies) and other studies (comments, editorials, systematic reviews, reviews, opinions, book chapters, meeting reports, guidelines and protocols).

MAIN OUTCOME MEASURES

Gender of authors, defined as a binary variable comprising either male or female categories, in six authorship categories: first author, joint first authors, first corresponding author, joint corresponding authors, last author and joint last authors.

RESULTS

Publications comprised 39% clinical research (n=939), 27% basic research (n=643) and 34% other types of research (n=827). The proportion of female authors as first author (41%), first corresponding authors (34%) and last author (23%) was statistically significantly lower than male authors in these authorship categories (p<0.001). Of total joint first authors (n=458), joint corresponding authors (n=169) and joint last authors (n=229), female only authors comprised statistically significant (p<0.001) smaller proportions, that is, 15% (n=69), 29% (n=49) and 10% (n=23) respectively, compared with male only authors in these joint authorship categories. There was a statistically significant association between gender of the last author with gender of the first author (p<0.001), first corresponding author (p<0.001) and joint last author (p<0.001). The mean journal impact factor (JIF) was statistically significantly higher when the first corresponding author was male compared with female (Mean JIF: 10.00 vs 8.77, p=0.020); however, the JIF was not statistically different when there were male and female authors as first authors and last authors.

CONCLUSIONS

Although the proportion of female authors is significantly lower than the proportion of male authors in all six categories of authorship analysed, the proportions of male and female last authors are comparable to their respective proportions as principal investigators in the BRC. These findings suggest positive trends and the NIHR Oxford BRC doing very well in gender parity in the senior (last) authorship category. Male corresponding authors are more likely to publish articles in prestigious journals with high impact factor while both male and female authors at first and last authorship positions publish articles in equally prestigious journals.

Measurement and prognosis of frail patients undergoing transcatheter aortic valve implantation: a systematic review and meta-analysis

OBJECTIVES

Our objectives were to review the literature to identify frailty instruments in use for transcatheter aortic valve implantation (TAVI) recipients and synthesise prognostic data from these studies, in order to inform clinical management of frail patients undergoing TAVI.

METHODS

We systematically reviewed the literature published in 2006 or later. We included studies of patients with aortic stenosis, diagnosed as frail, who underwent a TAVI procedure that reported mortality or clinical outcomes. We categorised the frailty instruments and reported on the prevalence of frailty in each study. We summarised the frequency of clinical outcomes and pooled outcomes from multiple studies. We explored heterogeneity and performed subgroup analysis, where possible. We also used Grading of Recommendations, Assessment, Development and Evaluation (GRADE) to assess the overall certainty of the estimates.

RESULTS

Of 49 included studies, 21 used single-dimension measures to assess frailty, 3 used administrative data-based measures, and 25 used multidimensional measures. Prevalence of frailty ranged from 5.67% to 90.07%. Albumin was the most commonly used single-dimension frailty measure and the Fried or modified Fried phenotype were the most commonly used multidimensional measures. Meta-analyses of studies that used either the Fried or modified Fried phenotype showed a 30-day mortality of 7.86% (95% CI 5.20% to 11.70%) and a 1-year mortality of 26.91% (95% CI 21.50% to 33.11%). The GRADE system suggests very low certainty of the respective estimates.

CONCLUSIONS

Frailty instruments varied across studies, leading to a wide range of frailty prevalence estimates for TAVI recipients and substantial heterogeneity. The results provide clinicians, patients and healthcare administrators, with potentially useful information on the prognosis of frail patients undergoing TAVI. This review highlights the need for standardisation of frailty measurement to promote consistency.

PROSPERO REGISTRATION NUMBER

CRD42018090597.

A practical review of functional neurological disorder (FND) for the general physician

We present a practical overview of functional neurological disorder (FND), its epidemiology, assessment and diagnosis, diagnostic pitfalls, treatment, aetiology and mechanism. We present an update on functional limb weakness, tremor, dystonia and other abnormal movements, dissociative seizures, functional cognitive symptoms and urinary retention, and 'scan-negative' cauda equina syndrome. The diagnosis of FND should rest on clear positive evidence, typically from a combination of physical signs on examination or the nature of seizures. In treatment of FND, clear communication of the diagnosis and the involvement of the multidisciplinary team is beneficial. We recommend that patients with FND are referred to specialists with expertise in neurological diagnosis. FND is a common presentation in emergency and acute medical settings and there are many practical elements to making a positive diagnosis and communication which are useful for all physicians to be familiar with.

Gender gap in medical research: a bibliometric study in Swiss university hospitals

Several studies explored gender inequalities in research, but only limited data are available concerning general internal medicine and family medicine. We aimed to assess the level of gender inequalities in Swiss academic medical research. In this bibliometric study conducted in March 2020, we selected all senior hospital physicians practicing internal medicine or family medicine in the six Swiss university hospitals. The list of these physicians was extracted from the hospitals’ websites. We recorded their socio-demographic characteristics. Then, using Web of Science, we retrieved the number of publications (overall, as first author, per year, per year as first author), the proportion of publications as first author, the number of citations (overall, per year, per publication) and the h-index, and we compared the data by gender. 367 senior physicians were included in the study [female physicians: 172 (47%), internal medicine: 187 (51%)]. Female physicians were four times less likely to be a professor (5% vs. 20%, p value < 0.001) and half as often heads of division or staff physicians (19% vs. 40%, p value < 0.001). The proportion of physicians having published at least one article was lower among women than men (79% vs. 90%, p value 0.003). Finally, all bibliometric indices were associated with male gender (incident rate ratios ranging from 1.9 [(95% CI 1.3–2.8), p value 0.001] for number of citations per publication to 9.3 [(95% CI 5.3–16.2), p value < 0.001] for number of citations), except the proportion of publications as first author that was associated with female gender [odds ratio 1.7 (95% CI 1.2–2.3), p value 0.003). Our data suggest a “leaky pipeline” phenomenon (a lower proportion of women moving up the academic ladder). In addition, with the exception of the proportion of publications as first author, all bibliometric indices were lower for female than male physicians.

Gender Disparities in Authorships of Alzheimer's Disease and Dementia Research Articles

BACKGROUND

Alzheimer's disease and dementia are an increasing burden affecting more than 50 million patients worldwide. Hence, research has increased significantly in recent decades. It is recognized that female authors are systematically underrepresented in research in general.

OBJECTIVE

In this article, we examine gender disparities in academic research on dementia and Alzheimer's disease in the last decade.

METHODS

104,858 male and female authorships from 37,961 original research articles were analyzed. The global and country-specific distribution of women across first, co, and last authorships was determined with the inclusion of a citation and productivity analysis.

RESULTS

42.1% of all authorships and 50.2% of the first, 42.2% of the co, and 32.8% of the last authorships were held by women. Women were less commonly cited, published fewer articles and were also less likely to secure prestigious authorships in articles with multiple authors compared with men. Distinct differences were observed among the countries.

CONCLUSION

Substantial growth in the number of prestigious female authorships has been observed to date and is predicted to continue in the future, with an emphasis on the progressive representation of women and a diminishing gender gap.

Contribution of gender on compensation of Veterans Affairs-affiliated dermatologists: A cross-sectional study

Background

Gender disparity in research funding, leadership, authorship, and compensation in medicine is well documented, with most parameters favoring men over women. Gender differences in salary in dermatology have not been well studied.

Objective

This study aimed to investigate the contribution of gender to dermatologists’ compensation in the Veterans Affairs (VA) health care system.

Methods

A retrospective cross-sectional study was conducted by identifying VA-affiliated dermatologists from the U.S. Department of VA website. The contributions of gender, years since graduation, h-index, academic appointment, race, and region on the publicly available salaries were analyzed using a linear-regression model to isolate the effects of gender and interaction with other variables.

Results

This study included 247 VA dermatologists with publicly available salaries (114 women and 133 men). On univariate analyses, male dermatologists had significantly higher compensation than female dermatologists (p = .0333). However, male dermatologists also had significantly more years since graduation (p < .0001) and higher h-indices (p < .0001). Multivariate analysis showed that gender was not a significant contributor to salary. Instead, years since graduation (p < .0001), h-index (p = .0066), and academic appointment (p < .0001) contributed significantly to VA dermatologists’ salaries. Region and race were not determinants of salary. Gender did not contribute to salary overall, but there was an interactive effect between gender and region (p = .0099). Compared with women, male dermatologists had significantly higher salaries in the Midwest (p < .0018).

Conclusion

Our study revealed that VA hospitals have maintained gender equality in dermatologist compensation nationally, which could serve as a model to close salary gender gaps in other health care systems. Further research should focus on inclusion of VA physicians from different specialties, as well as across multiple years, to further characterize this observation.

Representation of women in pediatric dermatology leadership and research: Trends over the past 45 years

BACKGROUND/OBJECTIVES

The representation of women among practicing dermatologists has increased over the last several decades. Here, we analyze the evolving representation of women in the Society for Pediatric Dermatology (SPD) and the Pediatric Dermatology Research Alliance (PeDRA), with particular focus on the role of women as society leaders, researchers, and annual meeting speakers.

METHODS

A retrospective review of SPD and PeDRA professional society leaders (SPD presidents, PeDRA co-chairs, PeDRA executive committee members), grant recipients (pilot grant recipients, team/collaborative grant recipients, William Weston Research Grant recipients), and annual meeting speakers (named lecturers at the SPD Annual Meeting, plenary lecturers at the PeDRA Annual Conference) was performed. Authors of research articles in Pediatric Dermatology were reviewed at three-year intervals from 1983 through 2019. The percentage of women among all leadership, grant, authorship, and lectureship categories was analyzed over time.

RESULTS

Women have represented 70% of SPD presidents since 2011 and 75% of PeDRA co-chairs since 2013. The percentage of women among first and senior authors of research articles in Pediatric Dermatology increased significantly from 1983 to 2019 (Cochran Armitage test for trend, P < .01), and women earned the majority of SPD/PeDRA pilot project grants (2008-2018), collaborative team grants (2016-2018), and William Weston Research Grants (1995-2015). At SPD Annual meetings from 2010 to 2019, women comprised 44% of named lecturers but accounted for approximately 78% of the pediatric dermatology workforce (P < .01).

CONCLUSION

Despite the widespread influence of women in pediatric dermatology leadership and research, gender discrepancies remain among named lecturer positions at national pediatric dermatology meetings.

Tools to assess the measurement properties of quality of life instruments: a meta-review

OBJECTIVE

This meta-review aims to discuss the methodological, research and practical applications of tools that assess the measurement properties of instruments evaluating health-related quality of life (HRQoL) that have been reported in systematic reviews.

DESIGN

Meta-review.

METHODS

Electronic search from January 2008 to May 2020 was carried out on PubMed, CINAHL, PsycINFO, SCOPUS, WoS, Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) database, Google Scholar and ProQuest Dissertations and Theses.

RESULTS

A total of 246 systematic reviews were assessed. Concerning the quality of the review process, some methodological shortcomings were found, such as poor compliance with reporting or methodological guidelines. Regarding the procedures to assess the quality of measurement properties, 164 (66.6%) of reviewers applied one tool at least. Tool format and structure differed across standards or scientific traditions (ie, psychology, medicine and economics), but most assess both measurement properties and the usability of instruments. As far as the results and conclusions of systematic reviews are concerned, only 68 (27.5%) linked the intended use of the instrument to specific measurement properties (eg, evaluative use to responsiveness).

CONCLUSIONS

The reporting and methodological quality of reviews have increased over time, but there is still room for improvement regarding adherence to guidelines. The COSMIN would be the most widespread and comprehensive tool to assess both the risk of bias of primary studies, and the measurement properties of HRQoL instruments for evaluative purposes. Our analysis of other assessment tools and measurement standards can serve as a starting point for future lines of work on the COSMIN tool, such as considering a more comprehensive evaluation of feasibility, including burden and fairness; expanding its scope for measurement instruments with a different use than evaluative; and improving its assessment of the risk of bias of primary studies.

PROSPERO REGISTRATION NUMBER

CRD42017065232.

Regular strength training and baseline fitness in overweight infantry members of Slovenian Armed Forces

INTRODUCTION

The prevalence of overweight subjects in military cohorts increases despite the obligatory army physical fitness test (APFT) requirements and the negative consequences of possible test failure due to the increased body mass index (BMI). Studies that have examined the association of BMI with baseline fitness in the military are showing conflicting evidence. The primary aim of the study is to examine BMI effects on baseline fitness that was measured by APFT and additional functional performance tests (FT) (vertical countermovement jump with and without load, loaded prone plank, single-leg hamstring bridge test and pull-ups). Our secondary goal is to explore if regular strength training modifies the BMI effect on baseline fitness.

METHODS

A cross-sectional study on a sample of 118 male infantry soldiers that have performed APFT and FT was carried out. Body mass and body height measurements were used to calculate BMI, and to categorise participants into BMI ranks. Two independent categorical variables (BMI rank and strength training) were used to evaluate their influence on dependent variables of physical performance acquired from APFT and FT.

RESULTS

A significantly large size effect of BMI rank (F=1.69, p=0.037; effect size (ES)=0.15) and regular strength training (F=2.66, p=0.006; ES=0.21) on physical performance was found. It was shown that strength training had a medium ES on push-up and pull-up performance, as well as on the overall APFT score and loaded plank.

CONCLUSIONS

The importance of regular strength training and normal BMI for better overall baseline fitness in infantry members was highlighted. Most importantly, it was shown that performance is not affected in overweight soldiers who are performing regular strength training in addition to their daily physical training.

TRIAL REGISTRATION NUMBER

NCT03415464.

Gender and race trends in academic rank of dermatologists at top U.S. institutions: A cross-sectional study

Background

Despite growth in the proportion of women and underrepresented minorities in the dermatology workforce, gender and racial differences persist.

Objective

This study sought to analyze the differences in academic rank between genders and races while controlling for achievement indicators.

Methods

Data from 15 institutions, selected based on residency program rankings, were analyzed.

Results

Women were well-represented as assistant professors (60.7% vs. 37.6% of men; p < .001) and underrepresented as full professors (17.0% vs. 37.6%; p < .001). However, in a multivariable analysis controlling for career duration, publications per year, National Institutes of Health funding, and PhD degrees, neither gender (adjusted odds ratio [aOR]: 1.01; confidence interval [CI], 0.55-2.73) nor race (aOR: 1.24; CI, 0.53-2.92) was associated with a higher academic rank. Career duration (aOR: 1.24; CI, 1.18-1.30), publications per year (aOR: 1.48; CI, 1.28-1.74), and National Institutes of Health research funding (aOR: 4.29; CI, 1.53-12.88) were predictive of higher academic rank.

Conclusion

Our findings confirm that for equal levels of achievement, men and women are promoted similarly in dermatology, yet reasons for disparity in research output and funding for women and minority dermatologists need further study.

Determinants of overweight/obesity among reproductive age group women in Ethiopia: multilevel analysis of Ethiopian demographic and health survey

OBJECTIVE

Overweight/obesity among women is associated with an increased risk of gestational diabetes, pre-eclampsia, postpartum haemorrhage, low birth weight, congenital malformation and neonatal deaths. Although the magnitude of overweight and obesity among the reproductive age group women is a common problem in Ethiopia, there are limited studies that determine the associated factors of overweight and obesity at the national level. Therefore, this study aimed to identify the determinant factors of overweight/obesity among reproductive age group women in Ethiopia.

DESIGN

Cross-sectional study design.

SETTING

Ethiopia.

PARTICIPANTS

Non-pregnant women aged 15-49 years.

PRIMARY OUTCOME

Overweight/obesity.

METHODS

The present study used the Ethiopia Demographic Health Survey (EDHS) data for 2016. A total of 10 938 non-pregnant reproductive age group women were included in the analysis. Both bivariable and multivariable multilevel logistic regression were performed to determine the determinants of overweight and obesity among women in Ethiopia. The OR with a 95% CI was estimated for potential determinants included in the final model.

RESULTS

Those women with secondary education (adjusted OR (AOR)=1.48, 1.01, 2.18), higher education (AOR=1.78, 1.13, 2.81), richer (AOR=1.85, 1.15, 2.98) and richest wealth index (AOR=3.23, 1.98, 5.29), urban residence (AOR=4.46, 2.89, 6.87), married (AOR=1.79, 1.21, 2.64), widowed (AOR=2.42, 1.41, 4.15), divorced (AOR=1.84, 1.13, 3.00), aged 25-34 years (AOR=2.04, 1.43, 2.89), 35-44 years (AOR=2.79, 1.99, 3.93) and 45-49 years (AOR=2.62, 1.54, 4.45) had higher odds of developing overweight and obesity.

CONCLUSION

Women with higher education level, high wealth status, older age, formerly married and those urban dwellers had higher odds of overweight and obesity. Therefore, regular physical activity, reducing consumption of fat/energy-dense food as well as modifying the mode of transportation is recommended.

ERS International Congress, Madrid, 2019: highlights from the Respiratory Intensive Care Assembly

The Respiratory Intensive Care Assembly of the European Respiratory Society is delighted to present the highlights from the 2019 International Congress in Madrid, Spain. We have selected four sessions that discussed recent advances in a wide range of topics: from acute respiratory failure to cough augmentation in neuromuscular disorders and from extra-corporeal life support to difficult ventilator weaning. The subjects are summarised by early career members in close collaboration with the Assembly leadership. We aim to give the reader an update on the most important developments discussed at the conference. Each session is further summarised into a short list of take-home messages.

Representation of women as editors in dermatology journals: A comprehensive review

BACKGROUND

Despite a substantial increase in the number of women matriculating into medical school, a gender gap still exists with respect to academic leadership positions. This gap is apparent in the field of dermatology, particularly in the composition of dermatology journal editorial boards. To address this gap, we must first acknowledge its existence, examine potential reasons for its existence, and propose strategies to narrow the gap.

OBJECTIVE

Our objective is to determine the representation of women as editors in dermatology journals.

METHODS

A comprehensive search was performed for dermatology journals indexed in Medline, Journal Citation Reports, Scopus, and Embase in August, September, and October 2018. The editorial board of each journal was analyzed for the number and percentage of male and female editors in four different positions. We verified the accuracy of editorial boards listed on publisher websites by emailing administrative personnel. We also recorded the number of years from terminal degree for editorial board members of the 10 journals with the highest impact factors using SCImago Journal Rankings.

RESULTS

Women occupied 18% of editor-in-chief positions, 36% of deputy editor roles, 22% of overall editorial board positions, and 22% of other board roles. The average number of years since terminal degree was not statistically different between women and men, with women averaging 30.2 years and men averaging 28.0 years since completion of terminal degree (p = .27).

CONCLUSIONS

Our findings suggest that women are underrepresented as editors at all levels in dermatology journals. This supports prior findings reporting a minority of women in academic leadership roles. Thus, although women have made major advancements in the medical field over the past century, there remains room for progress with regard to equal representation in academic leadership roles, including editorial positions, professorships, and department chair roles.

[Bibliometric analysis of female authorship in original articles in the journal ATENCIÓN PRIMARIA]

OBJECTIVES

To determine the percentage of female authors in original articles published during 2periods, in the journal of Atención Primaria (Primary Care), and to examine the differences between the categories of authorship (first, last author, and co-author) between both periods.

DESIGN

Cross-sectional study.

SETTING

Feminine scientific production published during the periods 2007-2008 and 2017-2018.

PARTICIPANTS

The study was focused on original articles.

MAIN MEASUREMENTS

The following variables were collected in an ad hoc form: gender based on the name of the author, total number of women and men appearing as authors, and order of authorship. Absolute and relative authorship frequencies were calculated, and the χ² test was used to examine the evolution of the percentages by type of authorship and gender.

RESULTS

A total of 108 articles were analysed in 2007-2008, and 100 in 2017-2018. No statistically significant differences were observed between the mean numbers of women authors within and between periods. In 2007-2008 a total of 548 female authors were identified and 540 in 2017-2018, the percentage of female authors was 48.7% and 54.4%, respectively. Only an increase in the percentage of first authors was observed between periods.

CONCLUSIONS

Practically one out of every 2authors of original articles published in the journal Atención Primaria was female. There was also a significant increase in the percentage of female first authors between the 2periods. Nevertheless, and despite the greater number of health workers, the number of latest female authors remain unchanged, which points to the persistence of female under-representation.

Sex Disparities in Ophthalmic Research: A Descriptive Bibliometric Study on Scientific Authorships

Importance

Previous studies examined sex distributions in different medical faculties, especially because increasingly more women entered the medical field in recent decades. Little is known at present about the female representation in ophthalmic research.

Objective

To clarify sex equalities in ophthalmic research by evaluating the representation of female authorships.

Design and Setting

This bibliometric analysis included original English-language articles published in ophthalmologic journals indexed in the Web of Science from January 2008 to August 2018. Authorships were assigned by sex according to first name.

Main Outcomes and Measures

Outcomes included the proportion of female authorships, odds ratios of women holding prestigious first and last authorships compared with men (measured by the prestige index), citation rates, a productivity analysis, and cross-journal and transnational female representation within ophthalmic research. The hypothesis was formulated during data collection.

Results

Bibliometric data were abstracted from 87 640 original articles published in 248 ophthalmologic journals. Of 344 433 total authorships, female scholars held 34.9% (120 305 of 344 433) of all authorships, 37.1% (24 924 of 67 226) of first authorships, 36.7% (77 295 of 210 372) of coauthorships, and 27.1% (18 086 of 66 835) of last authorships. The female-to-male odds ratio was 1.12 (95% CI, 1.10-1.14) for first authorships, 1.20 (95% CI, 1.18-1.22) for coauthorships, and 0.63 (95% CI, 0.62-0.64) for last authorships, with annual growth rates of 1.6% overall, 1.6% for first authorships, 1.3% for coauthorships, and 2.5% for last authorships. Women were underrepresented in prestigious authorships (prestige index = -0.22). The underrepresentation remains almost stable for articles with many authors (prestige index = -0.17 for articles with >9 authors per article). Articles with female key authors were cited slightly less frequently (95% CI for female vs male authors, 10.8-11.0 vs 11.5-11.7 citations/articles). Women published fewer papers than men (42.5% [n = 41 383]; women held 34.9% [n = 120 207] of the authorships), show cross-journal uniformity and differences among single countries (change in prestige index = 0.66 vs 1.96). Overall, 44.1% of female authorships and a sex-neutral distribution of prestigious authorships are prognosticated for 2028.

Conclusions and Relevance

This algorithm analysis suggests the integration of women into ophthalmic research is average compared with other disciplines. A sex-specific gap exists for last authorship, suggesting career inequalities. With a growing number of female researchers in ophthalmology, the number of women in senior ranks may increase in the future.

Gender Disparities in Invited Commentary Authorship in 2459 Medical Journals

Importance

In peer-reviewed medical journals, authoring an invited commentary on an original article is a recognition of expertise. It has been documented that women author fewer invited publications than men do. However, it is unknown whether this disparity is due to gender differences in characteristics that are associated with invitations, such as field of expertise, seniority, and scientific output.

Objective

To estimate the odds ratio (OR) of authoring an invited commentary for women compared with men who had similar expertise, seniority, and publication metrics.

Design, Setting, and Participants

This matched case-control study included all medical invited commentaries published from January 1, 2013, through December 31, 2017, in English-language medical journals and multidisciplinary journals. Invited commentaries were defined as publications that cite another publication within the same journal volume and issue. Bibliometric data were obtained from Scopus. Cases were defined as corresponding authors of invited commentaries in a given journal during the study period. Controls were matched to cases based on scientific expertise by calculating a similarity index for abstracts published during the same period using natural language processing. Data analyses were conducted from March 13, 2019, through May 3, 2019.

Exposure

Corresponding or sole author gender was predicted from author first name and country of origin using genderize.io.

Main Outcomes and Measures

The OR for gender was estimated after adjusting for field of expertise, publication output, citation impact, and years active (ie, years since first publication), with an interaction between gender and years active.

Results

The final data set included 43 235 cases across 2549 journals; there were 34 047 unique intraciting commentary authors, among whom 9072 (26.6%) were women. For researchers who had been active for the median of 19 years, the odds of invited commentary authorship were 21% lower for women (OR, 0.79 [95% CI, 0.77-0.81]; P < .001) compared with men who had similar scientific expertise, number of publications, and citation impact. For every decile increase in years active, the OR decreased by a factor of 0.97 (95% CI, 0.96-0.98; P < .001).

Conclusions and Relevance

In this case-control study, women had lower odds of authoring invited commentaries than their male peers. This disparity was larger for senior researchers. Journal editors could use natural language processing of published research to widen and diversify the pool of experts considered for commentary invitations.