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2.
BMJ ; 375: n2381, 2021 10 06.
Artigo em Inglês | MEDLINE | ID: mdl-34615644
4.
Nutrients ; 13(7)2021 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-34371825

RESUMO

The coronavirus pandemic enforced social restrictions with abrupt impacts on mental health and changes to health behaviors. From a randomized clinical trial, we assessed the impact of culinary education on home cooking practices, coping strategies and resiliency during the first wave of the COVID-19 pandemic (March/April 2020). Participants (n = 28) were aged 25-70 years with a BMI of 27.5-35 kg/m2. The intervention consisted of 12 weekly 30-min one-on-one telemedicine culinary coaching sessions. Coping strategies were assessed through the Brief Coping with Problems Experienced Inventory, and resiliency using the Brief Resilient Coping Scale. Home cooking practices were assessed through qualitative analysis. The average use of self-care as a coping strategy by the intervention group was 6.14 (1.66), compared to the control with 4.64 (1.69); p = 0.03. While more intervention participants had high (n = 5) and medium (n = 8) resiliency compared to controls (n = 4, n = 6, respectively), this difference was not significant (p = 0.33). Intervention participants reported using home cooking skills such as meal planning and time saving techniques during the pandemic. The key findings were that culinary coaching via telemedicine may be an effective intervention for teaching home cooking skills and promoting the use of self-care as a coping strategy during times of stress, including the COVID-19 pandemic.


Assuntos
Adaptação Psicológica , COVID-19/psicologia , Culinária , Educação à Distância/métodos , Ajustamento Emocional , Educação de Pacientes como Assunto/métodos , Culinária/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/terapia , Testes Psicológicos , Resiliência Psicológica , Inquéritos e Questionários
8.
PM R ; 2021 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-33886159

RESUMO

INTRODUCTION: Representativeness of research populations impacts the ability to extrapolate findings. The Burn Model System (BMS) National Database is one of the largest prospective, longitudinal, multi-center research repositories collecting patient-reported outcomes after burn injury. OBJECTIVE: To assess if the BMS Database is representative of the population that is eligible to participate. DESIGN: Data on adult burn survivors who were eligible for the BMS Database from 2015 to 2019 were analyzed. SETTING: Not applicable. PARTICIPANTS: Burn survivors treated at BMS centers meeting eligibility criteria for the BMS Database. Eligibility for the database is based on burn size and receipt of autografting surgery. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE(S): Race, ethnicity, gender, and age were compared between individuals who did and did not enroll. Regression analysis examined the correlation between demographic characteristics and study enrollment. Additional regression analysis examined the association between enrollment and the intersection of race, ethnicity, and gender. RESULTS: A total of 982 adult burn survivors were eligible for the BMS database during the study period. Of those who were eligible, 72.1% Enrolled and 27.9% were Not Enrolled. The Enrolled group included more female and more younger survivors compared to the Not Enrolled group. In regression analyses, Black/African American burn survivors were less likely and individuals identifying as female were more likely to enroll in the BMS Database. Furthermore, White men and women were more likely to enroll compared to Black/African American men and women, and non-Hispanic/Latino men were more likely to enroll compared to Hispanic/Latino men. CONCLUSIONS: This study found differences in BMS Database enrollment by race, ethnicity, and gender. Further research is warranted to investigate causes for the disparities found in this study. In addition, strategies are needed to improve enrollment to ensure future representativeness.

10.
BMJ Open Sport Exerc Med ; 7(1): e001028, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33680501

RESUMO

Objective: To investigate which factors, from demographics to work-life integration, are associated with burnout symptoms among self-declared active women physicians practising in the USA. Methods: Cross-sectional study of those actively engaged in a social media group for women physician runners. Electronically surveyed using 60 questions covering demographics, compensation, debt and domestic responsibilities with burnout assessed by the Mini-Z Burnout Survey. Results: Of the 369 women meeting inclusion criteria as attending physicians practising in the USA, the majority reported being White (74.5%) and at least 6 years out from training (85.9%). There was a significant association of increased burnout level with working more hours per week and being responsible for a greater percentage of domestic duties (p<0.0001 and p=0.003, respectively). Both factors remained significant in a multivariable model (p<0.0001). Conclusion: By exploring burnout in the physically active, we are better able to investigate contributors to burnout despite healthy exercise habits. Increased burnout was significantly associated with greater domestic responsibility and hours working. These findings in women physician runners suggest that exercise alone may not control burnout. Poor work-life integration deserves attention as a burnout contributor in women physicians, potentially serving as a target for burnout prevention strategies.

13.
Am J Phys Med Rehabil ; 100(6): 546-554, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-33782277

RESUMO

OBJECTIVE: Our objective was to investigate whether women, people 65 yrs and older, or individuals who identify with racial and/or ethnic minority groups, were underrepresented among participants in rehabilitation clinical trials. DESIGN: This is a cross-sectional study of completed rehabilitation clinical trials investigating the number and percentage of women, older adults, and racial and/or ethnic minorities enrolled in rehabilitation clinical trials between January 1, 2011, and January 1, 2020. Secondary outcome measures were inclusion by diagnostic group, as well as International Classification of Functioning, Disability and Health category, and intervention by diagnostic group. RESULTS: Of the 108 studies meeting inclusion criteria, a majority (69%) were based in the United States. Stroke was the most frequent diagnostic group, followed by musculoskeletal conditions. Ninety-six percent of the United States-based trials included at least one female participant in their study, but among specific diagnostic groups, this ranged from 5% to 73%. Age information was reported inconsistently; however, of the trials reporting age, 100% of cardiac trials included older adults, whereas no spinal cord injury (SCI) trials included them. Among trials based in the United States reporting race, 70% of participants were White, followed by 20% Black or African American and 1% Asian. Among trials based in the United States reporting ethnicity, Hispanic or Latino participants were underrepresented overall and among each diagnostic group. CONCLUSIONS: In this study, we found that among participants of rehabilitation clinical trials women, older individuals, and racial/ethnic minorities were generally underrepresented. In contrast, Black or African American participants were overrepresented with the exception of cardiac trials. An important finding was that many trials did not report age and/or race/ethnicity. Investigators should aim to include underrepresented populations and improve reporting.


Assuntos
Grupos de Populações Continentais , Grupos Étnicos , Grupos Minoritários , Seleção de Pacientes , Reabilitação , Projetos de Pesquisa , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Ensaios Clínicos como Assunto , Estudos Transversais , Feminino , Humanos , Fatores Sexuais
14.
Artigo em Inglês | MEDLINE | ID: mdl-33626311

RESUMO

Background: Gender disparities in academic promotion and leadership are well documented. Scholarly impact is essential for promotion. The Hirsch-index (h-index) is a measure of impact using number of publications and citations. We sought to (i) evaluate breast surgery fellowship faculty in North America by academic rank and research impact using the h-index, (ii) determine whether there is a gender difference in scholarly productivity, and (iii) determine the relationship between academic rank, h-index, and gender. Materials and Methods: A retrospective cross-sectional study of h-index and academic rank disparity in breast surgery faculty by gender was performed. We reviewed the faculty of Society of Surgical Oncology-accredited breast surgery fellowships in February 2019. Rank, gender, academic appointment, years in practice, program directorship, National Cancer Institute-designated cancer center association, size of the program, and h-index (via Scopus) were recorded. Univariate and multiple linear regression analyses were performed. Results: Fifty-two programs were identified, and 209 faculty had an h-index. Of them, 69.9% were women and 30.1% were men. h-index increased with academic rank although there was considerable overlap between ranks. Women were underrepresented at the professor level (46.4%), but accounted for the majority of assistant professors (91.5%, p < 0.001), and program directors (70.7%). Men professors had a significantly higher mean h-index than women professors, p < 0.001. However, women associate professors had a higher mean h-index than men, but this did not reach significance. Conclusions: Mean h-index increased with increasing rank among breast surgery faculty for both genders. Average h-index was significantly higher for men professors compared to women professors. No significant gender difference in h-index was found for assistant professors. For associate professors, h-index for women was higher than for men. Women are underrepresented at higher academic ranks despite forming the majority of breast surgical teaching faculty.

15.
Am J Phys Med Rehabil ; 100(1): 100-104, 2021 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-33534219

RESUMO

ABSTRACT: The incidence of leptomeningeal disease (LMD) is believed to be increasing in part because of more effective chemotherapy treatments allowing cancer progression behind the blood-brain barrier. However, little has been published about the rehabilitation of this growing patient population. In this study, impairments and rehabilitation utilization by cytology-proven LMD patients receiving intrathecal chemotherapy at a cancer center are described. A total of 109 consecutive patients with pathology-confirmed LMD who received an intrathecal chemotherapy infusion from January 1, 2017, through October 31, 2017, were retrospectively reviewed. Of the 109 patients, 103 (95%) had impairments described in their medical record that could impact physical function, including 74 of 109 (68%) who had deconditioning or fatigue. Kaplan-Meier median survival from initial LMD diagnosis was 13.1 mos. The median number of hospital admissions and intrathecal chemotherapy administrations was both 8. Of the 109 patients, 43 (39%) had magnetic resonance imaging radiology interpreted LMD. Most LMD patients used rehabilitation services (95/109, 87%) and most were able to forego post-acute inpatient rehabilitation facilities (96/109, 88%). Additional research and education for rehabilitation professionals about this increasingly common syndrome are needed.


Assuntos
Neoplasias Encefálicas/reabilitação , Fadiga/reabilitação , Neoplasias Meníngeas/reabilitação , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Encefálicas/complicações , Neoplasias Encefálicas/tratamento farmacológico , Fadiga/etiologia , Feminino , Humanos , Injeções Espinhais , Masculino , Neoplasias Meníngeas/complicações , Neoplasias Meníngeas/tratamento farmacológico , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos
16.
JAMA Netw Open ; 4(2): e2037640, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33606033

RESUMO

Importance: Medical research has not equitably included members of racial/ethnic minority groups or female and older individuals. There are limited data on participant demographic characteristics in vaccine trials despite the importance of these data to current trials aimed at preventing coronavirus disease 2019. Objective: To investigate whether racial/ethnic minority groups and female and older adults are underrepresented among participants in vaccine clinical trials. Design, Setting, and Participants: This cross-sectional study examined data from completed US-based vaccine trials registered on ClinicalTrials.gov from July 1, 2011, through June 30, 2020. The terms vaccine, vaccination, immunization, and inoculation were used to identify trials. Only those addressing vaccine immunogenicity or efficacy of preventative vaccines were included. Main Outcomes and Measures: The numbers and percentages of racial/ethnic minority, female, and older individuals compared with US census data from 2011 and 2018. Secondary outcome measures were inclusion by trial phase and year of completion. Results: A total of 230 US-based trials with 219 555 participants were included in the study. Most trials were randomized (180 [78.3%]), included viral vaccinations (159 [69.1%]), and represented all trial phases. Every trial reported age and sex; 134 (58.3%) reported race and 79 (34.3%) reported ethnicity. Overall, among adult study participants, White individuals were overrepresented (77.9%; 95% CI, 77.4%-78.4%), and Black or African American individuals (10.6%; 95% CI, 10.2%-11.0%) and American Indian or Alaska Native individuals (0.4%; 95% CI, 0.3%-0.5%) were underrepresented compared with US census data; enrollment of Asian individuals was similar (5.7%; 95% CI, 5.5%-6.0%). Enrollment of Hispanic or Latino individuals (11.6%; 95% CI, 11.1%-12.0%) was also low even among the limited number of adult trials reporting ethnicity. Adult trials were composed of more female participants (75 325 [56.0%]), but among those reporting age as a percentage, enrollment of participants who were aged 65 years or older was low (12.1%; 95% CI, 12.0%-12.3%). Black or African American participants (10.1%; 95% CI, 9.7%-10.6%) and Hispanic or Latino participants (22.5%; 95% CI, 21.6%-23.4%) were also underrepresented in pediatric trials. Among trials reporting race/ethnicity, 65 (48.5%) did not include American Indian or Alaska Native participants and 81 (60.4%) did not include Hawaiian or Pacific Islander participants. Conclusions and Relevance: This cross-sectional study found that among US-based vaccine clinical trials, members of racial/ethnic minority groups and older adults were underrepresented, whereas female adults were overrepresented. These findings suggest that diversity enrollment targets should be included for all vaccine trials targeting epidemiologically important infections.


Assuntos
Ensaios Clínicos como Assunto/normas , Grupos Étnicos/estatística & dados numéricos , Seleção de Pacientes , Sexismo/estatística & dados numéricos , Vacinas , Adulto , Grupo com Ancestrais do Continente Africano/etnologia , Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Grupo com Ancestrais do Continente Asiático/etnologia , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Ensaios Clínicos como Assunto/estatística & dados numéricos , Grupos de Populações Continentais/etnologia , Grupos de Populações Continentais/estatística & dados numéricos , Estudos Transversais , Grupo com Ancestrais do Continente Europeu/etnologia , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Grupo com Ancestrais Oceânicos/etnologia , Grupo com Ancestrais Oceânicos/estatística & dados numéricos , Sexismo/etnologia
17.
Am J Phys Med Rehabil ; 100(10): 996-1002, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-33433114

RESUMO

ABSTRACT: This study evaluated Women Physiatry Facebook group members' perceptions of the value of an online community. The authors hypothesized that members would find the group protective against burnout, and early career participants would be more likely to use the group for education and networking. This was a cross-sectional survey study of women physicians in the field of physical medicine and rehabilitation primarily in the United States. The survey consisted of 51 questions covering demographic information, work/life satisfaction, and physician burnout.There were 310 respondents. Those at an earlier career stage accessed the Women Physiatrists Facebook page significantly more often (P = 0.038). Most respondents were neutral regarding the group reducing burnout. Across all career stages, the group was most often used as an educational tool to review patient cases (82.2%). Mid- to late-career members were more likely to use the group to learn about maintenance of certification or continuing medical education requirements (P = 0.019) and searching for a physiatrist in another part of the county (P = 0.016). This study suggests that closed Facebook groups can be useful educational tools across career stages.


Assuntos
Esgotamento Profissional/prevenção & controle , Fisiatras , Médicas , Mídias Sociais , Apoio Social , Estudos Transversais , Feminino , Humanos , Inquéritos e Questionários , Estados Unidos
18.
J Womens Health (Larchmt) ; 30(8): 1095-1106, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33497583

RESUMO

Background: The Council of Faculty and Academic Societies (CFAS) comprises representatives from medical schools and professional societies who guide the Association of American Medical Colleges (AAMC). Given the AAMC's stated mission to improve diversity and inclusion, we used gender-related representation on journal editorial boards as a proxy for evaluating CFAS member societies' commitments to equity. Methods: From screenshots of journal mastheads (n = 44) collected June 3-6, 2019, individuals were categorized by editorial position. Outcome measures included numbers of men and women among faculty, deans, department chairs, physicians, and nonphysicians on editorial boards. Outcomes were compared with 2018 AAMC and US Bureau of Labor Statistics workforce data. Results: Overall, the proportion of women among journal editors was 29.0% (364 of 1,255), range 0%-53.3%. This proportion was significantly less than the proportion of women among US medical school faculty and medical scientists. The lowest percentages of women were found among journals' section or topic editors (19.2%) and editors-in-chief (20.4%). Men were significantly more likely to be a professor or department chair and women were significantly more likely to be an associate professor or assistant professor, suggesting a bidirectional process between rank and editorial position that may inhibit the advancement of academic women, particularly women physicians. Conclusions: This study revealed disparities in the equitable representation of women among CFAS member-affiliated journal editors. Because CFAS member societies participate in a mutually beneficial relationship with the AAMC, they should strive to attain the equity goals set forth by the AAMC.


Assuntos
Médicas , Docentes de Medicina , Feminino , Humanos , Masculino , Faculdades de Medicina , Sociedades Médicas , Estados Unidos , Recursos Humanos
19.
J Womens Health (Larchmt) ; 30(10): 1508-1518, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-33434440

RESUMO

Background: Recognition awards from professional medical societies play an important role in physicians' career advancement. Our aim was to evaluate the gender representation of award recipients from gastroenterology and hepatology societies. Methods: We analyzed the lists of award recipients from the American Association for the Study of Liver Diseases, American College of Gastroenterology, American Gastroenterological Association, and American Society for Gastrointestinal Endoscopy and determined the gender of these award recipients. The primary outcome was the overall representation of women physician award recipients as compared with the representation of women in the specialty. Results: Between 1941 and 2019, there were 921 awards, of which 77 (8.4%) were given to women and 844 (91.6%) to men. There was a significant increase in the proportion of women recipients over time, from 0% in 1970-1984 to 22.0% in 2015-2019 (p for trend <0.0001). Compared with the concurrent representation of women in the specialty, women physician recipients were underrepresented from 1970 to 1981 and 1984 to 2015, equitably represented from 1981 to 1984, and overrepresented from 2015 to 2019. Of the total number of awards in each category, women received 13.8% of teaching/mentorship awards and 3.8% of the highest achievement awards (p = 0.002). The proportion of women recipients varied among the societies, from 6.8% to 14.5%. Conclusions: The representation of women physician recipients of gastroenterology and hepatology society recognition awards has generally been low until most recently, when it has surpassed the proportion of women in the specialty. Because award recognition is important to career development, professional societies should have transparent processes that aim to identify and reduce various forms of bias, including gender-related bias, in all phases of award recognition.


Assuntos
Distinções e Prêmios , Gastroenterologia , Médicas , Feminino , Humanos , Masculino , Sexismo , Sociedades Médicas , Estados Unidos
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