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1.
Artigo em Inglês | MEDLINE | ID: mdl-36231264

RESUMO

Since 2017, San Francisco's Paid Parental Leave Ordinance (PPLO) has allowed parents who work for private-sector employers to take 6 weeks of fully paid postnatal parental leave. Previous studies have linked paid parental leave with health improvements for birthing people and babies, although evidence for birth outcomes is limited. We hypothesized that the PPLO may have improved birth outcomes via reduced stress during pregnancy due to anticipation of increased financial security and postnatal leave. We used linked California birth certificate and hospital discharge records from January 2013 to December 2018 (n = 1,420,781). We used quasi-experimental difference-in-difference (DD) models to compare outcomes among SF births before and after PPLO to outcomes among births in control counties. Births from January 2017 through December 2018 among working San Francisco (SF) people were considered "exposed" to PPLO; births during this time among working people outside of SF, as well as all births before 2017, served as controls. We conducted subgroup analyses by race/ethnicity, education and Medicaid coverage at delivery. Overall analyses adjusting for covariates and indicators for time and seasonality indicated no association between PPLO and birth outcomes. Our results indicate that PPLO may not have affected the birth outcomes we examined among marginalized groups who, due to structural racism, are at heightened risk of poor outcomes. We speculate that this result is due to the PPLO's design and focus on postnatal leave. Future work should examine the policy's effects on other outcomes.


Assuntos
Licença Parental , Salários e Benefícios , Emprego , Etnicidade , Feminino , Humanos , Lactente , Gravidez , São Francisco , Estados Unidos
3.
J Paediatr Child Health ; 58(11): 2068-2075, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36054633

RESUMO

AIM: Parents of preterm or sick infants are at increased risk of mental health problems. The financial stress associated with an infant's prolonged hospital stay can have an additional negative effect on families' wellbeing and child development. This study explores parent use of Australian paid parental leave (PPL) and the financial impact of having an infant requiring neonatal care. METHODS: Retrospective, cross-sectional, online survey study conducted from November 2020 to February 2021. Participants were parents of babies born from 1 January 2013, admitted to a neonatal intensive care unit or special care nursery in Australia. The survey explored use of Australian Government and private sector PPL, and financial stress. Parent-reported anxiety and depression were measured using the EuroQol Group 5D-5L Anxiety and Stress Subscale. RESULTS: Two hundred and thirty-one parents responded of which 93% had a preterm infant. Seventy-three percent of infants were hospitalised for more than 1 month, and 34% were readmitted to hospital within the first year following discharge home. Eighty-three percent of parents reported moderate, severe or extreme levels of anxiety or depression. Seventy-six percent reported that having a child in hospital had a moderate-very large financial impact on their family. Parents identified main costs to be travel, food, inability to work and direct medical costs. CONCLUSIONS: Having an infant born preterm or sick has significant emotional and financial implications for families. The current Australian Government PPL scheme does not adequately support parents of preterm or sick infants, and a change is urgently needed to improve outcomes for this vulnerable population.


Assuntos
Recém-Nascido Prematuro , Licença Parental , Lactente , Criança , Recém-Nascido , Humanos , Recém-Nascido Prematuro/psicologia , Estudos Transversais , Estudos Retrospectivos , Austrália , Pais/psicologia , Unidades de Terapia Intensiva Neonatal
4.
Plast Reconstr Surg ; 150(5): 1160-1168, 2022 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-36067473

RESUMO

BACKGROUND: Forty percent of physicians anticipate becoming parents during residency. This often occurs in the absence of clear parental leave and breastfeeding policies, which may adversely impact parental and child health or jeopardize residents' board eligibility, fellowship, and job prospects. This study reports on the current status of parental leave and breastfeeding policies across all specialties. METHODS: Twenty-six specialties recognized by the Accreditation Council for Graduate Medical Education were included. The maximum leave allowed in 2020 and breastfeeding accommodations during board examinations were collected for each specialty. Change in leave since 2006, 2018, and breastfeeding accommodations were analyzed by specialty. RESULTS: In 2020, the median time allowed for parental leave without the extension of training was 5 weeks, and there was no significant difference between 2006, 2018, and 2020 ( p = 0.58). In 2020, plastic surgery and obstetrics/gynecology provided the longest parental leave at 12 weeks. Surgical specialties provided 1 additional week of leave as compared to medical specialties after adjusting for year ( p = 0.02). Twenty-one specialties (81 percent) allowed additional time for lactation during board examinations; however, only seven (27 percent) guaranteed a private location to pump. CONCLUSIONS: There has been little improvement in parental leave allowances since 2006, and the current median, 5 weeks, falls short of guidelines recommending 6 to 12 weeks following the birth of a child. Starting in July of 2021, the Accreditation Council for Graduate Medical Education will require medical boards to provide a minimum of 6 weeks of leave. Ongoing improvement in culture and policy are needed to support residents and their families.


Assuntos
Ginecologia , Internato e Residência , Medicina , Cirurgia Plástica , Gravidez , Feminino , Criança , Humanos , Licença Parental , Ginecologia/educação , Cirurgia Plástica/educação , Educação de Pós-Graduação em Medicina , Políticas , Pais
5.
JAMA Ophthalmol ; 140(11): 1066-1075, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-36173610

RESUMO

Importance: Although parental leave is essential in enhancing resident wellness and fostering inclusive workplace environments, residents may often feel discouraged from using parental leave owing to perceived stigma and concerns about possible negative effects on their training. Objective: To examine parental leave usage across multiple institutions and compare residency performance metrics between residents who took parental leave vs their peers who did not take leave. Design, Setting, and Participants: This was a retrospective cross-sectional analysis conducted from April 1, 2020, to July 28, 2022, of educational records. Multicenter data were obtained from 10 Accreditation Council for Graduate Medical Education (ACGME)-accredited ophthalmology programs across the US. Included ophthalmology residents graduated between 2015 and 2019. Data were analyzed from August 15, 2021, to July 25, 2022. Exposures: Performance metrics of residents who used parental leave during residency were compared with those of residents who did not take parental leave. Main Outcomes and Measures: Measures of performance included the Ophthalmic Knowledge Assessment Program (OKAP) scores, ACGME milestones scores, board examination pass rates, research activity, and surgical volumes. Results: Of the 283 ophthalmology residents (149 male [52.7%]) included in the study, 44 (15.5%) took a median (IQR) parental leave of 4.5 (2-6) weeks. There were no differences in average OKAP percentiles, research activity, average ACGME milestones scores, or surgical volume between residents who took parental leave and those who did not. Residents who pursued fellowship were less likely to have taken parental leave (odds ratio [OR], 0.43; 95% CI, 0.27-0.68; P < .001), and residents who practiced in private settings after residency were more likely to have taken parental leave (OR, 3.56; 95% CI, 1.79-7.08; P < .001). When stratified by sex, no differences were identified in performance between female residents who took parental leave compared with residents who did not take leave, except a mild surgical number difference in 1 subspecialty category of keratorefractive procedures (difference in median values, -2; 95% CI, -3.7 to -0.3; P = .03). Conclusions and Relevance: In this multicenter cross-sectional study, no differences in performance metrics were identified between residents taking parental leave compared with their peers. These findings may provide reassurance to trainees and program directors regarding the unlikelihood, on average, that taking adequate parental leave will affect performance metrics adversely.


Assuntos
Internato e Residência , Oftalmologia , Médicos , Masculino , Feminino , Humanos , Estados Unidos , Oftalmologia/educação , Estudos Transversais , Licença Parental , Estudos Retrospectivos , Educação de Pós-Graduação em Medicina
8.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-49139

RESUMO

A convidada do podcast especial sobre amamentação da revista Residência Pediátrica (RP) é a dra. Rosa Negri, do Departamento Científico de Aleitamento Materno da Sociedade Brasileira de Pediatria (SBP). Na nova edição, ela aborda os desafios e orientações sobre “o fim da licença-maternidade”.


Assuntos
Aleitamento Materno , Licença Parental
9.
J Hosp Med ; 17(8): 609-623, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35855539

RESUMO

BACKGROUND: Residents and fellows with children face distinct challenges; however, knowledge of factors associated with increased parental stress is limited. OBJECTIVE: This study aimed to investigate experiences and concerns of physician trainees and identify factors associated with higher parental stress. METHODS: An anonymous survey was distributed to all resident and fellow trainees in June 2021 to assess experiences regarding parental leave, breastfeeding, and childcare. We used the Parental Stress Scale (PSS) to identify the factors associated with stress and analyzed the results using descriptive statistics, linear regression, and thematic analysis. RESULTS: Of 1719 trainees, 509 participated (62% women, 30% response rate); half were parents. One-third of the respondents (152/470) said that childcare costs affected the number of children they plan to have; One-third of respondents (152/470) said that childcare costs affected the number of children they plan to have; 45% (210/470) said childcare costs affected when they plan to have children. Among parents, the mean PSS score was 44.3 ± 12.3, with no significant gender differences. More women identified as primary or coprimary caregivers (97% [113/117] vs. 79% [60/76], p < .001) and anticipated training extensions due to parental leave (36% vs. 13% men, p = .009). Breastfeeding was associated with significantly higher PSS scores (p = .017). Twenty-four percent of breastfeeding parents (22/93) felt that their program/institution did not support their breastfeeding goals; lack of perceived support was associated with significantly higher PSS scores (63.6 ± 13.1 vs. 38.6 ± 8.7, p < .001). Trainees experiencing unreliable childcare had significantly higher PSS scores (p = .005). Forty percent (64/159) changed their career plans after becoming parents. CONCLUSIONS: Physician trainee parents experience high stress, with women bearing disproportionate burdens in the domains of parental leave and breastfeeding. These results should inform policies promoting trainee wellness and gender equity.


Assuntos
Internato e Residência , Licença Parental , Criança , Educação de Pós-Graduação em Medicina , Feminino , Humanos , Masculino , Pais , Gravidez , Inquéritos e Questionários
10.
Am J Surg ; 224(4): 1109-1114, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35781377

RESUMO

More women are choosing a career in surgery, many of whom plan to have children during their residency and fellowship training. However, women still face perceived physical and psychological barriers to childbearing during training. In this article we review the risks of surgical exposures such as bloodborne disease, radiation, bone cement, physical labor and fatigue, and emotional stressors for the pregnant resident. Cultural barriers for pregnant residents persist, including biased comments or resentment from colleagues or attendings. Parental leave policies are inconsistent among programs and specialties. This article is intended to empower female residents and program faculty to make informed decisions and policies to support trainees, encourage diversity, and keep surgical programs competitive among top applicants.


Assuntos
Internato e Residência , Licença Parental , Cimentos Ósseos , Criança , Bolsas de Estudo , Feminino , Humanos , Gravidez , Fatores de Risco , Inquéritos e Questionários
11.
Cutis ; 109(5): E16-E18, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35856761

RESUMO

With women comprising the majority of dermatologists and dermatology residents, childbearing and childrearing during training years should be anticipated and supported. Timing of pregnancy, maternity leave scheduling, planning for breastfeeding while working, and arranging for childcare are issues that the aspiring female dermatology resident must consider. This article highlights these considerations and reports methods for their successful navigation.


Assuntos
Dermatologia , Internato e Residência , Aleitamento Materno , Dermatologia/educação , Feminino , Humanos , Licença Parental , Gravidez , Inquéritos e Questionários
12.
J Surg Educ ; 79(6): e92-e102, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35842402

RESUMO

OBJECTIVE: Despite recent national improvements in family leave policies, there has been little focus on program-level support for surgical trainees. Trainees who may require clinical duty adjustments during pregnancy, who experience pregnancy loss, or who struggle with balancing work obligations with the demands of a new infant may face stigma when seeking schedule accommodations. The aim of this study was to describe program and colleague support of surgical trainees for pregnancy-related and postpartum health needs. DESIGN: Survey questionnaire. Participants responded to multiple-choice questions about their history of pregnancy loss, their experience with reduction of clinical duties during pregnancy, and their breastfeeding experience. Those who took time off after miscarriages or reduced their clinical duties during pregnancy were asked whether they perceived their colleagues and/or program leadership to be supportive using a 4-point Likert scale (1-strongly agree, 4-strongly disagree) which was dichotomized to agree/disagree. SETTING: Electronically distributed through social media and surgical societies from November 2020 to January 2021. PARTICIPANTS: Female surgical residents and fellows. RESULTS: 258 female surgical residents and fellows were included. Median age was 32 (IQR 30-35) years and 76.74% were white. Of the 52 respondents (20.2%) who reported a miscarriage, 38 (73.1%) took no time off after pregnancy loss, including 5 of 10 women (50%) whose loss occurred after 10 weeks' gestation. Of the 14 residents who took time off after a miscarriage, 4 (28.6%) disagreed their colleagues and/or leadership were supportive of time away from work. Among trainees who reported at least 1 live birth, only 18/114 (15.8%) reduced their work schedule during pregnancy. Of these, 11 (61.1%) described stigma and resentment from colleagues and 14 (77.8%) reported feeling guilty about burdening their colleagues. 100% of respondents reported a desire to breastfeed their infants, but nearly half (46.0%) were unable to reach their breastfeeding goals. 46 (80.7%) cited a lack of time to express breastmilk and 23 (40.4%) cited inadequate lactation facilities as barriers to achieving their breastfeeding goals. CONCLUSIONS: A minority of female trainees takes time off or reduces their clinical duties for pregnancy or postpartum health needs. National parental leave policies are insufficient without complementary program-level strategies that support schedule adjustments for pregnant trainees without engendering a sense of resentment or guilt for doing so. Surgical program leaders should initiate open dialogue, proactively offer clinical duty reductions, and ensure time and space for lactation needs to safeguard maternal-fetal health and improve the working environment for pregnant residents.


Assuntos
Aborto Espontâneo , Internato e Residência , Humanos , Gravidez , Lactente , Feminino , Adulto , Licença Parental , Admissão e Escalonamento de Pessoal , Inquéritos e Questionários
16.
J Womens Health (Larchmt) ; 31(10): 1403-1410, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35704286

RESUMO

Background: As medical training occurs during prime childbearing years, parental leave policies may affect the career and family choices of medical students. Materials and Methods: This cross-sectional study builds on existing research by quantifying the prevalence of formal policies for parental leave in highly ranked United States Medical Degree granting institutions, and analyzing the characteristics of those policies, with the objective of identifying existing best practices for future policy adopters to consider. Results: Only 14% of the medical schools reviewed had substantive, stand-alone parental leave policies, and the majority of schools had leave of absence policies without mention of parental leave. Discussion: Leveraging the authors' legal and medical expertise, this analysis highlights existing best practices for medical school leadership to consider, as they examine and develop their policies. Best practices utilized by institutions with the most robust parental policies include adopting a formal and public parental policy, providing a parental enrolled academic adjustment option, guaranteeing approval to take and return from leave/academic adjustment, and continuing health care and financial aid benefits. Given the role of childbearing as a factor associated with gender disparities in academic medicine, and potential impact on racial disparities for students of color, medical school leadership should consider implementation of best practice parental policies to promote equity and wellness of their students. In fact, the deficit of robust parental leave policies in most highly ranked schools may contribute to existing gender and racial disparities in violation with antidiscrimination law. Strengthening policies could increase equity in medical education with positive impacts on the patient population.


Assuntos
Faculdades de Medicina , Estudantes de Medicina , Humanos , Estados Unidos , Licença Parental , Estudos Transversais , Pais , Políticas
17.
Curr Probl Cardiol ; 47(10): 101299, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35753397

RESUMO

Gender and regional differences in paid parental leave among cardiologists worldwide has not been documented. We investigated differences in paid parental leave policies globally. There are significant regional differences in parental leave among cardiologists, with North America having the shortest duration for both men and women, and highest dissatisfaction. Both genders reported similar levels of dissatisfaction with parental leave policies worldwide. Most cardiologists in the United States were not aware of policy around adjustment of productivity expectations for the paid time off and one in five said that they did not receive an adjustment. This should be addressed by institutions to allow for career flexibility and work life balance.


Assuntos
Cardiologistas , Licença Parental , Feminino , Humanos , Masculino , Satisfação Pessoal , Políticas , Estados Unidos , Equilíbrio Trabalho-Vida
18.
Int J Radiat Oncol Biol Phys ; 113(5): 928-933, 2022 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-35500797

RESUMO

PURPOSE: Although supported by most men and women, paternity leave is heavily underused across industries owing in part to external pressures and inconsistent availability. The goal of this study was to assess the use of paternity leave in radiation oncology (RO) practices and identify any associated barriers. METHODS AND MATERIALS: A 36-item survey was distributed via e-mail to 536 male domestic RO attending and resident physicians. Questions assessed paternity leave policies, use, and departmental support. Data were collected using Research Electronic Data Capture from January to February 2021. Descriptive statistics were obtained for analysis, and logistic regression was performed to analyze the association between practice type and presence of policy. RESULTS: The survey response rate was 20% (n = 108), with 98% of participants completing all applicable questions. Respondents included 63 attending physicians (58%) and 45 resident physicians (42%). The median age of all respondents was 35 years. Among all participants, 51 (47%) stated their practice had a formal paternity leave policy. The median time allowed for leave was 4 weeks (range, 0.5 weeks to unlimited), whereas the median time taken was 2 weeks (range, 0.5-12 weeks). Sixteen men felt pressure to take less leave than what was allowed by their policy, and 46% of men stated that in retrospect, they would have taken more time off for paternity leave. CONCLUSIONS: To the authors' knowledge, this is the first study to investigate the use of paternity leave in RO practices in the United States. Integrating expanded family leave policies, including specifically allowing for paternity leave and accompanying these policies with cultural changes acknowledging the importance of family leave, would be beneficial to improving quality of life and work-life balance for parents.


Assuntos
Internato e Residência , Neoplasias , Radioterapia (Especialidade) , Adulto , Feminino , Humanos , Masculino , Licença Parental , Pais , Qualidade de Vida , Inquéritos e Questionários , Estados Unidos
19.
Can Fam Physician ; 68(5): 356-363, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35552210

RESUMO

OBJECTIVE: To explore the challenges that childbearing family medicine residents encounter during postgraduate training and to understand the available support systems. DESIGN: Descriptive qualitative research study. SETTING: British Columbia, Canada. PARTICIPANTS: Nine University of British Columbia family medicine residents who experienced pregnancy during their residencies between 2014 and 2018. METHODS: Semistructured telephone interviews with family medicine residents were conducted until data reached saturation. Audiorecorded interviews were transcribed and analyzed using content analysis with an iterative approach to elucidate themes. Member checking and peer debriefing were used to ensure the rigour of the findings. MAIN FINDINGS: The participants reported various unique challenges during pregnancy, maternity leave, and return to work. Residents during pregnancy tended to prioritize work over one's own well-being and reported an increased level of perceived adverse symptoms. During maternity leave, residents reported postpartum depression, anxiety, and conflict between the roles of parent and physician. Upon return to work, participants perceived a decrease in their clinical function and reported feelings of guilt and anxiety because of the shared burden of residency with family. Residents found their programs supportive throughout pregnancy and maternity leave; however, a decrease in support upon return to work was a recurring theme in responses. CONCLUSION: Pregnancy during family medicine residency has unique challenges, necessitating support from programs, preceptors, and colleagues. Further resources and incentives are needed to facilitate the transition back to work after maternity leave.


Assuntos
Internato e Residência , Colúmbia Britânica , Medicina de Família e Comunidade/educação , Feminino , Humanos , Licença Parental , Gravidez , Pesquisa Qualitativa
20.
J Am Coll Cardiol ; 79(21): 2119-2126, 2022 05 31.
Artigo em Inglês | MEDLINE | ID: mdl-35618349

RESUMO

BACKGROUND: Specialty training in cardiovascular diseases is consistently perceived to have adverse job conditions and interfere with family life. There is a dearth of universal workforce support for trainees who become parents during training. OBJECTIVES: This study sought to identify parental policies across cardiovascular training programs internationally. METHODS: An Internet-based international survey study available from August 2020 to October 2020 was sent via social media. The survey was administered 1 time and anonymously. Participants shared experiences regarding parental benefits/policies and perception of barriers for trainees. Participants were divided into 3 groups: training program directors, trainees pregnant during cardiology fellowship, and trainees not pregnant during training. RESULTS: A total of 417 replies were received from physicians, including 47 responses (11.3%) from training program directors, 146 responses (35%) from current or former trainees pregnant during cardiology training, and 224 responses (53.7%) from current or former trainees that were not pregnant during cardiology training. Among trainees, 280 (67.1%) were parents during training. Family benefits and policies were not uniformly available across institutions, and knowledge regarding the existence of such policies was low. Average parental leave ranged from 1 to 2 months in the United States compared with >4 months outside the United States, and in all countries, paternity leave was uncommon (only 11 participants [2.6%]). Coverage during family leave was primarily provided by peers (n = 184 [44.1%]), and 168 (91.3%) were without additional monetary or time compensation. CONCLUSIONS: This is the first international survey evaluating and comparing parental benefits and policies among cardiovascular training programs. There is great variability among institutions, highlighting disparities in real-world experiences.


Assuntos
Doenças Cardiovasculares , Internato e Residência , Doenças Cardiovasculares/terapia , Bolsas de Estudo , Feminino , Humanos , Licença Parental , Pais , Gravidez , Estados Unidos
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