Doctor, My Close Friend Died and I am Still Grieving

MedicalResearch.com Interview with:

Prof. Wai-Man (Raymond) Liu, PhDAssociate ProfessorResearch School of Finance, Actuarial Studies & StatisticsCollege of Business & Economics BuildingThe Australian National UniversityProf. Wai-Man (Raymond) Liu, PhD
Associate Professor
Research School of Finance, Actuarial Studies & Statistics
College of Business & Economics Building
The Australian National University

MedicalResearch.com: What is the background for this study?

Response: In our study, we studied survey responses of over 26,000 people from the largest Australian household survey over a period of 14 years. The survey was funded by the government called “The Household, Income and Labour Dynamics in Australia (HILDA) Survey”. The survey was conducted by the Melbourne Institute.

In the survey more than 9,500 of these respondents had experienced the death of a close friend.

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Transgender Adults Face Barriers to Health Care

MedicalResearch.com Interview with:

Kellan E. Baker, MPH, MACentennial Scholar PhD CandidateHealth Policy Research ScholarDepartment of Health Policy and ManagementJohns Hopkins Bloomberg School of Public Health

Kellan Baker

Kellan E. Baker, MPH, MA
Centennial Scholar PhD Candidate
Health Policy Research Scholar
Department of Health Policy and Management
Johns Hopkins Bloomberg School of Public Health

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: This study shows that transgender adults in the U.S. today have significantly worse health-related quality of life than cisgender (non-transgender) adults, as measured by self-reported health status and number of recent days of poor physical or mental health.

The study is important because it quantifies the gap in health-related quality of life between transgender and cisgender people, and it relies on a survey that allows us to believe that these findings are likely true not just for the people who answered the survey but for the U.S. as a whole.

Health-related quality of life is a very broad term that describes a person’s whole sense of well-being—we might think of it as the answer to the question, “how are you doing these days?” The answer has to do not just with your physical health but also your mental health, your outlook on your life and your community, your feelings of wholeness and happiness. Sources such as the National Academy of Medicine and the U.S. Transgender Survey have documented that transgender people face discrimination in areas of everyday life such as housing, health care, and public spaces. Encounters with discrimination don’t just keep transgender people from getting services they need: they hurt trans people both physically and mentally.  Continue reading

Ying and Yang of Empathy and Aggression Differ for Boys and Girls

MedicalResearch.com Interview with:
Dr. Eider Pascual-Sagastizabal, PhD

Professor of Evolutionary Psychology and Education
University School of Education of Bilbao (Leioa)
University of the Basque Country 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The search for markers of aggression during childhood is a particularly relevant area of research, since the results of intervention and prevention during this developmental stage are more promising than those obtained during later stages. The psychobiological approach to aggressive behavior is of particular importance, as it analyzes the joint, interactive influence of both psychological and biological variables.

We have found that there are different interactions on a biological and psychological level that could account for aggressive behavior in children. More deeply, empathy and hormones could together account for aggressive behavior. In fact, the interactions were different for boys and for girls.  Continue reading

Home Responsibilities Encourage Physician Mothers in Procedural Specialties To Consider Career Change

MedicalResearch.com Interview with:

Nelya Melnitchouk, MD,MScDirector, Program in Peritoneal Surface Malignancy, HIPECDr. Melnitchouk is an associate surgeon at Brigham and Women’s Hospital (BWH) and Brigham and Women’s Faulkner Hospital (BWFH) and instructor of surgery at Harvard Medical Schoo

Dr. Melnitchouk

Nelya Melnitchouk, MD,MSc
Director, Program in Peritoneal Surface Malignancy, HIPEC
Dr. Melnitchouk is an associate surgeon at Brigham and Women’s Hospital (BWH) and Brigham and Women’s Faulkner Hospital (BWFH) and
instructor of surgery at Harvard Medical School.

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Current literature on women in surgery show that female physicians, particularly those in procedural specialties, face many challenges in balancing responsibilities between work and home. We hypothesized that these challenges may affect career satisfaction more negatively for physician mothers in procedural specialties than those in nonprocedural specialties.

In our study, we found that physician mothers in procedural specialties who had more domestic responsibilities were more likely to report a desire to change careers than those in nonprocedural specialties.  Continue reading

Suboptimal Physical Activity in Women Associated With Increased Healthcare Spending

MedicalResearch.com Interview with:
Erin D. Michos, MD, MHS, FACC, FAHA, FASE
Associate Professor of Medicine and Epidemiology
Associate Director of Preventive Cardiology
Ciccarone Center for the Prevention of Heart Disease
Johns Hopkins School of Medicine

Victor Okunrintemi, MD, MPH
Department of Internal Medicine
East Carolina University
Greenville, North Carolina 

MedicalResearch.com: What is the background for this study?  

Response: Women are less physically active than men on average, and the lack of regular physical activity has been associated with increased risk of cardiovascular disease and poorer health outcomes. Although recommendations encouraging regular physical activity has been in place for decades, we do not know how much of these recommendations are met, particularly among high risk women with established cardiovascular disease for secondary prevention.

This study was therefore designed with the aim of describing the 10-year trends for the proportion of women with cardiovascular disease who do not meet these recommend physical activity levels, overall and by key sociodemographic groups, and the associated cost implications.

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Trans Women May Require Higher Doses of Estrogens

MedicalResearch.com Interview with:

Joshua Safer, MD, Executive DirectorCenter for Transgender Medicine and SurgeryMount Sinai Health SystemSenior Faculty, Medicine, Endocrinology, Diabetes and Bone DiseaseIcahn School of Medicine at Mount Sinai

Dr. Safer

Joshua Safer, MD, Executive Director
Center for Transgender Medicine and Surgery
Mount Sinai Health System
Senior Faculty, Medicine, Endocrinology, Diabetes and Bone Disease
Icahn School of Medicine at Mount Sinai

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The standard trans feminizing hormone regimen includes estrogen both to suppress testosterone and so that the individual has sufficient circulating sex hormone in the body for good bone health. After orchiectomy, there is no need to suppress testosterone because the levels are very low and it is common to cut the estrogen dose in half.  Cis women with premature ovarian failure often take about 2 mg of estradiol daily so that dose has seemed reasonable for trans women without testes.  However, when my co-author Sira Korpaisarn and I checked estradiol levels and gonadotropins (pituitary hormones, LH and FSH) as a guide to dosing, we found that based on that testing, trans women may require higher doses of estrogens than the 2 mg that we expected.

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Increasing Number of Military Dependents Receiving Transgender or Gender Diverse Medical Care

MedicalResearch.com Interview with:
Dr. David Klein MD MPH

Associate Program Director
National Capital Consortium (NCC) Family Medicine Residency
Fort Belvoir Community Hospital

Dr. Elizabeth Hisle-Gorman MSW, PhD
Assistant Professor, Uniformed Services University 

MedicalResearch.com: What is the background for this study? 

Response: Our study, “Transgender Children and Adolescents Receiving Care in the U.S. Military Healthcare System: A Descriptive Study,” sought to analyze the number of military dependent children and adolescents who have a transgender or gender-diverse identity and receive medical care in the Military Health System (MHS), recognizing that the number has been increasing, but not knowing to what extent. Ultimately, in studying this data, we hoped to document the needs of transgender children in military families to support provision of adequate and appropriate high-quality care.

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How Do Men Express Grief After Pregnancy Loss?

MedicalResearch.com Interview with

Haley Kranstuber Horstman, Ph.D.Department of CommunicationUniversity of Missouri

Dr. Kranstuber Horstman

Haley Kranstuber Horstman, Ph.D.
Department of Communication
University of Missouri

MedicalResearch.com: What is the background for this study?

Response: Miscarriage is a prevalent health concern, with one in five pregnancies ending in miscarriage, which is a pregnancy loss before 20 weeks’ gestation. Past research has shown that women who have miscarried often suffer mental health effects such as heightened grief, depression, loneliness, and suicidality.

Although much of the research on coping with miscarriage has focused on women’s health, many miscarriages occur within romantic relationships and affect the non-miscarrying partner as well. Women in heterosexual marriages report that their husband is often their top support-provider. Past research has shown that husbands suffer with mental health effects after a miscarriage, sometimes for even longer than their wives, but are not often supported in their grief because miscarriage is a “woman’s issue” and they feel uncomfortable talking about it.

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Birth Control Pills May Make It Harder for Women To Identify Complex Emotions

MedicalResearch.com Interview with:

Dr. Alexander Lischke, Dipl.-Psych. Universität Greifswald Institut für Psychologie Physiologische und Klinische Psychologie/Psychotherapie University of Greifswald, Germany

Dr. Lischke

Dr. Alexander Lischke, Dipl.-Psych.
Universität Greifswald
Institut für Psychologie
Physiologische und Klinische Psychologie/Psychotherapie
University of Greifswald, Germany

MedicalResearch.com: What is the background for this study?

Response: We know for a long time that cyclic variations in womens’ estrogen and progesterone levels affect their emotion recognition abilities by modulating neural activity in brain regions implicated in emotion processing. We also know that oral contraceptives suppress cyclic variations in womens’ estrogen and progesterone levels. We, thus, assumed that oral contraceptives would affect womens’ emotion recognition abilities due to the aforementioned suppression of cylic variations in estrogen and progesterone levels that modulate neural activity in brain regions during emotion processing. To test this assumption, at least with respect to the behavioral effects of oral contraceptive use on emotion recognition, we performed the current study.

We recruited regular cylcling women with and without oral contraceptive use for our study. None of the women were in psychotherapeutical or psychopharmacological treatment at the time of the study. During the study, women performed a emotion recognition task that required the recognition of complex emotional expressions like, for example, pride or contempt.
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Caring for Sick Family Members Exacerbates Burnout in Female Physicians

MedicalResearch.com Interview with:

Christina Mangurian, MD MAS Professor Department of Psychiatry, Weill Institute for Neurosciences Center for Vulnerable Populations, University of California, San Francisco

Dr. Mangurian

Christina Mangurian, MD MAS
Professor
Department of Psychiatry, Weill Institute for Neurosciences
Center for Vulnerable Populations,
University of California, San Francisco

Veronica Yank, MD Division of General Internal Medicine Department of Medicine University of California, San Francisco

Dr. Yank


Veronica Yank, MD
Assistant Professor
Division of General Internal Medicine
Department of Medicine
University of California
San Francisco

MedicalResearch.com: What is the background for this study?

Response: This article is about the behavioral health and burnout consequences among physician mothers who are caring for seriously ill loved ones. Our work was inspired, in part, by some of the authors’ own experiences caring for loved ones with serious illnesses while also being physician mothers themselves.  We sought to determine the proportion of physician mothers with such caregiving responsibilities beyond their patients and children and the how these additional responsibilities affected the women’s health and practice.

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Female Radiation Oncologists Less Likely to Receive Industry Payments

MedicalResearch.com Interview with:

Dr. Ann Raldow MD MPH Assistant Professor Department of Radiation Oncology David Geffen School of Medicine UCLA

Dr. Raldow

Dr. Ann Raldow MD MPH
Assistant Professor
Department of Radiation Oncology
David Geffen School of Medicine
UCLA 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Similar to women in other historically male-dominated fields, female radiation oncologists face unique obstacles in achieving many metrics of career success, including equal salary, research funding, and academic promotion. Our study of industry payments found that female radiation oncologists were less likely than their male colleagues to receive payments from industry and that these payments tended to be of smaller monetary value.

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Longevity Benefit of Physical Activity Plateaus in Women, Not in Men

MedicalResearch.com Interview with:

Lloyd Brandts PhD Candidate Maastricht University Maastricht, the Netherlands

Lloyd Brandts

Lloyd Brandts PhD Candidate
Maastricht University
Maastricht, the Netherlands

MedicalResearch.com: What is the background for this study?

Response: Although the number of people who reached old age has increased over the past few decades, in some developing countries it has been observed that the increase in life expectancy started to plateau.

One commonly used argument to explain this plateauing is the growing number of obese and physically inactive individuals. Therefore, we assessed whether there is an association between these factors and the chance of reaching the age of 90 years.

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Circadian Clock Gene Has Different Effects in Men and Women

MedicalResearch.com Interview with:

Lauren Douma, Ph.D. Postdoctoral Fellow University of Florida Department of Medicine Division of Nephrology, Hypertension, and Renal Transplantation Gainesville, FL 32610

Dr. Douma

Lauren Douma, Ph.D.
Postdoctoral Fellow
University of Florida
Department of Medicine
Division of Nephrology, Hypertension, and Renal Transplantation
Gainesville, FL 32610

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Our internal circadian clock not only controls our sleep/wake cycle, but also many other physiological functions including rhythms in body temperature, heart rate, and blood pressure. During the day when we are active our blood pressure peaks and at night when we are asleep our blood pressure dips. Certain individuals do not experience this dip in their blood pressure at night and are referred to as non-dippers. Non-dippers have an increased risk for heart and kidney disease. Previously, our lab has shown that if we knock out a core circadian clock gene (PER1) in male mice, they develop non-dipping hypertension on a treatment that mimics salt-sensitive hypertension. In the current study, we examined the effect of knocking out this circadian clock gene in female mice. We found that female mice without the PER1 gene do not develop the non-dipping hypertension that the males develop. Female mice without PER1 maintain their circadian rhythms of blood pressure, including the dip in their blood pressure at night even with the same treatment that the males received to mimic salt-sensitive hypertension.

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Men: Feeling a Lack of Power Can Drive Aggression Toward Women

MedicalResearch.com Interview with:
Emily J. Cross, MS
School of Psychology, Science Centre
The University of Auckland
Auckland 

MedicalResearch.com: What is the background for this study?

Response: Aggression and violence in intimate relationships is very harmful, and unfortunately Aggression and violence in intimate relationships is very harmful, and unfortunately very common. So identifying what predicts relationship aggression and why is important. Men’s hostile sexism toward women is an established risk factor for relationship aggression, but we actually know little about why these attitudes promote relationship aggression. Understanding why helps to identify how these damaging processes may be reduced.

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Why Don’t Younger Men Get Health Check Ups?

MedicalResearch.com Interview with:
"Blood pressure check" by Army Medicine is licensed under CC BY 2.0Pallavi Bhandarkar MPH
Nova Southeastern University
Kirkland, Washington

preetipshenoy@gmail.com 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Gender based preventative health has been of interest to medical community since 1900’s with health disparities between males and females being of particular interest. United States founded National Research Institutes for female health in 1900. This led to comprehensive and systematic medical services being offered which have improved female health care significantly. Similar research programs and initiatives to improve men’s health were started only in 2000 (1).

Cultural depiction of men being fearless and based on perception of masculinity leads them to underutilize the preventative health care screenings available to them or sometimes even delay care when they need it the most. Males have been found to have higher mortality rates compared to females.

Life expectancy for females was 5.0 years higher than for males. The difference in life expectancy between the sexes has narrowed since 1979, when it was 7.8 years, but it increased 0.2 year in 2016 from 2015, the first increase since 1990. Death rates for males increased significantly for age groups 15–24, 25–34, 35–44, and 55–64. Rates decreased significantly for age groups 75–84 and 85 and over” (2)

My research study adopted the basic survey design and conducted an anonymous survey throughout United States with men aged 18 to 40 being the participants.

Our goal was to identify these gaps, analyze the reasons for underutilization and identify opportunities to improve preventative care guidelines among the male population. The main findings were almost similar to the BFRSS data obtained by CDC in the year 2016. Continue reading

More Postnatal Depression with Baby Boys?

MedicalResearch.com Interview with:
Dr Sarah Myers PhDDr Sarah Myers PhD

Honorary Research Associate
UCL Department of Anthropology

MedicalResearch.com: What is the background for this study?

Response: Postnatal or postpartum depression is unfortunately common after giving birth; a figure often quoted is 15%, but some studies have found much higher numbers. Postnatal depression is associated with a range of poorer outcomes for mothers and their infants, and the financial costs of treating maternal mental ill health put health services under considerable strain. Studies have found that providing additional emotional support to at risk mothers, for instance via peer support programmes or regular phone calls with health visitors, can reduce the likelihood of them developing the condition. Therefore, it is really important that we understand the full range of risk factors that put women at greater risk of becoming depressed after giving birth.

There is increasing evidence for a link between inflammation and depression, with factors that trigger an inflammatory immune response also increasing the likelihood of depressive symptoms. The opens up the possibility of finding new risk factors for postnatal depression based on known associations with inflammation.

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Girls Recover From Concussions More Slowly Than Boys

MedicalResearch.com Interview with:

Andrée-Anne Ledoux, PhD Children’s Hospital of Eastern Ontario Research Institute Ottawa, Ontario, Canada

Dr. Ledoux

Andrée-Anne Ledoux, PhD
Children’s Hospital of Eastern Ontario Research Institute
Ottawa, Ontario, Canada

MedicalResearch.com: What is the background for this study?

Response: The natural recovery processes from a pediatric concussion remains poorly characterized throughout childhood. Children’s brains go through many phases of growth during development and sex differences exist. Therefore a 6-year-old child may not have the same recovery trajectory as an adolescent because of biopsychosocial differences. Thus, this study explored symptom improvement after concussion while considering these two key demographic factors. Understanding symptom improvement at different stages of development is important in order to provide the best possible care.

The study examined data from 2,716 children and adolescents who had presented at nine emergency departments across Canada and were diagnosed with concussion. We examined the natural progression of self-reported symptom recovery following pediatric concussion over the initial three months after injury. Participants in the study were aged 5 to 18 years old with acute concussion, enrolled from August 1, 2013, to May 31, 2015. We examined different age cohorts – 5 to 7 years of age, 8 to 12 years of age, and 13 to 18 years of age, and investigated how sex is associated with recovery.

Our study represents the largest study to evaluate symptom improvement trajectories in concussed pediatric population. Continue reading

Dermatology Care Varies Widely by Gender, Socioeconomic Factors and Race

MedicalResearch.com Interview with:

Raghav Tripathi, MPH Case Western Reserve University MD Candidate, Class of 2021

Raghav Tripathi

Raghav Tripathi, MPH
Case Western Reserve University
MD Candidate, Class of 2021

MedicalResearch.com: Why did you decide to perform this study?

Response: Differences in the impact of dermatologic conditions on different groups have been of interest to our research group for a long time. Previously, our group had found differences in time to treatment for patients with different skin cancers. Beyond this, we had found differences in mortality and incidence of various skin conditions (controlling for other factors) in different racial groups/ethnicities, socioeconomic groups, demographic groups, and across the rural-urban continuum.

The goal of this study was to investigate socioeconomic and demographic differences in utilization of outpatient dermatologic care across the United States. As demographics throughout the country become more diverse, understanding differences in utilization of dermatologic care is integral to developing policy approaches to increasing access to care across the country.  Continue reading

Medical Residents and Program Directors Have Different Perceptions of New Parent Leave and Breastfeeding Policies

MedicalResearch.com Interview with:

Prof-Lia E. Gracey

Prof. Gracey

Lia E. Gracey, MD, PhD
Department of Dermatology
Baylor Scott & White Health
Austin, Texas 

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: The co-authors and I were interested in this issue as new parent leave (or the lack thereof) is increasingly being examined in many professions.  As a mother who had children during dermatology residency, I felt the pressure to take a short new parent leave to avoid having to make up time at the end of my training.

I came back to work only 3 ½ weeks after having my first baby. Anecdotally, other new parent residents (both men and women) reported similar concerns and we noticed a lack of data about new parent leave policies in dermatology residency training programs.

We distributed surveys to dermatology residency program directors and residents and were struck by a basic lack of awareness by residents for whether their institution even offered new parent leave.  Less than 50% of surveyed residents were aware of a written new parent leave policy for their residency program, yet over 80% of program directors stated they had a policy in place. We also found discrepancies between resident and program director perceptions of sufficiency of new parent leave and the availability of pumping facilities for breastfeeding mothers.  Continue reading

Female Patients More Likely To Die If Treated By Male Doctor

MedicalResearch.com Interview with:

Brad N. Greenwood PhD Associate Professor Information & Decision Sciences Carlson School of Management University of Minnesota–Twin Cities, Minneapolis MN 

Dr. Greenwood

Brad N. Greenwood PhD
Associate Professor
Information & Decision Sciences
Carlson School of Management
University of Minnesota–Twin Cities, Minneapolis
MN

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There has been growing work in medicine which suggests both that a) women are more skilled physicians across a variety of ailments and b) women are particularly challenging heart attack patients (for a variety of reasons ranging from delays in seeking treatment to atypical presentation). When you coupled this with the deep literatures in economics, sociology, and political science which suggests that advocatees experience better outcomes when they share traits with their advocates, it seemed plausible that there might be differences in outcomes.

The key finding is that gender concordance matters most for female patients:  female patients are about 0.7-1.2% more likely to die if treated by a male doctor, relative to a female doctor.  This number seems small.  But, if the survival rate among the female heart attack patients treated by male doctor was the same as the survival rate among female heart attack patients treated by female doctors, about 1,500-3,000 fewer of the female heart attack patients in our sample would have passed away. Our sample covers the state of Florida from 1991-2010.  Florida is about 10% of the US population. Continue reading

Why Are There So Few Male Nurses and Kindergarten Teachers?

MedicalResearch.com Interview with:
“Nurse gives flu jab” by NHS Employers is licensed under CC BY 2.0Katharina Block, M.A.

Phd Student – Social Psychology
The University of British Columbia 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Healthcare workers and teachers are incredibly central to how we function as a society. We are having trouble filling these positions, and especially men are underrepresented in them.

In the U.S. men represent only about 10% of nurses and 4% of pre-school and kindergarten teachers. We wanted to know how men’s more basic values play into this.

Our main finding is that tend men see less importance in care-oriented careers then women do, and we find that this could be tied to the more basic values feel are important to them personally.  Continue reading

Why Do So Few Women Enter or Complete Surgical Residency?

MedicalResearch.com Interview with:

Erika L. Rangel, MD,MS Instructor, Harvard Medical School Trauma, Burn and Surgical Critical Care Department of Surgery, Center for Surgery and Public Health  Brigham and Women’s Hospital  Harvard T. H. Chan School of Public Health Boston, Massachusetts

Dr. Rangel

Erika L. Rangel, MD,MS
Instructor, Harvard Medical School
Trauma, Burn and Surgical Critical Care
Department of Surgery, Center for Surgery and Public Health
Brigham and Women’s Hospital
Harvard T. H. Chan School of Public Health
Boston, Massachusetts

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Although women make up half of medical student graduates in 2018, they only comprise a third of applicants to general surgery. Studies suggest that lifestyle concerns and perceptions of conflict between career and family obligations dissuade students from the field.

After entering surgical residencies, women residents have higher rates of attrition (25% vs 15%) and cite uncontrollable lifestyle as a predominant factor in leaving the field. Surgeons face reproductive challenges including stigma against pregnancy during training, higher rates of infertility, need for assisted reproduction, and increased rates of pregnancy complications. However, until recently, studies capturing the viewpoints of women who begin families during training have been limited. Single-institution experiences have described mixed experiences surrounding maternity leave duration, call responsibilities, attitudes of coworkers and faculty, and the presence of postpartum support.

Earlier this year, our group presented findings of the first national study of perspectives of surgical residents who had undergone pregnancy during training. A 2017 survey was distributed to women surgical residents and surgeons through the Association of Program Directors in Surgery, the Association of Women Surgeons and through social media via twitter and Facebook. Responses were solicited from those who had at least one pregnancy during their surgical training.

39% of respondents had seriously considered leaving surgical residency, and 30% reported they would discourage a female medical student from a surgical career, specifically because of the difficulties of balancing pregnancy and motherhood with training (JAMA Surg 2018; July 1; 153(7):644-652).

These findings suggested the challenges surrounding pregnancy and childrearing during training may have a significant impact on the decision to pursue or maintain a career in surgery. The current study provides an in-depth analysis of cultural and structural factors within residency programs that influence professional dissatisfaction.

We found that women who faced stigma related to their pregnancies, who had no formal maternity leave at their programs, and who altered subspecialty training plans due to perceived challenges balancing motherhood with the originally chosen subspecialty were most likely to be unhappy with their career or residency. Continue reading

Women in Tipping Professions Susceptible to Depression

MedicalResearch.com Interview with:
“Professional waitress” by Shih-Chi Chiang is licensed under CC BY 2.0Sarah Andrea, MPH
School of Public Health
OHSU-PSU

MedicalResearch.com: What is the background for this study?

Response: We spend one-third of our adult lives at work, and our work-related experiences and exposures affect our health. 14 million people work in the leisure and hospitality industry, a subset of the service industry that includes food service and personal care workers. This industry is simultaneously one of the fastest growing and lowest paid. In addition, work in this industry is frequently characterized by lack of control over hours and shifts worked, as well as insufficient access to health care and other benefits.

Studies have previously found the highest burden of depression and sleep problems for workers in this industry compared to others.

Individuals working in the service industry who earn the bulk for their income from tips from customers face additional vulnerabilities. In many states, tipped workers are paid as little as $2.13 an hour and rely on customers to make up the difference in tips, which are inequitable and unpredictable. Prior to this study, the potential health implications of tipped work were minimally assessed.

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Sexual Minorities More Likely To Be Unemployed and Uninsured

MedicalResearch.com Interview with:

Brittany M. Charlton, ScD, Assistant Professor Harvard Medical School Harvard T.H. Chan School of Public Health Boston Children's Hospital Boston, MA

Dr. Charlton

Brittany M. Charlton, ScD, Assistant Professor
Harvard Medical School
Harvard T.H. Chan School of Public Health
Boston Children’s Hospital
Boston, MA

MedicalResearch.com: What is the background for this study?

Response: Research has shown that nearly half of all sexual minorities (e.g., lesbian, gay, and bisexual individuals) experience employment discrimination in their lifetime, which may lead to many other disparities, including health insurance coverage, healthcare access, and ultimately health-related quality of life (e.g., pain, anxiety).

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Who is Underrepresented in Cardiology Trials?

MedicalResearch.com Interview with:

Quoc Dinh Nguyen, MD MA MPH Interniste-gériatre – Service de gériatrie Centre hospitalier de l’Université de Montréal – CHUM

Dr. Nguyen

Quoc Dinh Nguyen, MD MA MPH
Interniste-gériatre – Service de gériatrie
Centre hospitalier de l’Université de Montréal – CHUM

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Randomized trials are the best evidence basis we have to treat patients. It is known for more than 20 years that older adults and women are disproportionately excluded from randomized trials in cardiology diseases. As the current US population is fast aging, we examined whether this underrepresentation improved or worsened in the last 20 years in the most influential studies published between 1996 and 2015.

The main finding is that the women and older adults continue to be underrepresented in cardiology trials. Overall, the mean age was 63 years and the percentage of women was 29%. For coronary heart disease, women comprise 54% of the US population in need of treatment, yet are only 27% of the trial population. For heart failure, the median age of older adults in the US population is 70 years whereas it is only 64 years in the trial population.

Our results indicate that the gap has very slowly narrowed in the last 2 decades. However, based on current trends, reaching proportionate enrollment would require between 3 and 9 decades. This persistent lack of representation has significant impacts on the ability of clinicians to provide evidenced based care for these segments of the population. Physicians and other health care professionals are forced to extrapolate study results from younger and male-predominant populations. This is problematic since we know that older adults and women may react differently to medications and to interventions.  Continue reading

Most Pediatricians are Women, But Men’s Opinions are Valued More

MedicalResearch.com Interview with:

Julie Silver, MD Associate Professor and Associate Chair Department of Physical Medicine and Rehabilitation at Harvard Medical School and staff physician at Massachusetts General Brigham and Women’s and Spaulding Rehabilitation Hospitals

Dr. Silver

Julie Silver, MD
Associate Professor and Associate Chair
Department of Physical Medicine and Rehabilitation at Harvard Medical School and
Staff physician at Massachusetts General
Brigham and Women’s and Spaulding Rehabilitation Hospitals 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There are many documented disparities for women in medicine that include promotion and compensation. For physicians in academic medicine, both promotion and compensation may be directly or indirectly linked to publishing. Similarly, opportunities that stem from publishing such as speaking engagements, may be affected by a physician’s ability to publish.

For more than twenty years, there have been reports of women being underrepresented on journal editorial boards and gaps in their publishing rates. For example, a report titled “Is There a Sex Bias in Choosing Editors?” by Dickersin et al was published in JAMA in 1998 and made a compelling case for bias. Moreover, the authors noted that “a selection process favoring men would have profound ramifications for the professional advancements and influence of women”. Despite a steady stream of reports over the years, gaps have not been sufficiently addressed, and in 2014 Roberts published an editorial in Academic Psychiatry titled “Where Are the Women Editors?”. The 2017 review by Hengel titled “Publishing While Female” highlights many of the gaps, disparities and barriers for women in medicine.

Conventional reasons for disparities, such as there are not enough women in the pipeline or women do not want to conduct research or pursue leadership positions, are simply not valid. Therefore, it is important to look at other barriers, such as unconscious (implicit) bias that may affect the editorial process.

In this study, we analyzed perspective type articles from four high impact pediatric journals. We selected pediatrics, because most pediatricians are women, and therefore there are plenty of highly accomplished women physicians. We found that women were underrepresented among physician first authors in all of the journals (140 of 336 [41.7%]).

We also found that underrepresentation was more pronounced in article categories that were described as more scholarly (range, 15.4%-44.1%) versus narrative (52.9%-65.6%).  Continue reading

Powerful Men More Inclined to Sexually Harass When They Fear Being Perceived As Incompetent

MedicalResearch.com Interview with:

Leah Halper, PhD Associate Director Office of Student Life Center for the Study of Student Life Columbus, OH 43210

Dr. Halper

Leah Halper, PhD
Associate Director
Office of Student Life Center for the Study of Student Life
Columbus, OH 43210

MedicalResearch.com: What is the background for this study? What are the main findings?

 Response: We started to run these studies in 2014 given mutual research interests that we shared. We knew that there was much research on sexual harassment that focused on the victim, the victim’s experience and the reporting process for sexual harassment. This work is extremely valuable. We noticed, however, that there was less research on the perpetrator and if there were personality variables related to the likelihood of sexual harassment. In our studies, we demonstrate that a personality variable (Fear of Negative Evaluation, or anxiety that others will see one as incompetent) is related to sexual harassment among men in powerful positions. Our results held up after taking into account other personality variables, such as narcissism and self-esteem. Also, we found that men who felt insecure in their power (i.e., those that were anxious that others would see them as incompetent) were more likely to engage in both quid pro quo harassment – asking for sexual favors in return for something else – and gender harassment – creating a hostile environment for women.

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More Stress Among LGB Adults Where Policies Permit Denial of Service to Same Sex Couples

MedicalResearch.com Interview with:

Julia Raifman, ScD SM Assistant Professor Health Law, Policy, and Management Boston University School of Public Health Boston, MA 02118

Dr. Raifman

Julia Raifman, ScD SM
Assistant Professor
Health Law, Policy, and Management
Boston University School of Public Health
Boston, MA 02118

MedicalResearch.com: What is the background for this study? What methods did you use? What are the main findings?

Response: The study was motivated by evidence that lesbian, gay, and bisexual (LGB) people in the United States have elevated levels of depression, anxiety, suicide, and mental distress. LGB mental health disparities have been linked to experiences of stigma based on sexual orientation, but most of this evidence comes from studies of association. We were interested in investigating how state policies permitting the denial of services to same-sex couples affected the mental health of LGB individuals.

We used data that are representative of all adults in each of the nine states included in the study, from the 2014 to 2016 waves of the Behavioral Risk Factor Surveillance System (BRFSS). The main outcome was mental distress, which can include stress, depression, and problems with emotions. We evaluated changes in mental distress among LGB adults in three states that passed policies permitting the denial of services to same-sex couples compared to changes in mental distress among heterosexual adults in the same states and among LGB adults in six control states. We controlled for all state characteristics that did not change over time, as well as individual age group, race, ethnicity,  sex, educational attainment, employment, income, and marital status.  Continue reading

More Young Women Than Men Now Get Lung Cancer

MedicalResearch.com Interview with:
“Woman smoking” by Pedro Ribeiro Simões is licensed under CC BY 2.0Ahmedin Jemal, DVM, PHD
Scientific Vice President, Surveillance & Health Services Rsch
American Cancer Society, Inc.
Atlanta, GA 30303

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Historically, lung cancer rates have been higher in men than women at all ages because of the substantially higher cigarette smoking prevalence in men.

However, cigarette smoking prevalences over the past few decades have become similar between young men and women. Consistent with this pattern, we previously reported the convergence of lung cancer rates between young men and young women. In this paper, we examined the lung cancer incidence rates in young women versus young men in the contemporary cohorts.

We found that the historically higher lung cancer incidence rates in young men than in young women have reversed in whites and Hispanics born since the mid-1960s. However, this emerging incidence patterns were not fully explained by sex difference in smoking prevalence as cigarette smoking prevalences among whites and Hispanics were not higher in young women than young men.

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Men Receive Triple Amount of Cancer Research Funding

MedicalResearch.com Interview with:
“Faecal Coliforms analysis” by SuSanA Secretariat is licensed under CC BY 2.0Dr. Mahiben Maruthappu

Public Health Registrar

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Gender disparities in the fields of science and technology have been documented, and  it becomes increasingly apparent at higher levels of seniority. In this analysis, we found a quantifiable difference in cancer research funding awarded to female principle investigators compared to male principle investigators (PIs).

Across all cancer research funding grants that we identified, male PIs received 3.6 times the total investment value, and 1.6 times the average award value compared with their female counterparts.  Continue reading