Gender disparities

性别差异
  • 文章类型: Journal Article
    泌尿生殖系统癌症相关死亡率的社会人口统计学差异尚未得到充分研究,特别是在多种癌症类型中。本研究旨在调查性别,种族,以及美国最常见的泌尿生殖系统癌症死亡率的地理差异。
    前列腺死亡率数据,膀胱,肾,和睾丸癌从疾病控制和预防中心(CDC)WONDER数据库在1999年至2020年之间获得。按年份分析了年龄调整后的死亡率(AAMR),性别,种族,城乡地位,和地理区域使用P<0.05的显著性水平。
    总的来说,用于前列腺的AAMR,膀胱,肾癌显著下降,而睾丸癌相关死亡率保持稳定.膀胱和肾癌AAMR男性比女性高3-4倍。前列腺癌死亡率在黑人/非裔美国人中最高,2015年后开始增加。白种人膀胱癌死亡率显著下降,黑人个体,非洲裔美国人,和亚洲人/太平洋岛民,但在美洲印第安人/阿拉斯加原住民中保持稳定。与肾癌相关的死亡率在白人中最高,但在其他种族中显着下降。白人的睾丸癌死亡率显着增加,但黑人和非裔美国人保持稳定。大城市地区的泌尿生殖系统癌症死亡率下降,但在非大城市地区增加(膀胱癌和睾丸癌)或保持稳定(肾癌)。前列腺癌和肾癌死亡率在中西部最高,南方的膀胱癌,西方的睾丸癌.
    在美国泌尿生殖系统癌症的死亡率趋势中存在显著的社会人口统计学差异。这些发现强调了有针对性的干预措施和进一步研究的必要性,以解决这些差异并改善所有受泌尿生殖系统癌症影响的人群的结果。
    UNASSIGNED: Sociodemographic disparities in genitourinary cancer-related mortality have been insufficiently studied, particularly across multiple cancer types. This study aimed to investigate gender, racial, and geographic disparities in mortality rates for the most common genitourinary cancers in the United States.
    UNASSIGNED: Mortality data for prostate, bladder, kidney, and testicular cancers were obtained from the Centers for Disease Control and Prevention (CDC) WONDER database between 1999 and 2020. Age-adjusted mortality rates (AAMRs) were analyzed by year, gender, race, urban-rural status, and geographic region using a significance level of p < 0.05.
    UNASSIGNED: Overall, AAMRs for prostate, bladder, and kidney cancer declined significantly, while testicular cancer-related mortality remained stable. Bladder and kidney cancer AAMRs were 3-4 times higher in males than females. Prostate cancer mortality was highest in black individuals/African Americans and began increasing after 2015. Bladder cancer mortality decreased significantly in White individuals, Black individuals, African Americans, and Asians/Pacific Islanders but remained stable in American Indian/Alaska Natives. Kidney cancer-related mortality was highest in White individuals but declined significantly in other races. Testicular cancer mortality increased significantly in White individuals but remained stable in Black individuals and African Americans. Genitourinary cancer mortality decreased in metropolitan areas but either increased (bladder and testicular cancer) or remained stable (kidney cancer) in non-metropolitan areas. Prostate and kidney cancer mortality was highest in the Midwest, bladder cancer in the South, and testicular cancer in the West.
    UNASSIGNED: Significant sociodemographic disparities exist in the mortality trends of genitourinary cancers in the United States. These findings highlight the need for targeted interventions and further research to address these disparities and improve outcomes for all populations affected by genitourinary cancers.
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  • 文章类型: Journal Article
    目的:我们旨在描述当前时代主要心胸外科杂志编辑委员会性别构成的时间趋势。
    方法:对2008年至2023年两个北美心胸外科杂志的编辑委员会成员的性别代表性进行了横断面分析。成员姓名和角色是从可用的每月问题中收集的。使用经过验证的软件编程对性别进行分类。将女性代表的年度比例与胸外科劳动力进行了比较。
    结果:在研究期间,确定了558个人(3,641个名字),其中14.3%是女性。两种期刊的编辑委员会妇女总数都有所增加。妇女的比例也从2008年的2.5%(3/118)增加到2023年的17.8%(71/399)(P<.001),超过女性在胸外科劳动力中所占的比例,从2007年的3.8%增加到2021年的8.3%(P<0.001)。男性的平均参与时间比女性长(53.8个月比44.5个月,P=0.01)。编辑委员会高级职位中的女性也从2008年的3.3%(1/30)增加到2023年的28.6%(42/147)(P<.001),非指定职位的增长几乎是非指定职位的三倍,从2008年的2.3%(2/88)增加到2023年的11.5%(29/252)(P<.001)。
    结论:近年来,女性在高影响力心胸外科杂志编辑委员会和高级职位的任命比例超过了女性在心胸外科的总体代表性。这些发现表明在包容性努力方面取得了进展,并为减少学术性别差异提供了见解。
    OBJECTIVE: We aimed to characterize chronologic trends of gender composition of major cardiothoracic surgery journal editorial boards in the current era.
    METHODS: A cross-sectional analysis was performed of gender representation in editorial board members of two North American cardiothoracic surgery journals from 2008 to 2023. Member names and roles were collected from available monthly issues. Validated software programming was used to classify gender. The annual proportion of women representation was compared to the thoracic surgery workforce.
    RESULTS: During the study period, 558 individuals (3,641 names) were identified, 14.3% of whom were women. The total number of editorial board women increased for both journals. The proportion of women also increased from 2.5% (3/118) in 2008 to 17.8% (71/399) in 2023 (P < .001), exceeding the percentage of women in the thoracic surgery workforce which increased from 3.8% in 2007 to 8.3% in 2021 (P < .001). The average duration of participation was longer for men than for women (53.8 vs 44.5 months, P = .01). Women in editorial board senior roles also increased from 3.3% (1/30) in 2008 to 28.6% (42/147) in 2023 (P < .001), almost triple the increase in non-designated roles from 2.3% (2/88) in 2008 to 11.5% (29/252) in 2023 (P < .001).
    CONCLUSIONS: In recent years, the appointment of women to high-impact cardiothoracic surgery journal editorial boards and senior roles have proportionally exceeded the overall representation of women in cardiothoracic surgery. These findings indicate progress in inclusive efforts and offer insight towards reducing academic gender disparities.
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  • 文章类型: Journal Article
    目的:这项研究的目的是检查过去二十年来女性在CT杂志编辑委员会中的代表性,以确定与女性CT外科医生和实习生代表性相比随时间的变化。并强调额外的改进机会。
    方法:回顾了2000年至2023年两本高影响力CT期刊的编辑委员会。包括总编辑在内的编委会职位数据,助理/副编辑,功能编辑器,和编辑委员会的一般成员被抽象出来。评估了女性编辑的比例。将数据与美国医学院协会(AAMC)按性别分列的医师专业公开信息进行比较。
    结果:在3,460个编辑职位中,332人(9.6%)由妇女持有。女性占总编辑职位的2.2%(n=1/45),13.2%(n=78/592)的高级编辑职位,11.5%(n=33/287)的特征编辑器位置,和8.3%(n=221/2663)的总编委职位。担任任何编辑委员会职位的妇女比例从2000年的2.4%显着增加到2023年的18.2%(p=0.01)。总的来说,编委会代表以每年0.7%±1.3%的平均±标准差增加,与每年0.3%±0.5%的执业女性CT外科医生的增长没有显着差异(p=0.584)。
    结论:在CT杂志编辑委员会中,女性的比例随着女性CT外科医生的增加而增加,但仍保持在16%。仍然需要继续招募妇女进行CT手术,并确定可以支持她们担任领导职务的关键因素。
    OBJECTIVE: The objective of this study was to examine representation of women on CT journal editorial boards over the past two decades to identify changes over time compared to women CT surgeon and trainee representation, and to highlight additional opportunities for improvement.
    METHODS: The editorial boards of two high impact CT journals were reviewed from 2000 to 2023. Data on editorial board positions including editors-in-chief, associate/deputy editors, feature editors, and general members of the editorial board were abstracted. The proportion of women editors was assessed. Data were compared to publicly available information from the Association of American Medical Colleges (AAMC) on physician specialty by sex.
    RESULTS: Of 3,460 editorial positions, 332 (9.6%) were held by women. Women occupied 2.2% (n=1/45) of editor-in-chief positions, 13.2% (n=78/592) of senior editor positions, 11.5% (n=33/287) of feature editor positions, and 8.3% (n=221/2,663) of general editorial board positions. The proportion of women holding any editorial board position significantly increased from 2.4% in 2000 to 18.2% in 2023 (p=0.01). Overall, editorial board representation increased at a mean ± standard deviation rate of 0.7%±1.3% per year, not significantly different from the growth of practicing women CT surgeons at 0.3%±0.5% per year (p=0.584).
    CONCLUSIONS: Representation of women on CT journal editorial boards has increased commensurate with the increasing proportion of practicing women CT surgeons, though remains at 16%. Work remains to continue the recruitment of women to CT surgery as well as to identify the key elements that can support them in positions of leadership.
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  • 文章类型: Journal Article
    背景:研究表明,与男性医生相比,患者对女性医生的期望不同。包括对以患者为中心的沟通和解决社会经济或情感需求的更高期望。最近的证据表明,这种性别差异延伸到电子健康记录(EHR)。没有对住院医师进行过类似的研究。
    目的:本研究旨在描述女性住院医师与男性住院医师相比EHR工作量的差异。
    方法:本研究使用Epic的信号和医师效率概况(PEP)数据评估了2020年7月至2021年6月的156名梅奥诊所内科住院医师的12个月数据。Excel,BlueSky统计,采用SAS分析软件进行分析。配对t检验和方差分析用于按性别和研究生年(PGY)比较PEP数据。“男性”和“女性”被用来代替“性别”,这是文献中的先例。
    方法:梅奥诊所内科住院医师。
    方法:每天在EHR中花费的总时间;每天的入篮和笔记时间;每次预约的笔记时间;通过门户网站提出的患者建议请求数;消息周转时间。
    结果:女性居民每年收到更多的患者建议请求(p=0.004),平均为86.7,而平均为68,导致每天工作的患者建议请求增加了34%(p<0.001)。女性居民每天花费更多的时间(p=0.002),在每天的笔记中(p<0.001),以及每次预约的笔记(p=0.001)。居民小组比较显示,女性(n=55)相对于男性(n=34)居民小组中女性患者明显更多(p<0.001)。消息周转时间没有区别,总消息,或收到的结果数。
    结论:尽管结果数量和小组规模相当,但女性住院医师的患者主动信息和EHR工作量明显增多。收入负担中的性别差异可能会不成比例地影响居民的教育经历。
    BACKGROUND: Studies have demonstrated patients hold different expectations for female physicians compared to male physicians, including higher expectations for patient-centered communication and addressing socioeconomic or emotional needs. Recent evidence indicates this gender disparity extends to the electronic health record (EHR). Similar studies have not been conducted with resident physicians.
    OBJECTIVE: This study seeks to characterize differences in EHR workload for female resident physicians compared to male resident physicians.
    METHODS: This study evaluated 12 months of 156 Mayo Clinic internal medicine residents\' inbasket data from July 2020 to June 2021 using Epic\'s Signal and Physician Efficiency Profile (PEP) data. Excel, BlueSky Statistics, and SAS analytical software were used for analysis. Paired t-tests and analysis of variance were used to compare PEP data by gender and postgraduate year (PGY). \"Male\" and \"female\" were used in substitute for \"gender\" as is precedent in the literature.
    METHODS: Mayo Clinic internal medicine residents.
    METHODS: Total time spent in EHR per day; time in inbasket and notes per day; time in notes per appointment; number of patient advice requests made through the portal; message turnaround time.
    RESULTS: Female residents received more patient advice requests per year (p = 0.004) with an average of 86.7 compared to 68, resulting in 34% more patient advice requests per day worked (p < 0.001). Female residents spent more time in inbasket per day (p = 0.002), in notes per day (p < 0.001), and in notes per appointment (p = 0.001). Resident panel comparisons revealed equivocal sizes with significantly more female patients on female (n = 55) vs male (n = 34) resident panels (p < 0.001). There was no difference in message turnaround time, total messages, or number of results received.
    CONCLUSIONS: Female resident physicians experience significantly more patient-initiated messages and EHR workload despite equivalent number of results and panel size. Gender differences in inbasket burden may disproportionally impact the resident educational experience.
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  • 文章类型: Journal Article
    背景:基于性别的歧视,特别是在医疗保健方面,影响女性的角色和机会,包括在外科手术中,他们在领导职位上的代表性仍然不足。这种歧视在担任职务中普遍存在的程度尚不清楚。
    方法:提取了德国48所大学和大学相关医院的公开记录,以量化内脏领域的主治医生和头外科医生的性别比例。血管,心脏,胸廓,儿科,口面,神经-,创伤,整形手术。统计分析,包括卡方检验和学生t检验,用于分析数据。
    结果:在367个部门负责人中,男性353(96.2%),女性14(3.8%)。在2366名出席者中,1,854(78.4%)为男性,512(21.6%)为女性。这些差异是显著的(χ²=64.95,p<0.001,比值比=0.14,95%置信区间=0.08-0.25)。由女性部门负责人领导的部门不太可能雇用女性就诊(χ²=0.379,p=0.538,比值比=1.17,95%置信区间=0.70-1.96)。
    结论:大学医院的德国外科部门存在显著的性别差异,妇女在更高层次上的代表性不足。这可能对患者结果产生负面影响。为了解决这个问题,需要进一步的研究来充分理解这个问题。
    BACKGROUND:  Gender-based discrimination, particularly in healthcare, affects women\'s roles and opportunities, including in surgery where they remain underrepresented in leadership positions. The extent to which such discrimination is prevalent in attending positions is unclear.
    METHODS:  The publicly available records of 48 universities and university-associated hospitals in Germany were extracted to quantify gender ratios among attending surgeons and head surgeons in the fields of visceral, vascular, cardiac, thoracic, pediatric, orofacial, neuro-, trauma, and plastic surgery. Statistical analysis, including Chi-Square tests and Student\'s t-test, was used to analyze the data.
    RESULTS:  Among the 367 department heads, 353 (96.2%) were male and 14 (3.8%) were female. Among the 2,366 attendings, 1,854 (78.4%) were men and 512 (21.6%) were women. These differences were significant (χ²=64.95, p<0.001, odds ratio=0.14, 95% confidence interval=0.08-0.25). Departments being led by a female department head were not more likely to employ female attendings (χ²=0.379, p=0.538, odds ratio=1.17, 95% confidence interval=0.70-1.96).
    CONCLUSIONS:  German surgical departments in University Hospitals have significant gender disparities, with women underrepresented at higher levels. This may negatively affect patient outcomes. To tackle the problem, further research is needed to fully understand the issue.
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  • 文章类型: Journal Article
    COVID-19深刻而独特地影响了艾滋病毒感染者。艾滋病毒感染者经历了重大的心理社会和社会经济影响,然而,有限的研究探索了艾滋病毒感染者在性别和种族/族裔群体之间的潜在差异。
    这项研究的目的是检查南佛罗里达州不同样本的艾滋病毒感染者中与COVID-19大流行相关的心理社会和社会经济压力源,并确定压力源的类型是否因性别和种族/族裔而异。
    我们分析了迈阿密戴德县的横断面调查数据,RyanWhite计划的接受者.结果包括心理健康,社会经济,药物/酒精,和护理责任/社会支持的变化。加权描述性分析提供了按性别和种族/族裔群体划分的压力源概述,逻辑回归估计了人口统计与压力源之间的关联。
    在291名参与者中,39%是非西班牙裔黑人,18%是海地人,43%是西班牙裔。调整年龄,性别,语言,和外国出生的身份,西班牙裔人更有可能报告精神健康恶化(即孤独感增加,焦虑)和社会经济压力源(即收入下降)。讲西班牙语的人更有可能报告没有得到他们需要的社会支持。女性更有可能报告花更多的时间照顾孩子。
    研究结果强调了文化和性别期望影响艾滋病毒感染者经历的方式,并提出了在持续和未来的公共卫生紧急情况期间提供干预措施和资源的策略。结果表明,突发公共卫生事件对不同社区的影响不同。不承认和回应分歧,我们面临着在卫生公平方面取得进展的风险。
    UNASSIGNED: COVID-19 profoundly and uniquely impacted people with HIV. People with HIV experienced significant psychosocial and socioeconomic impacts, yet a limited amount of research has explored potential differences across gender and racial/ethnic groups of people with HIV.
    UNASSIGNED: The objective of this study was to examine psychosocial and socioeconomic stressors related to the COVID-19 pandemic among a diverse sample of people with HIV in South Florida and to determine if the types of stressors varied across gender and racial/ethnic groups.
    UNASSIGNED: We analyzed data from a cross-sectional survey with Miami-Dade County, Ryan White Program recipients. Outcomes included mental health, socioeconomic, drug/alcohol, and care responsibility/social support changes. Weighted descriptive analyses provided an overview of stressors by gender and racial/ethnic group and logistic regressions estimated associations between demographics and stressors.
    UNASSIGNED: Among 291 participants, 39% were Non-Hispanic Black, 18% were Haitian, and 43% were Hispanic. Adjusting for age, sex, language, and foreign-born status, Hispanics were more likely to report several worsened mental health (i.e. increased loneliness, anxiety) and socioeconomic stressors (i.e. decreased income). Spanish speakers were more likely to report not getting the social support they needed. Women were more likely to report spending more time caring for children.
    UNASSIGNED: Findings highlight ways in which cultural and gender expectations impacted experiences across people with HIV and suggest strategies to inform interventions and resources during lingering and future public health emergencies. Results suggest that public health emergencies have different impacts on different communities. Without acknowledging and responding to differences, we risk losing strides towards progress in health equity.
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  • 文章类型: Journal Article
    背景和客观沙特阿拉伯的快速医学教育扩张对其学生提出了独特的挑战,特别是关于专业选择。广泛接触医学专业对于做出明智的决定至关重要。这项研究探讨了学生家乡的大小如何影响他们对自己喜欢的专业的接触,影响了他们的选择。方法我们的横断面研究收集了4年级和5年级医学生的数据,实习生,和沙特阿拉伯的毕业生。电子调查收集了有关医学专业选择的信息,兴趣水平,学生自我排名与同龄人相比,以及对所选专业的接触水平。通过计算参与者在临床前观察中的经验来量化对专科的总体暴露,说教讲座,研究项目,核心和选修轮换,参加会议。我们将学生分为三个城市大小:主要城市中心,中等城市,和小城镇,并比较了这三组的结果。结果从1072名参与者中获得了回应,424人(39.6%)来自主要城市中心,367(34.2%)来自中等城市,和281个(26.2%)来自小城镇。学生家乡大小是专业暴露的独立预测因素,来自较小城市的学生报告较低的暴露分数(OR=0.73,(0.63-0.84),p<0.01)。该研究还确定了暴露方面的性别差异,发现女学生与较低的暴露分数相关(OR=0.72,(0.58-0.89),p<0.01)。结论城市规模是沙特医学生专业暴露的重要决定因素。这些发现强调了促进平等教育经验的举措的必要性,确保全面的专业接触所有学生。
    Background and objective Saudi Arabia\'s rapid medical education expansion has posed unique challenges for its students, particularly concerning specialty selection. Having broad exposure to medical specialties is crucial for making informed decisions. This study explores how the size of students\' hometowns influences their exposure to their preferred specialty, thereby affecting their choice. Methods Our cross-sectional study collected data from medical students in their 4th and 5th years, interns, and graduates across Saudi Arabia. An electronic survey gathered information about medical specialty choice, interest levels, students\' self-ranking compared to their peers, and level of exposure to the chosen specialty. Overall exposure to specialties was quantified by tallying participants\' experiences in preclinical observerships, didactic lectures, research projects, core and elective rotations, and attended conferences. We divided the students into three city sizes: primary urban centers, intermediate urban cities, and small townships and compared the outcomes between these three groups. Results Responses were obtained from 1,072 participants, with 424 (39.6%) from primary urban centers, 367 (34.2%) from intermediate urban cities, and 281 (26.2%) from small townships. Student hometown size was an independent predictor of specialty exposure, with students from smaller cities reporting lower exposure scores (OR = 0.73, (0.63-0.84), p<0.01). The study also identified gender disparities in exposure, with female students found to be correlated with a lower exposure score (OR = 0.72, (0.58-0.89), p<0.01). Conclusion City size is a significant determinant of specialty exposure for Saudi medical students. These findings highlight the need for initiatives that promote equal educational experiences, ensuring comprehensive specialty exposure to all students.
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  • 文章类型: Journal Article
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  • 文章类型: Editorial
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  • 文章类型: Journal Article
    背景:心脏病学领域的女性在出版物中经历了相当大的性别差异,这阻碍了他们的职业发展到更高的教师和高级领导职位。然而,不同类型心血管文献之间的差异程度尚不清楚.
    目的:我们调查了十年来各种心血管出版物中作者身份的性别差异,并研究了女性作者代表的地理差异。
    方法:从2010年1月1日至2019年12月31日在4种主要心血管杂志上发表的所有论文(美国心脏病学会杂志,欧洲心脏杂志,美国医学会心脏病学杂志,和NatureReviews心脏病学)进行了审查。
    结果:在18,535篇论文中,有111,562位作者,20.6%的作者是女性,47.7%的论文没有女性作者。超过10年,女性作者的比例仍然很低(2010年为20.7%,2019年为21.4%),社论论文比例最低(14.8%),研究论文比例最高(21.8%)。与其他国家相比,更多的女性作为第一作者(34.6%)和最后作者(47.6%)加入美国机构。在以女性为第一作者(29.4%比20.5%)或最后作者(30.6%比21.3%)的论文中,女性中阶作者的比例更高,与男性作为第一或最后作者的论文相比,分别。
    结论:在过去的十年中,主要心血管期刊所有文章类型中女性作者的比例仍然很低.需要呼吁采取行动,促进妇女从事心脏病学,并为她们提供公平的机会。
    BACKGROUND: Women in cardiology experience considerable gender disparities in publications, which hinders their career advancements to higher faculty and senior leadership positions. However, the extent of these disparities across different types of cardiovascular literature is not well understood.
    OBJECTIVE: We investigated gender differences in authorship across various cardiovascular publications over a decade and examined geographic variations in the representation of women authors.
    METHODS: All papers published from January 1, 2010, to December 31, 2019, in 4 major cardiovascular journals (Journal of the American College of Cardiology, European Heart Journal, Journal of the American Medical Association Cardiology, and Nature Reviews Cardiology) were reviewed.
    RESULTS: Of the 18,535 papers with 111,562 authors, 20.6% of the authors were women, and 47.7% of the papers had no women authors. Over 10 years, the proportion of women authors remained low (20.7% in 2010 to 21.4% in 2019), with the lowest proportion in editorial papers (14.8%) and the highest in research papers (21.8%). More women as first (34.6%) and last (47.6%) authors were affiliated with institutions in the United States compared with other countries. The proportion of women middle-order authors was higher on papers with women as first authors (29.4% vs 20.5%) or last authors (30.6% vs 21.3%), compared with papers with men as first or last authors, respectively.
    CONCLUSIONS: Over the past decade, the proportion of women authors across all article types in major cardiovascular journals remained low. A call to action is needed to promote women in cardiology and provide them with equitable opportunities.
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