Gender disparities in advanced endoscopy fellowship

Abstract Background and study aims Women remain underrepresented in gastroenterology, especially advanced endoscopy. Women represent 30 % of general gastroenterology fellows; yet in 2019, only 12.8 % of fellows who matched into advanced endoscopy fellowship (AEF) programs were women. Methods We administered a web-based survey to the program directors (PDs) of AEF programs that participated in the 2018–2019 American Society for Gastroenterology (ASGE) match. We assessed PD and program characteristics, in addition to perceived barriers and facilitators (scale 1–5, 5 = most important) influencing women pursuing AEF training. Results We received 38 (59.3 %) responses from 64 PDs. 15.8 % (6/38) of AEF PDs and 13.2 % (5/38) of endoscopy chiefs were women. By program, women represented 14.8 % (mean) ± 17.0 % (SD) of AEF faculty and 12.0 % (mean) ± 11.1 % (SD) of AEF trainees over the past 10 years. 47.4 % (18/38) programs reported no female advanced endoscopy faculty and 31.6 % (12/38) of programs have never had a female fellow. Percentage of female fellows was strongly associated with percentage of female AEF faculty (ß = 0.43, P < 0.001). Inflexible hours and call (mean rank 3.3 ± 1.1), exposure to fluoroscopy (2.9 ± 1.1), lack of women endoscopists at national conferences/courses (2.9 ± 1.1) and lack of female mentorship (2.9 ± 1.0) were cited as the most important barriers to recruitment. Conclusion We utilized a survey of AEF PDs participating in the ASGE match to determine program characteristics and identify contributors to gender disparity. Women represent a minority of AEF PDs, endoscopy chiefs, advanced endoscopy faculty and AEF trainees. Our study highlights perceived barriers and facilitators to recruitment, and emphasizes the importance of having female representation in faculty, and leadership positions in endoscopy.

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Factors associated with self-reported adherence to daily oral pre-exposure prophylaxis among men who have sex with man and transgender women: PrEP Brasil study

International Journal of STD & AIDS ◽

10.1177/09564624211031787 ◽

2021 ◽

pp. 095646242110317

Author(s):

Luana Monteiro Spindola Marins ◽

Thiago Silva Torres ◽

Paula Mendes Luz ◽

Ronaldo I Moreira ◽

Iuri C Leite ◽

...

Keyword(s):

Multivariable Analysis ◽

Transgender Women ◽

Perceived Barriers ◽

Barriers And Facilitators ◽

Open Label ◽

Stimulant Use ◽

Factors Associated ◽

The Past ◽

Exposure Prophylaxis ◽

Oral Prep

Understanding the factors associated with pre-exposure prophylaxis (PrEP) adherence may help in the development of strategies to support, motivate and sustain PrEP use. This study estimated self-reported adherence, described perceived barriers and facilitators and investigated factors associated with adherence to daily oral PrEP among men who have sex with man (MSM) and transgender women after 1 year of PrEP use in Brazil. PrEP Brasil was a prospective, multicentre, open-label demonstration study with MSM and transgender women at high risk for HIV infection. We used logistic regression to evaluate factors associated with complete adherence (not forgetting to take any pills in the past 30 days) at week 48. Of 338 participants included in this analysis, 60% reported complete adherence to daily oral PrEP at week 48. Perceived barriers and facilitators to daily oral PrEP were reported by 38.2% and 98.5%, respectively. The most reported barrier and facilitator were ‘I forgot to take my pills’ (19.2%) and ‘Associate PrEP with a daily activity/task’ (58.6%), respectively. In final multivariable analysis, living in Rio de Janeiro (aOR: 0.38; 95% CI: 0.20–0.73), being transgender women (aOR: 0.22; 95% CI: 0.07–0.73), reporting stimulant use (a OR: 0.40; 95% CI: 0.20–0.80) and having any perceived barriers to daily oral PrEP (aOR: 0.12; 95% CI: 0.07–0.23) were associated with decreased odds of complete adherence. Our findings provide information for developing the best practices to promote PrEP adherence in the Brazilian context.

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Barriers and Facilitators When Implementing Web-Based Disease Monitoring and Management as a Substitution for Regular Outpatient Care in Pediatric Asthma: Qualitative Survey Study (Preprint)

10.2196/preprints.9245 ◽

2017 ◽

Author(s):

Lara S van den Wijngaart ◽

Wytske W Geense ◽

Annemie LM Boehmer ◽

Marianne L Brouwer ◽

Cindy AC Hugen ◽

...

Keyword(s):

Health Care ◽

Health Care Professionals ◽

Outpatient Care ◽

Organizational Context ◽

Perceived Barriers ◽

Barriers And Facilitators ◽

Survey Study ◽

Disease Monitoring ◽

Successful Implementation ◽

Web Based

BACKGROUND Despite their potential benefits, many electronic health (eHealth) innovations evaluated in major studies fail to integrate into organizational routines, and the implementation of these innovations remains problematic. OBJECTIVE The purpose of this study was to describe health care professionals’ self-identified perceived barriers and facilitators for the implementation of a Web-based portal to monitor asthmatic children as a substitution for routine outpatient care. Also, we assessed patients’ (or their parents) satisfaction with this eHealth innovation. METHODS Between April and November 2015, we recruited 76 health care professionals (from 14 hospitals). During a period of 6 months, participants received 3 questionnaires to identify factors that facilitated or impeded the use of this eHealth innovation. Questionnaires for patients (or parents) were completed after the 6-month virtual asthma clinic (VAC) implementation period. RESULTS Major perceived barriers included concerns about the lack of structural financial reimbursement for Web-based monitoring, lack of integration of this eHealth innovation with electronic medical records, the burden of Web-based portal use on clinician workload, and altered patient-professional relationship (due to fewer face-to-face contacts). Major perceived facilitators included enthusiastic and active initiators, a positive attitude of professionals toward eHealth, the possibility to tailor care to individual patients (“personalized eHealth”), easily deliverable care according to current guidelines using the VAC, and long-term profit and efficiency. CONCLUSIONS The implementation of Web-based disease monitoring and management in children is complex and dynamic and is influenced by multiple factors at the levels of the innovation itself, individual professionals, patients, social context, organizational context, and economic and political context. Understanding and defining the barriers and facilitators that influence the context is crucial for the successful implementation and sustainability of eHealth innovations.

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Jackie (and Jill) Robinson in the Statehouse: Gender and Educational Attainment Influences on Office-Holding and Leadership Positions in the U.S. States

International Journal of Social Science Studies ◽

10.11114/ijsss.v5i6.2290 ◽

2017 ◽

Vol 5 (6) ◽

pp. 15

Author(s):

Jayme L. Neiman

Keyword(s):

United States ◽

The United States ◽

Gender Disparity ◽

Gender Imbalance ◽

Leadership Positions ◽

The Past ◽

Female Candidates ◽

Education Levels ◽

The Relationship ◽

The U.S

While legislative gender disparity has declined over the past few decades, gender imbalance has continued to be a stubborn fact of representative democracy in the United States. This divide persists even though females have caught up in terms of the historical educational gap. These societal shifts have been significant, however little time has been devoted to analysis of legislator education levels and none to the relationship with gender in the extant literature. This paper seeks to fill that gap, looking at the intersection through the lens of one of the prevailing theories of the expectations of female candidates and legislators.

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Knowledge and perceptions of cardiopulmonary resuscitation amongst New Zealand podiatrists: a web-based survey

Journal of Foot and Ankle Research ◽

10.1186/s13047-021-00481-9 ◽

2021 ◽

Vol 14 (1) ◽

Author(s):

Angela Brenton-Rule ◽

Daniel Harvey ◽

Kevin Moran ◽

Daniel O’Brien ◽

Jonathon Webber

Keyword(s):

New Zealand ◽

Cardiopulmonary Resuscitation ◽

Life Support ◽

Survival Rates ◽

Sudden Cardiac Arrest ◽

Cross Sectional Study ◽

Trial Registration ◽

Cross Sectional ◽

Web Based ◽

The Past

Abstract Background Podiatrists in New Zealand have a duty of care to assist patients in an emergency, and current cardiopulmonary resuscitation (CPR) certification is a requirement for registration. However, it is unknown how competent and confident podiatrists are in administering CPR and how they would respond in an emergency. Having a health professional who has a competent knowledge of CPR and skills in basic life support, can improve survival rates from sudden cardiac arrest. Therefore, the aim of this study was to survey New Zealand podiatrists to determine their CPR knowledge and qualifications; beliefs about the application of CPR; and perceptions of their competency in CPR. Methods This cross-sectional study used a web-based survey. Participants were New Zealand registered podiatrists with a current annual practising certificate. The 31-item survey included questions to elicit demographic information, CPR practice and attitudes, and CPR knowledge. Responses were collected between March and August 2020. Results 171 podiatrists responded to the survey. 16 % of the podiatrists (n = 28) had performed CPR in an emergency, with a 50 % success rate. Participants were predominantly female (n = 127, 74 %) and working in private practice (n = 140,82 %). Nearly half of respondents were younger than 40 years (n = 75,44 %) and had less than 10 years of clinical experience (n = 73, 43 %). Nearly all (n = 169,97 %) participants had received formal CPR training in the past two years, with 60 % (n = 105) receiving training in the past 12 months. Most respondents (n = 167,98 %) self-estimated their CPR ability as being effective, very effective, or extremely effective. Participants’ knowledge of CPR was variable, with the percentage of correct answers for CPR protocol statements ranging between 20 and 90 %. Conclusions This study provides the first insight into New Zealand podiatrists’ CPR knowledge and perceptions. Podiatrists were found to have high levels of CPR confidence but demonstrated gaps in CPR knowledge. Currently, New Zealand registered podiatrists require biennial CPR re-certification. However, resuscitation authorities in New Zealand and overseas recommend an annual update of CPR skills. Based on this study’s findings, and in line with Australia and the United Kingdom, the authors recommend a change from biennial to annual CPR re-certification for podiatrists in New Zealand. Trial registration The study was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12620001144909).

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How Is Geriatric Assessment Used in Clinical Practice for Older Adults With Cancer? A Survey of Cancer Providers by the American Society of Clinical Oncology

JCO Oncology Practice ◽

10.1200/op.20.00442 ◽

2020 ◽

pp. OP.20.00442

Author(s):

William Dale ◽

Grant R. Williams ◽

Amy R. MacKenzie ◽

Enrique Soto-Perez-de-Celis ◽

Ronald J. Maggiore ◽

...

Keyword(s):

Older Adults ◽

Geriatric Assessment ◽

Online Survey ◽

Task Force ◽

Statistical Significance ◽

Geriatric Oncology ◽

Perceived Barriers ◽

Patients With Cancer ◽

Change Behavior ◽

American Society

PURPOSE: For patients with cancer who are older than 65 years, the 2018 ASCO Guideline recommends geriatric assessment (GA) be performed. However, there are limited data on providers’ practices using GA. Therefore, ASCO’s Geriatric Oncology Task Force conducted a survey of providers to assess practice patterns and barriers to GA. METHODS: Cancer providers treating adult patients including those ≥ 65 years completed an online survey. Questions included those asking about awareness of ASCO’s Geriatric Oncology Guideline (2018), use of validated GA tools, and perceived barriers to using GA. Descriptive statistics and statistical comparisons between those aware of the Guideline and those who were not were conducted. Statistical significance was set at P < .05. RESULTS: Participants (N = 1,277) responded between April 5 and June 5, 2019. Approximately half (53%) reported awareness of the Guideline. The most frequently used GA tools, among those aware of the Guideline and those who were not, assessed functional status (69% v 50%; P < .001) and falls (62% v 45%; P < .001). Remaining tools were used < 50% of the time, including tools assessing weight loss, comorbidities, cognition, life expectancy, chemotherapy toxicity, mood, and noncancer mortality risk. GA use was two to four times higher among those who are aware of the Guideline. The most frequent barriers for those who reported being Guideline aware were lack of resources, specifically time (81.7%) and staff (77.0%). In comparison, those who were unaware of the Guideline most often reported the following barriers: lack of knowledge or training (78.4%), lack of awareness about tools (75.2%), and uncertainty about use of tools (75.0%). CONCLUSION: Among providers caring for older adults, 52% were aware of the ASCO Guideline. Some domains were assessed frequently (eg, function, falls), whereas other domains were assessed rarely (eg, mood, cognition). Guideline awareness was associated with two to four times increased use of GA and differing perceived barriers. Interventions facilitating Guideline-consistent implementation will require various strategies to change behavior.

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Nurses’ Perceptions of Barriers and Facilitators to Implement EBP in the Maldives

Advances in Nursing ◽

10.1155/2014/698604 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 10

Author(s):

Fathimath Shifaza ◽

David Evans ◽

Helen Bradley

Keyword(s):

Relevant Literature ◽

Developed Countries ◽

Perceived Barriers ◽

Barriers And Facilitators ◽

Healthcare Organisation ◽

Clear Understanding ◽

Healthcare Facilities ◽

New Ideas ◽

Insufficient Time ◽

Nurses Perceptions

This study aims to explore the barriers to evidence based practice (EBP) experienced by nurses working in a Maldivian healthcare organisation. A total of 400 questionnaires were distributed to nurses in 5 healthcare facilities and 198 completed questionnaires were returned. The results of this study show that the perceived barriers by the nurses in the Maldives are not significantly different from those reported in developed countries. For healthcare organisations in the Maldives, it is necessary to have a clear understanding of the barriers and facilitators to research practice in order to implement EBP. The study showed that the major barriers to research use were that “the relevant literature is not compiled in one place,” there is “insufficient time on the job to implement new ideas,” and “administration will not allow implementation.” The key facilitating factors for EBP include support, encouragement, and recognition by the management and administration. The findings of this study can be useful for determining strategies that can be introduced in the clinical setting to use EBP. Healthcare organisations must continue their support in order to decrease the barriers and optimise care in healthcare facilities.

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Changing Patterns of Politicization and Partisanship Among Women in France

British Journal of Political Science ◽

10.1017/s0007123400004075 ◽

1985 ◽

Vol 15 (1) ◽

pp. 75-96 ◽

Cited By ~ 5

Author(s):

Sylvia B. Bashevkin

Keyword(s):

Political Attitudes ◽

Decision Makers ◽

Political Involvement ◽

North American Society ◽

Social Activists ◽

The Past ◽

Changing Patterns ◽

American Society ◽

Feminist Movements

During the past decade, political researchers have devoted growing attention to women's political involvement and, to a somewhat lesser extent, their political attitudes in Western cultures. This interest has been a response in part to contemporary feminist movements and, more specifically, to the increasingly visible role of women as social activists, partisan elites and governmental decision makers in Western European and North American society.

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