The prevalence and impact of gender bias and sexual discrimination in orthopaedics, and mitigating strategies

2020 ◽  
Vol 102-B (11) ◽  
pp. 1446-1456
Author(s):  
Usman A. Halim ◽  
Abdulrahman Elbayouk ◽  
Adam M. Ali ◽  
Clare M. Cullen ◽  
Saqib Javed
Keyword(s):  
Gender Bias ◽  
Role Models ◽  
Orthopaedic Surgery ◽  
Educational Interventions ◽  
Cochrane Library ◽  
Original Research ◽  
Significant Heterogeneity ◽  
Substantial Impact ◽  
Sexual Discrimination ◽  
The Impact

Aims Gender bias and sexual discrimination (GBSD) have been widely recognized across a range of fields and are now part of the wider social consciousness. Such conduct can occur in the medical workplace, with detrimental effects on recipients. The aim of this review was to identify the prevalence and impact of GBSD in orthopaedic surgery, and to investigate interventions countering such behaviours. Methods A systematic review was conducted by searching Medline, EMCARE, CINAHL, PsycINFO, and the Cochrane Library Database in April 2020, and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to which we adhered. Original research papers pertaining to the prevalence and impact of GBSD, or mitigating strategies, within orthopaedics were included for review. Results Of 570 papers, 27 were eligible for inclusion. These were published between 1998 and 2020. A narrative review was performed in light of the significant heterogeneity displayed by the eligible studies. A total of 13 papers discussed the prevalence of GBSD, while 13 related to the impact of these behaviours, and six discussed mitigating strategies. GBSD was found to be common in the orthopaedic workplace, with all sources showing women to be the subjects. The impact of this includes poor workforce representation, lower salaries, and less career success, including in academia, for women in orthopaedics. Mitigating strategies in the literature are focused on providing female role models, mentors, and educational interventions. Conclusion GBSD is common in orthopaedic surgery, with a substantial impact on sufferers. A small number of mitigating strategies have been tested but these are limited in their scope. As such, the orthopaedic community is obliged to participate in more thoughtful and proactive strategies that mitigate against GBSD, by improving female recruitment and retention within the specialty. Cite this article: Bone Joint J 2020;102-B(11):1446–1456.

The prevalence and impact of gender bias and sexual discrimination in orthopaedics, and mitigating strategies

2020 ◽  
pp. 1-11
Author(s):  
Usman A. Halim ◽  
Abdulrahman Elbayouk ◽  
Adam M. Ali ◽  
Clare M. Cullen ◽  
Saqib Javed
Keyword(s):  
Gender Bias ◽  
Role Models ◽  
Orthopaedic Surgery ◽  
Educational Interventions ◽  
Cochrane Library ◽  
Original Research ◽  
Significant Heterogeneity ◽  
Substantial Impact ◽  
Sexual Discrimination ◽  
The Impact

Aims Gender bias and sexual discrimination (GBSD) have been widely recognized across a range of fields and are now part of the wider social consciousness. Such conduct can occur in the medical workplace, with detrimental effects on recipients. The aim of this review was to identify the prevalence and impact of GBSD in orthopaedic surgery, and to investigate interventions countering such behaviours. Methods A systematic review was conducted by searching Medline, EMCARE, CINAHL, PsycINFO, and the Cochrane Library Database in April 2020, and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to which we adhered. Original research papers pertaining to the prevalence and impact of GBSD, or mitigating strategies, within orthopaedics were included for review. Results Of 570 papers, 27 were eligible for inclusion. These were published between 1998 and 2020. A narrative review was performed in light of the significant heterogeneity displayed by the eligible studies. A total of 13 papers discussed the prevalence of GBSD, while 13 related to the impact of these behaviours, and six discussed mitigating strategies. GBSD was found to be common in the orthopaedic workplace, with all sources showing women to be the subjects. The impact of this includes poor workforce representation, lower salaries, and less career success, including in academia, for women in orthopaedics. Mitigating strategies in the literature are focused on providing female role models, mentors, and educational interventions. Conclusion GBSD is common in orthopaedic surgery, with a substantial impact on sufferers. A small number of mitigating strategies have been tested but these are limited in their scope. As such, the orthopaedic community is obliged to participate in more thoughtful and proactive strategies that mitigate against GBSD, by improving female recruitment and retention within the specialty.

O44 Gender bias and sexual discrimination in orthopaedics: time for change

2021 ◽  
Vol 108 (Supplement_5) ◽  
Author(s):  
U A Halim ◽  
A Elbayouk ◽  
A M Ali ◽  
C M Cullen ◽  
S Javed
Keyword(s):  
Gender Bias ◽  
Role Models ◽  
Orthopaedic Surgery ◽  
Cochrane Library ◽  
Original Research ◽  
Substantial Impact ◽  
Sexual Discrimination ◽  
International Orthopaedic ◽  
Orthopaedic Community ◽  
The Impact

Abstract Introduction Gender bias and sexual discrimination (GBSD) have been widely recognized across a range of fields and are now part of the wider social consciousness. Such conduct can occur in the medical workplace, with detrimental effects on recipients. The aim of this review was to identify the prevalence and impact of GBSD in orthopaedic surgery, as well as mitigating strategies. Method A systematic review was conducted by searching Medline, EMCARE, CINAHL, PsycINFO, and the Cochrane Library Database. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Original research papers pertaining to the prevalence and impact of GBSD, or mitigating strategies, within orthopaedics were reviewed. Result Of 570 papers, 27 were eligible for inclusion. These were published between 1998 and 2020. 13 papers discussed the prevalence of GBSD, 13 related to the impact of these behaviours, and six discussed mitigating strategies. GBSD was found to be common in the orthopaedic workplace, with all sources showing women to be the subjects. Effects include poor workforce representation, lower salaries, and less career success for women in orthopaedics. Mitigating strategies in the literature are focused on providing female role models, mentors, and educational interventions. Conclusion GBSD is common in orthopaedic surgery, with a substantial impact on sufferers. A small number of mitigating strategies have been tested but these are limited in their scope. As such, the orthopaedic community is obliged to participate in more thoughtful and proactive strategies that mitigate against GBSD, by improving female recruitment and retention within the specialty. Take-home Message Gender bias and sexual discrimination remain common within orthopaedics. The international orthopaedic community is obliged to do more to tackle this problem.

988 The Prevalence and Incidence of Gender Bias and Sexual Discrimination in Orthopaedics, and Mitigating Strategies: A Systematic Review

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
A Elbayouk ◽  
U Halim ◽  
A Ali ◽  
S Javed ◽  
C Cullen
Keyword(s):  
Systematic Review ◽  
Gender Bias ◽  
Role Models ◽  
Educational Interventions ◽  
Original Research ◽  
Sexual Discrimination ◽  
Orthopaedic Training ◽  
Orthopaedic Community ◽  
Training Programmes ◽  
The Impact

Abstract Background The aim of this systematic review was to outline the prevalence and impact of Gender bias and sexual discrimination (GBSD) in orthopaedics, and to investigate interventions countering such behaviours. Method Original research papers pertaining to the prevalence and impact of gender bias or sexual discrimination, or mitigating strategies in orthopaedics, were suitable for inclusion. PRISMA guidelines were adhered to in this review. Results Of 570 papers, 27 were eligible for inclusion. A total of 13 papers discussed the prevalence of GBSD, whilst 13 related to the impact of these behaviours, and 6 discussed mitigating strategies. GBSD were found to be prevalent in the orthopaedic workplace, with all sources showing females to be the victims. The impact of GBSD includes poor workforce representation, lower salaries, barriers to career progression, and reduced academic output for females in orthopaedics. Mitigating strategies in the literature are focussed on encouraging females to apply for orthopaedic training programmes, by providing female role models, mentors, and educational interventions. Conclusions GBSD are highly prevalent in orthopaedic surgery, impacting females at all stages of their careers. Mitigating strategies have been tested but are limited in their scope. As such, the orthopaedic community as a whole is obliged to do more to tackle GBSD.

scholarly journals Intentions to “Reuse” Medication in the Future Modelled and Measured Using the Theory of Planned Behavior

Pharmacy ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 213 ◽  
Author(s):  
Hamza Alhamad ◽  
Parastou Donyai
Keyword(s):  
Theory Of Planned Behavior ◽  
Planned Behavior ◽  
Educational Interventions ◽  
Environmental Benefits ◽  
Perceived Behavioral Control ◽  
Substantial Impact ◽  
Medication Waste ◽  
The Future ◽  
The Uk ◽  
The Impact

Background: A range of pro-environmental behaviors are recognized, promoted, and investigated, but urgent action is also needed to tackle the direct and indirect environmental impact of medication waste. One solution is to reissue medicines, returned unused to pharmacies (i.e., reuse medicines). Yet, if medicines reuse is to be formally introduced in the UK, it is imperative also to understand people’s willingness to take part in such a scheme and importantly, the underpinning drivers. This study aimed to develop, validate, and evaluate a Theory of Planned Behavior model aimed at predicting medicines reuse behavioral intentions. Methods: The behavior of interest, medicines reuse, was defined according to its Target, Action, Context, and Time. Then themes from an existing qualitative study were used in order to draft, validate and pilot a Theory of Planned Behavior-based questionnaire before its completion by a representative sample (n = 1003) of participants from across the UK. Results: The majority expressed pro-medicines reuse intentions. The three direct measures accounted for 73.4% of the variance in relation to people’s intention to reuse medicines in the future, which was statistically significant at p < 0.001. People’s specific beliefs about medicines reuse and how they evaluate other people’s expectations of them had a substantial impact on their intentions to reuse medication in the future, mediated in an intricate way via attitudes, subjective norms and perceived behavioral control (PBC). Conclusions: This study shows how people could embrace medicines reuse via practical measures that illustrate the safety and quality assurance of reissued medicines, educational interventions that bolster beliefs about the pro-environmental benefits, and norm-based interventions encouraging doctors and pharmacists to endorse the practice. The findings add to the emerging work on medicines reuse and, significantly, provide a theoretical framework to guide policymakers and other organizations looking to decrease the impact of medication waste through medicines reuse schemes.

Adverse effects of ADT on cognitive function and dementia for men with prostate cancer: A meta-analysis and systematic review.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 150-150 ◽  
Author(s):  
Maxine Sun ◽  
Alexander Cole ◽  
Nawar Hanna ◽  
Adam S. Kibel ◽  
Toni K. Choueiri ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Systematic Review ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
English Language ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Cochrane Library ◽  
Significant Heterogeneity ◽  
The Impact

150 Background: Nearly 50% of men diagnosed with prostate cancer may receive treatment with some form of androgen deprivation therapy (ADT). While some side effects of ADT are well acknowledged, the specific impact of ADT on cognitive function is uncertain. Our objective was to perform a systematic review and meta-analysis assessing the impact of ADT on overall cognitive decline, and the risks of Alzheimers, Parkinson’s disease. Methods: Relevant studies were identified through search of English language articles indexed in PubMed Medline, PsycINFO, Cochrane Library and Web of Knowledge/Science. First, we assessed rates of cognitive decline in five cohorts from three studies. Second, we assessed rates of Alzheimer’s or Parkinson disease using three large retrospective studies. A pooled-analysis was conducted using a meta-analysis. Weighted averages were reported as odds ratios (OR) with 95% confidence intervals (CI) using RevMan and a DerSimonian and Laird random-effects model. The heterogeneity test was measured using the Q-Mantel-Haenszel ( P< 0.10 was considered of significant heterogeneity). Results: With respect to overall cognitive decline (defined as scoring 1.5 standard deviations [SD] in two or more objective cognitive tests), patients receiving ADT had higher odds of overall cognitive decline than patients with prostate cancer not treated with ADT or health controls (OR: 2.03, 95% CI: 1.42–2.90). Furthermore, men with a history of ADT for prostate cancer had higher odds of developing Alzheimer’s and Parkinson dementia compared to men with prostate cancer not treated with ADT (OR: 1.32, 95% CI: 1.27–1.37). Conclusions: Men receiving ADT for prostate cancer performed significantly worse on measures of overall cognitive function. Additionally, results from the three large observational trials included suggest men exposed to ADT for prostate cancer have higher rates of Parkinson/Alzheimer’s compared to men without ADT.

Effect of Night Time Eating on Postprandial Triglyceride Metabolism in Healthy Adults: A Systematic Literature Review

2019 ◽  
Vol 34 (2) ◽  
pp. 119-130 ◽  
Author(s):  
Maxine P. Bonham ◽  
Elleni Kaias ◽  
Iona Zimberg ◽  
Gloria K. W. Leung ◽  
Rochelle Davis ◽  
...  
Keyword(s):  
Time Course ◽  
Postprandial Lipemia ◽  
Cochrane Library ◽  
Original Research ◽  
Cvd Risk ◽  
Night Time ◽  
Shift Workers ◽  
Postprandial Triglyceride ◽  
Meal Time ◽  
The Impact

Eating at night time, as is frequent in shift workers, may contribute to increased cardiovascular disease (CVD) risk through a disruption in usual lipid metabolism, resulting in repeated and sustained hyperlipidemia at night. This systematic review aimed to investigate the impact of eating a meal at night compared with the same meal eaten during the day on postprandial lipemia. Six databases were searched: CINAHL Plus, Cochrane Library, EMBASE, Ovid MEDLINE, Informit, and SCOPUS. Eligible studies were original research cross-over design with a minimum fasting period of 5 h before testing preceded by a standardized control meal; measured postprandial triacylglycerol (TAG) for 5 h or greater; had meal time between 0700 h and 1600 h for day time and between 2000 h and 0400 h for night time; and had within-study test meals (food or drink) that were identical in macronutrient composition and energy. Two authors independently completed eligibility and quality assessment using the American Dietetic Association Quality Criteria Checklist for Primary Research. After removing duplicates, 4,423 articles were screened, yielding 5 studies for qualitative synthesis. All studies identified at least one parameter of the postprandial TAG response that was different as a result of meal time (e.g., the total concentration or the time course kinetics). Two studies reported a greater total TAG concentration (area under curve) at night compared with day, and 3 studies found no difference. Four studies reported that the kinetics of the postprandial time course of TAGs was different at night compared with during the day. Inconsistent reporting in the primary studies was a limitation of the review. Night eating may negatively affect postprandial lipemia and this review shows there is a need to rigorously test this using standardized methods and analysis with larger sample sizes. This is critical for informing strategies to lower CVD risk for shift workers.

scholarly journals The Impact of Virtual Nature Therapy on Stress Responses: A Systematic Qualitative Review

Forests ◽  
2021 ◽  
Vol 12 (12) ◽  
pp. 1776
Author(s):  
Sharifah Shuthairah Syed Abdullah ◽  
Dayang Rohaya Awang Rambli ◽  
Suziah Sulaiman ◽  
Emad Alyan ◽  
Frederic Merienne ◽  
...  
Keyword(s):  
Stress Reduction ◽  
Stress Responses ◽  
Well Being ◽  
Cochrane Library ◽  
Original Research ◽  
Natural Environments ◽  
Stress Levels ◽  
Stress Therapy ◽  
Meta Analyses ◽  
The Impact

This study aims to review the key findings of past studies that assessed the impact of virtual environments, such as nature and forests for stress therapy. Previous research has found that virtual reality (VR) experiences affect socio-affective behavior, indicating the potential of using VR for cognitive and psychological stress therapy. However, evidence for the impacts of virtual forest therapy as a stress-reduction technique is lacking, and the usefulness of these techniques has yet to be determined. This review was carried out following the preferred reporting items for meta-analyses and systematic reviews. It summarized the literature and provided evidence on virtual forest therapy (VFT) effectiveness in stress relief. We conducted a literature search considering VR-related studies published from 2013 until June 2021 for different databases, including Embase, Medline/PubMed, Hindawi, ScienceDirect, Scopus, Web of Science, Taylor & Francis, and the Cochrane Library, to see how effective VFT reduces stress levels and improves mental well-being. According to the set inclusion criteria, eighteen relevant papers detailing original research were eligible for inclusion. This overview suggests that VR provides benefits for assessing and reducing stress levels. While real natural environments effectively promote recovery from stress, virtual exposure to nature also positively affects stress. Thus, VR could be an effective technique for promoting relaxation, particularly during the COVID-19 pandemic, where stress levels rise globally. However, more in-depth studies are required to substantiate this potential field of VR relaxation.

The impact of socioeconomic position on non-communicable diseases: what do we know about?

2020 ◽  
pp. 175791392091495
Author(s):  
S Lago - Peñas ◽  
B Rivera ◽  
D Cantarero ◽  
B Casal ◽  
M Pascual ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Socioeconomic Position ◽  
Heart Diseases ◽  
Oecd Countries ◽  
Communicable Diseases ◽  
Health Concern ◽  
Cochrane Library ◽  
Significant Heterogeneity ◽  
Non Communicable Diseases ◽  
The Impact

Aims: Non-communicable diseases (NCDs) have become a primary health concern for most countries around the world. The aim of this research is to analyze the relevant evidence that determines the effect of socioeconomic position (SEP) on the incidence and prevalence of NCDs. Methods: A systematic literature search was performed using PubMed, Cochrane Library, and Web of Science to identify evidence regarding the relationship between income inequalities and NCDs, between 2005 and 2015. The final selection of papers was based on applied studies focusing on Organisation for Economic Co-operation and Development (OECD) countries and articles referring to three main groups of chronic diseases: cardiovascular and heart diseases, cancer, and diabetes. Results: A final set of 47 selected studies were fully taken into account in this review. Despite significant heterogeneity in exposure and outcomes measures, overall the evidence suggests that having low SEP increases the risk of developing cardiovascular diseases (CVDs), lung and breast cancer, and type 2 diabetes. SEP is also associated with multiple NCD risk factors such as smoking and physical inactivity. Conclusion: Low socioeconomic status appears to have a significant consistent impact on mortality and morbidity caused by NCDs in OECD countries. Social and economic disadvantages are associated with health inequalities in terms of access to care, increased incident risk of NCDs, and early death. These findings point to the need for public health strategies and research to address socioeconomic status disparity among individuals.

scholarly journals Four types of gender bias affecting women surgeons and their cumulative impact

2020 ◽  
Vol 46 (4) ◽  
pp. 236-241 ◽  
Author(s):  
Katrina Hutchison
Keyword(s):  
Gender Bias ◽  
Role Models ◽  
Parental Leave ◽  
Theoretical Work ◽  
Epistemic Injustice ◽  
Pay Gap ◽  
Cumulative Impact ◽  
Women Surgeons ◽  
Implicit Biases ◽  
The Impact

Women are under-represented in surgery, especially in leadership and academic roles, and face a gender pay gap. There has been little work on the role of implicit biases in women’s under-representation in surgery. Nor has the impact of epistemic injustice, whereby stereotyping influences knowledge or credibility judgements, been explored. This article reports findings of a qualitative in-depth interview study with women surgeons that investigates gender biases in surgery, including subtle types of bias. The study was conducted with 46 women surgeons and trainees of the Royal Australasian College of Surgeons. Maximum variance sampling strategies ensured a comprehensive set of perspectives. Data were analysed using iterative thematic analysis to document and classify forms of gender bias experienced by the participants, including implicit bias and epistemic injustice. It found four types of bias affecting women surgeons: (1) workplace factors such as access to parental leave and role models; (2) epistemic injustices—unfair assessments of women surgeons’ credibility by patients and colleagues; (3) stereotyped expectations that they will carry out more of surgery’s carework, such as meeting the emotional needs of patients and (4) objectification. Implicit biases arose in each category. Given that many of the biases identified in this study are small, are harmless on their own and are not necessarily under anyone’s conscious control, important questions arise regarding how they cause harm and how to address them. I draw on theoretical work on cumulative harm to answer these questions.

scholarly journals The impact of pregnancy induced hypertension on low birth weight in Ethiopia: systematic review and meta-analysis

2020 ◽  
Vol 46 (1) ◽  
Author(s):  
Temesgen Getaneh ◽  
Ayenew Negesse ◽  
Getenet Dessie ◽  
Melaku Desta
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Mortality ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Significant Heterogeneity ◽  
Pregnancy Induced Hypertension ◽  
Pooled Prevalence ◽  
Induced Hypertension ◽  
The Impact

Abstract Background Even though neonatal mortality reduction is the major goal needed to be achieved by 2030, it is still unacceptably high especially in Ethiopia. In the other hand, low birth weight is the major cause of neonatal mortality and morbidity. More than 10 millions of low birth weight infants occurred as a result of pregnancy induced hypertension. However, in Ethiopia the association between low birth weight and pregnancy induced hypertension was represented with un-updated, inconclusive and different studies. Therefore, this review aimed to estimate the overall pooled impact of pregnancy induced hypertension on low birth weight and its association in Ethiopia. Methods articles searched on PubMed/Medline, EMBASE, CINAHL, Cochrane library, Google, Google Scholar and local shelves. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was applied for critical appraisal. The I2 statistic was computed to check the presence of heterogeneity. Publication bias was evaluated using funnel plot asymmetry and Egger’s test. A random effect model was used to estimate the pooled prevalence of low birth weight. Result From the total 131 identified original articles, 25 were eligible and included for the final analysis. The overall pooled prevalence of low birth weight among women who had pregnancy induced hypertension in Ethiopia was 39.7% (95% CI: 33.3, 46.2). But, I2 statistic estimation evidenced significant heterogeneity across included studies (I2 = 89.4, p < 0.001). In addition, the odds of having low birth weight newborns among women who had pregnancy induced hypertension was 3.89 times higher compared to their counterparts (OR = 3.89, 95% CI: 2.66, 5.69). Conclusion The pooled prevalence of low birth weight among women who had pregnancy induced hypertension was more than two times higher than the pooled estimate of low birth weight among all reproductive aged women. The odds of low birth weight also increased nearly four times among women with pregnancy induced hypertension than normotensive women. Therefore, health policies which provide better and quality antenatal care with more oriented on importance of early detection and management of pregnancy induced hypertension should be implemented.

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