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1.
Elife ; 112022 03 16.
Article in English | MEDLINE | ID: covidwho-1766127

ABSTRACT

Publications are essential for a successful academic career, and there is evidence that the COVID-19 pandemic has amplified existing gender disparities in the publishing process. We used longitudinal publication data on 431,207 authors in four disciplines - basic medicine, biology, chemistry and clinical medicine - to quantify the differential impact of COVID-19 on the annual publishing rates of men and women. In a difference-in-differences analysis, we estimated that the average gender difference in publication productivity increased from -0.26 in 2019 to -0.35 in 2020; this corresponds to the output of women being 17% lower than the output of men in 2109, and 24% lower in 2020. An age-group comparison showed a widening gender gap for both early-career and mid-career scientists. The increasing gender gap was most pronounced among highly productive authors and in biology and clinical medicine. Our study demonstrates the importance of reinforcing institutional commitments to diversity through policies that support the inclusion and retention of women in research.


Subject(s)
COVID-19 , Efficiency , Female , Humans , Male , Pandemics , Publishing , Sex Factors
2.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-305577

ABSTRACT

The COVID-19 pandemic has resulted in school closures and distancing requirements that have disrupted both work and family life for many. Concerns exist that these disruptions caused by the pandemic may not have influenced men and women researchers equally. Many medical journals have published papers on the pandemic, which were generated by researchers facing the challenges of these disruptions. Here we report the results of an analysis that compared the gender distribution of authors on 1,893 medical papers related to the pandemic with that on papers published in the same journals in 2019, for papers with first authors and last authors from the United States. Using mixed-effects regression models, we estimated that the proportion of COVID-19 papers with a woman first author was 19% lower than that for papers published in the same journals in 2019, while our comparisons for last authors and overall proportion of women authors per paper were inconclusive. A closer examination suggested that women's representation as first authors of COVID-19 research was particularly low for papers published in March and April 2020. Our findings are consistent with the idea that the research productivity of women, especially early-career women, has been affected more than the research productivity of men.

3.
BMJ Open ; 11(10): e052856, 2021 10 27.
Article in English | MEDLINE | ID: covidwho-1495468

ABSTRACT

OBJECTIVE: To evaluate whether the COVID-19 experts who appear most frequently in media have high citation impact for their research overall, and for their COVID-19 peer-reviewed publications in particular and to examine the representation of women among such experts. DESIGN: Cross-linking of data sets of most highly visible COVID-19 media experts with citation data on the impact of their published work (career-long publication record and COVID-19-specific work). SETTING: Cable news appearance in prime-time programming or overall media appearances. PARTICIPANTS: Most highly visible COVID-19 media experts in the USA, Switzerland, Greece and Denmark. INTERVENTIONS: None. OUTCOME MEASURES: Citation data from Scopus along with discipline-specific ranks of overall career-long and COVID-19-specific impact based on a previously validated composite citation indicator. RESULTS: We assessed 76 COVID-19 experts who were highly visible in US prime-time cable news, and 50, 12 and 2 highly visible experts in media in Denmark, Greece and Switzerland, respectively. Of those, 23/76, 10/50, 2/12 and 0/2 were among the top 2% of overall citation impact among scientists in the same discipline worldwide. Moreover, 37/76, 15/50, 7/12 and 2/2 had published anything on COVID-19 that was indexed in Scopus as of 30 August 2021. Only 18/76, 6/50, 2/12 and 0/2 of the highly visible COVID-19 media experts were women. 55 scientists in the USA, 5 in Denmark, 64 in Greece and 56 in Switzerland had a higher citation impact for their COVID-19 work than any of the evaluated highly visible media COVID-19 experts in the respective country; 10/55, 2/5, 22/64 and 14/56 of them were women. CONCLUSIONS: Despite notable exceptions, there is a worrisome disconnect between COVID-19 claimed media expertise and scholarship. Highly cited women COVID-19 experts are rarely included among highly visible media experts.


Subject(s)
COVID-19 , Bibliometrics , Female , Greece , Humans , SARS-CoV-2 , Switzerland
4.
Elife ; 92020 06 15.
Article in English | MEDLINE | ID: covidwho-1497818

ABSTRACT

The COVID-19 pandemic has resulted in school closures and distancing requirements that have disrupted both work and family life for many. Concerns exist that these disruptions caused by the pandemic may not have influenced men and women researchers equally. Many medical journals have published papers on the pandemic, which were generated by researchers facing the challenges of these disruptions. Here we report the results of an analysis that compared the gender distribution of authors on 1893 medical papers related to the pandemic with that on papers published in the same journals in 2019, for papers with first authors and last authors from the United States. Using mixed-effects regression models, we estimated that the proportion of COVID-19 papers with a woman first author was 19% lower than that for papers published in the same journals in 2019, while our comparisons for last authors and overall proportion of women authors per paper were inconclusive. A closer examination suggested that women's representation as first authors of COVID-19 research was particularly low for papers published in March and April 2020. Our findings are consistent with the idea that the research productivity of women, especially early-career women, has been affected more than the research productivity of men.


Subject(s)
Authorship , Bibliometrics , Coronavirus Infections , Pandemics , Pneumonia, Viral , Research Personnel/statistics & numerical data , Women , COVID-19 , Efficiency , Female , Humans , Medicine , Periodicals as Topic/statistics & numerical data , Physicians, Women/statistics & numerical data , Sex Factors , Social Isolation , United States
6.
JCO Oncol Pract ; 18(1): e89-e97, 2022 01.
Article in English | MEDLINE | ID: covidwho-1331970

ABSTRACT

PURPOSE: The COVID-19 pandemic has created a new set of problems for clinicians. This study examines the experiences of oncologists providing care to seriously ill persons near the end of life in the context of the COVID-19 pandemic. METHODS: Between January 2020 and August 2020, we conducted semistructured, in-depth individual interviews with 22 purposefully sampled oncologists from practices enrolled in the Michigan Oncology Quality Consortium. Deidentified transcripts of the interviews were examined using thematic analysis. RESULTS: Our respondents described several novel problems created by the COVID-19 pandemic, including: (1) ethical challenges, (2) the need to manage uncertainty-physically and emotionally-on the part of both patients and oncologists, and (3) the difficulty of integrating technology and communication for seriously ill persons. These problems were made more complex by features of the pandemic: resource scarcity (and the need to fairly allocate poor resources), delays in care, high levels of fear, and the increased importance of advance care planning. Nonabandonment served as a way to cope with increased stress, and the use of telemedicine became an increasingly important medium of communication. CONCLUSION: This study offers an in-depth exploration of the problems faced by oncologists as a result of the COVID-19 pandemic and how they navigated them. Optimal decision making for seriously ill persons with cancer during the COVID-19 pandemic must include open acknowledgment of the ethical challenges involved, the emotions experienced by both patients and their oncologists, and the urgent need to integrate technology with compassionate communication in determining patient preferences.


Subject(s)
COVID-19 , Oncologists , Communication , Empathy , Humans , Pandemics , Prognosis , SARS-CoV-2
8.
Adv Radiat Oncol ; 6(5): 100724, 2021.
Article in English | MEDLINE | ID: covidwho-1252373

ABSTRACT

PURPOSE: To generate an understanding of the primary concerns facing medical physicists regarding integration of a demanding technical career with their personal lives. METHODS AND MATERIALS: In 2019, we recruited 32 medical physics residents, faculty, and staff via emails to US medical physics residency program directors to participate in a 1-hour, semistructured interview that elicited their thoughts on several topics, including work-life integration. Standard techniques of qualitative thematic analysis were used to generate the research findings. RESULTS: Of the participants, 50% were women and 69% were non-Hispanic White individuals, with a mean (SD) age of 37.5 (7.4) years. They were evenly split between residents and faculty or staff. Participant responses centered around 5 primary themes: the gendered distribution of household responsibilities, the effect of career or work on home and family life, the effect of family on career or work, support and strategies for reconciling work-life conflicts, and the role of professional societies in addressing work-life integration. Participants expressed concern about the effect of heavy workloads on home life, with female respondents more likely to report carrying the majority of the household burden. CONCLUSIONS: Medical physicists experience challenges in managing work-life conflict amid a diverse array of personal and professional responsibilities. Further investigations are needed to quantitatively assess the division of work and household labor by gender in medical physics, particularly after the outbreak of the COVID-19 pandemic, but this study's qualitative findings suggest that the profession should consider ways to address root causes of work-life conflict to promote the future success and well-being of all medical physicists, and perhaps women in particular.

9.
The American Journal of Psychiatry ; 178(2):203-204, 2021.
Article in English | APA PsycInfo | ID: covidwho-1208454

ABSTRACT

The letter presents a study on the impact of COVID-19 on mental health of physician mothers. To quantify the mental health impact of the COVID-19 pandemic on a predominantly U.S. cohort of physician mothers, authors surveyed the Physician Moms Group on Facebook from April 18 to April 29, 2020, after receiving approval from the institutional review board at Stanford University. The rates of anxiety among physician mothers in this study appear substantial;for context, in the general U.S. population in normal circumstances, about 19% of adults had any anxiety disorder in the past year. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

10.
J Womens Health (Larchmt) ; 30(4): 514-524, 2021 04.
Article in English | MEDLINE | ID: covidwho-1147921

ABSTRACT

Objectives: The coronavirus disease 2019 (COVID-19) pandemic has presented extreme challenges for health care workers. This study sought to characterize challenges faced by physician mothers, compare differences in challenges by home and work characteristics, and elicit specific needs and potential solutions. Methods: We conducted a mixed-methods online survey of the Physician Moms Group (PMG) and PMG COVID19 Subgroup on Facebook from April 18th to 29th, 2020. We collected structured data on personal and professional characteristics and qualitative data on home and work concerns. We analyzed qualitative data thematically and used bivariate analyses to evaluate variation in themes by frontline status and children's ages. Results: We included 1,806 participants in analysis and identified 10 key themes. The most frequently identified need/solution was for Community and Government Support (n = 545, 47.1%). When comparing frontline and nonfrontline physicians, those on the frontline more frequently raised concerns about Personal Health and Safety (67.8% vs. 48.4%, p < 0.001), Organizational Communication and Relationships (31.8% vs. 23.8%, p < 0.001), and Family Health and Safety (27.2 vs. 16.6, p < 0.001), while nonfrontline physicians more frequently addressed Patient Care and Safety (56.4% vs. 48.2%, p < 0.001) and Financial/Job Security (33.8% vs. 46.9%, p < 0.001). Participants with an elementary school-aged child more frequently raised concerns about Parenting/Homeschooling (44.0% vs. 31.1%, p < 0.001) and Work/Life Balance (28.4 vs. 13.7, p < 0.001), and participants with a preschool-aged child more frequently addressed Access to Childcare (24.0 vs. 7.7, p < 0.001) and Spouse/Partner Relationships (15.8 vs. 9.5, p < 0.001), when compared to those without children in these age groups. Conclusions: The physician workforce is not homogenous. Health care and government leaders need to understand these diverse challenges in order to meet physicians' professional and family needs during the pandemic.


Subject(s)
COVID-19/psychology , Mothers/psychology , Occupational Stress/psychology , Pandemics , Physicians, Women/psychology , Work-Life Balance , Adult , COVID-19/epidemiology , COVID-19/prevention & control , Child , Child, Preschool , Female , Humans , Mental Health , Middle Aged , SARS-CoV-2 , Young Adult
11.
Acad Med ; 96(6): 792-794, 2021 06 01.
Article in English | MEDLINE | ID: covidwho-1078860

ABSTRACT

The COVID-19 pandemic and the upheaval it is causing may be leading to novel manifestations of the well-established mechanisms by which women have been marginalized in professional roles, robbing the field of the increased collective intelligence that exists when diverse perspectives are embraced. Unconscious bias, gendered expectations, and overt hostility minimize the contributions of women in academic medicine to the detriment of all. The current environment of heightened stress and new socially distant forms of communication may be exacerbating these well-recognized obstacles to women contributing to the field. Of note, none of these actions requires ill intent; all they require is the activation of unconscious biases and almost instinctive preferences and behaviors that favor the comfortable and familiar leadership of men in a time of extreme stress. The authors argue that it is time to investigate the frequency of behaviors that limit both the recognition and the very exercise of women's leadership during this pandemic, which is unprecedented but nevertheless may recur in the future. Leaders in health care must pay attention to equity, diversity, and inclusion given increases in undermining and harassing behaviors toward women during this crisis. The longer-term consequences of marginalizing women may hamper efforts to combat the next pandemic, so the time to flatten the rising gender bias curve in academic medicine is now.


Subject(s)
Academic Medical Centers/ethics , COVID-19/psychology , Physicians, Women/psychology , Sexism/prevention & control , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/virology , Cultural Diversity , Female , Gender Equity , Humans , Leadership , Male , SARS-CoV-2/isolation & purification , Sexism/psychology , Social Inclusion
16.
J Womens Health (Larchmt) ; 30(3): 341-347, 2021 03.
Article in English | MEDLINE | ID: covidwho-939540

ABSTRACT

Background: Due to the COVID-19 pandemic, most faculty in science, technology, engineering, mathematics, and medicine (STEMM) began working from home, including many who were simultaneously caring for children. The objective was to assess associations of gender and parental status with self-reported academic productivity before (i.e., mid-January to mid-March 2020) and during the pandemic (i.e., mid-March to mid-May 2020). Materials and Methods: STEMM faculty in the United States (N = 284, 67.6% women, 57.0% with children younger than the age of 18 years living at home) completed a survey about the number of hours worked and the frequency of academic productivity activities. Results: There was no significant difference in the hours worked per week by gender (men, M [standard deviation, SD] = 45.8 [16.7], women = 43.1 [16.3]). Faculty with 0-5-year-old children reported significantly fewer work hours (33.7 [13.9]) compared to all other groups (No children = 49.2 [14.9], 6-11 years old = 48.3 [13.9], and 12-17 years old = 49.5 [13.9], p < 0.0001). Women's self-reported first/corresponding author's and coauthor's article submissions decreased significantly between the two time periods; men's productivity metrics did not change. Faculty with 0-5-year-old children completed significantly fewer peer review assignments, attended fewer funding panel meetings, and submitted fewer first authors' articles during the pandemic compared to the previous period. Those with children aged 6 years or older at home or without children at home reported significant increases or stable productivity. Conclusions: Overall, significant disparities were observed in academic productivity by gender and child age during the pandemic and if confirmed by further research, should be considered by academic institutions and funding agencies when making decisions regarding funding and hiring as well as promotion and tenure.


Subject(s)
Biomedical Research/statistics & numerical data , COVID-19/psychology , Faculty, Medical/statistics & numerical data , Physical Distancing , Sex Factors , Work-Life Balance , Adolescent , Adult , COVID-19/prevention & control , Career Mobility , Child , Child, Preschool , Efficiency , Female , Humans , Male , Mathematics , Medicine , Middle Aged , Pandemics , SARS-CoV-2 , Technology , United States/epidemiology
17.
Am J Bioeth ; 20(7): 15-27, 2020 07.
Article in English | MEDLINE | ID: covidwho-828574

ABSTRACT

The COVID-19 pandemic has raised a host of ethical challenges, but key among these has been the possibility that health care systems might need to ration scarce critical care resources. Rationing policies for pandemics differ by institution, health system, and applicable law. Most seem to agree that a patient's ability to benefit from treatment and to survive are first-order considerations. However, there is debate about what clinical measures should be used to make that determination and about other factors that might be ethically appropriate to consider. In this paper, we discuss resource allocation and several related ethical challenges to the healthcare system and society, including how to define benefit, how to handle informed consent, the special needs of pediatric patients, how to engage communities in these difficult decisions, and how to mitigate concerns of discrimination and the effects of structural inequities.


Subject(s)
Advisory Committees , Betacoronavirus , Coronavirus Infections/epidemiology , Health Care Rationing/ethics , Pneumonia, Viral/epidemiology , Bioethics , COVID-19 , Coronavirus Infections/prevention & control , Humans , Pandemics/ethics , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , SARS-CoV-2 , United States/epidemiology
18.
Am J Infect Control ; 49(4): 516-520, 2021 04.
Article in English | MEDLINE | ID: covidwho-800031

ABSTRACT

A significant change for patients and families during SARs-CoV-2 has been the restriction of visitors for hospitalized patients. We analyzed SARs-CoV-2 hospital visitation policies and found widespread variation in both development and content. This variation has the potential to engender inequity in access. We propose guidance for hospital visitation policies for this pandemic to protect, respect, and support patients, visitors, clinicians, and communities.


Subject(s)
COVID-19/epidemiology , Hospital Administration , Organizational Policy , SARS-CoV-2 , Visitors to Patients , Family , Humans
19.
JAMA Oncol ; 6(9): 1424-1428, 2020 Sep 01.
Article in English | MEDLINE | ID: covidwho-695709

ABSTRACT

IMPORTANCE: The novel coronavirus disease 2019 (COVID-19) pandemic has dramatically changed the US health care system, causing an influx of patients who require resources. Many oncologists are having challenging conversations with their patients about how the COVID-19 pandemic is affecting cancer care and may desire evidence-based communication guidance. OBJECTIVES: To identify the clinical scenarios that pose communication challenges, understand patient reactions to these scenarios, and develop a communication guide with sample responses. DESIGN, SETTING, AND PARTICIPANTS: This qualitative study that was conducted at a single Midwestern academic medical center invited physicians to respond to a brief semistructured interview by email or telephone and then disseminated an anonymous online survey among patients with cancer. Oncology-specific, COVID-19-related clinical scenarios were identified by the physicians, and potential reactions to these scenarios were gleaned from the patient responses to the survey. Health communication experts were invited to participate in the iterative development of a communication guide, comprising 3 essential communication principles and strategies and informed by insights from physicians and patients. This study was conducted from March 25, 2020, to April 2, 2020. INTERVENTIONS: Expert review, interviews, and surveys assessing challenging situations specific to cancer management during the COVID-19 pandemic. MAIN OUTCOMES AND MEASURES: Oncology-specific, COVID-19-related clinical scenarios from physician interviews; responses to each scenario from patient surveys; and applicable communication principles from health communication expert literature review. RESULTS: Of the 8 physicians who participated in interviews, 4 were men (50%) and 4 were women (50%). These physicians represented the following disciplines: internal medicine (n = 1), hematology/oncology (n = 2), radiation oncology (n = 3), and surgical oncology (n = 2). Their disease site specialization included cancers of the breast, head and neck, melanoma, and gastrointestinal and genitourinary tracts. A total of 48 patients with cancer completed the online survey; no demographic information was collected from the patients. The physicians identified 8 oncology-specific, COVID-19-related scenarios in which communication might be challenging: (1) worse outcomes from COVID-19, (2) delay in cancer screening, (3) delay in diagnostic workup, (4) delay in initiation of treatment, (5) offer of nonstandard treatment, (6) treatment breaks, (7) delay in follow-up imaging or care, and (8) inability to be admitted into the hospital for management. Potential patient reactions to each of these scenarios were compiled from survey responses. For most scenarios, patient reactions involved anger, fear, and anxiety (eg, "I'm scared"; "This isn't fair. I am upset."). These emotional patient responses informed the selection of the 3 general communication principles, which suggested language and strategies that physicians can use to respond to patients. CONCLUSIONS AND RELEVANCE: In this qualitative study, physicians and patients identified communication needs used by health communication experts to inform the development of a practical, evidence-based communication guide for oncology care during the COVID-19 pandemic.


Subject(s)
Coronavirus Infections/epidemiology , Neoplasms/epidemiology , Oncologists/psychology , Pandemics , Pneumonia, Viral/epidemiology , Betacoronavirus/pathogenicity , COVID-19 , Communication , Coronavirus Infections/complications , Coronavirus Infections/virology , Delivery of Health Care/standards , Female , Humans , Language , Male , Neoplasms/complications , Neoplasms/virology , Patients/psychology , Physicians/psychology , Pneumonia, Viral/complications , Pneumonia, Viral/virology , SARS-CoV-2 , Telemedicine
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