RESUMO
In critical care medicine, research trials serve as crucial avenues for disseminating knowledge, influencing clinical practices, and fostering innovation. Notably, a significant gender imbalance exists within this field, potentially mirrored in the authorship of critical care research. This study aimed to investigate an exploration to ascertain the presence and extent of female representation in first and senior authorship roles within critical care literature. To this end, a systematic search was conducted across PubMed, Google Scholar, and Web of Science databases for original articles published up to February 2024, coupled with a methodological quality assessment via the Newcastle-Ottawa Scale (NOS) and statistical analyses through Review Manager software (RevMan, version 5.4.1, The Cochrane Collaboration, 2020). The study's findings, distilled from seven studies included in the final analysis, reveal a pronounced gender disparity. Specifically, in critical care literature examining mixed populations, female first authors were significantly less common than their male counterparts, with an odds ratio (OR) of 4.25 (95% confidence interval (CI): 3.18-5.68; p < 0.00001). Conversely, pediatric critical care studies did not show a significant difference in gender distribution among first authors (OR: 1.37; 95% CI: 0.31-6.10; p = 0.68). The investigation also highlighted a stark underrepresentation of female senior authors in critical care research across both mixed (OR: 11.67; 95% CI: 7.76-17.56; p < 0.00001) and pediatric populations (OR: 5.41; 95% CI: 1.88-15.56; p = 0.002). These findings underscore the persistent underrepresentation of women in critical care literature authorship and their slow progression into leadership roles, as evidenced by the disproportionately low number of female senior authors.
RESUMO
This article discusses the multifaceted impact of wars and armed conflicts on healthcare systems, with a focus on the Israel-Palestine war and its consequences for individuals with chronic kidney disease (CKD) and end-stage renal disease (ESRD). The war has severely disrupted healthcare infrastructure, leading to damage or destruction of hospitals and clinics, shortages in medical supplies and staff, and interruptions in the delivery of essential services. This disruption poses significant challenges for the management of chronic conditions such as CKD and ESRD, where patients rely on regular and specialized care. The article highlights the logistical challenges and health risks faced by these patients, including the interruption of dialysis treatment, shortages of medications, and the impact of displacement on continuity of care. It also addresses the psychological toll on patients, emphasizing the increased stress, anxiety, and depression that can exacerbate their condition. The need for international aid and humanitarian efforts to support CKD and ESRD patients in conflict zones is underscored, along with the importance of addressing the root causes of the conflict to ensure the well-being of vulnerable populations.
RESUMO
Within the healthcare sector, especially in the field of nephrology, the matter of gender and racial inequalities continues to be a critical concern that requires immediate focus. Women, particularly those of underrepresented racial groups, face significant challenges due to a lack of representation in research studies, leading to a deficit in knowledge about how kidney diseases affect them differently. These challenges are exacerbated by systemic biases in the healthcare system, which manifest in both gender and racial dimensions, hindering access to and the quality of care for kidney diseases. Addressing these complex disparities requires a recalibration of risk stratification models to include both gender- and race-specific factors and a transformation of healthcare policies to facilitate a more inclusive and sensitive approach. Essential to this transformation is the empowerment of women of all races to actively participate in their healthcare decisions and the strengthening of support systems to help them navigate the complexities of the healthcare environment. Furthermore, education programs must be designed to be culturally competent and address the unique needs and concerns of women across different racial backgrounds. Promoting a collaborative patient-provider relationship is crucial in fostering an environment where equity, dignity, and respect are at the forefront. The path to equitable nephrology care lies in a concerted, collective action from researchers, healthcare providers, policymakers, and patients, ensuring that every individual receives the highest standard of care, irrespective of gender or race.
RESUMO
Authorship in clinical trials and clinical practice guidelines is considered prestigious and is associated with broader peer recognition. This systematic review investigated female representation among studies reporting authorship trends in clinical trials or clinical practice guidelines in different medicine subspecialties. Our search strategy yielded 836 articles, of which 30 met the inclusion criteria. Our findings indicate that females are severely underrepresented in authorship of clinical trials and clinical practice guidelines. Although the proportions of females may have improved in the past decade, the gains are marginal. Notably, studies in this domain predominantly focus on first/last authorship positions, and whether females are underrepresented in other positions as collaborative partners is currently unknown. Also, authorship trends in clinical trials or clinical practice guidelines of most medicine subspecialties besides cardiovascular medicine remain under-researched. Hence, standardizing the methodology for studying gender disparity in research output for comparative analysis between different subspecialties is as urgent as addressing the gender disparity in authorship.
