Medicine and Health Sciences Commons^™

Perpetuation Of Gender Discrimination In Pakistani Society: Results From A Scoping Review And Qualitative Study Conducted In Three Provinces Of Pakistan, Tazeen Saeed Ali, Shahnaz Shahid Ali, Sanober Nadeem, Zahid Memon, Sajid Bashir Soofi, Falak Madhani, Yasmin Karim, Shah Mohammad, Zulfiqar Ahmed Bhutta

School of Nursing & Midwifery

Background: Gender discrimination is any unequal treatment of a person based on their sex. Women and girls are most likely to experience the negative impact of gender discrimination. The aim of this study is to assess the factors that influence gender discrimination in Pakistan, and its impact on women's life.
Methods: A mixed method approach was used in the study in which a systematic review was done in phase one to explore the themes on gender discrimination, and qualitative interviews were conducted in phase two to explore the perception of people regarding gender discrimination. The qualitative interviews (in-depth interviews and …

Developing A Lifestyle Intervention Program For Overweight Or Obese Preconception, Pregnant And Postpartum Women Using Qualitative Methods, Chee Wai Ku, Shu Hui Leow, Lay See Ong, Christina Erwin, Isabella Ong, Xiang Wen Ng, Jacinth Jia Xin Tan, Fabian Yap, Jerry K. Y. Chan, See Ling Loy

Research Collection School of Social Sciences

The time period before, during and after pregnancy represents a unique opportunity for interventions to cultivate sustained healthy lifestyle behaviors to improve the metabolic health of mothers and their offspring. However, the success of a lifestyle intervention is dependent on uptake and continued compliance. To identify enablers and barriers towards engagement with a lifestyle intervention, thematic analysis of 15 in-depth interviews with overweight or obese women in the preconception, pregnancy or postpartum periods was undertaken, using the integrated-Promoting Action on Research Implementation in Health Services framework as a guide to systematically chart factors influencing adoption of a novel lifestyle intervention. …

Academic Leadership In Physician Assistant/Associate Medical Education: A Cross-Sectional Analysis Of The Association With Doctoral Degree, Gender, And Minority Status, Lucy W. Kibe, Gerald Kayingo, Katrina M. Schrode, Alicia Klein

Graduate School Faculty Publications

Background

There is a critical need for a diverse pool of academic leaders to increase the number and diversity of the medical workforce. Physician Assistant/Associate (PA) is a growing medical profession. Although the master’s degree is the terminal degree for PAs, a growing number of PAs obtain a variety of doctoral degrees. However, there is no standardized training for academic PA leaders. The purpose of this study was to identify factors associated with PA academic leadership. Specifically, this study explored the following factors: doctoral degree credentials, gender and underrepresented minority status.

Methods

Using the 2019 Physician Assistant Education Association Faculty …

Covid-19, Nutrition, And Gender: An Evidence-Informed Approach To Gender-Responsive Policies And Programs, Anna Kalbarczyk, Noora-Lisa Aberman, Bregje S M Van Asperen, Rosemary Morgan, Zulfiqar Ahmed Bhutta, Bianca Carducci, Rebecca Heidkamp, Saskia Osendarp, Neha Kumar, Anna Lartey

Department of Paediatrics and Child Health

In addition to the direct health impacts of COVID-19, government and household mitigation measures have triggered negative indirect economic, educational, and food and health system impacts, hitting low-and middle-income countries the hardest and disproportionately affecting women and girls. We conducted a gender focused analysis on five critical and interwoven crises that have emerged because of the COVID-19 crisis and exacerbated malnutrition and food insecurity. These include restricted mobility and isolation; reduced income; food insecurity; reduced access to essential health and nutrition services; and school closures. Our approach included a theoretical gender analysis, targeted review of the literature, and a visual …

Medical Student Sensitivity Training On The Differences In Sex Development, Paul Endres, Deborah Ziring, Dimitrios Papanagnou

Student Papers, Posters & Projects

No abstract provided.

Association Between Suicidal Attempts In Connection To Discrimination Among Trans Genders, Asghar Ali, Saad Ahmed Khan, Shah Zeb, Zahir Munir, Tazeen Saeed Ali

School of Nursing & Midwifery

Suicide has become a serious public health challenge across the world with around 800,000 people dying by suicide each year. Amongst these a majority of the people (79%) belongs to low and middle-income countries.
Objective:The study aimed to identify the association between suicidal attempts in connection to discrimination among transgender.
Methods: An analytical cross-sectional study was conducted. Data were collected from a registered NGO (Gender Interactive Alliance) from February to May, 2020, using a universal and purposive sampling technique.DatawasanalyzedonSPSS(version21.0).Meanandstandarddeviationwas calculated for frequency distribution, while Chi-square was used for categorical variables.
Results: Overall, 250 transgender were approached through a registered …

Hypertension In Women: A South-Asian Perspective, Fatima Farrukh, Amin Abbasi, Misbah Jawed, Aysha Almas, Tazeen Jafar, Salim S. Virani, Zainab Samad

Medical College Documents

Introduction: Hypertension is an important contributor to cardiovascular disease related morbidity and mortality. Despite the magnitude of its negative impact on cardiovascular outcomes, treatment and control of hypertension remain suboptimal in both men and women.
Materials and methods: Numerous databases, i.e., PubMed, ScienceDirect, etc., were searched using keywords to identify relevant studies to our narrative review. The findings from the most pertinent articles were summarized and integrated into our narrative review on hypertension in women.
Results: The pathophysiology of essential hypertension is still being delineated in both men and women; there are multiple sex specific factors in association with the …

Comparing Substance Use Outcomes By Sexual Identity Among Women: Differences Using Propensity Score Methods, Katherine J. Karriker-Jaffe, Laurie Drabble, Libo Li, Cat Munroe, Amy A. Mericle, Karen F. Trocki, Tonda L. Hughes

Faculty Research, Scholarly, and Creative Activity

Background: Differences in alcohol, tobacco, and other drug (ATOD) use by sexual identity vary across samples of women recruited using different sampling methods. We used propensity score (PS) weighting methods to address two methodological questions: (1) Do disparities between sexual minority women (SMW) and heterosexual women persist when differences in risk and protective factors are similarly distributed between groups, and (2) Does accounting for SMW-specific resiliency factors impact differences between non-probability samples of SMW? Methods: Four samples included SMW from a longitudinal study with a nonprobability sample (n = 373), a national general population panel sample (n = 373), …

Impact Of The Policy Environment On Substance Use Among Sexual Minority Women, Laurie A. Drabble, Cat Munroe, Amy A. Mericle, Sarah Zollweg, Karen F. Trocki, Katherine J. Karriker-Jaffe

Faculty Research, Scholarly, and Creative Activity

Background: Sexual minority women (SMW) are at greater risk for heavy episodic drinking, frequent marijuana use, and tobacco use than heterosexual women. Because past research has suggested the political and social environment may influence disparities in substance use by sexual orientation, this study examined associations of the U.S. state-level policy environment on substance use by SMW.

Methods: A total of 732 SMW participants were recruited from two national online panels: a general population panel (n = 333) and a sexual minority-specific panel (n = 399). Past year substance use was defined by number of days of heavy episodic drinking (HED; …

Sex Differences In The Association Between Cardiovascular Diseases And Dementia Subtypes: A Prospective Analysis Of 464,616 Uk Biobank Participants, Caiyun Dong, Chunmiao Zhou, Chunying Fu, Wenting Hao, Akihiko Ozaki, Nipun Shrestha, Salim S. Virani, Shiva Raj Mishra, Dongshan Zhu

Office of the Provost

Background: Whether the association of cardiovascular diseases (CVDs) with dementia differs by sex remains unclear, and the role of socioeconomic, lifestyle, genetic, and medical factors in their association is unknown.
Methods: We used data from the UK Biobank, a population-based cohort study of 502,649 individuals. We used Cox proportional hazards models to estimate sex-specific hazard ratios (HRs) and 95% confidence intervals (CI), and women-to-men ratio of HRs (RHR) for the association between CVD (coronary heart diseases (CHD), stroke, and heart failure) and incident dementia (all-cause dementia, Alzheimer's Disease (AD), and vascular dementia (VD)). The moderator roles of socioeconomic (education, income), …

Evaluating The Validity Of Restrictions On Blood Donation Eligibility For Men Who Have Sex With Men (Msm) In The United States, France, And Switzerland, Swathi Gorantla

Independent Study Project (ISP) Collection

For the first time in a decade, the number of new human immunodeficiency virus (HIV) diagnoses is higher for heterosexual people compared to gay and bisexual men (Florêncio, 2022). Additionally, in the United States, the American Red Cross has declared a national blood crisis due to the nationwide shortage of donated blood. During this crisis, charged with the new information on HIV diagnosis rates, many advocates for the Lesbian, Gay, Bisexual, Transgender, Queer (LGBTQ+) community question why discriminatory policy surrounding gay and bisexual men donating still exist around the world. These policies are changing worldwide – several European countries have …

Prevention Of Violence Against Women And Girls: A Cost-Effectiveness Study Across 6 Low- And Middle-Income Countries, Giulia Ferrari, Sergio Torres-Rueda, Esnat Chirwa, Andrew Gibbs, Stacey Orangi, Edwine Barasa, Theresa Tawiah, Rebecca Kyerewaa Dwommoh Prah, Rozina Karmaliani, Hussain Maqbool Ahmed Khuwaja

School of Nursing & Midwifery

Background: Violence against women and girls (VAWG) is a human rights violation with social, economic, and health consequences for survivors, perpetrators, and society. Robust evidence on economic, social, and health impact, plus the cost of delivery of VAWG prevention, is critical to making the case for investment, particularly in low- and middle-income countries (LMICs) where health sector resources are highly constrained. We report on the costs and health impact of VAWG prevention in 6 countries.
Methods and findings: We conducted a trial-based cost-effectiveness analysis of VAWG prevention interventions using primary data from 5 randomised controlled trials (RCTs) in sub-Saharan Africa …

Intergenerational Risk And Resilience Pathways From Discrimination And Acculturative Stress To Infant Mental Health, Sabrina R. Liu, Curt A. Sandman, Elyssia Poggi Davis, Laura M. Glynn

Psychology Faculty Articles and Research

Preconception and prenatal stress impact fetal and infant development, and women of color are disproportionately exposed to sociocultural stressors like discrimination and acculturative stress. However, few studies examine links between mothers’ exposure to these stressors and offspring mental health, or possible mitigating factors. Using linear regression, we tested associations between prenatally assessed maternal acculturative stress and discrimination on infant negative emotionality among 113 Latinx/Hispanic, Asian American, Black, and Multiethnic mothers and their children. Additionally, we tested interactions between stressors and potential pre- and postnatal resilience-promoting factors: community cohesion, social support, communalism, and parenting self-efficacy. Discrimination and acculturative stress were related …

Examination Of Lgbtqia+-Inclusive Recommendations Issued By Professional Medical Associations Across Healthcare Fields, Alexandra R. Gates, Anna Goldina Ph.D., Jonathan J. Wisco Ph.D., Anastasia Filimonov M.S.

Summer Scholarship, Creative Arts and Research Projects (SCARP)

LGBTQIA+ populations persistently experience discrimination and limited access to informed, quality, and patient-centered healthcare. The gap between population needs and provider competence can be attributed to the inadequate education of healthcare professionals, suggesting the need for educational reform not just within medical schools, but also in physician assistant, nursing, and emergency medical services programs. To create the most widespread change across all these programs, it is imperative that the leading, most influential professional medical associations (PMAs) in each field take steps to make LGBTQIA+-focused healthcare education a priority, provide actionable statements and plans, and encourage educational institutions to ardently take …

Mitigating The Mental Health Impact Of Marginalization And Discrimination, Debra A. Hope

Trans Collaborations Academic Papers

In honor of the life and work of Aaron T. Beck, this paper describes the application of cognitive therapy to management of marginalization stress among minoritized communities. Collaborative empiricism, cognitive restructuring, and behavioral interventions are highlighted as being particularly useful in a contemporary multicultural approach for the anxiety, depression, stress, and other sequelae of marginalization due to a stigmatized identity. Although primarily illustrated through recent work with transgender and gender diverse adults, the discussion extends to other groups including racial, ethnic, and sexual minorities and immigrants. This work illustrates the power of Dr. Beck’s approach to address the presenting concerns …

Test–Retest Reliability And Sensitivity Of A Brief Clinical Monitoring Measure For Transgender And Gender Diverse Adults: The Trans Collaborations Clinical Check-In (Tc3), T. Zachary Huit, Natalie R. Holt, Alexander Farquhar-Leicester, Rebecca L. Brock, Richard Mocarski, Nathan Woodruff, Debra Hope

Trans Collaborations Academic Papers

The current study aimed to examine the test–retest reliability and sensitivity of the Trans Collaborations Clinical Check-In (TC³) in a 3-month period with four assessment points at baseline, 1, 2, and 3 months to examine its utility as a clinical progress monitoring measure. This study builds on the initial validation study conducted by Holt et al. (2019). The sample of 32 transgender and gender diverse (TGD) participants were chosen who met screening for at least modest depression and anxiety, and did not have other significant risk factors (e.g., mania, self-harm). Participants completed a battery of measures that assessed …

Bridging The Gap Between Practice Guidelines And The Therapy Room: Community-Derived Practice Adaptations For Psychological Services With Transgender And Gender Diverse Adults In The Central United States, Debra A. Hope, Natalie Holt, Nathan Woodruff, Richard Mocarski, Heather M. Meyer, Jae A. Puckett, Joshua Eyer, Shelley Craig, Jamie Feldman, Jay A. Irwin, John Pachankis, K. J. Rawson, Jae Sevelius, Sim Butler

Trans Collaborations Academic Papers

Individuals who identify as transgender and gender diverse (TGD) are presenting at mental health clinicians’ offices with increasing frequency. Many TGD clients are seeking care related to affirming their gender identity but also may present with anxiety, depression, trauma, substance abuse, or other problems forwhich a clinician may commonly provide services. Some clinicians may hesitate to accept TGD clients into their practice if they have little specialized training to work with this population in an affirming manner, especially in more underserved areas where a generalist practice is the norm. Numerous professional associations and experts have developed guidelines for affirmative behavioral …

Educational Preparedness To Care For Transgender And Gender Diverse Adults: Perspectives Of Mental Health Professionals, Sharon N. Obasi, Robyn E. King, Natalie R. Holt, Richard Mocarski, Debra A. Hope, Nathan Woodruff

Trans Collaborations Academic Papers

Ensuring that mental health professionals are appropriately trained to provide affirming and sensitive care to transgender and gender diverse (TGD) adults is one mechanism that may reduce the marginalization sometimes experienced by TGD adults in mental health contexts. In this study, mental health professionals (n = 142) completed an online survey documenting the sources and types of training received to provide TGD-sensitive care; and, shared a self-assessment of their comfort, competence, and ability to provide TGD-sensitive care. Findings revealed that the majority of the mental health professionals in the study (approximately 81%) received specific training to work with TGD …

Reproductive Regrets Among A Population-Based Sample Of U.S. Women, Arthur L. Greil, Michele H. Lowry, Andrea R. Burch, Kathleen Slauson-Blevins, Nicholas Park, Julia Mcquillan

Sociology & Criminal Justice Faculty Publications

Women have many reproductive options, but little is known about their regrets regarding prior reproductive choices and outcomes. Guided by the life-course and stratified reproduction perspectives, this study draws on an open-ended question about reproductive regrets from wave I of the National Survey of Fertility Barriers, a representative telephone survey of reproductive aged U.S. women conducted from 2004 to 2006. The authors classified regrets into five broad categories: (1) none, (2) problematic fertility, (3) unfulfilled fertility desires, (4) family, and (5) pregnancy experiences. The authors conducted the analyses separately by motherhood status. Logistic regression analysis revealed that regardless of parental …

The New Abortion Battleground, David S. Cohen, Greer Donley, Rachel Rebouché

Articles

This Article examines the paradigm shift that is occurring now that the Supreme Court has overturned Roe v. Wade. Returning abortion law to the states has spawned perplexing legal conflicts across state borders and between states and the federal government. This article emphasizes how these issues intersect with innovations in the delivery of abortion, which can now occur entirely online and transcend state boundaries. The interjurisdictional abortion wars are coming, and this Article is the first to provide the roadmap for the immediate aftermath of Roe’s reversal and what lies ahead.

Judges and scholars, and most recently the Supreme …

Re-Thinking Strategy After Roe, David S. Cohen, Greer Donley, Rachel Rebouché

Articles

The Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization overturns nearly fifty years of precedent and radically changes abortion law, throwing both sides of the debate into uncharted territory. This essay, published in the immediate aftermath of Dobbs, offers some initial thoughts about what the changed legal landscape means for abortion rights legal advocacy. Our focus in recent writings has been to identify concrete measures federal and state actors can take to secure abortion access after Dobbs. Here, we investigate a more overarching concern: what fundamental values and strategies should govern the abortion rights movement going …