Saba W. Masho

Why Do Faculty Leave? Reasons for Attrition of Women and Minority Faculty from a Medical School: Four-Year Results

PURPOSE Faculty attrition, particularly among female and minority faculty, is a serious problem in academic medical settings. The reasons why faculty in academic medical settings choose to leave their employment are not well understood. Further, it is not clear if the reasons why women and minority faculty leave differ from those of other groups. METHODS One hundred sixty-six medical school faculty who left the School of Medicine (SOM) between July 1, 2001, and June 30, 2005, completed a survey about their reasons for leaving. RESULTS The three most common overall reasons for leaving the institution included career/professional advancement (29.8%), low salary (25.5%), and chairman/departmental leadership issues (22.4%). The ranking of these reasons varied slightly across racial and gender groups, with women and minority faculty also citing personal reasons for leaving. Women and minority faculty were at lower academic ranks at the time they left the SOM compared with male and majority groups. Although salary differences were not present at the time of initial hire, sex was a significant predictor of lower salary at the start of the new position. Opportunity for advancement and the rate of promotion were significantly different between women and men. Job characteristics prior to leaving that were rated most poorly were protected time for teaching and research, communication across the campus, and patient parking. Harassment and discrimination were reported by a small number of those surveyed, particularly women and minority faculty. CONCLUSIONS The majority of reasons for faculty attrition are amenable to change. Retaining high-quality faculty in medical settings may justify the costs of faculty development and retention efforts.

Obesity as a risk factor for premenstrual syndrome.

Purpose: To determine the association between obesity and Premenstrual Syndrome (PMS). Methods: A cross-sectional study was conducted using a random-digit dialing method. The sampling frame consisted of all possible area codes, exchanges, and 4-digit suffixes in Virginia. A total of 874 women between the ages of 18–44 residing in the state of Virginia between August 1 and September 15, 1994 were interviewed. Cases were defined as women who reported severe or extreme PMS symptom changes using the Shortened Premenstrual Assessment Form. The main exposure variable was obesity as measured by Body Mass Index. Results: The prevalence of PMS in Virginia was 10.3 percent. Obese women (BMI ⩾ 30) had nearly a three-fold increased risk for PMS than non-obese women OR = 2.8 (95% CI = 1.1, 7.2). PMS was more prevalent among whites, younger women, and smokers. Conclusion: This data provided evidence that obesity is strongly associated with PMS. Since obesity is a modifiable risk factor, PMS management strategies should not only consider factors such as, high stress, and smoking but also obesity.

Early Age at First Intercourse and Subsequent Gaps in Contraceptive Use

BACKGROUND Sexual debut before age 15 years has been associated with increased sexual risk behaviors among teens, but little is known about its effects beyond adolescence. This study examines the relationship between the age at first intercourse and subsequent contraceptive gaps. METHODS We identified 3538 sexually active, fertile women participants from the 2006-2008 National Survey of Family Growth. Women were classified as consistent contraceptive users or inconsistent/nonusers. Age at first intercourse with a man was determined by self-report and categorized as <15, 15-17, and ≥18 years. RESULTS Twenty-three percent reported gaps in contraceptive use in the year prior to interview. Compared with women who were 18 or older at first intercourse, women who were <15 years of age at the time of first intercourse were nearly two times as likely to report a gap in contraceptive use (adjusted odds ratio: 1.93; 95% confidence interval: 1.23-3.00). CONCLUSIONS Age at first intercourse is associated with inconsistent or nonuse of contraceptives in later life. Primary prevention efforts should be established to empower girls to make informed and autonomous decisions about sexual debut. Personalized contraceptive counseling has been demonstrated as being effective in increasing contraceptive use and compliance and should be offered to all women, with particular focus on women who report an early age at first intercourse or other factors associated with inconsistent contraceptive use.

Factors Contributing to Infant Overfeeding with Hispanic Mothers

OBJECTIVE To evaluate existing evidence on factors potentially contributing to infant overfeeding among Hispanic mothers that may explain the high infant overweight rates often seen among this ethnic group. DATA SOURCES Electronic databases including CINHAL and MEDLINE were searched for relevant studies published from 1998 to January 2012. Related article searches and reference list searches were completed on all included studies. STUDY SELECTION Thirty-five studies (nine qualitative, 15 cross-sectional, nine cohort, and two longitudinal) were identified that met the following inclusion criteria: (a) studies of Hispanic-only or multiethnic mothers, (b) studies of healthy full-term infants or toddlers, (c) studies in which a majority of the sample included children within the target age group (0-24 months of age), and (d) studies conducted in the United States. The methodological quality of the studies ranged from fair to excellent. DATA EXTRACTION Data extraction included content related to Hispanic infant feeding and weight gain. DATA SYNTHESIS Reviewed research fell into three main foci of inquiry: breastfeeding and formula-feeding beliefs, attitudes, and practices; family and cultural influences of maternal feeding beliefs and practices; and maternal perceptions of infant feeding satiety and weight gain. The Preferred Reporting Items of Systematic Reviews Meta-Analysis (PRISMA) guidelines were followed for data extraction and reporting the results of this integrative review. CONCLUSION Three major feeding practices and beliefs among Hispanic mothers potentially contribute to infant overfeeding. Hispanic mothers are more likely to practice nonexclusive breastfeeding, initiate early introduction of solid foods including ethnic foods, and perceive chubbier infants as healthy infants. Cultural norms driving family influences and socioeconomic factors play a role in the feeding tendencies of Hispanics. Empirical research is needed to further define the primary factors that influence Hispanic mothers feeding decisions and practices that contribute to excessive weight gain in their infants.

Intimate Partner Violence and Utilization of Prenatal Care in the United States

Over 1.5 million women are victims of physical, sexual, and emotional abuse by former or present intimate partners. Intimate partner violence (IPV) around pregnancy can lead to devastating health consequences to mothers and infants. While some research suggests that IPV negatively affects the utilization of health services like prenatal care (PNC), inconsistencies in the assessment of PNC utilization, timing of partner violence, and definitions of IPV yield conflicting results. The objective for the present study is to evaluate whether preconception IPV, prenatal IPV, or IPV in the preconception and/or prenatal period affects PNC utilization. This study analyzed the 2004-2008 national Pregnancy Risk Assessment Monitoring System (PRAMS), which included 202,367 women who delivered a live birth in the United States. IPV victimization was measured using four items that addressed physical abuse by a current or former husband/partner in the 12 months before (preconception) and during (prenatal) pregnancy. Responses were categorized as preconception, prenatal, and preconception and/or prenatal IPV. The outcome was PNC adequacy categorized as inadequate, intermediate, adequate, and adequate plus based on the Adequacy of Prenatal Care Utilization index. Separate logistic regression models provided crude and adjusted odds ratios and 95% confidence intervals (CI). Over 6% of women reported preconception and/or prenatal IPV and 26% had less than adequate PNC. Women who reported abuse before and/or during pregnancy were more likely to have inadequate PNC (odds ratio [OR] = 1.4, 95% CI = [1.3, 1.6]). Similarly, women who experienced preconception or prenatal IPV were 30% more likely to have inadequate PNC (OR = 1.3, 95% CI = [1.2, 1.5]; OR = 1.3, 95% CI = [1.1, 1.7], respectively). Adequate PNC is essential in improving pregnancy outcomes; however, women in abusive relationships may face ongoing challenges and difficulties with obtaining appropriate care. Findings underscore a critical problem and health providers are urged to screen and educate women about IPV during all preconception and prenatal visits.

Adolescent and sexual history factors influencing reproductive control among women aged 18–44

BACKGROUND Reproductive control refers to the ability of a man or woman to control his or her own reproduction. Unintended pregnancy is a commonly used proxy measure for reproductive control. METHODS Using heterosexually active women participating in the National Survey of Family Growth Cycle 6 (n = 4521), we evaluated unintended pregnancy as a proxy measure for reproductive control. We identified four categories of women by self-reported pregnancy intention: (1) women reporting one unintended pregnancy, (2) women reporting two or more unintended pregnancies, (3) women reporting intentionally having no pregnancies and (4) women who reported that all pregnancies were intended (reference category). Polytomous logistic regression, weighted for the complex sampling design, provided estimates of odds ratios (OR) and 95% confidence intervals (CI). RESULTS Fifty-one percent of women who reported having one unintended pregnancy went on to experience at least one additional unintended pregnancy. Being black, Hispanic, born to a mother who was <18 years at first birth, having multiple partners and age of first sexual debut (consensual or non-consensual) were significant predictors of multiple unintended pregnancies. Relative to sexual debut after 18 years of age, women reporting a sexual debut at less than 15 years were at increased risk of multiple unintended pregnancies (adjusted OR (reported as consensual): 6.96; 95% CI: 4.26 to 11.39; adjusted OR (reported as non-consensual: 27.10; 95% CI: 11.03-66.57)). CONCLUSIONS Efforts to delay sexual debut and to protect girls from non-consensual sex are sorely needed to prevent a lifelong trajectory of lack of reproductive control.

Problematic Situations Associated with Dating Experiences and Relationships Among Urban African American Adolescents: A Qualitative Study

This qualitative study focused on the identification of problem situations associated with adolescent dating experiences and relationships, including those that placed youth at risk for dating violence perpetration or victimization. Interviews were conducted with 44 African American middle and high school students in an urban school system. Qualitative analysis identified 18 individual themes representing six categories of problem situations: (a) approach and initiation; (b) conflict, conflict resolution, and break-ups; (c) communication, connection, and emotion; (d) aggression and victimization; (e) the role of others; and (f) media and technology. Identification of these problem situation themes has important implications for developing and evaluating prevention efforts designed to foster healthy adolescent dating relationships.

Do African American Men Have Lower Survival From Prostate Cancer Compared With White Men? A Meta-analysis

Prostate cancer is the second leading cause of cancer-related mortality in men. This meta-analysis was conducted to investigate the relationship between race and survival from prostate cancer. A systematic review of articles published from 1968 to 2007 assessing survival from prostate cancer was conducted. Analysis of unadjusted studies reported that African American men have an increased risk of all-cause mortality (hazard ratio [HR] = 1.47, 95% confidence interval [CI] = 1.31-1.65, p < .001). However, examination of adjusted studies identified no difference (HR = 1.07, 95% CI = 0.94-1.22, p = .308). No statistically significant difference was observed in prostate cancer—specific survival in both analyses using unadjusted (HR = 1.11, 95% CI = 0.94-1.31, p = .209) and adjusted studies (HR = 1.15, 95% CI = 0.95-1.41, p = .157). This meta-analysis concludes that there are no racial differences in the overall and prostate cancer—specific survival between African American and White men.

Factors determining whether Ethiopian women support continuation of female genital mutilation

To examine the factors influencing the opinions of women about whether female genital mutilation (FGM) should continue in Ethiopia.

Adverse childhood experiences and intimate partner aggression in the US: Sex differences and similarities in psychosocial mediation

Six in ten people in the general population have been exposed to adverse childhood experiences (ACEs). Intimate partner violence (IPV) is a major public health problem in the US. The main objective of this study was to assess sex differences in the role of posttraumatic stress disorder (PTSD), substance abuse, and depression as mediators in the association between ACEs and intimate partner aggression. Data were obtained from Wave 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions. Structural equation modeling was used to determine the mediational role of PTSD, substance abuse and depression in the association between ACE constructs (neglect, physical/psychological abuse, sexual abuse, parental violence, and parental incarceration/psychopathology) and intimate partner aggression. Among men, PTSD mediated the relationship between sexual abuse and intimate partner aggression. However, among men and women, substance abuse mediated the relationship between physical and psychological abuse and intimate partner aggression. IPV programs geared towards aggressors should address abuse (sexual, physical and psychological), which occurred during childhood and recent substance abuse and PTSD. These programs should be implemented for men and women. Programs aimed at preventing abuse of children may help to reduce rates of depression and PTSD in adulthood, and subsequent intimate partner aggression.