We sought to evaluate common leadership experiences and academic achievements obtained by current U.S. Medical School Deans of Medicine (DOMs) prior to their first appointment as Dean in order to ...elucidate a common pathway for promotion.
In April-June 2019 the authors requested a curriculum vitae from each of the 153 LCME-accredited U.S. Medical School DOMs. The authors abstracted data on prior appointments, demographics, and achievements from CVs and online databases. Differences by gender and institutional rank were then evaluated by the Fisher's exact and Wilcoxon rank sum tests.
CVs were obtained for 62% of DOMs (95 of 153), with women comprising 16% of the responding cohort (15/95). Prior to appointment as DOM, 34% of respondents had served as both permanent Department Chair and Associate Dean, 39% as permanent Department Chair but not Associate Dean, and 17% as Associate Deans but not permanent Department Chair. There was a non-significant trend for men to have been more likely to have been a permanent Department Chair (76% vs 53%, p = 0.11) and less likely to have been an Associate Dean (48% vs 67%, p = 0.26) compared to women. Responding DOMs at Top-25 research institutions were mostly male (15/16), more likely to have been appointed before 2010 (38% vs 14%, p = 0.025), and had higher H-indices (mean (SD): 73.1 (32.3) vs 33.5 (22.5), p<0.01) than non-Top-25 Deans.
The most common pathway to DOM in this study cohort was prior service as Department Chair. This suggests that diversification among Department Chair positions or expansion of search criteria to seek leaders from pools other than Department Chairs may facilitate increased diversity, equity, and inclusion among DOM overall.
Organs suitable for donation are a scarce resource and maximizing the use of available organs is a priority. We aimed to determine whether there is a supply restricting left digit bias in organs ...offered and accepted for donors entering a new decade of age.
Potential deceased organ donors (n = 105,387) who had any organs offered for transplantation from 2010 to 2019 Organ Procurement and Transplantation Network data were analyzed. Donors were identified 1 year before and after a decade altering birthday.
At age 70 there was a 5.4% decrease in the probability of any organ placement compared to 69 (95% CI 1.1–9.7). There was a decrease of 0.25 organs (95% CI 0.13–0.37) after age 70.
There was a significant left digit bias in the acceptance of any organs for transplantation at ages 60 and 70 as well as in the acceptance of a kidney at age 70.
•There was a decrease in the probability of any organ placement for donors at age 70 compared to 69.•After a donor's 70th birthday there was a decrease in number of organs placed.•These findings represent a left digit bias in the evaluation of donor organs that restricts the supply of available organs.
There is limited research on the psychological impact of cancer for teenagers and young adults (TYAs) and the role of protective factors such as resilience. This study investigated associations ...between resilience and psychosocial outcomes in this group.
Data were collected from TYAs (aged 16-24) who attended the TYA cancer clinic at Guy's Hospital between 2013 and 2021. Participants (
= 63) completed psychosocial questionnaires within 4 weeks of their treatment start date (
) and again between 9 and 15 months later (
). We used separate multivariable linear regression models to analyze associations of resilience (Brief Resilience Questionnaire) with outcomes measured at
including symptoms of depression (Patient Health Questionnaire PHQ-9), anxiety (Generalized Anxiety Disorder GAD-7), and subjective quality of life. Models were adjusted for age, gender, ethnicity, and
outcome assessments.
Higher resilience at
was associated with increased anxiety (
= 1.68; bootstrapped confidence interval 95% CI -0.28 to 3.19), depression (
= 1.24; -0.85 to 2.90), and quality of life (5.76; -0.88 to 15.60). In contrast, an increase in resilience over time was associated with decreases in the same period in anxiety (
= -3.16; -5.22 to -1.47) and depression (
= -2.36, -4.41 to -0.58), and an increase in quality of life (
= 9.82, -0.24 to 21.13).
Increases in resilience during cancer treatment were associated with reduced symptoms of depression and anxiety in TYAs. We discuss factors likely to influence these outcomes, the implications for psychosocial interventions in this population, and identify further research to explore the impact of other factors such as diagnosis and treatment type.
Teenagers and young adults (TYAs; ages 16-24 in the United Kingdom) with cancer have specific needs and experience worse physiological and psychological outcomes compared with pediatric and adult ...cancer. In the United Kingdom, psychosocial screening is a mandatory part of TYA care. However, there is a lack of age-appropriate and acceptable psychosocial measures for this population. This review aimed to (1) identify the psychosocial measures utilized and available for TYA cancer and (2) describe their psychometric properties.
We searched five databases for studies meeting the eligibility criteria. We extracted data relevant to the review and assessed study quality using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines and the Hughes Quality Assessment Tool developed by the research team.
We identified 40 studies that included 105 psychosocial measures. The main constructs measured were distress, depression, and anxiety. The TYA age range varied widely. Reporting of psychosocial measures and their psychometric properties was poor, and most measures were not validated or developed for TYA cancer populations.
There is an urgent need for psychosocial measures that are designed for and validated in TYA cancer populations. Appropriate measures would enable clinicians to reliably identify and effectively support the psychosocial challenges faced by TYAs. The use of validated psychosocial measures enables earlier detection of difficulties, fosters patient-centered care, and is cost-effective since resources can be allocated to those most in need.
•Underrepresented minorities in medicine (URiMs) consider many more factors in their daily clinical activities than their white counterparts including: how they style their hair, how they speak, and ...how their racial or ethnic background influences perceptions of them•URiM report tension between being their authentic selves and adapting to white standards of professionalism while in the clinical environment•Despite the disproportionate cognitive burden that URiM carry, they quantitatively perform at the same level as their white peers
It is well documented that medical students who identify as underrepresented in medicine are more likely to encounter social challenges in the clinical environment. Successful navigation of these challenges requires a social and emotional agility that is unmeasured in traditional metrics of success. The effects of this requirement has not yet been explored. The authors therefore set out to investigate the variations in experiences that exist between underrepresented minority students in medicine (URiM) and white students, and to determine if there was a difference in the quantitative performance evaluations applied to both groups of students.
This was a mixed-methods study. In the quantitative portion, the authors retrospectively analyzed the standardized patient encounter scores of medical students from a single medical school in Michigan during the years of 2016 to 2018. The authors used multivariable ordinary least squares regression models to evaluate the differences in scores by race. In the qualitative portion, students volunteered to be interviewed and self-identified their race and gender. The authors employed semi-structured interview techniques to gather information about how the student felt their cultural or ethnic background affected their experience in the clinical environment.
For the quantitative portion of this study, the authors analyzed the scores of 534 students over 4 different standardized patient encounters. The average score across all 4 standardized patient encounters was 88.7 (SD=5.6). The average score across all 4 standardized patient encounters for white students was 89 (SD=5.3), Black 87.9 (SD=7.4) Twenty-four students participated in the semi-structured interviews. Participants described feeling that the way their assessors interacted with them was largely affected by their race or gender. They also described feeling tension between how they would usually express themselves and how they were expected to in the clinical environment. When probed further, participants described various methods of adaptation to this tension including changing their hair or natural style of speech and modifying their perception of their role in the clinical environment.
Background
Health determinants are known to influence the stage of breast cancer presentation, but it is unclear to what extent language affects stage. This study investigates whether ...non–English‐speaking (NES) patients present at a later stage than their English‐speaking (ES) counterparts and whether language is associated with mammographic screening.
Methods
This study was a retrospective, single‐institution cohort analysis of women undergoing breast radiotherapy from 2012 to 2017 (n = 1057). Patients were categorized as ES (n = 904) or NES (n = 153). Ordinal logistic regression analysis identified variables associated with later stage presentation, including language, race/ethnicity, and age. A subcohort analysis investigated the influence of mammographic screening on stage for NES patients.
Results
NES patients had greater odds of later stage disease than ES patients (odds ratio, 1.47; 95% confidence, 1.001‐2.150). This association persisted across all races/ethnicities. An additional analysis examined age categories associated with mammographic screening. For women eligible for screening (ie, those 40‐50 years old or older than 50 years), there was a significant association between language and stage. NES patients older than 50 years were twice as likely to present at an advanced stage in comparison with ES patients (16.19% vs 8.11%; P = .0082). An additional subset analysis accounted for mammograms. NES patients who did not undergo screening had a higher probability of stage III disease (40.3% of NES patients vs 12.7% of ES patients). There was no difference in stage between NES and ES patients who did undergo screening.
Conclusions
Language is independently associated with later stage breast cancer for NES patients, regardless of race/ethnicity. NES patients may have difficulty in accessing the health care system. Future interventions should seek to reduce language barriers for mammographic screening and diagnosis.
Language is independently associated with later stage breast cancer for non–English‐speaking patients, regardless of race/ethnicity. For women eligible for screening, there is a significant association between language, a lack of mammographic screening, and advanced‐stage presentation.
The oxidative coupling of alkylboronic acids with oxygen nucleophiles offers a strategy for replacing toxic, electrophilic alkylating reagents. Although the Chan–Lam reaction has been widely applied ...in the arylation of heteroatom nucleophiles, O-alkylation with boronic acids is rare. We report a Cu-catalyzed nondecarboxylative methylation of carboxylic acids with methylboronic acid that proceeds in air with no additional oxidant. An isotope-labeling study supports an oxidative cross-coupling mechanism, in analogy to that proposed for Chan–Lam arylation.
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