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Women dominate OBGYN field but make less money than male counterparts

While women outnumber men as OB-GYN practitioners, they still make significantly less money and the pay gap extends to subspecialties like reproductive endocrinology and infertility (REI), according to researchers at the University of Colorado Anschutz Medical Campus.

“It’s interesting that the OB-GYN field is dominated by women and yet this gender inequality in pay persists,” said the study’s senior author Malgorzata Skaznik-Wikiel, MD, assistant professor of obstetrics and gynecology at the University of Colorado School of Medicine. “Why the discrepancy?”

The study was published on-line this month in the journal Fertility and Sterility.

It showed that even after adjusting for variables like hours worked, years in practice, location, academic vs. private practice, female reproductive endocrinology and infertility subspecialists make on average $67,000 less than male REIs per year.

Pay inequity among physicians in well-documented. According to Doximity, an online social network for health care professionals, women doctors make about 27.7 percent less than male physicians or about $105,000.

Dr. Skaznik-Wikiel | CU ARM
Malgorzata Skaznik-Wikiel, MD, assistant professor of obstetrics and gynecology at the University of Colorado School of Medicine.

A recent commentary in the journal Obstetrics and Gynecology noted that 82 percent of those going into OB-GYN were women, yet the field is the fourth worst of 18 specialties in pay inequity among the sexes. Skaznik-Wikiel and her colleagues sent surveys to 796 board-certified or board-eligible Society for Reproductive Endocrinology and Infertility members. Of those, 215 responded, an above average response for such surveys.

The study noted that although women were more likely to practice less than five days per week, there were no significant differences in the number of hours they spent per week seeing patients, doing research or being involved in other academic activities.

The researchers reviewed a number of reasons given for the pay gap – women working fewer hours, taking more personal leave, practicing in specialties that pay less or practicing in academia rather than privately.

Yet they found little to substantiate these suggestions.

For example, the study said it’s unlikely that a woman taking more personal leave, like maternity leave, would affect a base salary. Also, they said, more and more men are taking paternity leave as well.

One possible culprit is `salary compression.’ That’s when the market rate for a job outpaces pay increases for those already in those positions. New hires may get bigger salaries.

“There is some evidence that men switch jobs more often than women and sometimes new jobs will pay more to attract new employees,” Skaznik-Wikiel said.

She also said women are often reluctant to negotiate hard over salary for fear of being seen as overly aggressive, traits many do not associate with men who do the same thing.

Ultimately, Skaznik-Wikiel said, there is no good reason for the discrepancy.

“The first step in addressing the gender gap is acknowledging it exists,” she said. “Ignorance of this issue is no longer acceptable.”

The second step is opening a frank and honest discussion about income, salary negotiations and implementation of academic institutional and private practice policies addressing potential gender biases, the study said.

Salaries, raises and bonuses should be more transparent, said Skaznik-Wikiel.

“Women also need to step into mentorship roles now more than ever,” she said. “An opportunity exists for practitioners in the field of obstetrics and gynecology and its subspecialties to lead by example in establishing new transparent norms and better policies that create an environment of equity in pay.”

The study co-authors include: Sara Babcock Gilbert, MD, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology at the CU School of Medicine and Amanda Allshouse, MS, Department of Biostatistics and Informatics at the Colorado School of Public Health at CU Anschutz.

 

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Dermatology students improve Wikipedia entries on skin disease

A group of medical students recruited to improve Wikipedia articles on skin-related diseases, saw millions more views of those stories following their editing, highlighting the value of expert input on the popular web encyclopedia.

“We tried to make the articles more readable, while adding more relevant information,” said Olivia Hutton, BS, a medical student at the University of Colorado School of Medicine who led the project. “The articles we edited have been viewed 10 million times since adding the new information.”

Robert Dellavalle, MD, PhD, MSPH, professor of dermatology at the CU School of Medicine
Robert Dellavalle, MD, PhD, MSPH, professor of dermatology at the CU School of Medicine

The research letter was published online March 28 in the Journal of the American Academy of Dermatology.

Medical stories on Wikipedia receive 10 million views daily and the top 500 skin-related articles saw over 16 million views during August 2018 alone.

But in an effort to make those articles more complete and accurate, an editing partnership was set up between the evidence-based medicine organization Cochrane and Wikipedia in 2014. Cochrane Review Groups work with Wikipedia to recruit and train editors to share high-quality Cochrane Review evidence in Wikipedia stories.

In this case, five students were trained to beef up the articles on skin-diseases. They learned Wikipedia editing, were mentored by an experienced Wikipedia medical editor and were given a list of articles to improve.

The project was supervised by Robert Dellavalle, MD, PhD, MSPH, professor of dermatology at the CU School of Medicine. According to Hutton, the trainees improved 40 skin-specific articles on Wikipedia. They did this by adding paraphrased conclusions and background information from 60 Cochrane Reviews.

The 40 edited stories won millions more views. The top five most viewed articles dealt with psoriasis, leprosy, cellulitis, melanoma and molluscum contagiosum.

“Criticisms of Wikipedia include concerns over the quality of shared content,” Hutton said. “It is important to ensure that Wikipedia’s content is evidence-based, unbiased and up-to-date. We have shown that a small Wikipedia editing initiative has the potential to share evidence-based information with many people.”

Dellavalle, who is also a joint-coordinating editor of Cochrane Skin, said the students’ work with Wikipedia in this regard “is the most expansive provision of public health dermatology information in the world.”

The next step, he said, is to recruit more trainees, improve skin-related Wikipedia content in other languages and make further improvements in articles to increase accuracy and understandability.

The article co-authors include Jennifer E. Dawson, PhD; Kachiu C. Lee, MPH; Peter R. Shumaker, MD; Elizabeth Doney, MSc; Robert P. Dellavalle, MD, PhD, MSPH.

 

 

 

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Women dominate Ob/Gyn field but make less money than male counterparts

Pregnant patient

While women outnumber men as Ob/Gyn practitioners, they still make significantly less money and the pay gap extends to subspecialties like reproductive endocrinology and infertility (REI), according to researchers at the University of Colorado Anschutz Medical Campus.

“It’s interesting that the Ob/Gyn field is dominated by women and yet this gender inequality in pay persists,” said the study’s senior author Malgorzata Skaznik-Wikiel, MD, assistant professor of obstetrics and gynecology at the University of Colorado School of Medicine. “Why the discrepancy?”

The study was published on-line this month in the journal Fertility and Sterility.

It showed that even after adjusting for variables like hours worked, years in practice, location, academic vs. private practice, female reproductive endocrinology and infertility subspecialists make on average $67,000 less than male REIs per year.

Pay inequity among physicians in well-documented. According to Doximity, an online social network for health care professionals, women doctors make about 27.7 percent less than male physicians or about $105,000.

Dr. Skaznik-Wikiel | CU ARM
Malgorzata Skaznik-Wikiel, MD, assistant professor of obstetrics and gynecology at the University of Colorado School of Medicine.

A recent commentary in the journal Obstetrics and Gynecology noted that 82 percent of those going into Ob/Gyn were women, yet the field is the fourth worst of 18 specialties in pay inequity among the sexes.  Skaznik-Wikiel and her colleagues sent surveys to 796 board-certified or board-eligible Society for Reproductive Endocrinology and Infertility members. Of those, 215 responded, an above average response for such surveys.

The study noted that although women were more likely to practice less than five days per week, there were no significant differences in the number of hours they spent per week seeing patients, doing research or being involved in other academic activities.

The researchers reviewed a number of reasons given for the pay gap – women working fewer hours, taking more personal leave, practicing in specialties that pay less or practicing in academia rather than privately.

Yet they found little to substantiate these suggestions.

For example, the study said it’s unlikely that a woman taking more personal leave, like maternity leave, would affect a base salary. Also, they said, more and more men are taking paternity leave as well.

One possible culprit is `salary compression.’ That’s when the market rate for a job outpaces pay increases for those already in those positions. New hires may get bigger salaries.

“There is some evidence that men switch jobs more often than women and sometimes new jobs will pay more to attract new employees,” Skaznik-Wikiel said.

She also said women are often reluctant to negotiate hard over salary for fear of being seen as overly aggressive, traits many do not associate with men who do the same thing.

Ultimately, Skaznik-Wikiel said, there is no good reason for the discrepancy.

“The first step in addressing the gender gap is acknowledging it exists,” she said. “Ignorance of this issue is no longer acceptable.”

The second step is opening a frank and honest discussion about income, salary negotiations and implementation of academic institutional and private practice policies addressing potential gender biases, the study said.

Salaries, raises and bonuses should be more transparent, said Skaznik-Wikiel.

“Women also need to step into mentorship roles now more than ever,” she said. “An opportunity exists for practitioners in the field of obstetrics and gynecology and its subspecialties to lead by example in establishing new transparent norms and better policies that create an environment of equity in pay.”

The study co-authors include: Sara Babcock Gilbert, MD, Division of Reproductive Endocrinology and Infertility, Dept. of Obstetrics and Gynecology at the CU School of Medicine and Amanda Allshouse, MS, Dept. of Biostatistics and Informatics at the Colorado School of Public Health at CU Anschutz.

 

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CU Anschutz study offers clues for why birth control may fail

Birth Control Pills

Women who get pregnant while using birth control may carry a gene that breaks down the hormones common in contraceptives, according to researchers at the University of Colorado Anschutz Medical Campus.

“The findings mark the first time a genetic variant has been associated with birth control,” said the study’s lead author Aaron Lazorwitz, MD, assistant professor of Obstetrics and Gynecology at the University of Colorado School of Medicine.

The study was published today in the journal Obstetrics & Gynecology.

Aaron Lazorwitz, MD, assistant professor of Obstetrics and Gynecology at the University of Colorado School of Medicine
Aaron Lazorwitz, MD, assistant professor of Obstetrics and Gynecology at the University of Colorado School of Medicine

Contraceptives are not 100 percent effective but the reasons they fail have never been fully explained.

Women are usually blamed for not using the medication properly. But Lazorwitz and his colleagues suspected that there may be other reasons at work. They looked at 350 healthy women with a median age of 22.5 years old and a contraceptive implant in place for between 12 and 36 months.

The researchers found that 5 percent of women tested had a gene called CYP3A7*1C that is usually active in fetuses and then switched off before birth. But some women with this gene continue to make the CYP3A7 enzyme into adulthood.

“That enzyme breaks down the hormones in birth control and may put women at a higher risk of pregnancy while using contraceptives, especially lower dose methods,” Lazorwitz said.

The variant could be found during genetic screening.

“When a woman says she got pregnant while on birth control the assumption was always that it was somehow her fault,” Lazorwitz said. “But these findings show that we should listen to our patients and consider if there is something in their genes that caused this.”

The findings point to how pharmacogenomics, a relatively new field which analyzes how genes affect a person’s response to drugs, has the potential to dramatically alter the field of women’s health.

“Especially in light of the social, financial, and emotional consequences of contraceptive failure and the breadth of indications for steroid hormones throughout a woman’s life-span,” the study said.

Lazorwitz said the study may help spur the development of more precise medical tools that can help tailor treatment to individual patients.

“As more genetic data becomes available, clinicians may need to consider adding genetic predisposition to increased steroid hormone metabolism in their differential diagnosis for unintended pregnancies in women reporting perfect adherence to hormonal contraceptive methods,” he said.

The study co-authors include: Christina L. Aquilante, PharmD; Kris Oreschak, BS; Jeanelle Sheeder, PhD; Maryam Guiahi, MD, MSc; Stephanie Teal, MD, MPH.

 

 

 

 

 

 

 

 

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New study shows hidden genes may underlie autism severity

Scientists at the University of Colorado Anschutz Medical Campus  have implicated a largely hidden part of the human genome in the severity of autism symptoms, a discovery that could lead to new insights into the disorder and eventually to clinical therapies for the condition.

James Sikela, PhD, professor in the Department of Biochemistry and Molecular Genetics at the CU School of Medicine.
James Sikela, PhD, professor in the Department of Biochemistry and Molecular Genetics at the CU School of Medicine.

The researchers found the critical genes are a part of the human genome that is so complex and difficult to study that it has been unexamined by conventional genome analysis methods.

In this case, the region encodes most copies of the Olduvai (formerly DUF1220) protein domain, a highly duplicated (~300 copies in the human genome) and highly variable gene coding family that has been implicated in both human brain evolution and cognitive disease.

The researchers, led by James Sikela, PhD, a professor in the Department of Biochemistry and Molecular Genetics at the University of Colorado School of Medicine, analyzed the genomes of individuals with autism and showed that, as the number of copies of Olduvai increased, the severity of autism symptoms became worse.

While the Sikela lab has shown this same trend previously, the discovery has not been pursued by other researchers due to the complexity of the Olduvai family.

“It took us several years to develop accurate methods for studying these sequences, so we fully understand why other groups have not joined in.” Sikela said. “We hope that by showing that the link with autism severity holds up in three independent studies, we will prompt other autism researchers to examine this complex family.”

Image result for genome

In order to provide more evidence that the association with autism severity is real, the Sikela lab used an independent population and developed a different, higher resolution measurement technique. This new method also allowed them to zero in on which members of the large Olduvai family may be driving the link with autism.

Though autism is thought to have a significant genetic component, conventional genetic studies have come up short in efforts to explain this contribution, Sikela said.

“The current study adds further support to the possibility that this lack of success may be because the key contributors to autism involve difficult-to-measure, highly duplicated and highly variable sequences, such as those encoding the Olduvai family, and, as a result, have never been directly measured in other studies of autism,” Sikela said.

The study was published today in the American Journal of Psychiatry, and included CU Anschutz co-authors Jonathan M. Davis, PhD and Ilea Heft, PhD. Work was performed in collaboration with Dr. Stephen Scherer of The Hospital for Sick Children (SickKids) and University of Toronto and used whole genome sequences generated by the Autism Speaks MSSNG Open Science project. The work was supported by grants from the National Institute for Mental Health (NIMH) and the Simons Foundation for Autism Research (SFARI).

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Over half of home health care clinicians say they lack adequate information from hospitals

Home health care clinician

A survey of Colorado home health care clinicians (HHCs) revealed that 60 percent said they had not received enough information to guide patient treatment while 52 percent said patients often had unrealistic expectations of the kind of care they would receive.

The study, conducted by researchers at the University of  Colorado Anschutz Medical Campus, also showed major gaps in communication between hospital and home health care staff, some that could have serious medical consequences.

The study was published today in the Journal of the American Medical Directors Association.

“We have heard of medication errors occurring between hospitals and home health care providers,” said the study’s lead author Christine D. Jones, MD, MS, assistant professor at the University of Colorado School of Medicine.  “As a result, patients can receive the wrong medication or the wrong dose. Some home health providers don’t get accurate information about how long to leave a urinary catheter or intravenous line in.”

Jones and her colleagues surveyed nurses and staff at 56 HHC agencies throughout Colorado. Participants were sent a 48-question survey covering communication between hospitals and HHCs, patient safety, pending tests, medication schedules, clinician contact and other areas.

More than half said hospitals did not adequately prepare patients for home health care upon discharge. They also said patients often expected a level of home care that was simply not available including extended hours, housekeeping and help with transportation.

Dr. Christine Jones, assistant professor of medicine and lead author of the study.
Dr. Christine Jones, assistant professor of medicine and lead author of the study.

Home health care workers with access to electronic health records (EHRs) for referring providers had fewer problems relating to a lack of information about patients, including critical medication data.

They were able to electronically access notes, orders, lab and radiology results and referrals. Some 12 percent of respondents reported positive experiences when accessing the Colorado Regional Health Information Organization (CORHIO, www.corhio.org) about hospital admissions.

Yet many did not have access to such information.

“Although almost all (96 percent) indicated that Internet-based access to a patient’s hospital record would be at least somewhat useful,” Jones said. “Fewer than half reported having access to EHRs for referring hospitals or clinics.”

She said the survey revealed problems getting medication doses right due to conflicting information.

“Notably, additional studies have found extremely high rates of medication discrepancies (94 percent – 100 percent) when referring provider and HHC medications lists are compared,” Jones said.

The study suggested targeted education of hospital staff about what home health clinicians actually provide to patients and caregivers to avoid frustration.

Jones noted that if these issues are arising in Colorado, they could signify a national problem.

“For hospitals and HHC agencies seeking strategies to improve communication, this study can provide targets for improvement,” she said. “Future interventions to improve communication between the hospital and HHC should aim to improve preparation of patients and caregivers to ensure they know what to expect from HHC and to provide access to EHR information for HHC agencies.”

The study’s co-authors include: Jacqueline Jones, PhD, RN, FAAN; Kathryn H. Bowles, PhD, RN, FAAN, FACMI; Linda Flynn, PhD, RN, FAAN; Frederick A. Masoudi, MD, MSPH; Eric A. Coleman, MD, MPH; Cari Levy, MD, PhD and Rebecca S. Boxer, MD, MS.

 

 

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Researchers discover a genetic defect linked to pediatric liver disease

Researchers from the University of  Colorado Anschutz Medical Campus, in collaboration with several other institutions, have discovered a genetic defect linked to Biliary atresia (BA), the most common pediatric cause of end-stage liver disease, and the leading indication for liver transplantation in children.

Their findings were published January in the journal Hepatology.

Ronald Sokol, MD
Ronald Sokol, MD

“We don’t know the cause of Biliary atresia, which interferes with our ability to treat affected children,” said study co-author Ronald Sokol, MD, a pediatric gastroenterologist and hepatologist at Children’s Hospital Colorado and Director of the Colorado Clinical and Translational Sciences Institute (CCTSI) at CU Anschutz.

By identifying a genetic mutation linked to the disease, Sokol, along with researchers from Emory University, University of Utah, Children’s Hospital of Philadelphia, Washington University at St. Louis, and others, may finally determine the cause of this devastating condition. The group used next-generation gene sequencing to discover that a genetic defect of the gene PKD1L1 was linked to BA in a subset of patients.

Some children with BA also have splenic abnormalities and cardiac malformations called biliary atresia splenic malformation syndrome or BASM. Researchers hypothesized that the genetic factors causing an asymmetric position of organs in the body could also cause the development of BA in BASM patients, and that the genes involved could be discovered using whole exome sequencing.

So they sequenced DNA specimens from 67 subjects with BASM, including 58 patient-parent trios. Researchers looked at 2,016 genes – a subset of the full genome – that were associated with proteins that were candidates to cause a disease like BA. The study found five patients who had two copies of mutations in the gene PKD1L1 and three additional patients who had one mutation in the gene.

“The importance of this is that researchers have never identified a gene, when mutated, that causes BA,” Sokol said. “This is the first time it has been found.”

The CCTSI’s Pediatric Clinical and Translational Research Center played a key role in the study. The patients who were participants came from a liver disease research network, which Dr. Sokol chairs, the Childhood Liver Disease Research Network (ChiLDReN). This network has been funded by the NIH for 15 years and includes 14 centers across the nation, Canada and the UK.

The gene that was identified may be the first of other genes to be found to be linked with BASM or BA. Understanding what causes BA is a breakthrough that could lead to new therapeutic approaches that would ultimately avoid liver transplantation.

In the first analysis of the data, researchers looked at more than 2,000 genes. Now that they have the data from the whole exome sequencing, researchers can go back and analyze the other 18,000 genes for other genetic causes of BA.

“What we learn about what causes the disease could translate into new therapeutic targets and strategies,” Sokol said.

Guest contributor: Wendy Meyer, Colorado Clinical and Translational Sciences Institute

 

 

 

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Researchers find genetic clues to high rates of asthma in those of African ancestry

In the largest study of its kind, researchers at the University of Colorado Anschutz Medical Campus have found new clues into the parts of the human genome associated with the higher rates of asthma in those of African ancestry.

The study was published today in the journal Nature Communications.

Using advanced new technology, scientists were able to identify loci or locations on a specific chromosome that may put those of African descent at a higher risk of asthma.

Kathleen Barnes, PhD, director of the Colorado Center for Personalized Medicine at CU Anschutz.
Kathleen Barnes, PhD, director of the Colorado Center for Personalized Medicine at CU Anschutz.

They also discovered four chromosomal regions usually found in whites and Asians associated with asthma. One of those chromosomal areas is known as the 17q12 – 21 region.

Despite the high incidence of asthma among those of African ancestry, it has been historically underrepresented in genome-wide association studies (GWAS) even though the African genome is the most diverse on earth.

“In the largest GWAS of asthma in African ancestry populations to date, we found strong evidence for association at four previously reported asthma loci whose discovery was driven largely by non-African populations, and we also identified two novel loci on chromosome 8 that may be specific to asthma risk in African ancestry populations,” said the study’s first author Michelle Daya, PhD, assistant professor in the division of Biomedical Informatics and Personalized Medicine at the CU School of Medicine.

According to Kathleen Barnes, PhD, the senior author on the study and director of the Colorado Center for Personalized Medicine at CU Anschutz, those of African ancestry in the Americas and elsewhere suffer a disproportionate burden of disability, disease and death from common chronic illnesses like asthma and diabetes. Yet the group has been understudied.

Michelle Daya, PhD, assistant professor in the division of Biomedical Informatics and Personalized Medicine.
Michelle Daya, PhD, assistant professor in the division of Biomedical Informatics and Personalized Medicine.

To better understand this population and its genetic impact, Barnes worked with the National Institutes of Health’s National Heart, Lung and Blood Institute (NHLBI) to create the `Consortium on Asthma among African-ancestry Populations in the Americas’ or CAAPA.

They sequenced the genome of 642 people of African ancestry from 15 North, Central and South American and Caribbean populations plus Yoruba-speaking individuals from Ibadan, Nigeria.

“NHLBI has been promoting basic research to understand the genetic contribution to asthma disparities across racial and ethnic groups, and the CAAPA is one of our major investments in this area,” said James Kiley, director of the Division of Lung Diseases at NHLBI and the NIH.

In this latest study, researchers looked at 7,009 asthma cases and 7,645 controls.

“From this study we can say chromosome 17q is important for the development of asthma not just in populations of European or Asian ancestry, but also those of African ancestry,” Barnes said. “This is a big step forward in untangling what is happening at this loci.”

The researchers were able to make these findings due to new technology like the development of the African Diaspora Power Chip in partnership with Illumina Inc. which allows for improved tagging and coverage of African ancestry genetic variation.

“We need to understand what is driving asthma in these populations,” Barnes said. “Now we have a much better genetic foundation for pursuing this.”

Daya agreed.

“Ultimately, we hope that a better understanding of the genetic risk factors for asthma in African ancestry populations will lead to the development of better therapeutic interventions,” she said.

 

 

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Women in hospital medicine face major obstacles in pregnancy and returning to work

Women in hospital medicine face major obstacles during pregnancy, parental leave and returning to work, prompting a discussion about gender equity in medicine, according to a new study from researchers at the University of Colorado Anschutz Medical Campus.

Emily Gottenborg, MD, assistant professor in the division of Hospital Medicine at the University of Colorado School of Medicine
Emily Gottenborg, MD, assistant professor in the division of Hospital Medicine at the CU School of Medicine

The study, published recently in the Journal of Hospital Medicine, includes wide-ranging interviews with 10 female academic hospitalists from institutions around the country. They were asked about their experiences during pregnancy, parental leave and the challenges of returning to work including barriers to breastfeeding and diminished career opportunities.

“It is commonly thought that the medical profession is more enlightened around parental support than other professions, but it really isn’t,” said the study’s lead author Emily Gottenborg, MD, assistant professor in the division of Hospital Medicine at the University of Colorado School of Medicine. “We found a lack of paid leave policies in academic settings, difficulty in support for breastfeeding, and loss of career opportunities when new parents return to work.”

Gottenborg said hospital medicine is unique in that 47 percent of practitioners are women and 80 percent are under age 40, indicative of a large proportion of women entering the profession during a time in life when many want to start a family.

“The field poses known challenges to this population, including shift work, atypical schedules and unpredictable hours,” Gottenborg said. “Our goal was to both explore the challenges to undergoing this experience and discovering solutions to support female academic hospitalists.”

Most participants described inadequate paid parental leave that resulted in haggling with managers, human resources and administrative staff for time away from work with their newborns.

“All of my leave was unpaid…managed to finagle short-term disability into paying for it…the system was otherwise set up to screw me financially,” one research participant said.

All of the women described significant physical challenges when working during pregnancy.

“I used to lie on the floor of my office, take a little nap, wake up, write some notes, go home, take another nap, wake up, write some more notes,” a doctor reported.

Breastfeeding, extolled by the medical community for its long-term benefits to children, was an endless challenge, the study said. Privacy was often elusive.

“It’s two chairs that are behind a curtain in a women’s locker room in the basement of the hospital, that are tiny and gross,” said one physician.

Another said this:

“I would get to work, set up, and pump while chart reviewing. Then I would go and see people…and come back to my office and pump and write a few notes. And go out and see more patients, and then pump. I was like a cow.”

Some stopped breastfeeding early because of these difficulties.

Many of the physicians interviewed faced serious career challenges during this period. Sometimes they were left out of projects or not asked to participate.

“People feel they are missing out and their career suffers,” Gottenborg said. “One of the reasons women are not in more leadership positions in medicine is because of these big breaks in their lives.”

The study calls for a more generous paid leave policy that not only includes maternity leave but a flexible scheduling period before and after the leave to account for the challenges of pregnancy and new motherhood.

“Paid parental leave is rare in academic settings, but studies from other industries show that when women take paid leave, they are more likely to remain in the workforce 9-12 months afterward, work more weekly hours and feel more loyal to the organization,” the study said.

Ultimately, Gottenborg said, if academic medicine wants to continue to attract and retain women it needs to reexamine work-life policies that often feel antiquated.

“As medical professionals we should be in the forefront of this kind of change,” she said, “not lagging behind.”

The study co-authors include: Anna Maw, MD; Li-Kheng Ngov, MD; Marisha Burden, MD; Anastasiya Ponomaryova, BS and Christine Jones, MD, MS.

 

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Infants born to obese mothers risk developing liver disease, obesity

Infant gut microbes altered by their mother’s obesity can cause inflammation and other major changes within the baby, increasing the risk of obesity and non-alcoholic fatty liver disease later in life, according to researchers at the University of Colorado Anschutz Medical Campus.

The study was published in the journal Nature Communications.

“Alteration of the gut microbiome early in life may precede development of obesity instead of being caused by established obesity,” said the study’s lead author Taylor Soderborg, an MD/PhD candidate in the Integrative Physiology Program at the University of Colorado School of Medicine. “This is the first study to show a causative role of these microbes in priming development of obesity.”

Childhood obesity is a world-wide epidemic with recent predictions saying that 57 percent of today’s children will be obese by age 35. That parallels the rate of maternal obesity which is nearly 40 percent. Obesity increases the risk of non-alcoholic fatty liver disease (NAFLD) which impacts at least 30 percent of obese children. NAFLD can lead to liver failure, requiring a transplant.

Taylor Soderborg
Taylor Soderborg, an M.D./PhD candidate in the Integrative Physiology Program at the University of Colorado School of Medicine.

In this study, researchers looked at two-week old infants born to normal weight mothers and obese mothers.  They took stool samples from infants from both groups and colonized them inside germ-free mice.

They discovered that the gut microbes from babies born to obese mothers caused metabolic and inflammatory changes to the liver and bone marrow cells of the mice. Then, when fed a Western-style high fat diet, these mice were predisposed to more rapid weight gain and development of fattier livers.

“This is the first experimental evidence in support of the hypothesis that changes in the gut microbiome in infants born to obese mothers directly initiate these disease pathways,” Soderborg said.

For the study’s senior author, Jed Friedman, PhD, MS, professor of pediatrics and neonatology at the CU School of Medicine, the findings offer potential hope for understanding how early microbes might go awry in children born to obese mothers.

“About 35 percent of these kids have NAFLD and there is no known therapy for it,” he said. “But if we can alter the microbiome we can change the course of NAFLD.”

Friedman said the study shows that the microbiome can cause the disease rather than simply be associated with it. Newborns of obese mothers, he said, could be screened for potential changes in their gut that put them at risk for NAFLD.

Jed Friedman
Jed Friedman, PhD, MS, professor of pediatrics and neonatology at the CU School of Medicine

“If we could modify the first two weeks of the infant microbiome, we could reduce the risk of this disease,” said Friedman.

That could be done through giving the infant probiotics or other supplements.

Soderborg said future studies on pre and probiotics are needed to better understand how they could help modify the risk of childhood obesity and the risk of liver disease in infants born to obese mothers.

The study co-authors include Sarah E. Clark; Christopher E. Mulligan; Rachel C. Janssen; Lyndsey Babcock; Diana Ir; Dominick J. Lemas; Linda K. Johnson; Tiffany Weir; Laurel L. Lenz; Daniel N. Frank; Teri L. Hernandez; Kristine A. Kuhn; Angelo D’Alessandro; Linda A. Barbour; Karim C. El Kasmi.

 

 

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