Publications
Department of Medicine faculty members published more than 3,600 peer-reviewed articles in 2024.
2007
2007
2007
BACKGROUND & AIMS
Women comprise 19% of the American Gastroenterological Association (AGA) membership. We performed a prospective study to determine whether female gastroenterologists were less likely to achieve career advancement and satisfaction.
METHODS
We administered an online survey to AGA members from 2004-2006. The survey contained questions regarding effects of gender on career advancement, satisfaction with career, promotional policies, and integration of family and career.
RESULTS
A total of 457 individuals (response rate 9% after 2 major invitations) completed the survey, including 262 (57%) women (20% in private practice, 53% in academic careers, and 27% trainees) and 195 men (23% in private practice, 58% in academic careers, and 19% trainees). The male gastroenterologists were significantly older (P < .005) and in their careers for significantly more years (P = .002). There were no significant differences with respect to marital status, number of children, or number of hours worked between the genders. Men were more likely to achieve the rank of full professor (P = .035), and significantly more women reported that gender affected their career advancement (47% vs 9%; P < .001). Women in academic careers reported less satisfaction with their careers (P = .01) and perceived more difficulty in achieving promotion and tenure. Women were more likely to choose private practice careers because of part-time options (P = .025). Equal numbers of men and women in practice reported difficulty balancing work and family life.
CONCLUSIONS
Significantly more female than male gastroenterologists perceive that gender has affected their career advancement. Female academic gastroenterologists reported less overall career satisfaction and promotion than male academic gastroenterologists.
View on PubMed2007
BACKGROUND
There are few contemporary estimates of prevalence rates for inflammatory bowel disease (IBD) in diverse North American communities.
METHODS
We estimated the period prevalence of IBD for January 1, 1999, through June 30, 2001, among 1.8 million randomly sampled members of nine integrated healthcare organizations in the US using computerized diagnoses and outpatient pharmaceutical dispensing. We also assessed the positive predictive value (PPV) and sensitivities of 1) the case-finding algorithm, and 2) the 30-month sampling period using medical chart review and linkage to a 78-month dataset, respectively.
RESULTS
The PPV of the case-finding algorithm was 81% (95% confidence interval [CI], 78-87) and 84% (95% CI, 79-89) in two different organizations. In both, the sensitivity of the optimal algorithm, compared with the most inclusive, exceeded 90%. The sensitivity of the 30-month sampling period compared with 78 months was 61% (95% CI, 57-64) in one organization. Applying a slightly more sensitive case-finding algorithm, the average period prevalence of IBD across the nine organizations, standardized to the age- and gender-distribution of the US population, 2000 census, was 388 cases (95% CI, 378-397) per 100,000 persons (range 209-784 per 100,000; average follow-up 26 months). The prevalence of Crohn's disease, ulcerative colitis, and unspecified IBD was 129, 191, and 69 per 100,000, respectively.
CONCLUSIONS
The observed average prevalence was similar to prevalence proportions reported for other North American populations (369-408 per 100,000). Additional research is needed to understand differences in the occurrence of IBD among diverse populations as well as practice variation in diagnosis and treatment of IBD.
View on PubMed2007
BACKGROUND
The combined effect of socioeconomic, organizational, psychosocial, and physical factors on work-related musculoskeletal disorders (WRMSDs) were studied in a heterogeneous, socioeconomically diverse sample (cases and their matched referents) of hospital workers.
METHODS
Cases were defined by a new acute or cumulative work-related musculoskeletal injury; referents were matched by job group, shift length, or at random. Information was obtained through telephone interviews and on-site ergonomics observation. Questionnaire items included sociodemographic variables, lost work time, work effectiveness, health status, pain/disability, and psychosocial working conditions using Effort Reward Imbalance (ERI) and Demand-Control (DC) models. Two multivariate models were tested: Model 1 included occupation as a predictor; Model 2 included education-income as a predictor.
RESULTS
Cases reported greater pain, disability, lost time, and decreased work effectiveness than the referents. Model 1 was statistically significant for neck/upper extremity injury (Chi-square = 19.3, P = 0.01), back/lower extremity injury (Chi-square = 14.0, P = 0.05), and all injuries combined (Chi-square = 25.4, P = 0.001). "Other Clinical" occupations (34% mental health workers) had the highest risk of injury (OR 4.5: 95%CI, 1.7-12.1) for all injuries. The ERI ratio was a significant predictor for neck and upper extremity (OR 1.5: 95%CI, 1.1-1.9) and all injuries (OR 1.3; 95%CI, 1.04-1.5), per SD change in score.
CONCLUSIONS
In this study, the risk of WRMSDs was more strongly influenced by specific psychosocial and physical job-related exposures than by broad socioeconomic factors such as education and income.
View on PubMed2007
BACKGROUND
Multidrug transporters are postulated to contribute to antiepileptic drug (AED) resistance. The transporter best studied is P-glycoprotein, an ATP-Binding Cassette (ABC) transporter superfamily member. RLIP76 is suggested to be an energy-dependent non-ABC transporter, reducing AED blood-brain barrier penetration, with a more important role than P-glycoprotein. Knowledge of which transporters may be critical in drug resistance is important for design of potential therapies. We tested the hypothesis that RLIP76 mediates AED resistance using methods complementary to those in the original report.
METHODS
Double-labeling fluorescent immunohistochemistry localized RLIP76 expression. Population genetics was used to explore association of variation in the RLIP76-encoding gene with drug-response and epilepsy phenotypes. Comparative protein structure modeling and bioinformatic annotation were used to predict RLIP76 structure and features.
RESULTS
In normal and epileptogenic brain tissue, immunoreactivity for RLIP76 was cytoplasmic, with colocalization with a neuronal, but not an endothelial, marker. Genotyping of six tagging SNPs, representing common genetic variation in RLIP76, in patients with epilepsy responsive (n = 262) or resistant (n = 107) to AEDs showed no association with phenotype at any level. RLIP76 genotypic and haplotypic frequencies in 783 patients with epilepsy and 359 healthy controls showed no association with epilepsy susceptibility. RLIP76 is not predicted to have transmembrane localization or ATPase activity.
CONCLUSIONS
No support for RLIP76 itself in directly mediating resistance to AEDs nor in increasing susceptibility to epilepsy was found. More evidence is required before either a role for RLIP76 in drug resistance can be accepted or focus directed away from other transporters, such as P-glycoprotein.
View on PubMed2007
2007
2007