Estimated Prevalence of US Physicians With Disabilities.
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ABSTRACT:
SUBMITTER: Nouri Z
PROVIDER: S-EPMC7955270 | biostudies-literature | 2021 Mar
REPOSITORIES: biostudies-literature
Publications
Estimated Prevalence of US Physicians With Disabilities.
Nouri Zakia Z Dill Michael J MJ Conrad Sarah S SS Moreland Christopher J CJ Meeks Lisa M LM
JAMA network open 20210301 3
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Project description:ImportanceThe prevalence of asthma in US children with various developmental disabilities and delays is unclear, including how estimates vary by ethnic group.ObjectiveTo report asthma prevalence estimates by various disability categories and developmental delays in a diverse sample of the US pediatric population.Design, setting, and participantsThis population-based cross-sectional study encompassed a total of 71 811 families with children or adolescents aged 0 to 17 years (hereinafter referred to as children) who participated in the 2016 and 2017 National Survey of Children's Health. Data were collected from June 10, 2016, to February 10, 2017, for the 2016 survey and from August 10, 2017, to February 10, 2018, for the 2017 survey. Data were analyzed from September 20, 2019, to April 5, 2020.ExposuresDevelopmental disability, including attention-deficit/hyperactivity disorder, autism spectrum disorder, cerebral palsy, seizure, intellectual and/or learning disability, and vision, hearing, and/or speech delay. Delay was defined as not meeting growth milestones with unknown cause.Main outcomes and measuresWeighted asthma prevalence estimates and 95% CIs were generated for children with and without disabilities.ResultsA total of 71 811 participants (mean [SE] age, 8.6 [0.1] years; 36 800 boys [51.1%; 95% CI, 50.2%-52.0%]; 50 219 non-Hispanic white [51.4%; 95% CI, 50.6%-52.3%]) were included in our final analytical sample, of whom 5687 (7.9%; 95% CI, 7.5%-8.4%) had asthma and 11 426 (15.3%; 95% CI, 14.7%-16.0%) had at least 1 disability. Overall asthma prevalence estimates were 10 percentage points higher in children with a disability (16.1%; 95% CI, 14.3%-17.8%) vs children without a disability (6.5%; 95% CI, 6.0%-6.9%). The odds of asthma were significantly higher in children with a disability (odds ratio [OR], 2.77; 95% CI, 2.39-3.21) or delay (OR, 2.22; 95% CI, 1.78-2.77) vs typically growing children. Adjusted models remained significant for all disability categories (overall adjusted OR, 2.21; 95% CI, 1.87-2.62). Subgroup analyses showed ethnic minorities had a higher prevalence of concurrent asthma and developmental disabilities vs non-Hispanic whites (19.8% [95% CI, 16.6%-23.0%] vs 12.6% [95% CI, 11.1%-14.0%]; P < .001).Conclusions and relevanceThese results suggest that US children with various developmental disabilities or delay may have higher odds for developing asthma vs their typically developing peers. These findings support asthma screening in pediatric health care settings among patients with developmental disabilities and delays, particularly among those from ethnic minority backgrounds. In addition, very young children with asthma should be screened for disabilities and delays, because temporality cannot be determined by the current data source and analytical approach.
| S-EPMC7298611 | biostudies-literature
Project description: Not available
| S-EPMC10692836 | biostudies-literature
Project description:Differences in income between male and female academic physicians are well known, but differences for community physicians and career differences in income have not been quantified. We used earnings data from 80,342 full-time US physicians to estimate career differences in income between men and women. The differences in annual income between male and female physicians that we observed in our simulations increased most rapidly during the initial years of practice. Over the course of a simulated forty-year career, male physicians earned an average adjusted gross income of $8,307,327 compared with an average of $6,263,446 for female physicians-an absolute adjusted difference of $2,043,881 and relative difference of 24.6 percent. Gender differences in career earnings were largest for surgical specialists ($2.5 million difference), followed by nonsurgical specialists ($1.6 million difference) and primary care physicians ($0.9 million difference). These findings imply that over the course of a career, female US physicians were estimated to earn, on average, more than $2 million less than male US physicians after adjustment for factors that may otherwise explain observed differences in income, such as hours worked, clinical revenue, practice type, and specialty.
| S-EPMC9910787 | biostudies-literature
Project description:ObjectiveThere is a lack of research on the prevalence of eating disorders (EDs) in Singapore. The aims of our study were to (a) estimate the prevalence of EDs, risk status, and help-seeking behaviors among adults in Singapore, (b) examine gender differences between ED status groups, and (c) characterize clinical profiles of ED status groups.MethodWe administered a cross-sectional survey that included a validated EDs screening tool to adults in Singapore.ResultsA total of 797 Singaporean adults ages 21-77 years completed the ED screen. The majority of participants screened positive for a current DSM-5 clinical ED (6.2%), other specified feeding or ED (37.0%) or at high risk of developing an ED (19.5%). Only 1.6% of those who screened positive for an ED reported currently being in treatment. The ratio of males to females who screened positive for an ED was nearly 1:1. The clinical profiles of ED groups were consistent with the clinical presentations found in Western nations.DiscussionThis is the first study in Singapore to estimate the prevalence of EDs in a large sample of adults. Results highlight the urgent need for more ED research and expansion of prevention and treatment programs to address the high prevalence of ED psychopathology in Singapore.
| S-EPMC8011933 | biostudies-literature
Project description:IntroductionFew studies have examined lifetime and past-year sexual violence against men with disabilities and the types of perpetrator-survivor relationships among men with disabilities. The purpose of this study is to document the prevalence of lifetime and past-year sexual violence against men with disabilities in the U.S., compare these estimates with those of men without disabilities and women with and without disabilities, and examine the gender and relationship of the perpetrator of sexual violence against men with disabilities relative to perpetrator characteristics identified in incidents against other adults.MethodsBehavioral Risk Factor Surveillance System 2005-2007 data were analyzed in 2014 using domain analysis and multivariate logistic regression.ResultsMen with a disability were more likely than men without a disability to report lifetime sexual violence (8.8% vs 6.0%). They were also more likely than men without a disability to report lifetime experience of attempted or completed nonconsensual sex (5.8% and 2.3% vs 4.1% and 1.4%, respectively). There were no statistically significant differences between the two groups of men's reports of their relationship to the perpetrator of the most recent incident of sexual violence or perpetrator gender.ConclusionsMen with disabilities are at heightened risk for lifetime and current sexual violence compared with men without disabilities. Given the relatively high prevalence of sexual violence among people with disabilities of both genders, sexual assault screening, prevention, and response efforts need to be inclusive and attentive to all people with disabilities.
| S-EPMC4762736 | biostudies-literature
Project description:ImportanceHigh blood pressure (BP) during sleep (asleep blood pressure) is associated with an increased risk of cardiovascular disease, but a national prevalence estimate of masked asleep hypertension (high BP while sleeping but without high BP measured in the clinic [clinic BP]) for the United States is lacking.ObjectivesTo estimate the prevalence of masked asleep hypertension among US adults by using BP thresholds from the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC7) and the 2017 American College of Cardiology-American Heart Association (ACC-AHA) BP guidelines.Design, setting, and participantsThis cohort analysis pooled data from 3000 participants in 4 US population-based studies that conducted 24-hour ambulatory BP monitoring (ABPM) and 17 969 participants in the 2011-2016 National Health and Nutrition Examination Survey (NHANES) without ABPM. Masked asleep hypertension status in NHANES was imputed using a 2-stage multiple imputation process. Data were collected from 2000 to 2016 and analyzed from March 4, 2019, to June 29, 2020.Main outcomes and measuresHigh clinic BP was defined as clinic systolic BP (SBP)/diastolic BP (DBP) of at least 140/90 mm Hg using JNC7 and at least 130/80 mm Hg using 2017 ACC-AHA guidelines. High asleep BP was defined as mean asleep SBP/DBP of at least 120/70 mm Hg for JNC7 and at least 110/65 mm Hg for the 2017 ACC-AHA guidelines. Masked asleep hypertension was defined as high asleep BP without high clinic BP.ResultsFor the 3000 pooled cohort participants, the mean (SD) age was 52.0 (12.0) years, and 62.6% were women. For the 17 969 NHANES participants, the mean (SD) age was 46.7 (17.5) years, and 51.8% (weighted) were women. The estimated prevalence of masked asleep hypertension among US adults was 18.8% (95% CI, 16.7%-20.8%; 44.4 million US adults) using the JNC7 guideline and 22.7% (95% CI, 20.6%-24.8%; 53.7 million US adults) using the 2017 ACC-AHA guideline criteria. The prevalence of masked asleep hypertension was higher among older adults (aged ≥65 years, 24.4% [95% CI, 20.7%-28.0%]), men (27.0% [95% CI, 24.1%-29.9%]), non-Hispanic Black individuals (28.7% [95% CI, 25.4%-32.0%]), those who were taking antihypertensives (24.4% [95% CI, 21.1%-27.8%]), those who had masked daytime hypertension (44.7% [95% CI, 40.1%-49.3%]), and those with diabetes (27.6% [95% CI, 23.5%-31.8%]), obesity (24.3% [95% CI, 21.8%-26.9%]), or chronic kidney disease (21.5% [95% CI, 17.3%-25.6%]) using the 2017 ACC-AHA guideline. An estimated 11.9% of US adults (28.2 million) had isolated masked asleep hypertension (masked asleep hypertension but without high awake BP) using JNC7 guideline criteria, as did an estimated 13.3% (31.5 million) using 2017 ACC-AHA guideline criteria.Conclusions and relevanceThese findings suggest that the prevalence of masked asleep hypertension is high among US adults. Data are needed on the cardiovascular risk reduction benefits of treating asleep hypertension.
| S-EPMC7593881 | biostudies-literature
Project description:More than thirty years since the enactment of the Americans with Disabilities Act (ADA), people with disability continue to experience health care disparities. The ADA mandates that patients with disability receive reasonable accommodations. In our survey of 714 US physicians in outpatient practices, 35.8 percent reported knowing little or nothing about their legal responsibilities under the ADA, 71.2 percent answered incorrectly about who determines reasonable accommodations, 20.5 percent did not correctly identify who pays for these accommodations, and 68.4 felt that they were at risk for ADA lawsuits. Physicians who felt that lack of formal education or training was a moderate or large barrier to caring for patients with disability were more likely to report little or no knowledge of their responsibilities under the law and were more likely to believe that they were at risk for an ADA lawsuit. To achieve equitable care and social justice for patients with disability, considerable improvements are needed to educate physicians and make health care delivery systems more accessible and accommodating.
| S-EPMC8740697 | biostudies-literature
Project description:People with disabilities face barriers when attempting to gain access to health care settings. Using qualitative analysis of three physician focus groups, we identified physical, communication, knowledge, structural, and attitudinal barriers to care for people with disabilities. Physicians reported feeling overwhelmed by the demands of practicing medicine in general and the requirements of the Americans with Disabilities Act of 1990 specifically; in particular, they felt that they were inadequately reimbursed for accommodations. Some physicians reported that because of these concerns, they attempted to discharge people with disabilities from their practices. Increasing health care access for people with disabilities will require increasing the accessibility of space and the availability of proper equipment, improving the education of clinicians about the care of people with disabilities, and removing structural barriers in the health care delivery system. Our findings also suggest that physicians' bias and general reluctance to care for people with disabilities play a role in perpetuating the health care disparities they experience.
| S-EPMC9984238 | biostudies-literature
Project description:ImportanceBurnout is a self-reported job-related syndrome increasingly recognized as a critical factor affecting physicians and their patients. An accurate estimate of burnout prevalence among physicians would have important health policy implications, but the overall prevalence is unknown.ObjectiveTo characterize the methods used to assess burnout and provide an estimate of the prevalence of physician burnout.Data sources and study selectionSystematic search of EMBASE, ERIC, MEDLINE/PubMed, psycARTICLES, and psycINFO for studies on the prevalence of burnout in practicing physicians (ie, excluding physicians in training) published before June 1, 2018.Data extraction and synthesisBurnout prevalence and study characteristics were extracted independently by 3 investigators. Although meta-analytic pooling was planned, variation in study designs and burnout ascertainment methods, as well as statistical heterogeneity, made quantitative pooling inappropriate. Therefore, studies were summarized descriptively and assessed qualitatively.Main outcomes and measuresPoint or period prevalence of burnout assessed by questionnaire.ResultsBurnout prevalence data were extracted from 182 studies involving 109 628 individuals in 45 countries published between 1991 and 2018. In all, 85.7% (156/182) of studies used a version of the Maslach Burnout Inventory (MBI) to assess burnout. Studies variably reported prevalence estimates of overall burnout or burnout subcomponents: 67.0% (122/182) on overall burnout, 72.0% (131/182) on emotional exhaustion, 68.1% (124/182) on depersonalization, and 63.2% (115/182) on low personal accomplishment. Studies used at least 142 unique definitions for meeting overall burnout or burnout subscale criteria, indicating substantial disagreement in the literature on what constituted burnout. Studies variably defined burnout based on predefined cutoff scores or sample quantiles and used markedly different cutoff definitions. Among studies using instruments based on the MBI, there were at least 47 distinct definitions of overall burnout prevalence and 29, 26, and 26 definitions of emotional exhaustion, depersonalization, and low personal accomplishment prevalence, respectively. Overall burnout prevalence ranged from 0% to 80.5%. Emotional exhaustion, depersonalization, and low personal accomplishment prevalence ranged from 0% to 86.2%, 0% to 89.9%, and 0% to 87.1%, respectively. Because of inconsistencies in definitions of and assessment methods for burnout across studies, associations between burnout and sex, age, geography, time, specialty, and depressive symptoms could not be reliably determined.Conclusions and relevanceIn this systematic review, there was substantial variability in prevalence estimates of burnout among practicing physicians and marked variation in burnout definitions, assessment methods, and study quality. These findings preclude definitive conclusions about the prevalence of burnout and highlight the importance of developing a consensus definition of burnout and of standardizing measurement tools to assess the effects of chronic occupational stress on physicians.
| S-EPMC6233645 | biostudies-literature
Project description:BackgroundIn this study, the prevalence of different types of mucopolysaccharidoses (MPS) was estimated based on data from the exome aggregation consortium (ExAC) and the genome aggregation database (gnomAD). The population-based allele frequencies were used to identify potential disease-causing variants on each gene related to MPS I to IX (except MPS II).MethodsWe evaluated the canonical transcripts and excluded homozygous, intronic, 3', and 5' UTR variants. Frameshift and in-frame insertions and deletions were evaluated using the SIFT Indel tool. Splice variants were evaluated using SpliceAI and Human Splice Finder 3.0 (HSF). Loss-of-function single nucleotide variants in coding regions were classified as potentially pathogenic, while synonymous variants outside the exon-intron boundaries were deemed non-pathogenic. Missense variants were evaluated by five in silico prediction tools, and only those predicted to be damaging by at least three different algorithms were considered disease-causing.ResultsThe combined frequencies of selected variants (ranged from 127 in GNS to 259 in IDUA) were used to calculate prevalence based on Hardy-Weinberg's equilibrium. The maximum estimated prevalence ranged from 0.46 per 100,000 for MPSIIID to 7.1 per 100,000 for MPS I. Overall, the estimated prevalence of all types of MPS was higher than what has been published in the literature. This difference may be due to misdiagnoses and/or underdiagnoses, especially of the attenuated forms of MPS. However, overestimation of the number of disease-causing variants by in silico predictors cannot be ruled out. Even so, the disease prevalences are similar to those reported in diagnosis-based prevalence studies.ConclusionWe report on an approach to estimate the prevalence of different types of MPS based on publicly available population-based genomic data, which may help health systems to be better prepared to deal with these conditions and provide support to initiatives on diagnosis and management of MPS.
| S-EPMC7672855 | biostudies-literature