About the Project
The Spencer S. Eccles Health Sciences Library and the Center of Excellence in Women’s Health co-sponsored a half-day conference focused on sex and gender differences in research and women’s health. The intent of the conference was to raise the visibility of University of Utah researchers who are considering sex and gender differences in their research. Two panels consisting of well-known University faculty discuss campus resources and their own research.
#1: Effect of Intrauterine Growth Restriction on Retinopathy of Prematurity
Authors: Adriana Vieira-de-Abreu, Lori Fotheringham, Xing Yu, Deeksha Gambhir, Haibo Wang and Mary Elizabeth Hartnett
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- Objective: Preterm infants with intrauterine growth restriction (IUGR) can have poor postnatal growth and retinopathy of prematurity (ROP), a leading cause of blindness. Males with IUGR have worse overall outcomes, but the effect of IUGR on ROP remains unclear. Using an experimental model, we sought to determine the effect of IUGR on growth and ROP, by sex.
- Methods: Using a well-established protocol, IUGR was created in rat pups by prenatal bilateral uterine artery ligation in pregnant dams 3 days before birth. Some IUGR pups and anesthesia controls were placed into a model of ROP, in which oxygen fluctuated between 50% and 10% every 24 hours, or into room air (RA). Lectin-stained retinal flat mounts were analyzed for retinal angiogenesis at days 0, 7, and 18.
- Results: 4 female and 2 male IUGR pups died before birth. There were no differences in birthweight, mortality or retinal angiogenesis at day 18 in IUGR pups in RA, by sex. The differences in weight gain between birth and day 18 were 31.6+/-0.2 g in IUGR+RA and 14.5+/-0.6 gin IUGR+ROP (p<0.001). There was no avascular retina in the IUGR+RA group and 22.8+/-3% of total retina in the IUGR+ROP group (p<0.0001). There were no differences in weight gain or avascular retinal area, by sex.
- Conclusions: In experimental IUGR, fluctuations in oxygen were associated with reduced body weight gain compared to RA and led to avascular retina, a prerequisite for ROP. Although no differences based on sex were noted, more studies are needed.
#2: Evaluating sepsis in trauma patients in the United States using NEDS
Authors: Iris Faraklas, Amalia Cochran
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- Introduction: The 2010 Nationwide Emergency Department Sample (NEDS) yields national estimates of emergency department (ED) v isits in the United States. NEDS was constructed from merging State Emergency Department Database (capturing ED visits that did not result in admission to the same hospital) and State Inpatient Database (linking all ED visits admitted to the same hospital) from 28 participating states. NEDS 2010, the largest all-payer ED database available in the United States, contains information from over 28 million ED vis its at 961 hospitals that approximate a 20% stratified sample of U.S. hospital-based EDs. By stratifying based on key hospital characteristics, NEDS provides a snapshot view of US hospital- based EDs.
- Methods: Design: Observational cohort study. Patients: With IRB approval we isolated all ED visits that were injury-related and resulted in an inpatient admission (n=2,413,384). NEDS identifies injuries by ICD-9 CM diagnosis code using a scheme recommended by a consensus report from the Safe States Alliance. We further delineated patients with ICD-9 diagnosis codes 995.90-995.94 for sepsis (S) from the non-sepsis injury group (NS).
- Results: Out of the estimated 128 million ED visits in the United States in 2010, 30.2 million were injury related. The vast majority of patients were treated and released from t he ED, but 2.4 million injuryrelated visits resulted in admissions to that same hospit al. The rmst frequent injury mechanism was falls (1.0 million) but 37% of all admissions recorded rmre than one t ype of injury . Reviewing linked inpatient records for these visits, 3.2% had ICD-9 codes for sepsis. Sepsis patients were older than non-sepsis group (63.9 vs. 57.5 years old, p<0.0001) and rmre likely to be male (57% vs . 50%, p<0.0001). The length of stay was longer (13.3 vs. 5. 0, p<0.0001) and inpatient charges were significantly greater ($126,321 vs. $42,870, p<0.0001) for sepsis t han non- sepsis. The mortality rate was also significantly higher among sepsis patients ( 18.0% vs. 2. 7%, p<0.0001). Using logistic regression analysis the following independent risk factors were identified : patients older than ag 50 (odds ratio OR=l.9, CI : 1.8-2. 1), male gender (OR=1.4, CI: 1.3- 1.4), and presence of a chronic comorbid condition (such as diabetes, cancer or anemia etc. OR= 5.9, CI: 5. 0-6.9). Fire (OR=1.4, CI: 1.0-1.8), injury involved with nature (OR=l.S, CI: 1.4-1. 7), and suffocation (OR=4.2, CI: 3. 7- 4. 7) all showed an inc reased inc idence of sepsis.
- Conclusions: Sepsis is an expensive and often fatal complication of injury- related admissions in the United States. Based upon our findings, patients with specific injuries related to suffocation, nature or fire were more likely to develop sepsis. Older patients, males, and those with chronic cond itions are also at higher risk. Development of sepsis increases resource utilization and contributes to poor out comes.
#3: The Physician Assistant Education Association (PAEA) annual report has shown substantial salary differences between male and female physician assistant (PA) faculty
Authors: Jennifer Coombs, Virginia Valentin
- Objective: The Physician Assistant Education Association (PAEA) annual report has shown substantial salary differences between male and female physician assistant (PA) faculty. Despite this published difference between the salaries very little research has been conducted on the subject. The purpose of this study is to determine if there is a significant difference between male and female PA faculty salaries. The researchers set out to then determine if these differences could be further distinguished by education level, rank or position. In addition, it was examined if there was a difference between the percentages of male and female faculty promoted to higher ranks and in leadership positions.
- Methods: Salary, gender, degree, rank, and position and were obtained de identified from the 25th PAEA annual report. SPSS Version 20 was used to analyze the data. Statistical analysis included descriptive measures and independent t-test. Only those PA educators who reported fulltime employment were used.
- Results: Four-hundred seventy-seven PA faculty sa laries were in cluded in the final analysis. Female PA educators showed statistically significant lower annual incomes than their male counterparts. The income disparity persisted when differentiated by education, rank and position. Higher percentages of male PA faculty members were in higher ranks and found in leadership positions.
- Conclusions: This study confirms previous reports that female PA faculty earn less than their male counterparts. With increasing numbers of women entering academia as PAs, the lack of females in leadership positions and the wage disparity is concerning.
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#4: Building Awareness of Sex and Gender Differences Research
Authors: Jeanne Le Ber, Alfred Mowdood, Louisa Stark, Jessi Van Der Volgen, John Langell, Jean P. Shipman
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- Objective: To improve awareness of and access to sex and gender differences research (S&GDR) resources in the University community through innovative strategies and partnerships. To invite and encourage the University community to contribute to the databank of resources by working with the Library to produce materials, including videotaped testimonials.
- Methods: The Library partnered with several campus entities to create S&GDR materials in a variety of formats, including research guides, online tutorials, social media posts, recorded and in-person training sessions and testimonial videos from researchers and community members. In the second year, a main campus library team was added in order to reach faculty not associated with the health sciences. The Library sponsored an S&GDR award at the Center for Medical Innovation’s Bench 2 Bedside (B2B) student competition.
- Results: Freely available S&GDR materials have been organized and advertised to the University community. Most of these resources are published online, with print flyers and display monitor ads supplementing the marketing effort. Key individuals from the University have contributed their expertise and helped spread the word. Offering the B2B award confirmed the need for more widespread awareness and it is hoped that the cultural competency videos will impact clinicians and researchers.
- Conclusions: With new NIH policies requiring grantees to include both sexes in preclinical research, it is essential to improve awareness of resources created and highlighted in this project. The S&GDR project has made significant progress in keeping the University campus community infmmed about resources available to them as they begin planning their research.
#5: Sex Differences in Physical Activity Levels of Adolescent and Young Adult Cancer Survivors
Authors: Jessica McPhail, Ryan Mooney, Anne Kirchhoff, Kathi Mooney,, Jennifer Wright, Theresa Werner, Anna Beck, Stephen Alder, Yelena Wu
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- Objective: Assessing health related quality of life (HRQOL) has important implications for adolescent and young adult (A Y A) cancer survivors who are at increased risk for mental and physical health problems. HRQOL includes physical, mental, emotional and social functioning. In comparison to male cancer survivors, females report lower HRQOL, including physical, psychological, and cognitive functioning. Physical activity (PA) is a measurable and modifiable factor that can impact HRQOL. Among cancer survivors, increased P A levels are associated with less fatigue, better physical functioning, higher HRQOL, and lower rates of cancer recurrence. his study sought to understand sex differences in P A levels between male and female cancer survrvors.
- Methods: Seventeen A Y A cancer (71% female) completed self-reported questionnaires about their weekly exercise duration and frequency of exercise.
- Results: Results oft-tests indicated a significant difference between the amount of exercise that male and female cancer survivors reported completing each week (p=0.0201), with males reporting higher amounts. In addition, there was a trend for duration of each exercise session (p=0.05), with males exercising longer at each session.
- Conclusions: Female cancer survivors in our sample do not appear to be completing recommended amounts of P A. They may be important targets for future interventions focused on increasing PA and HRQOL in cancer survivors. Additional research on psychological or physiological differences among male and female cancer survivors is wananted to ensure that services are targeted towards the groups needing them most.
#6: Sexual behavior and satisfaction of postpartum women
Authors: Christina Sok, Jessica N. Sanders, David K. Turok, Pamela A. Royer, Ivana Thompson
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- Objectives: To assess pregnancy and postpartum effects on sexual behavior and sexual satisfaction.
- Methods: Women either attending a prenatal clinic or immediate postpartum at the University of Utah Hospital completed an initial survey regarding pregnancy and prepregnancy sexual behavior and satisfaction. They were followed prospectively at 2-week intervals until return to vaginal intercourse or 12 weeks postpartum. Women reported their return to sexual activity, their sexual behaviors, and sexual satisfaction. Psychological and physical satisfaction was measured using a five-point Likert Scale with anchors “not at all” and “extremely.”
- Results: Data on sexual behavior were collected from 304 women. Initiation of postpartum sexual activity was described as mutually agreed upon for 64% of all cases.Among all women, vaginal sex was the most commonly reported activity before, during, and after pregnancy. The proportion of women receiving oral sex significantly decreased from 70% before pregnancy to 14% postpartum (p<o.ol). psychological=”” and=”” physical=”” satisfaction=”” during=”” sex=”” was=”” lower=”” pregnancy=”” following=”” delivery=”” relative=”” to=”” prior=”” on=”” an=”” individual=”” (p<o.ol)=”” population=”” level=”” (p<o.ol).<=”” li=””>
- Conclusion: Women commonly report mutually agreed upon return to sexual activity prior to 6 weeks postpartum. Female sexual satisfaction during pregnancy and postpartum is lower than antepartum. Discussions of peripartum sexual activity and contraceptive planning are integral parts of comprehensive prenatal care and should involve significant others. Future research should include a partner perspective.
#7: Urinary Bisphenol A Concentrations Measured on Multiple Consecutive Days in a Prospective, Pre-conception Cohort
Authors: Kyley Joell Cox, Christina A. Porucznik, Lindsey Canfield Schmidt, James A. VanDerslice, Joseph B. Stanford, Diana G. Wilkins, Eric Brozek
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- Objective: Examine and compare distribution of urinary BP A concentrations collected from partners of male-female couples. Bisphenol A (BPA) is an endocrine disrupting chemical found in canned food and other consumer products. BP A has been detected in human specimens throughout the world and at levels similar to those associated with adverse reproductive outcomes in animal models.
- Methods: A prospective, pre-conception cohort of couples (women 18- 35, men 18-40) were recruited beginning in early 2012. Recruitment is ongoing. Couples observed cervical mucus to identify an estimated day of ovulation (EDO) and fertile window. Participants collected firstmorning urine samples beginning during the fertile window, after which men discontinued collecting but women collected for the remainder of the cycle. BPA was measured in each urine sample using quantitative LC-MS. Geometric means with 95% confidence intervals (CI) for BP A concentrations were calculated. Differences in geometric mean by sex were tested using the Wilcoxon Test to account for daily repeated urines and the coupled, matched-pair design.
- Results: BPA was detected in 100% of samples at concentrations 2:0.4ng/mL. Within-individual values varied several-fold from day-to-day. Preliminary results of 846 urine samples (636 female, 210 male) show a geometric mean ofBPA as 2.72ng/mL (95% CI, 2.57- 2.88) and median of2.63ng/mL (interquartile range, 1.78ng/mL). Geometric mean BPA levels were higher among men (p=0.025) at 3.26ng/mL (95% CI, 2.90- 3.65) compared to women at 2.57ng/mL (95% CI, 2.4 1- 2.74).
- Conclusions: Preliminary findings suggest that BPA exposure is higher among men than women.
#8: Gender Differences in Speech: Correlating pulmonary function with symptoms of vocal fatigue among occupational voice users
Authors: Lynn Maxfield, Eric J. Hunter, Simone Graetzer, Catherine Mellum, Tyler Duraes
- Objective: To determine if there is a relationship between chronic voice fatigue and the pulmonary function of individuals who work in occupations that require a lot of talking and whether that relationship differs between females and males.
- Methods: Teaching is an occupation that requires frequent and prolonged voice use; thus approximately 50 public school teachers were recruited to participate in this study. Subjects completed a series of questionnaires about their voice use and voice comfort. Following the questionnaires, they underwent a three-part assessment consisting of ( 1) a pulmonary function test (spirometry), (2) a phonation threshold test, and (3) a vocal acoustical assessment. Whenever possible, the assessment was conducted at the subjects’ work environment. Scores from one of the questionnaires (the vocal fatigue index- VFI) were tabulated and examined in relation to spirometry and acoustical measures. Statistical analysis was conducted to determine the strength of any relationships.
- Results: Among teachers whose VFI scores provided the strongest indication of voice fatigue, a relationship was found between VFI scores and individual spirometry measures. This relationship appears to be stronger among female participants than males.
- Conclusions: A relationship between spirometry measures and the occunence of voice fatigue suggests that underlying pulmonary function issues may predispose individuals to experiencing symptoms of chronic fatigue. Females may be particularly at risk.
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#9: Exploring the Mobility of Refugee Women Seeking Healthcare Resources
Authors: Caren J Frost, Lisa Gren, Scott Benson, Rachel Jaggi
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- Objective: Refugee women often arrive in the United States with significant and unique health care needs. However, research has shown that refugee women often are unable to access necessary health care due to an inability to overcome the geographic barrier of travelling to a medical appointment. This project seeks to evaluate the ability of refugee women to successfully navigate within their resettlement city.
- Method: Approximately 30 women from the Congolese refugee community participated in a health workshop held at a local multicultural center not far from women’s homes. At the conclusion of the workshop, participants were asked to navigate back to their homes with the assistance of workshop facilitators.
- Results: Participants varied widely in their ability to direct facilitators to their homes. Many were unable to provide a street address or directions. Those who were able to provide directions to the facilitator generally relied on recognizable landmarks to navigate. Among these, some could navigate across the greater city area, while others were only able to do so within the boundaries of their neighborhood. Overall, returning home presented significant challenges for most of these women.
- Conclusions: Because many of the women were unable to navigate to their own home, it is likely that this population also faces significant spatial barriers in accessing health care. This study suggests that interventions seeking to improve refugee women’s health should carefully evaluate the geographic barriers and seek to establish tools to expand the spatial mobility of this vulnerable population.
#10: Gender Differences in Speech: Within-session stability of acoustic features of conversational and clear speech for male and female talkers
Authors: Sarah Hargus Ferguson, Shae D. Morgan, Lydia Rosado Rogers, Eric J. Hunter
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- Objective: To determine whether and how much the acoustic details of speech production are affected by simple repetition of a set of speech tasks, and whether these effects differ for male and female talkers.
- Methods: Ten talkers (5 male) performed three speech production tasks (a passage, a list of sentences, and a picture description) four times in each of two speaking styles: conversational speech and clear speech. The two speaking styles were recorded in separate test sessions. Several acoustic features relevant to clear speech (e.g., vowel space, speaking rate) were compared between the first and fourth repetition in each speaking style as well as between the styles and between male and female talkers.
- Results: While the expected speaking style and gender effects were found for most acoustic measures (e.g., slower speaking rate for female versus male talkers and for clear versus conversational speech), speaking style effects did not differ between genders. Task set effects (i.e., differences between the first and fourth repetitions) were found for some measures but not others and did not interact with talker gender.
- Conclusions: The effects of talker gender were independent from the other factors of interest in the present study. This suggests that in future studies, any differences in the way male versus female talkers adjust to changes in speaking conditions will be unaffected by speaking style instructions or task set order.
#11: Gender Norms and Obesity-Related Health Behaviors in Five Diverse Utah Communities
Authors: Simonsen SE, Prevedel J, Davis F, Lee D, Mukundente V, Napia E, Nash I, Rickard S, Tavake-Pasi F, Alder SC, Aiono H, Ralls B, Stark LA, Sunada G, Eisenman P, Waitzman NJ, Johnston L, Hoggard J, Webber J, Frost C, Buder IA, Zick CD, Digre K
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- Background: Minority Utah women experience disparities related to obesity; however, most approaches to addressing obesity have not considered the impact of gender norms on health behaviors.
- Objectives: A multi-partner coa lition is using a gender-based approach to address obesity among Utah women. Here, we describe the association between perceived gender norms and health behaviors. Material/Methods: We have implemented a randomized trial to eva luate a wellness coaching program addressing obesity in African, African American, American Indian, Hispanic, and Pacific Islander women. Participants are asked a series of questions about decision making in the home, whether decision making is dominated by a male family member, perceived power to make health cha nges, and typica l health behaviors.
- Results: At baseline, 26% of 180 women agreed that within their home, a male makes most of the financial decisions. Thirteen-percent agreed a male decides what activities the family does during free time, and 5% agreed that a male decides which foods the family eats. Women who reported male decision making about food or finances were less likely to consume 5 or more fruits and vegetables per day (0% vs. 38%, p=0.030 & 30% vs. 39%, p=0.279, respectively). Women who believed they had littlepower to implement dietary changes at home were also less likely to consume 5 or more fruits and vegetables per day (11% vs. 40%, p=0.012).
- Conclusions: These findings highlight the importance of incorporating gender norms into behavioral interventions for obesity.
#12: Assessing physical activity (PA) in primary health care may improve PA awareness and provide meaningful opportunities for PA promotion in large segments of the population
Authors: Terrell Messerly, Zac Hansen, Trever Ball, Dr. Janet Shaw
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- Introduction: Assessing physical activity (PA) in primary health care may improve P A awareness and provide meaningful opportunities for P A promotion in large segments of the population.
- Purpose: To determine the propotiion of clinic patients that self-report meeting federal guidelines of recommended, weekly aerobic P A, if there is a difference in self-reported P A between men and women and between younger (18-45 y) and older (>45 y) age groups, and whether there is a difference in confidence reporting P A by gender.
- Methods: Patients reported to a physical activity vital sign (P A VS) typical weekly minutes of moderate or vigorous P A (MVP A). Patients also reported how confident they felt their responses to the P A VS were accurate, where 1 =very unsure and 5=very sure.
- Results: Only 2.1% of all participants (N=97) met P A recommendations of an equivalent combination of 150 mins/wk of MVP A. There was no statistical difference in mean mins/wk of MVP A reported by females (M=63 .5 min SD= 11.2) compared to males (M=46.2 mins; SD=31.5; p=0.180). Younger patients reported a mean 58.4 (+/-31.4) and the older patients a mean 42.0 (+/-22.6) minutes of aerobic MVPA per week. More younger patients met PA recommendations (5.2%) compared to older patients (1.3%;p<0.05). There was no statistical difference in confidence repmiing PA between females (M=4.6; SD=0.73) and males (M=4.5; SD=0.78;p=0.541).
- Conclusion: These preliminary data indicate minor to no gender or age differences in reported P A to a P A VS in a primary care clinic setting. A larger sample size is needed to confirm these findings.
#13: HPV vaccine knowledge among five ethnic communities in Utah
Authors: Djin Lai, BSN, RN; Maria Borrero, BS; Echo L. Warner, MPH; Fahina Tavake-Pasi; Ed Napia; Ivoni Nash; Valentine Mukundente; Pastor France A. Davis; Heather Aiono, MEd; Deanna Kepka, PhD, MPH
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- Objective: To assess HPV vaccine knowledge among five ethnic communities to further understand knowledge of the HPV vaccine among vulnerable populations in Utah.
- Methods: Five community organizations in Salt Lake City are actively recruiting parents of adolescents between the ages 11-17 to participate in a focus group and survey. This abstract focuses on the survey results from the first 3 sessions, which were conducted in a culturally appropriate setting. Survey questions were read aloud in the participants’ primary language. Data from the surveys were analyzed in Stata 12 to assess HPV vaccine knowledge.
- Results: There were N=26 parents, mostly female (73.1%), of American Indian, Hispanic, or Pacific Islander ethnicity who participated, with an average age of 44.3 years. Of these, 88.5% had heard of cervical cancer, 61.5% of HPV, and 65.4% of the HPV vaccine. Over 80% of participants correctly identified that the vaccine is not given in one injection. Fewer participants were aware that HPV can cause cervical cancer (46.1%) and that most people have HPV during their lifetime (38.5%).
- Conclusions: Slightly over half of our participants have heard of HPV, the HPV vaccine and cervical cancer, and approximately 80% knew that the vaccine is not given in one injection. Fewer participants were aware of the link between HPV and cervical cancer and the high prevalence of HPV infection meaning that targeted educational interventions are needed to emphasize the cervical cancer prevention aspect of the HPV vaccine. To address this, seven additional focus groups are planned which will include African American and African refugee participants.
#14: Building understanding of gender differences and culture that are important to healthcare and research with five diverse communities
Authors: Heather Aiono, Sylvia Rickard, Pastor France A. Davis, O. Fahina Tavake-Pasi, Doriena Lee, Harmony Starr, Valentine Mukundente, Louisa A. Stark
- Objective: Few healthcare providers or researchers in Utah are members of the diverse communities that experience the greatest health disparities. This can lead to critical gaps in understanding that may impact the provision and uptake of healthcare as well as research design and participation. To address this gap, the Community Faces of Utah worked with the Genetic Science Learning Center to develop videos of community members discussing healthcare issues.
- Methods: The Community Faces of Utah includes leaders from the Best of Africa, Calvary Baptist Church, Hispanic Health Care Task Force, National Tongan American Society and the Urban Indian Center. They recruited community members to participate in video-taped focus groups that were co-led by the CCTS Community Liaison and a leader of that community; separate women’s and men’s groups were held in each community.
- Results: The focus group discussions addressed diet, exercise, education, finances, mental health, reproductive health, substance abuse, transportation needs, traditional remedies and unique things participants wanted researchers to know about their community. In all communities, participants said that women are more likely to be aware of available services and thus responsible for identifying health issues, taking children to the doctor and making health-elated decisions. However, traditional gender roles are changing to become more egalitarian, particularly for immigrant communities.
- Conclusions: Participants’ responses showed more similarities than differences across all focus groups. While the videos represent the viewpoints of only a few members of each community hey can serve as a valuable resource for healthcare provider training and researcher education.