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IntroductionMentorship is critical for faculty success, satisfaction, and engagement. However, many faculty, particularly underrepresented racial/ethnic (UR) faculty, lack access to high-quality mentoring. In an effort to improve mentoring for all faculty, we developed and implemented a formally structured faculty mentor training program (FMTP) across UC San Diego Health Sciences, which included institutional support, mentorship training, and department/division mentorship programs.MethodsFMTP impact was evaluated using three primary outcome variables: mentoring quality, mentoring behaviors, and institutional climate. Participants' self-assessed mentoring competencies were measured using validated instruments.ResultsA total of 391 (23%) of Health Sciences faculty participated in FMTP. Participation rate was higher for women than men (30% versus 17%) and highest for UR faculty (39%). FMTP was implemented in 16 of 19 departments. Self-reported mentoring improved for FMTP participants with mentoring quality (p = 0.009) and meeting mentees' expectations (p = 0.01) continuing to improve for up to 2 years after training. However, participants were unsure if they were meeting UR mentees' expectations. FMTP participants were significantly more satisfied with mentoring quality (p < 0.001) compared to non-participants, with the greatest increase in satisfaction reported by UR faculty (38-61%). UR faculty reported improved overall morale (51-61%) and a perception that the environment was supportive for UR faculty (48-70%).ConclusionThe implementation of a system-wide formal structured FMTP was associated with improved faculty satisfaction, quality of mentoring, and institutional climate, especially for UR faculty.

There is a national call for academic medicine to use evidence-based initiatives to improve its culture and climate. The authors report data-driven policy and programmatic interventions that were associated with increased faculty diversity, equity, respectful behavior and improved faculty climate, at UC San Diego Health Sciences.MethodsBased on demographic and survey data, interventions were designed to improve the climate between 2005 and 2015. Interventions included routine measuring and dissemination of demographic data, changes and dissemination of policy and procedures, and new and improved faculty development programming. Impact was measured using demographic data over time, salary equity studies, and school-wide climate surveys in 2005, 2011, and 2015. Specific outcomes included measures of diversity, salary equity, behavior, and climate.ResultsOver the ten-year period, the proportion of women increased from 16% to 23% of tenure/tenure-track faculty and 31%-40% of all faculty. Underrepresented minority faculty increased from less than 1%-7% of tenure/tenure-track faculty and from 5% to 8% of all faculty. While women continued to be paid less than men, the adjusted difference dropped from 23% to 12%. Reports of inappropriate behavior by faculty decreased significantly, while satisfaction and knowledge about institutional mentoring and resources improved.ConclusionMultiple interventions including new faculty development programs, changes in policy, and measuring demographics/climate supported diverse faculty recruitment, enhanced a culture of respect and improved faculty morale. Cultural changes in policy, periodic faculty data collection with dissemination, and increased faculty development, improve the climate in academic medicine.

ObjectiveThe culture of academic medical institutions impacts trainee education, among many other faculty and patient outcomes. Disrespectful behavior by faculty is one of the most challenging and common problems that, left unattended, disrupts healthy work and learning environments. Conversely, a respectful environment facilitates learning, creates a sense of safety, and rewards professionalism. The authors developed surveys and an intervention in an effort to better understand and improve climate concerns among health sciences faculty at the University of California, San Diego (UCSD), a research-intense, public, academic medical center.MethodsAn online "climate survey" of all UC San Diego health sciences faculty was conducted in 2011-2012. A strategic campaign to address the behavioral issues identified in the initial survey was subsequently launched. In 2015, the climate was re-evaluated in order to assess the effectiveness of the intervention.ResultsA total of 478 faculty members (223 women, 235 men, 35 % of faculty) completed the baseline survey, reporting relatively low levels of observed sexual harassment (7 %). However, faculty reported concerning rates of other disruptive behaviors: derogatory comments (29 %), anger outbursts (25 %), and hostile communication (25 %). Women and mid-level faculty were more likely to report these behavioral concerns than men and junior or senior colleagues. Three years after an institutional strategy was initiated, 729 faculty members (50 % of the faculty) completed a follow-up survey. The 2015 survey results indicate significant improvement in numerous climate factors, including overall respectful behaviors, as well as behaviors related to gender.ConclusionsIn order to enhance a culture of respect in the learning environment, institutions can effectively engage academic leaders and faculty at all levels to address disruptive behavior and enhance positive climate factors.

ObjectiveWe examined the association between breastfeeding and postmenopausal visceral adiposity.MethodsParticipants were community-dwelling women aged 55-80 from the Caucasian Rancho Bernardo Study, the Filipino Women's Health Study, and the Health Assessment Study of African-American Women who had visceral adipose tissue (VAT) measurements by computed tomography between 2000 and 2002. Linear regression was used to determine the association between average breastfeeding duration per child and VAT.ResultsIn Caucasian, Filipino, and African-American women, average number of live births was 3, 4, and 3; average breastfeeding duration was 4.3, 1.8, and 5.1 months, respectively. Filipino women had more live births, were more likely to breastfeed, and breastfed shorter durations. African-American women had lower VAT, despite higher subcutaneous adipose tissue (SAT), BMI, and waist girth. Women who breastfed >3 months on average had 8.8 cm(3) lower VAT than women who breastfed ≤3 months, independent of covariates. Women who initiated breastfeeding had lower BMI and waist girth than those who did not, but they did not differ by VAT unless they breastfed >3 months. Associations were independent of race/ethnicity.ConclusionsResults suggest breastfeeding initiation is associated with reduced BMI and smaller waist girth, and breastfeeding >3 months is associated with lower postmenopausal VAT.

Low birth weight is associated with poorer cognitive function from infancy through early adulthood, but little is known about low birth weight and cognitive performance in the elderly. This study examines the association of birth weight with cognitive function in community-dwelling older women. Participants were 292 community-dwelling women aged 55–89 (median = 71 years) who attended a 1988–91 clinic visit when cognitive function was assessed, and responded to a 1991 mailed questionnaire assessing birth weight. All analyses were adjusted for age and education. Birth weight ranged from 2 to 12 pounds (lbs; mean = 7.4 ± 1.9). When birth weight was categorized into tertiles (2–6.9 lbs, 7–8 lbs, and 8.1–12.4 lbs), women in the lowest tertile had significantly lower (“poorer”) scores on Serial 7’s, a test of concentration and calculation (p

The present study was performed to determine whether acetaminophen (paracetamol) use after the measles-mumps-rubella vaccination could be associated with autistic disorder. This case-control study used the results of an online parental survey conducted from 16 July 2005 to 30 January 2006, consisting of 83 children with autistic disorder and 80 control children. Acetaminophen use after measles-mumps-rubella vaccination was significantly associated with autistic disorder when considering children 5 years of age or less (OR 6.11, 95% CI 1.42-26.3), after limiting cases to children with regression in development (OR 3.97, 95% CI 1.11-14.3), and when considering only children who had post-vaccination sequelae (OR 8.23, 95% CI 1.56-43.3), adjusting for age, gender, mother's ethnicity, and the presence of illness concurrent with measles-mumps-rubella vaccination. Ibuprofen use after measles-mumps-rubella vaccination was not associated with autistic disorder. This preliminary study found that acetaminophen use after measles-mumps-rubella vaccination was associated with autistic disorder. (Contains 5 tables.)

Objectives. In non-American Indian/Alaska Native groups, current smoking prevalence is similar for those with or without diabetes (26%) We analyzed current smoking prevalence in American Indian/Alaska Natives by diabetes status. Methods. Data were extracted from Indian Health Service clinic visit information from 1998 to 2003. After consolidation into unique patient records, the sample comprised 71 221 patients aged 14 years or older with both diabetes and current smoking information. Results. Cross-sectional results indicated that diabetic American Indian/Alaska Natives were significantly more likely than those without diabetes to be current smokers (29.8% vs 18.8%; P Conclusions. American Indian/Alaska Natives with diabetes at all sites and age categories were found to smoke at significantly higher rates than those without diabetes. Smoking cessation programs should target diabetic patients to more effectively prevent complications and promote successful management of diabetes in American Indians/Alaska Natives. (doi: 10.2106/AJPH.2006.104042)

Introduction: Mentorship is critical for faculty success, satisfaction, and engagement. However, many faculty, particularly underrepresented racial/ethnic (UR) faculty, lack access to high-quality mentoring. In an effort to improve mentoring for all faculty, we developed and implemented a formally structured faculty mentor training program (FMTP) across UC San Diego Health Sciences, which included institutional support, mentorship training, and department/division mentorship programs. Methods: FMTP impact was evaluated using three primary outcome variables: mentoring quality, mentoring behaviors, and institutional climate. Participants' self-assessed mentoring competencies were measured using validated instruments. Results: A total of 391 (23%) of Health Sciences faculty participated in FMTP. Participation rate was higher for women than men (30% versus 17%) and highest for UR faculty (39%). FMTP was implemented in 16 of 19 departments. Self-reported mentoring improved for FMTP participants with mentoring quality (p = 0.009) and meeting mentees' expectations (p = 0.01) continuing to improve for up to 2 years after training. However, participants were unsure if they were meeting UR mentees' expectations. FMTP participants were significantly more satisfied with mentoring quality (p < 0.001) compared to non-participants, with the greatest increase in satisfaction reported by UR faculty (38–61%). UR faculty reported improved overall morale (51–61%) and a perception that the environment was supportive for UR faculty (48–70%). Conclusion: The implementation of a system-wide formal structured FMTP was associated with improved faculty satisfaction, quality of mentoring, and institutional climate, especially for UR faculty. [ABSTRACT FROM AUTHOR]

Using an archival prospective design, the authors studied associations among parental divorce occurring during participants' childhood, adult psychosocial mediators, and mortality over the life span of a subgroup of participants (N = 1,261) in the Terman Life Cycle Study (1921-1991). Children from divorced families grew up to show a higher risk of premature mortality across the life span. The higher mortality risk for men was explained, in part, when 3 mediating factors were controlled: Men who had experienced parental divorce were more likely to have their own marriages end in divorce, obtained less education, and engaged in fewer service activities. Women who had experienced parental divorce smoked more and were more likely themselves to divorce, both of which predicted higher mortality risk. The findings extend previous work on the negative sequelae of parental divorce to long-term effects on personality and longevity.

Objectives. This study examined the relation of hysterectomy and oophorectomy to heart disease risk factors. Methods. Data were collected and analyzed for 1150 women aged 50 through 89. Results. Of these women, 21.8% reported hysterectomy with bilateral oophorectomy; 22.1%, hysterectomy with ovarian conservation. Compared with women without hysterectomy, oophorectomized women, especially those 20 or more years postmenopause, had increased lipids, lipoproteins, glucose, and insulin; blood pressures were increased among current estrogen users. Women with hysterectomies with ovarian conservation had similar or more favorable risk factors than nonhysterectomized women. Conclusions. Bilateral oophorectomy, but not hysterectomy, may have long-term negative consequences for heart disease risk factors not totally ameliorated by estrogen use. (Am J Public Health. 1997;87: 676-680)

Personality traits, sex, and parental divorce may influence subsequent longevity. Researchers analyzed various predictors of mortality in 1,285 white middle-class children with above-average intelligence, born between 1904 and 1915. By 1991, 44% of the participants had died. Factors examined included childhood health, family stability (parental death or divorce), six personality aspects, and sex. Mortality among those whose parents had divorced during childhood increased by 44% compared to people with stable families. Personality factors, such as conscientiousness and permanency of mood, were linked to lower mortality rates. Contrary to expectation, health status during childhood and cheerfulness did not extend longevity. By 1991, being male resulted in a higher mortality rate compared to women. Half of the men and 35% of the women had died, indicating a sex difference not explained by other factors early in life.

Impulsive, undercontrolled personalities and major family stresses are known predictors of impaired adjustment, but long-term health effects are unclear. In an archival prospective cohort design, we followed up on L. M. Terman's (Terman & Oden, 1947) sample of gifted children by collecting and coding death certificates for the half of the sample that is now dead. Statistical survival analyses were used to predict longevity and cause of death as a function of parental divorce during childhood, unstable marriage patterns in adulthood, childhood personality, adult adjustment, and possible mediating health behaviors. Psychosocial factors emerged as important risks for premature mortality.

Objectives. The purpose of the study was to determine whether breast-feeding is associated with increased longevity or cause-specific survival. Methods. Teachers throughout California identified intellectually gifted children as part of a prospective study begun in the 1920s by Lewis Terman. Information on breast-feeding was available on 1170 subjects, who have been followed for more than 65 years. Results. Survival analysis (Cox proportional hazards model) indicated that breast-feeding was associated with increased longevity, even after adjustment for age at baseline, birthweight, infant health, and childhood socioeconomic status, but only among men, and the association was not significant (P = .15). Neither cardiovascular disease nor cancer survival was significantly associated with duration of breast-feeding for either sex. Survival from deaths due to injuries was positively associated with breast-feeding after adjustment (P = .03) and demonstrated a clear gradient with duration, but only among men. Conclusions. Overall, the present study does not provide strong evidence that breast-feeding is associated with adult longevity. The reduced risk of death from injury may reflect chance, in that the association was significant only for men, or it may reflect psychosocial correlates of breast-feeding practices. (Am J Public Health. 1994;84:1458-1462), Breast feeding infants may have some affect on their long-term survival, especially for males. An analysis of data from the Terman Life Cycle Study focused on participants born between 1904 and 1915. The Terman project surveyed gifted, mostly white, mostly middle-class children in California and followed them until 1986. The analysis of breast feeding and survival included 647 males and 523 females. Of these, 115 were never breast-fed. The average length of breast feeding was eight months for the 1,155 who were breast-fed for some period. The children who were breast-fed were healthier infants, with the effect increasing with the length of time they were breast-fed. When mortality rates were analyzed as of 1986, 449 subjects had died. Although overall mortality rates were higher for men than women, they were lower for men who had been breast-fed than for men who had not. This difference was not present for the women. Breast feeding seemed to have little effect on most specific causes of death or survival of specific illnesses. However, both men and women who had been breast-fed had lower rates of death from injury. This was significant for men and the benefit increased with the length of breast feeding.

Key models relating personality and health predict that personality in childhood is indicative of later health and longevity. Longevity predictions are tested using data derived from the 7-decade longitudinal study initiated by L. M. Terman in 1921 (L. M. Terman & M. H. Oden, 1947). Variables representing major dimensions of personality are used in statistical survival analyses of longevity in 1,178 males and females. Conscientiousness in childhood was clearly related to survival in middle to old age. This finding (a) establishes that childhood personality is related to survival decades into the future, (b) confirms the validity of the conscientiousness dimension in conceptualizing personality, and (c) points to likely and unlikely pathways linking personality to health. Contrary to expectation, cheerfulness (optimism and sense of humor) was inversely related to longevity, suggesting a possible need for reconceptualization of its health relevance.