Early mortality and primary causes of death in mothers of children with ID or ASD: a retrospective cohort study

INTRODUCTION: Mothers of children with intellectual disability or autism spectrum disorder (ASD) have poorer health than other mothers. Yet no research has explored whether this poorer health is reflected in mortality rates or whether certain causes of death are more likely. We aimed to calculate the hazard ratios for death and for the primary causes of death in mothers of children with intellectual disability or ASD compared to other mothers. METHODS: The study population comprised all mothers of live-born children in Western Australia from 1983-2005. We accessed state-wide databases which enabled us to link socio-demographic details, birth dates, diagnoses of intellectual disability or ASD in the children and dates and causes of death for all mothers who had died prior to 2011. Using Cox Regression with death by any cause and death by each of the three primary causes as the event of interest, we calculated hazard ratios for death for mothers of children intellectual disability or ASD compared to other mothers. RESULTS AND DISCUSSION: During the study period, mothers of children with intellectual disability or ASD had more than twice the risk of death. Mothers of children with intellectual disability were 40% more likely to die of cancer; 150% more likely to die of cardiovascular disease and nearly 200% more likely to die from misadventure than other mothers. Due to small numbers, only hazard ratios for cancer were calculated for mothers of children with ASD. These mothers were about 50% more likely to die from cancer than other mothers. Possible causes and implications of our results are discussed. CONCLUSION: Similar studies, pooling data from registries elsewhere, would improve our understanding of factors increasing the mortality of mothers of children with intellectual disability or ASD. This would allow the implementation of informed services and interventions to improve these mothers' longevity

An Exploration of Part-Time U.S. Medical School Faculty: A Thematic Overview

Despite the fact that many medical schools have increased their reliance on part-time faculty over the past several decades and that the number of part-time faculty is likely to continue to increase in the future, scant information about their experiences, satisfaction, and engagement exists in the literature. First. This report contains salient themes from focus groups with part-time faculty in academic medicine designed and conducted to provide insight into the issues that comprise workplace satisfaction for these faculty and to explore the unique concerns that they may face. In the report we first present a summary of the reasons faculty reported for being part-time. Next, we present themes about what comprises satisfaction for these faculty members. Third, we present unique challenges that these faculty members face because of their part-time status and suggestions that they have for their schools for improving the workplace for faculty in part-time employment arrangements

Perceptions of the Promotion Process: An Analysis of U.S. Medical School Faculty

Faculty satisfaction is important to medical schools for myriad reasons, including the empirical links between job satisfaction and increased organizational performance, faculty retention, productivity, and patient care. Half of U.S. medical faculty leave their academic medical centers within 10 years, and the resulting loss of these faculty poses financial and human capital costs to the institution. Additionally, the academic medicine workplace has changed significantly in recent decades, resulting in increased demands for research, teaching, patient care, and administration on faculty. To be effective, medical school leaders and researchers must remain abreast of the issues that comprise workplace satisfaction for their faculty. In this Analysis in Brief (AIB), we explore faculty perceptions of the promotion process as a key area of faculty satisfaction worth increased attention, given that the perception of equity in the promotion process is one of the lowest areas of satisfaction among academic medicine faculty members

An Exploration of the Satisfaction and Experiences of Part-time U.S. Medical School Faculty

Despite the fact that many medical schools have increased their reliance on part-time faculty over the past several decades, scant information about the experiences and job satisfaction of parttime faculty exists in the literature. This Analysis in Brief is an exploratory study to provide insight—from the part-time faculty perspective—into the unique issues facing this faculty group and suggestions they offer for improving the workplace. Understanding the part-time faculty members’ experience is important, as they serve a significant and permanent role in the medical school workforce. When used appositely, these part-time medical school faculty appointments can benefit both individuals and institutions. For example, part-time careers can address the work-life balance many faculty hope to achieve—especially the newer generation of both male and female faculty—and may serve as a pathway to retirement for others. To help inform these discussions around these issues and to create a baseline for future studies, we present salient themes from a set of focus groups

Job Satisfaction of US Medical School Faculty with a Focus on Internal Medicine Departments

As demands on academic medical faculty have risen, medical school leaders and researchers have raised awareness about and attention to job satisfaction, faculty stress and burnout, and struggles with recruitment and retention. This increased attention is important because researchers have consistently demonstrated an empirical link between job satisfaction and retention as well as between job dissatisfaction and intent to leave an organization (1–4). Given the high costs of faculty turnover (5–7), it is essential to understand the factors that contribute to the satisfaction of medical school faculty. Using responses from a faculty satisfaction survey administered to full-time faculty at 10 medical schools, we examined key areas of medical faculty job satisfaction and dissatisfaction, first, for all faculty, and second, for faculty in internal medicine departments. Results illustrate significant differences between clinical faculty and basic science faculty in the areas of highest faculty satisfaction, and differences between internal medicine faculty and other clinical faculty on satisfaction with their clinical practice

Trends in Tenure for Clinical M.D. Faculty in U.S. Medical Schools: A 25-Year Review

The number of faculty in academic medical centers, and clinical enterprises in particular, has expanded profoundly over the past several decades. During this expansion, the prevalence of tenure systems and the actual numbers and proportions of tenured positions in U.S. medical schools have garnered much attention. Some commentators have remarked that tenure, as a system, is vanishing from schools and that the opportunity for tenure-track appointments is declining, especially for clinical faculty. This Analysis in Brief presents data on the current status of tenure systems, the changing distribution of clinical M.D. faculty on tenure-eligible tracks, and trends in numbers of these positions over the past quarter century

Retention of Full-Time Clinical M.D. Faculty at U.S. Medical Schools

Physician and faculty retention have garnered increased attention in recent years, in part because academic medical centers are grappling with the lost human and financial capital associated with turnover. Medical schools (and their departments) face significant financial costs when they lose faculty members. For example, one school demonstrated the average costs of replacing a single generalist and specialist totaled $115,554 and$286,503, respectively. In addition, with projected workforce shortages of over 90,000 physicians looming,2 physician faculty turnover will likely have workforce implications, especially within certain specialties. In response to these concerns, this Analysis in Brief (AIB) examines retention rates of clinical M.D. faculty (i.e., faculty members who typically engage in patient care) by department, and analyzes correlates of faculty intentions to leave their institutions

Clinical Faculty Satisfaction with the Academic Medicine Workplace

Faculty members in US academic medical centers face multiple pressures, including increasing clinical productivity while also providing quality education to medical students and residents. With the resulting potential for decreased job satisfaction and burnout, understanding these issues is paramount—especially given the associations of job satisfaction and important outcome measures like quality of patient care and retention. The turnover of these faculty could rise and pose great financial and human capital costs to institutions. Despite the challenging context in which clinical faculty find themselves, current understanding of the facets of clinical faculty workplace satisfaction, especially by specialty area, is limited. We undertook this research to describe dimensions of workplace satisfaction of full-time MD clinical faculty physicians at US academic medical centers and to examine the factors associated with satisfaction and intent to leave academic medicine