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Browsing by Author "Volerman, Anna"
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Item Doris Duke Charitable Foundation Fund to Retain Clinical Scientists: innovating support for early-career family caregivers(American Society for Clinical Investigation, 2022-12-01) Jagsi, Reshma; Beeland, T. DeLene; Sia, Kevin; Szczygiel, Lauren A.; Allen, Matthew R.; Arora, Vineet M.; Bair-Merritt, Megan; Bauman, Melissa D.; Bogner, Hillary R.; Daumit, Gail; Davis, Esa; Fagerlin, Angela; Ford, Daniel E.; Gbadegesin, Rasheed; Griendling, Kathy; Hartmann, Katherine; Hedayati, S. Susan; Jackson, Rebecca D.; Matulevicius, Susan; Mugavero, Michael J.; Nehl, Eric J.; Neogi, Tuhina; Regensteiner, Judith G.; Rubin, Michael A.; Rubio, Doris; Singer, Kanakadurga; Tucker Edmonds, Brownsyne; Volerman, Anna; Laney, Sandra; Patton, Carrie; Escobar Alvarez, Sindy; Anatomy, Cell Biology and Physiology, School of MedicineItem Ensuring Access to Albuterol in Schools: From Policy to Implementation. An Official ATS/AANMA/ALA/NASN Policy Statement(American Thoracic Society, 2021) Volerman, Anna; Lowe, Ashley A.; Pappalardo, Andrea A.; Anderson, Charmayne M. C.; Blake, Kathryn V.; Bryant-Stephens, Tyra; Carr, Thomas; Carter, Heather; Cicutto, Lisa; Gerald, Joe K.; Miller, Tina; Moore, Nuala S.; Phan, Hanna; Sadreameli, S. Christy; Tanner, Andrea; Winders, Tonya A.; Gerald, Lynn B.; School of NursingRationale: For children with asthma, access to quick-relief medications is critical to minimizing morbidity and mortality. An innovative and practical approach to ensure access at school is to maintain a supply of stock albuterol that can be used by any student who experiences respiratory distress. To make this possible, state laws allowing for stock albuterol are needed to improve medication access. Objectives: To provide policy recommendations and outline steps for passing and implementing stock albuterol laws. Methods: We assembled a diverse stakeholder group and reviewed guidelines, literature, statutes, regulations, and implementation documents related to school-based medication access. Stakeholders were divided into two groups—legislation and implementation—on the basis of expertise. Each group met virtually to review documents and draft recommendations. Recommendations were compiled and revised in iterative remote meetings with all stakeholders. Main Results: We offer several recommendations for crafting state legislation and facilitating program implementation. 1) Create a coalition of stakeholders to champion legislation and implement stock albuterol programs. The coalition should include school administrators, school nurses and health personnel, parents, or caregivers of children with asthma, pediatric primary care and subspecialty providers (e.g., pulmonologists/allergists), pharmacists, health department staff, and local/regional/national advocacy organizations. 2) Legislative components critical for effective implementation of stock albuterol programs include specifying that medication can be administered in good faith to any child in respiratory distress, establishing training requirements for school staff, providing immunity from civil liability for staff and prescribers, ensuring pharmacy laws allow prescriptions to be dispensed to schools, and suggesting inhalers with valved holding chambers/spacers for administration. 3) Select an experienced and committed legislator to sponsor legislation and guide revisions as needed during passage and implementation. This person should be from the majority party and serve on the legislature’s health or education committee. 4) Develop plans to disseminate legislation and regulations/policies to affected groups, including school administrators, school nurses, pharmacists, emergency responders, and primary/subspecialty clinicians. Periodically evaluate implementation effectiveness and need for adjustments. Conclusions: Stock albuterol in schools is a safe, practical, and potentially life-saving option for children with asthma, whether asthma is diagnosed or undiagnosed, who lack access to their personal quick-relief medication. Legislation is imperative for aiding in the adoption and implementation of school stock albuterol policies, and key policy inclusions can lay the groundwork for success. Future work should focus on passing legislation in all states, implementing policy in schools, and evaluating the impact of such programs on academic and health outcomes.Item Parental leave, childcare policies, and workplace bias for hepatology professionals: A national survey(Wolters Kluwer, 2023-08-28) Feld, Lauren D.; Sarkar, Monika; Au, Jennifer S.; Flemming, Jennifer A.; Gripshover, Janet; Kardashian, Ani; Muir, Andrew J.; Nephew, Lauren; Orloff, Susan L.; Terrault, Norah; Rabinowitz, Loren; Volerman, Anna; Arora, Vineet; Farnan, Jeanne; Villa, Erica; Monika; Medicine, School of MedicineBackground: The presence of workplace bias around child-rearing and inadequate parental leave may negatively impact childbearing decisions and sex equity in hepatology. This study aimed to understand the influence of parental leave and child-rearing on career advancement in hepatology. Methods: A cross-sectional survey of physician members of the American Association for the Study of Liver Diseases (AASLD) was distributed through email listserv in January 2021. The 33-item survey included demographic questions, questions about bias, altering training, career plans, family planning, parental leave, and work accommodations. Results: Among 199 US physician respondents, 65.3% were women, and 83.4% (n = 166) were attendings. Sex and racial differences were reported in several domains, including paid leave, perceptions of bias, and child-rearing. Most women (79.3%) took fewer than the recommended 12 paid weeks of parental leave for their first child (average paid leave 7.5 wk for women and 1.7 for men). A majority (75.2%) of women reported workplace discrimination, including 83.3% of Black and 62.5% of Hispanic women. Twenty percent of women were asked about their/their partners' pregnancy intentions or child-rearing plans during interviews for training. Women were more likely to alter career plans due to child-rearing (30.0% vs. 15.9%, p = 0.030). Women were also more likely to delay having children than men (69.5% vs.35.9%). Conclusions: Women reported sex and maternity bias in the workplace and during training interviews, which was more frequently experienced by Black and Hispanic women. As two-thirds of women had children during training, it is a particularly influential time to reevaluate programmatic support to address long-term gender disparities in career advancement.