Professional Category Research Articles

Needs and expectations of healthcare professionals regarding the topic of alcohology: Results of a survey conducted in France in 2022

ContextAlcohol-related health problems represent a significant public health concern, and it is imperative for the healthcare team to accurately perceive and detect these issues to provide appropriate care. The objective of this survey was to evaluate the knowledge, practices, and educational background of healthcare professionals in the field of alcohol-related health concerns, aiming to identify their information requirements. MethodsThis study employs a cross-sectional descriptive survey methodology, in which data were gathered through a digital questionnaire designed for healthcare professionals (including those in medical, paramedical, and medico-social professions) working in addictology services as well as other relevant services across France and its overseas departments. ResultsA total of 611 questionnaires were deemed usable for analysis. A considerable percentage of participants reported their knowledge and skills to be insufficient or very insufficient, with rates of 33 % and 36 %, respectively. Moreover, a significant proportion of respondents (≈ 28 %) stated that they had received no education in addictology. Our results highlight differences in levels of knowledge and competence among the various healthcare settings, notably with lower reported levels of satisfaction in hospital settings (public and private), private practice, and in Harm Reduction Centers. Furthermore, certain professions reported unsatisfactory levels of skills and knowledge in alcohol-related issues, particularly support staff, pharmacists, expert patients, administrative staff, and social workers. These findings suggest the need to enhance knowledge and skills by tailoring interventions according to the specific healthcare settings and professions. Additionally, the priority themes and channels for disseminating information varied depending on age, region, and professional category. ConclusionThis survey reveals a low level of knowledge, practice, and education in addictology, emphasizing the critical need for training. The importance of training extends not only to the priority topics addressed but also to the channels used for dissemination, all while customizing them to suit the age, professional category, structure, and region of healthcare professionals.

Factors associated with engagement in nursing workers

Objective: to measure the engagement of nursing workers and verify the association between engagement and sociodemographic variables in these workers. Method: quantitative cross-sectional research, with nursing workers, from the Mother and Child Department, of a private and philanthropic hospital, in the city of São Paulo - SP/Brazil. Data collection took place in 2022, via the REDcapTM digital platform, with sociodemographic questions and the UWES-9 (Utrecht Work Engagement Scale). Descriptive analyzes were carried out and correlations between variables were obtained using Spearman's correlation coefficient, using the free software R version 4.2.2 for the analyses. Result: for half of the 210 respondents, all dimensions and the total scale score presented median values above 5.00, indicating high worker engagement. The variables Age and Professional category had a positive statistical association with engagement, and it was identified that nursing workers who did not have health issues in the previous month had a higher median score. Conclusion: the study showed high participant engagement, with all items scoring greater than or equal to 5.00. Engagement was positively correlated with the variables age, with greater engagement among older ages, and with the professional category, which showed the highest median score among nursing assistants and technicians, 5.33, while nurses had a median score of 5.06.

Historical Changes, Contemporary Characteristics, and Five Transformations of Environmental Design in China

Starting from the characteristics of modernization in three different historical stages since the founding of the People’s Republic of China, this paper analyses the internal changes in the professional name, subordinate disciplines and categories, and professional mission of the environmental design profession, and summarizes the changes in the characteristics of the environmental design profession in 10 aspects such as subordinate disciplines, design objects, design types, cultural characteristics, and aesthetic values on the basis of the results of the analysis, and explores five transformations of the environmental design profession in the process of China’s development in the future. The five transformations in the future development of China are to serve the harmony and beauty of the three major urban and rural spaces with “small and micro-renewal and reconstruction”; to serve the transmission of Chinese culture and the spread of Chinese civilization with “spatial heritage and innovation”; to serve the balance and sufficiency of the four functions of urban and rural settlements with “friendliness and equilibrium”; to serve the intelligence, wisdom, and enjoyment of indoor and outdoor living environment space with “scientific and technological achievements”; and to serve the co-construction, co-management, and sharing of indoor and outdoor public space in urban and rural areas with “public participation.”

Factors associated with symptoms of depression and anxiety in health professionals in high-complexity services

The aim of this study was to estimate the prevalence of anxiety and depression symptoms in health professionals in high-complexity services and the associated factors. Epidemiological, cross-sectional, analytical study. The Beck Anxiety and Depression Inventories and a questionnaire with sociodemographic and occupational aspects, health conditions, lifestyle and quality of life were used. A total of 490 professionals participated. The prevalence of anxiety and depression symptoms was 26.5% and 19.8%, respectively. The prevalence of anxious symptoms was lower among nurses and physicians, was higher among female professionals, who used sleep medications, with altered fasting blood glucose levels, with a good and regular/need to improve lifestyle, and with scores below average in the social relationships domain. The prevalence of depression symptoms was higher in females, who took time off work due to stress, depression, or anxiety, had a good and regular/need to improve lifestyle, and had below-average scores in the psychological and environmental domains. The outcomes investigated were associated with the following variables: gender, professional category, use of sleep medication, fasting glucose, stress leave, depression or anxiety, lifestyle, and quality of life.

Unveiling the heterogeneous utilisation of the same digital patient management platform: case studies in primary healthcare in Sweden

BackgroundThe utilisation of digital technology in primary healthcare, particularly digital patient management platforms, has gained prominence, notably due to the global pandemic. These platforms are positioned as substitutes for face-to-face consultations and telephone triage. They are seen as a potential solution to the escalating costs associated with an aging population, increasing chronic conditions, and a shrinking healthcare workforce. However, a significant knowledge gap exists concerning the practical aspects of their implementation and their effect on the utilisation of digital patient management in primary healthcare.MethodsThis study addresses this gap by conducting a comprehensive analysis of three case studies involving the implementation of a specific digital patient management platform. Over a period of three years, we examine how the practicalities of implementation shape the adoption and utilisation of a digital patient management platform in three different clinics.ResultsOur findings revealed that differences in implementation strategies directly influenced variations in utilisation. The successful utilisation of the platform was achieved through a bottom-up decision-making process that involved the employees of the primary healthcare clinics. Onsite training, close collaboration with the eHealth provider, and a structured patient onboarding process played crucial roles in this utilisation. In contrast, a top-down approach at two of the primary healthcare clinics led to limited utilisation of the platform into daily workflows. Furthermore, making the platform a part of everyday work meant putting accessibility, by working as a team of physicians, at the forefront of continuity of care, with patients being managed by their designated physician. Additionally, it was observed that digital patient management proved most effective for addressing simple patient issues such as skin rashes, rather than complex cases, and did not reduce the demand for phone triage.ConclusionOnly one of the three clinics studied effectively integrated digital patient management into its daily operations, and did so by aligning objectives among management and all categories of healthcare professionals, employing a bottom-up decision-making process, collaborating with the eHealth service provider for regular platform adjustments to clinic needs, and implementing active patient onboarding. This sociotechnical integration resulted in high platform utilisation. In contrast, the other two clinics faced challenges due to incoherent objectives among diverse healthcare professional employees and top management, a top-down decision-making approach during implementation, limited collaboration with the eHealth service provider, and passive patient onboarding. The findings indicate that these factors negatively affected utilisation and led to low platform adoption as well as disrupted the sociotechnical balance.

Evidence of Horizontal Violence in Healthcare Settings: A Narrative Review.

In the professional realm, the healthcare sector stands out as one of the most susceptible to violence. One notable manifestation of this is violence among colleagues, commonly referred to as horizontal violence, which has garnered significant attention in recent times. To delve deeper into this phenomenon across various categories of healthcare professionals, a comprehensive search was conducted on PubMed, Scopus, and CINAHL, resulting in the inclusion of 13 articles. The findings of this narrative review illuminate how horizontal violence can manifest in both physical and psychological forms and how it often becomes normalized among the healthcare professionals who endure it. Particularly vulnerable to such occurrences are recent graduates and those with limited professional experience. Furthermore, it has been observed that horizontal violence has detrimental effects on the well-being of those subjected to it, as well as on the quality of patient care delivered. Considering preventive measures, numerous studies emphasize the pivotal role of effective departmental leadership in fostering a harmonious work environment. Despite the largely underreported nature of this phenomenon, the conclusions drawn in this study advocate for a deeper exploration of the dynamics surrounding horizontal violence, with the goal of devising targeted strategies to mitigate its occurrence.

P-722 What is the state of well-being among professionals working in French Assisted Reproductive Technology (ART) centers?

Abstract Study question What is the state of well-being among professionals working in French Assisted Reproductive Technology (ART) centers? Summary answer Over 35% of French ART professionals experience job strain, and an additional 21% lack social support, posing risks of stress, burnout, and physical health issues. What is known already The health of professionals is notably impacted by the psychosocial work environment, where stress arises from imbalances between demands and available resources. Job strain, characterized by high psychological demands and low decision latitude, can lead to negative health outcomes, especially when combined with poor social support. Research on the well-being of diverse ART teams is scarce. Previous studies focused on burnout risk among embryologists in the US, Spain, and the UK, leaving other professional categories unexplored. A wider understanding of the psychosocial dynamics within ART centers is crucial for promoting a supportive work environment and limiting stress-related challenges among professionals. Study design, size, duration This cross-sectional study aims at evaluating the state of well-being among professionals working in the 104 French ART centers. An online survey was distributed via email to potential participants from November 2023 to January 2024. The questionnaire was built upon Karasek and Siegrist’s models. It included 26 queries assessing psychological demands, decision latitude, and social support, along with 23 questions evaluating effort, rewards, and perceived control. Additional questions covered personal and professional details. Participants/materials, setting, methods Responses were scored based on predefined points for psychological demand, decision latitude, job support, extrinsic efforts, and rewards. According to Karasek model, job strain combines high psychological demands (score >21) with low decision latitude (score <70). Isostrain, a more severe form of job strain, adds low social support (score <24) to job strain. Siegrist’s model identifies work situations with an imbalance between extrinsic efforts and rewards (ratio effort/reward >1). Main results and the role of chance The study included 464 participants (13% participation rate), including biologists (n = 129, 28%), gynecologists (n = 125, 27%), embryologists (n = 106, 23%), secretaries (n = 51, 11%), midwifes (n = 31, 6%) and other professions (n = 22, 5%). Most professionals were women (81.5%), while the remaining where men (18.1%) mainly biologists and gynecologists, and non-binary individuals (0.4%). Among all professionals, 164 (36%) experience job strain, while others either fell in active (n = 186, 40%), relaxed (n = 68, 15%) or passive (n = 41, 9%) categories. Furthermore, 80 (21%) professionals were in an isostrain situation. A total of 15% of professionals experience an imbalance between their extrinsic efforts and rewards. Multivariate analysis showed that women (OR 2.10 [1.07; 4.11]), public centers (OR 1.86 [1.13; 3.08]), embryologists (OR 9.26 [4.90; 17.50]), and secretaries (OR 5.78 [2.75; 12.17]) exhibited higher job strain risks compared to men, for-profit private centers, and gynecologists. Gender and function also showed significant associations with isostrain risk. Moreover, working 10 hours per day for 5-6 days weekly (OR 4.75 [1.47; 15.37]), along with functions of embryologists (OR 7.58 [2.21; 26.05]) and secretaries (OR 4.41 [1.20; 16.18]), were independently associated with an effort/reward imbalance, compared to a 4-day weekly work schedule and the function of gynecologist, respectively. Limitations, reasons for caution Due to the email distribution method, some professionals might not have received the survey. Sampling or non-response bias may result in the underrepresentation of specific individuals, limiting the generalizability of the findings. Finally, used scales might not fully capture all psycho-emotional aspects, such as burnout levels or quality of life. Wider implications of the findings 35% of French ART professionals face psychosocial imbalance, exceeding the general population’s rate (23.2%, Sumer study, 2003). Job strain may affect care quality (Scheepers et al., 2015), so research is needed to understand its causes and potential impact. Organizational and managerial improvements could constitute preventive approaches to stress and burnout. Trial registration number Not applicable

Knowledge and attitudes toward artificial intelligence in nursing among various categories of professionals in China: a cross-sectional study.

The application of artificial intelligence (AI) in healthcare is an important public health issue. However, few studies have investigated the perceptions and attitudes of healthcare professionals toward its applications in nursing. This study aimed to explore the knowledge, attitudes, and concerns of healthcare professionals, AI-related professionals, and others in China toward AI in nursing. We conducted an online cross-sectional study on nursing students, nurses, other healthcare professionals, AI-related professionals, and others in China between March and April 2024. They were invited to complete a questionnaire containing 21 questions with four sections. The survey followed the principle of voluntary participation and was conducted anonymously. The participants could withdraw from the survey at any time during the study. This study obtained 1,243 valid questionnaires. The participants came from 25 provinces and municipalities in seven regions of China. Regarding knowledge of AI in nursing, 57% of the participants knew only a little about AI, 4.7% did not know anything about AI, 64.7% knew only a little about AI in nursing, and 13.4% did not know anything about AI in nursing. For attitudes toward AI in nursing, participants were positive about AI in nursing, with more than 50% agreeing and strongly agreeing with each question on attitudes toward AI in nursing. Differences in the numbers of participants with various categories of professionals regarding knowledge and attitudes toward AI in nursing were statistically significant (p < 0.05). Regarding concerns and ethical issues about AI in nursing, every participant expressed concerns about AI in nursing, and 95.7% of participants believed that it is necessary to strengthen medical ethics toward AI in nursing. Nursing students and healthcare professionals lacked knowledge about AI or its application in nursing, but they had a positive attitude toward AI. It is necessary to strengthen medical ethics toward AI in nursing. The study's findings could help develop new strategies benefiting healthcare.

Abandoned Code: War and Migration of Ukrainian IT Specialists

Introduction. Modern conditions, including the full scale war and economic instability in Ukraine, present Ukrainian IT specialists with a series of complex challenges, among which migration-related issues are prominent. In this context, the problem of migration among Ukrainian IT specialists becomes crucial and requires attention from the government, IT companies, and other stakeholders. This problem requires a comprehensive analysis and the development of effective strategies and solutions to attract and retain IT specialists in Ukraine.Problem Statement. This research examines various aspects of migration among Ukrainian IT specialists, identifies the key challenges they face in times of armed conflict, and proposes recommendations and strategies to address the issues related to intellectual migration.Purpose. The main objective is to identify the primary problems encountered by Ukrainian IT specialists during migration and to develop specific recommendations and strategies to support and attract this category of professionals to contribute to the development of the IT industry in Ukraine.Materials and Methods. The study employs general scientific and specialized research methods, such as in vestigating cause-and-effect relationships, using the scientific abstraction method, comparative assessments, analysis, and synthesis.Results. Some key challenges affecting the migration of Ukrainian IT specialists have been identified. These include restrictions on leaving the country, migration of IT specialists and their families, conscription into the army, currency regulations, challenges related to working with foreign clients, relocation challenges, and the occupation of Ukrainian territory.Conclusions. To support Ukrainian IT specialists and harness their potential for the country’s development, it is essential to focus on creating favorable working conditions, fostering interaction with IT specialists, developing the innovation sector, facilitating knowledge transfer, and providing promising opportunities for their growth.

Unveiling the Driving Factors of Emerging Trends in the Ghanaian Construction Industry: An Evaluative Analysis of Push and Pull Factors

There is a significant change in the Ghanaian construction sector, driven by the convergence of emerging trends. The study investigated the underlying factors influencing these emerging trends in the Ghanaian construction industry, focusing on both pull and push factors. A mixed-methods approach was employed, combining survey data with qualitative analysis, to gain a comprehensive understanding of the drivers shaping the industry's development. The study was conducted within three cities (Cape Coast, Kasoa, and Winneba) in the Central Region of Ghana. Fifteen (15) construction companies were purposively selected based on their interest in technological advancements within the construction ecosystem. Five (5) categories of construction professionals, project managers, quantity surveyors, architects, structural engineers, safety officers, and site supervisors employed by the aforementioned fifteen (15) construction companies were considered for the study. Data collected were analyzed utilizing SPSS software version 20. Push factors highlighted environmental degradation, technological innovation, and infrastructure renewal as significant motivators. Pull factors emphasized the industry's extrinsic motivations, including community development, cultural considerations, and economic growth. The analysis revealed that both push and pull factors play crucial roles in driving the trends within the industry. Qualitative interviews conducted as part of the study provided deeper insights, identifying six key themes: regulatory compliance and market competition, technological advancements, skill development, economic considerations, leadership and strategic vision, and customer demand. These themes underscore the complex relationship between external pressures and internal motivations. Correlation and regression analyses indicated significant relationships between trend recognition and both push and pull factors, emphasizing the interplay between external pressures and aspirational drivers in shaping industry trends. This study contributes to a deeper understanding of the dynamic forces driving change in the Ghanaian construction sector, offering substantial insights for stakeholders. These insights can help stakeholders navigate challenges and capitalize on opportunities for sustainable growth and development. The findings underscore the importance of balancing technological advancements with socio-economic goals to foster a robust and forward-thinking construction industry in Ghana.

Humor Styles in Healthcare Professionals: A Correlational Study.

Using humor as a caregiving strategy can help professionals perceive daily and work-related events from a more optimistic and light-hearted perspective. The main objective of this study was to analyze humor styles among health care professionals. A cross-sectional and correlational design was employed. Data were collected using the Humor Styles Questionnaire, which measures four humor styles: affiliative, self-enhancing, aggressive, and self-defeating humor. Health care professionals scored higher in positive humor than negative humor. Age exhibited a negative correlation with positive humor. Significant differences were observed between marital status and affiliative and self-enhancing humor, professional category and hospital unit with aggressive humor, shift work and self-enhancing humor, and type of contract and experience with affiliative humor. Health care professionals employ various humor styles based on their social and work contexts. It is crucial for health care professionals to receive training in the use of positive humor to consciously avoid humor styles that can hinder well-being.

Barriers and Enablers Affecting the Uptake of Biosimilar Medicines Viewed Through the Lens of Actor Network Theory: A Systematic Review.

Biosimilars represent an opportunity to realise savings against the costs of innovative medicines. Despite efforts made by stakeholders, there are numerous barriers to the uptake of biosimilars. To realise the promise of biosimilars reducing costs, barriers must be identified, understood, and overcome, and enablers magnified. The aim of this systematic reviewis to summarise the enablers and barriers affecting uptake of biosimilars through the application of a classification system to organise them into healthcare professional (HCP), patient, or systemic categories. A systematic literature search was performed in PubMed, Scopus, CINAHL, eConlit, and Embase. Included were primary research studies published in English between Jan 2017 through June 2023 focused on enablers and barriers affecting uptake of biosimilars. Excluded studies comprised comparisons of biosimilar efficacy and safety versus the reference biologic. One reviewer extracted data that included classification of barriers or enablers, the sub-classification, and the identification of the degree of agency associated with the actor through their role and associations as a mediator within their network, through the application of Actor Network Theory. The data were validated by a second reviewer(PV). Of the 94 studies included, 59 were cross-sectional, 20 were qualitative research, 12 were cohort studies, and three were economic evaluations. Within the review, 51 of the studies included HCP populations and 35 included patients. Policies and guidelines were the most cited group of enablers, overall. Systemic enablers were addressed in 29 studies. For patients, the most frequently cited enabler was positive framing of a biosimilar, while for HCPs, cost benefit was the most frequently noted enabler. The most frequently discussed systemic barrier to biosimilar acceptance was lack of effective policies or guidelines, followed by lack of financial incentives, while the most significant barriers for HCPs and patients, respectively, were their lack of general knowledge about biosimilars and concerns about safety and efficacy. Systemic actors and HCPs most frequently acted with broad degree of agency as mediators, while patient most frequently acted with a narrow degree of agency as mediators within their networks. Barriers and enablers affecting uptake of biosimilars are interconnected within networks, and can be divided into systemic, HCP, and patient categories. Understanding the agency of actors within networks may allow for more comprehensive and effective approaches. Systemic enablers in the form of policies appear to be the most effective overall levers in affecting uptake of biosimilars, with policy makers advised to give careful consideration to appropriately educating HCPs and positively framing biosimilars for patients.

Constrains in the articulation between profession, family, and personal life: a case study of the Portuguese police (PSP).

The dangers and stresses of a police officer's career cause physical and psychological distress which in turn cause considerable challenges for the integration of professional, family, and personal life. This study focuses on the conditions that influence this articulation between the personal, family, and professional lives of Portuguese Police (PSP) officers. A questionnaire survey was applied to 414 police officers from 11 divisions of COMETLIS. At the empirical level, several models were tested to assess the articulation between the professional, family, and personal lives of police officers. The results highlight the influence of having young children, elderly people or other dependents living in the family home, as well as the employee's age, on the job's interaction with professional life. At a professional level, the variables shift work, professional category, years of service and working away from home were identified by the officers as conditioning factors in the work-family-personal life balance. Sex differences in the articulation of professional, family, and personal life were also observed.

COVID-19-related temporary disability in healthcare workers in Spain during the four first pandemic waves

Healthcare workers (HCW) have been the professional category most exposed to SARS-CoV-2. The pandemic’s impact on HCW was analyzed in terms of COVID-19-related temporary disability (TD) between February 15th, 2020 and May 1st, 2021. TDs in HCW for COVID-19 infection or quarantine were described. TD quarantine/infection ratios and TDs per 100,000 affiliated HCW were compared with the cumulative incidence (CI) of COVID-19 cases notified to the National Network of Epidemiological Surveillance. TDs rates by economic activity and occupation were computed. A total of 429,127 TDs were recorded, 36,6% for infection. Three-quarters (76%) were women. The median TD quarantine/infection ratio was 2.5 (Interquartile range [IQR] 1.5–3.9). TDs rates in HCW were always above the CI except for the last two months of the fourth wave. Hospital activities accounted for 84% of TDs and showed the highest TD rate for infection (8,279/100,000). Nursing professionals and midwifery, Physicians, and Nursing assistants accounted for 26, 18 and 17 % of the conceded TD respectively, whereas the highest TDs rates were registered among Nursing assistants, Nursing professionals and Physicians: 7,426, 6,925 and 5,508/100,000, respectively. The results indicate the high impact of COVID-19 on HCW in Spain and it’s inequalities. They also confirm that TDs represent a complementary source of information for epidemiological and public health surveillance and could provide an early warning of new emerging infections.

Assessment of challenges and opportunities in antibiotic stewardship program implementation in Northwest Ethiopia

BackgroundIndiscriminate use of antibiotics leads to antibiotic resistance (AMR) and results in mortality, morbidity, and financial burden. Antibiotic stewardship programs (ASPs) with education can resolve a number of barriers recognized in the implementation of successful ASPs. The aim of this study was to assess health professionals’ perceptions and status of ASPs in hospitals in 2022. MethodsA cross-sectional study was conducted from September 1, 2022 to October 30, 2022. A total of 181 health professionals were included, and a self-administered questionnaire was used to collect data. The status of hospitals was assessed using a checklist. The data were analyzed using SPSS version 23, and descriptive statistics and Chi-square tests (X2) at a P-value of <0.05 were used. ResultsOf the 181 respondents, 163 (90.1 %), and 161 (89.0 %) believed that AMR is a significant problem in Ethiopia and globally, respectively. Easy access to antibiotics 155 (85.6 %), and inappropriate use 137 (75.7 %) were perceived as key contributors to AMR. Antibiotics were believed to be prescribed/dispensed without laboratory results 86 (47.5 %), and antibiotic susceptibility patterns were not considered to guide empiric therapy 81 (44.8 %). ASP was believed to reduce the duration of hospital stays and associated costs 137 (75.7 %), and improve the quality of patient care 133 (73.5 %), whereas 151 (83.4 %), 143 (79 %), and 142 (78.5 %) suggested education, institutional guidelines, and prospective audits with feedback interventions to combat AMR in their hospitals, respectively. There were significant differences in perception among professionals based on professional category and attempts by hospitals to implement ASPs. Although ASPs were not functioning according to standard, there have been attempts to implement it in three hospitals. The issue of ASP had never been heard in general hospitals. Currently, it is feasible to implement ASPs in four hospitals. ConclusionThe status of ASP in hospitals was very poor. Despite a lack of prior knowledge on ASPs, most respondents do have a positive perception of AMR and the implementation of ASPs. Pharmacist-led prospective audits and feedback with education and institutional guidelines for empiric antibiotic use can be better implemented in hospitals. Involvement of representatives from infection prevention and control, and collaboration among hospitals in ASP implementation will help establish a strong ASP in the area.

Continuing Professional Development Program in Health Facilities in Rwanda: A Qualitative Study on the Perceptions of Health Professionals.

Continuous professional development (CPD) is an important pillar in healthcare service delivery. Health professionals at all levels and disciplines must continuously update their knowledge and skills to cope with increasing professional demands in the context of a continuously changing spectrum of diseases. This study aimed to assess the CPD programs available in healthcare facilities (HFs) in Rwanda. Semi-structured interviews were conducted using purposive sampling. Accordingly, the respondents belonged to different categories of health professionals, namely nurses, midwives, laboratory technicians, pharmacists, general practitioners, and specialist doctors. Thirty-five participants from district, provincial, and national referral hospitals were interviewed between September and October 2020. A thematic analysis was conducted using Atlas ti.7.5.18, and the main findings for each theme were reported as a narrative summary. The CPD program was reported to be available, but not for all HPs and HFs, because of either limited access to online CPD programs or limited HF leaders. Where available, CPD programs have sometimes been reported to be irrelevant to health professionals and patients' needs. Furthermore, the planning and implementation of current CPD programs seldom involves beneficiaries. Some HFs do not integrate CPD programs into their daily activities, and current CPD programs do not accommodate mentorship programs. The ideal CPD program should be designed around HPs and service needs and delivered through a user-friendly platform. The motivators for HPs to engage in CPD activities include learning new things that help them improve their healthcare services and license renewal. This study provides an overview of the status and perceptions of the CPD program in HFs in Rwanda and provides HPs' insights on the improvements in designing a standardized and harmonized CPD program in Rwanda.

Violence against healthcare workers during the phases of the COVID-19 Pandemic: a descriptive observational study from 2018 to 2023 in the metropolitan city of Genoa (North-Western Italy).

Violence against healthcare workers is an escalating public health concern, affecting the quality of care, and causing significant psychological and physical effects on healthcare professionals. This study analysed the trend in aggressions in healthcare settings in the pre-pandemic, pandemic, and post-pandemic periods. An observational descriptive study was conducted to analyse reports of violence against healthcare workers from January 2018 to June 2023 at a Local Health Authority "ASL3" in the Liguria region of Italy. The study considered variables such as the severity of aggression, professional category involved, and location of incident. Episodes of violence were classified according to severity by means of a colour-coded system. We used multinomial logistic regression to examine any associations between the pandemic phase and the various factors, while controlling for relevant variables. The number of reported aggressions rose from 48 in 2018 to 90 in 2022, with a partial count of 35 in the first half of 2023. The pandemic phase saw a rise in incidents classified as Green codes, which accounted for 58.3%, and a significant involvement of District Services. The post-pandemic phase showed a reversion to pre-pandemic levels but with an increase in Yellow codes (5.6%). Nurses were the most frequent victims, with figures ranging from 50.8% to 95.6% over the years. The Emergency Department and Psychiatric Services emerged as the most critical settings of aggressions, with incidents recorded in these areas constituting over half of the total number. However, an increase in violence was also recorded in district healthcare settings during the post-pandemic phase. There is an urgent need for comprehensive strategies for the prevention of violence in healthcare settings. The increasing trend in violence, especially during the pandemic, necessitates integrated approaches that encompass training, psychological support, security policies, and a strong organizational culture to promote safety and respect. Protecting healthcare workers is crucial to their wellbeing and the quality of healthcare delivery.

Water Intrusion: An Analysis of Water Sources, Categories, and the Degradation Science of Building Materials

Water intrusion into a building envelope describes the unwanted movement of water or vapor into a building, where it causes damage. Various factors dictate water intrusion category determination and classification. These factors include, but are not limited to, the type and degree of water intrusion, the source and route of the contamination, and exposure time, as well as geographical environmental conditions. This comprehensive research paper looked at the literature and the science to explore the bases for indoor environmental professional (IEP) classification and category determination, but also the science behind the effects of water intrusion on building materials (BM). The efficacy of building materials once degradation has occurred and any accelerating effects impacting the efficiency of building materials and their loss of integrity were closely examined in terms of material microstructural and compositional changes. The damaging effects of moisture and heat on building materials are called hygrothermal damage, which compromises the properties and use of materials. Both aspects of building integrity, i.e., water intrusion and structural deterioration, should be of concern when mitigating and remediating the intrusion of moisture. Previous research on the clarification of water categories for water intrusions is lacking. Past approaches to water classification have lacked universal scientific clarity and understanding. In addition to a need to understand the effects that water category might have on building materials and their corresponding degree of degradation, more science and reviews are needed. The need for proper class and category determination for the remediation of water intrusion within buildings is the first step toward achieving correct mitigation to ensure human health and safety. The possible adverse health effects of water intrusion need focus and cohesion for the determination of categories. We know that the final determination of water categories differs according to the degree of contamination over time and the degree of a given class of water intrusion; however, what role do the route and initial water contamination play in the determination of the category? The following paper aims to provide not only a review of the science but also an elaboration of the category determination process and the degradation effects on building materials which should be considered, as well as possible avenues of scientific research.

Reform of the first year of medical studies and diversification of student profiles in France: an unmet need?

ObjectivesTo determine whether the reform of the first year of medical studies implemented in September 2020 in France met its objective of diversifying the profiles of students admitted to second year at the faculty of medicine at the University of Tours.MethodsSingle-centered, retrospective study, covering students who passed the first year of medical studies between 2018 and 2022. Student profiles originating from three different entry gateways (PACES, PASS and L.AS) to the second year of medical studies were compared.ResultsOne thousand four hundred and seventy-nine students over five promotions were included (806 in PACES, 329 in PASS, 198 in L.AS). The ratio of students who had obtained a baccalaureate with high or highest honors was significantly higher in PACES (85%) and PASS (96%) compared to L.AS (66%; p < 0.001). These differences were related to increased student intake via a standard pass in L.AS (21% compared to 3.2% in PACES and 0.9% in PASS) (p < 0.001). In terms of geographical origin, the proportion of students residing in regions outside the University City area increased significantly in L.AS (11%) compared to PACES (1.7%) and PASS (3.3%) (p < 0.001). The mean number of parents from the white-collar and knowledge professional category was significantly higher in PACES (0.91) and PASS (1.06) compared to L.AS (0.80; p < 0.001).ConclusionStudents with a scientific background and who obtained highest honors in their high school diploma, remain the standard in PACES and PASS. Diversification of student profiles was achieved only within the L.AS gateway, which represented 42% of total second year admissions during the post-reform year. Student profile diversification was therefore a partially achieved objective and follow up studies of future promotions is needed to assess the medium and long-term impact of the reform. Particular attention should be paid to the future of these students who have different profiles between L.AS and PASS to determine whether these changes will have any impact in the quality of healthcare for the French population.

Abusive Metajournalistic Discourse Towards Journalists on Social Media

ABSTRACT In this study, we used a mixed method approach to investigate online abuse mostly targeting journalists, by focusing on the use of the term presstitute. We inductively analyzed the professional categories of the targeted people, whether be journalists, news organizations, politicians, etc., and the countries where these professionals live. Our findings show that Twitter was the most active platform for attacking journalists, and that the top targeted groups were Indian journalists followed by American and Filipino ones. Building on Metajournalistic Discourse theory, we introduce the concept of Abusive Metajournalistic Discourse (AMD) as a form of reactive discourse, and we argue that using the term presstitute is one manifestation of AMD. To corroborate our findings, we used the collected datasets to identify the journalists who are being trolled with different types of abusive content and interviewed 12 journalists through semi-structured interviews in order to elicit their views on the abusive content targeting them. Five themes emerged from these interviews including: (1) cloaked coordinated AMD; (2) hyper-nationalist, racist and sexist AMD; (3) state-sanctioned AMD and disinformation; (4) journalists’ resolve and resilience; and (5) sinister AMD outcomes, which help shed light on the impact of AMD on journalism practice.