Daily Clinical Work Research Articles

Current Approaches to Treatment and Protein Intake Management in Pre-Dialysis Chronic Kidney Disease: Impact on Physical Exercise

Chronic kidney disease (CKD) is the 8th most common condition in the modern world. Unfortunately, it becomes more and more frequent and constitutes a significant global health problem, affecting millions of people worldwide. Therefore, its treatment is an important topic among researchers all over the world. It has been the subject of many trials, so it will eventually be as effective, secure, and comfortable for patients as it possibly can be. That is why updating and assembling current knowledge is the key to organizing information. This paper focuses on pharmacological treatment and nutritional guidelines for CKD pre-dialysis patients, as well as physical activity outcomes. It aims to summarize this knowledge, educate, and help doctors in their daily clinical work.

Using simulation scenarios and a debriefing structure to promote feedback skills among interprofessional team members in clinical practice

BackgroundTeam reflexivity and peer feedback in daily clinical work can improve patient safety. However, teams do not always engage in reflection after patient care. A reason could be that team members may lack skills in engaging in team reflection. This study explores the use of interprofessional team-based simulations to encourage and equip teams for reflective conversations in the real-world clinical practice.MethodsThis was a prospective, explorative study of team members’ perceptions of the use of in situ simulation-based scenarios with critically ill patient cases to train team-based reflections and peer feedback. The study took place in two neurological wards. Prior to the intervention, a 1-day observation in each ward and semi-structured short interviews with physicians and nurses were conducted.ResultsA total of 94 staff members, 57 nurses, 8 nurse assistants and 29 physicians participated in the in situ simulation scenarios. All team members showed appreciation of the safe learning environment. The authors found that the simulations and the debriefing structure provided an opportunity for training of team reflexivity and feedback. The team members evaluated the simulation-based training very positively, and their initial reaction indicated that they found peer feedback useful for the individual and the team. This approach allowed them to reflect on their own clinical practice.ConclusionThe simulation-based training scenarios and the debriefing structure promoted team members’ team reflexivity and peer feedback skills. The method is feasible and could be used in other specialties and situations.The team members’ reactions to feedback were positive, and based on their reflections, there is a potential to increase both individual and team skills as well as improve patient treatment.

Rare forms of monogenic diabetes in non-European individuals. First reports of CEL and RFX6 mutations from the Indian subcontinent.

Monogenic diabetes is one of the few examples in metabolic diseases in which a real precision medicine approach can be implemented in daily clinical work. Unfortunately, most of what is known today comes from studies in Whites, thus leaving much uncertainty about the genetics and the clinical presentation of monogenic diabetes in non-Europeans. To fill this gap, we report here two pedigrees from Bangladesh with CEL- and RFX6- diabetes, two rare types of monogenic diabetes which have never been described so far in individuals of the Indian subcontinent. Next generation, Sanger sequencing and Multiplex Ligation-dependent Probe Amplification (MLPA) were performed. Variants' interpretation was according to the American College of Medical Genetics and Genomics guidelines. In the pedigree with CEL-diabetes, a large and never described deletion of exon 2-11 of CEL (confirmed by MLPA) affecting the entire catalytic domain and being likely pathogenic (LP) was observed in both the proband (who had diabetes at 16) and his mother (diabetes at 31), but not in relatives with normoglycemia. In the pedigree with RFX6-diabetes, a LP protein truncation variant (PTV, p.Tyr192*) in RFX6 was found in both the proband (diabetes at 9) and his mother (diabetes at 30), thus suggesting high heterogeneity in disease onset. Normoglycemic relatives were not available for genetic testing. We report genetic features and clinical presentation of the first two cases of CEL- and RFX6-diabetes from the Indian subcontinent, thus contributing to fill the gap of knowledge on monogenic diabetes in non-Europeans.

Serious gaming as potential training tool for recognition of adverse drug reactions: side-effect exposure—medical education (SeeMe)

PurposeThe recognition of adverse drug reactions (ADRs) is an important part of daily clinical work. However, medical education in this field is mostly drug-based and does not address adequately the complexity of this field regarding individual risk factors and polypharmacy. This study investigates the potential of the web-based serious game SeeMe (side-effect exposure—medical education) in pharmacological education of medical students to improve the recognition of relevant ADRs.MethodsOne hundred fifty-seven medical students were recruited to evaluate the serious game SeeMe. SeeMe was developed to improve knowledge and recognition of ADRs in clinical practice. Players take on the role of a physician trying to understand fictional patients with ADRs. Before and after an 8-week playing period, an evaluation was carried out through a pre- and post-questionnaire and a pre- and post- knowledge test.ResultsThe students achieved significantly better results in the knowledge test, as almost twice as many exam-relevant questions were answered correctly (p < 0.001). The serious game had a positive effect on the students’ perception of the importance of ADRs.ConclusionThis study demonstrates the potential of web- and case-based fictional serious games in medical education. The improved recognition of side effects represents a crucial step for education and training in clinical pharmacology. Future versions of the serious game may take this further and focus on training in the treatment of ADRs and their relevance in various healthcare professions.

Acceptability and perceived benefits of validated pruritus assessment instruments in the dermatological office and clinic: Theperspectives of patients and physicians.

Several patient-reported outcome measures (PROMs) have been developed for research to assess the multiple dimensions of chronic pruritus (CP). The acceptability and perceived benefits of their use in clinical practice remain unknown. To assess the acceptability and perceived benefits of validated PROMs from the perspective of patients and physicians in dermatological offices and clinics. Patients with CP due to atopic dermatitis, psoriasis, chronic prurigo or chronic urticaria were recruited at 10 dermatological offices and two dermatological clinics in Germany. Patients completed a set of validated PROMs on pruritus intensity (numerical rating scale, NRS), symptom control (itch-controlled days, ItchCD), quality of life (Dermatology Life Quality Index, DLQI; 5-pruritus life quality, 5PLQ) and general health status (EuroQol, EQ-VAS). Acceptability (relevance, difficulty of completion, length) and benefits (usefulness, feasibility) of these tools were assessed on a NRS (0-10) by patients and physicians, respectively. Data were analysed descriptively. Linear regression was used to study potential associations between age, sex, occupation, office versus clinic, change of therapy and physician-reported benefits. N = 523 patients (46% male, average age: 53.5 years) participated. Acceptability of PROMs by patients was high, indicated by low difficulty (Md = 0, IQR = 0-1 for all PROMs) and high relevance (Md = 8, IQR = 4-10 for all PROMs). Also, most patients (89-95%) rated length of the questionnaires as 'exactly right'. Physicians rated the NRS as the most beneficial instrument (feasibility: Md = 8, IQR = 6-10; usefulness: Md = 9, IQR = 7-10). Hierarchical linear regression revealed that only recruitment site (dermatological office vs. clinic) was significantly associated with usefulness and feasibility (higher ratings for clinical context; βs = 0.149-0.258, ps <0.05; except feasibility for EQ5d, β = ns). PROMs are welcomed by patients, while physicians consider instruments measuring pruritus intensity and impairment of quality of life as beneficial for the clinical routine. Widespread implementation of PROMs in daily clinical work is needed to improve care.

The need for a change in medical research thinking. Eco-systemic research frames are better suited to explore patterned disease behaviors.

Many practicing physicians struggle to properly evaluate clinical research studies - they either simply do not know them, regard the reported findings as 'truth' since they were reported in a 'reputable' journal and blindly implement these interventions, or they disregard them as having little pragmatic impact or relevance to their daily clinical work. Three aspects for the latter are highlighted: study populations rarely reflect their practice population, the absolute average benefits on specific outcomes in most controlled studies, while statistically significant, are so small that they are pragmatically irrelevant, and overall mortality between the intervention and control groups are unaffected. These observations underscore the need to rethink our research approaches in the clinical context - moving from the predominant reductionist to an eco-systemic research approach will lead to knowledge better suited to clinical decision-making for an individual patient as it takes into account the complex interplay of multi-level variables that impact health outcomes in the real-world setting.

Clinical predictive value of the age, creatinine, and ejection fraction score in patients in acute type A aortic dissection after total arch replacement

The age, creatinine, and ejection fraction (ACEF) score has been accepted as a predictor of poor outcome in elective operations. This study aimed to investigate the predictive value of ACEF score in acute type A aortic dissection (AAAD) patients after total arch replacement. A total of 227 AAAD patients from July 2021 and June 2022 were enrolled and divided into Tertiles 1 (ACEF ≤ 0.73), Tertiles 2 (0.73 < ACEF ≤ 0.95), and Tertiles 3 (ACEF > 0.95). Using inverse probability processing weighting (IPTW) to balance the baseline characteristics and compare the outcomes. Cox logistic regression was used to further evaluate the survival prediction ability of ACEF score. The in-hospital mortality was 9.8%. After IPTW, in the baseline characteristics reached an equilibrium, a higher ACEF score before operation still associated with higher in-hospital mortality. After 1 year follow-up, 184 patients (90.6%) survival. Multivariable analysis revealed that ACEF score (adjusted hazard ratio 1.68; 95% confidence interval 1.34–4.91; p = 0.036) and binary ACEF score (adjusted HR 2.26; 95% CI 1.82–6.20; p < 0.001) was independently associated with 1-year survival. In addition, net reclassification improvement (NRI) and integrated differentiation improvement (IDI) verified that the ACEF score and binary ACEF score is an accurate predictive tool in clinical settings. In conclusions, ACEF score could be considered as a useful tool to risk stratification in patients with AAAD before operation in daily clinical work.

Artificial intelligence as a new answer to old challenges in maternal-fetal medicine and obstetrics.

Following the latest trends in the development of artificial intelligence (AI), the possibility of processing an immense amount of data has created a breakthrough in the medical field. Practitioners can now utilize AI tools to advance diagnostic protocols and improve patient care. The aim of this article is to present the importance and modalities of AI in maternal-fetal medicine and obstetrics and its usefulness in daily clinical work and decision-making process. A comprehensive literature review was performed by searching PubMed for articles published from inception up until August 2023, including the search terms "artificial intelligence in obstetrics", "maternal-fetal medicine", and "machine learning" combined through Boolean operators. In addition, references lists of identified articles were further reviewed for inclusion. According to recent research, AI has demonstrated remarkable potential in improving the accuracy and timeliness of diagnoses in maternal-fetal medicine and obstetrics, e.g., advancing perinatal ultrasound technique, monitoring fetal heart rate during labor, or predicting mode of delivery. The combination of AI and obstetric ultrasound can help optimize fetal ultrasound assessment by reducing examination time and improving diagnostic accuracy while reducing physician workload. The integration of AI in maternal-fetal medicine and obstetrics has the potential to significantly improve patient outcomes, enhance healthcare efficiency, and individualized care plans. As technology evolves, AI algorithms are likely to become even more sophisticated. However, the successful implementation of AI in maternal-fetal medicine and obstetrics needs to address challenges related to interpretability and reliability.

Impulsivity, suicide risk and cannabis consumption

IntroductionCannabis is the most widely consumed illegal drug in the world and one of the easiest to access. This drug provides a feeling of well-being and euphoria. However, frequent consumption is associated with several complications including increased impulsivity and an increased risk of suicidal behaviour.ObjectivesOur objective was to study the link between cannabis consumption, impulsivity and suicide intentionality.MethodsWe conducted a cross-sectional study, during the period from September 2020 to October 2021, among cannabis users consulting the Sfax Detoxification Center in Tunisia. Impulsivity was studied using the Barrat Impulsivity Scale (BIS 15) and suicide intentionality was assessed using the Suicide intent scale Beck; Pierce (SIS) in subjects with history of a suicide attempt.ResultsWe included 38 consumers. The average age is 26 years old and the sex ratio was 8.5 with an over-representation of men. The average BIS15 score was 38.2 ranging between 19 and 45. We have demonstrated that the higher the level of cannabis dependence, the higher the level of impulsivity. A high level of impulsivity was found in younger subjects (p=0,04) and with a low socio-economic level and unemployment (p =0,021). Suicidal intentionality, assessed in 10 patients with a history of suicide attempt, was low and intermediate in 40% and 60% of users respectively, which means a low to intermediate risk of subsequent completed suicide.Conclusions Impulsivity is associated with aggressive behaviour, various accidents including motor vehicle accidents, more self-mutilation and a much greater risk of dying by suicide than the general population. Frequent cannabis use is also associated with increased risk of developing all types of suicidal behaviours independently of the existence of depressive symptomatology. Overall, it is important to take into account the issues of impulsivity and substance abuse in daily clinical work as they influence the level of dangerousness.Disclosure of InterestNone Declared

Exploring the interplay of discourses, jurisdictions and restratification in medicine and the implications for intraprofessional collaboration

This study builds on calls to explore the tensions and dynamics of intraprofessional collaboration and boundary work. It reaches beyond the literature describing the micro-level strategies deployed by physician subgroups to establish legitimacy and defend jurisdictions in the face of health care re-organization. Specifically, it offers a view of how macrosocial imperatives shape intraprofessional boundaries, relations, and the possibilities for collaboration. Drawing on empirical data from a case study of intraprofessional collaboration in caring for patients with diabetes - a clinical context in which patients commonly receive care from family physicians (FPs) and specialist physicians (SPs) – Foucault's concept of governmentality and the sociology of the professions are employed to make visible the sociohistorical construction of intraprofessional collaboration within discourses of evidence-based medicine, and its implications for the [re-]negotiation of professional jurisdictions and restratification of the medical profession. This analysis contributes to the intraprofessional literature through two analytical moves. First, it outlines the discursive mechanisms through which the meso-level deployment of the referral-consultation process provides an arena for SPs to maintain and reinforce their position of influence at both the micro-level of daily clinical work and across broader health care delivery. Second, it provides an understanding of how the transmission of governmental rationality in diabetes occurs through the social relations between SPs and FPs, making the restratification of medicine possible without tension or conflict.

Standardized and quality-assured predictive PD-L1 testing in the upper gastrointestinal tract. German version

As aresult of the high approval dynamics and the growing number of immuno-oncological therapy concepts, the complexity of therapy decisions and control in the area of carcinomas of the esophagus, gastroesophageal junction and stomach is constantly increasing. Since the treatment indication for PD‑1 inhibitors that are currently approved in the European Union is often linked to the expression of PD-L1 (programmed cell death-ligand1), the evaluation of tissue-based predictive markers by the pathologist is of crucial importance for treatment stratification. Even though the immunohistochemical analysis of the PD-L1 expression status is one of the best studied, therapy-relevant biomarkers for an immuno-oncological treatment, due to the high heterogeneity of carcinomas of the upper gastrointestinal tract, there are challenges in daily clinical diagnostic work with regard to implementation, standardization and interpretation of testing. An interdisciplinary group of experts from Germany has taken aposition on relevant questions from daily pathological and clinical practice, which concern the starting material, quality-assured testing and the interpretation of pathological findings, and has developed recommendations for structured reporting.

Concept of green dentistry in Serbia

Introduction/Objective. Green dentistry as a term has been introduced into dental practice in Serbia in recent years. Minimal amount of research on the topic of medical waste disposal in health care institutions is available at the moment. The aim of this research is to determine how familiar the professional public as well as dental students are with this term and whether they apply the recommended environmental protection measures in their daily clinical work. Methods. The study was conducted in the form of a survey that referred to the attitude of the professional public regarding environmentally friendly dental practice, in the period from June 1, 2022 until November 1, 2022. The survey includes demographic information, as well as 21 questions related to awareness and application of green dentistry in daily clinical practice. Results. Results indicate a very low level of information among the professional public regarding the mentioned concept, where as much as 36% of the total number of respondents do not have any information about green dentistry (n = 45) and only 6% (n = 8) are fully informed about the given concept. Conclusion. On the basis of the obtained results, it can be concluded that the professional public?s attitude towards green dentistry is such that its application is expected to reduce the consumption of available resources, as well as to improve the environment.

Awareness and usage of mobile applications as an orthodontic diagnostic tool among Croatian orthodontic clinicians.

To assess the impact of gender and orthodontic qualification length on the awareness, knowledge and usage of orthodontic diagnostic mobile applications, non-diagnostic mobile applications and social media platforms among orthodontic clinicians. Cross-sectional questionnaire-based study. The Republic of Croatia. A total of 92 orthodontic specialists, members of the Croatian Dental Chamber. This study was conducted using a questionnaire distributed via email to orthodontic clinicians between May and July 2022. In total, 92 respondents were divided into groups according to sex and median orthodontic qualification length: more recently qualified (MRQ) with ⩽12 years; and longer qualified (LQ) with >12 years. Nearly one-third of respondents did not have any prior knowledge of mobile applications used as an orthodontic diagnostic tool. MRQ respondents were more interested in using mobile apps as opposed to computer software for digital analysis (P < 0.05). This interest was in a negative correlation with orthodontic qualification length (P < 0.01) and was more prevalent among female respondents (P < 0.001). About one-third (32.6%) of respondents did not use non-diagnostic mobile applications and 44.6% did not use social media platforms. Nearly two-thirds (62%) of the respondents did not promote their work through social media. Male respondents and LQ promoted their work more frequently than others (P < 0.05). The usage of other mobile applications was in a positive correlation with the knowledge and awareness of orthodontic mobile applications (P < 0.05). Orthodontic clinicians lacked knowledge, awareness and the usage of orthodontic diagnostic mobile applications according to sex and orthodontic qualification length. One-third used non-diagnostic mobile applications and less than half used social platforms in daily clinical work.

Carpal Tunnel Syndrome and SLAC: Implications for Oro-Dentists and Cranio-Maxillo-Facial Surgeons

Scapholunate Advanced Collapse (SLAC) is a progressive condition that can cause wrist pain and functional impairment. This condition often results from injury to the scapholunate ligament, which connects two important bones in the wrist. While SLAC can affect anyone, it is particularly relevant to dentists and maxillofacial surgeons due to the repetitive hand and wrist motions associated with these professions. In addition, Carpal Tunnel Syndrome (CTS), a common neurological disorder that occurs when the median nerve becomes pressed or squeezed at the wrist, is another occupational hazard that can impact dental and surgical professionals. Given the considerable prevalence and sensing that awareness among dental students and surgeons is subpar, alongside the lack of studies investigating such issues, this personal experience-based editorial briefly explores the etiology, classification, diagnosis, and available treatment options for SLAC and CTS, principally, with the dental and maxillofacial professional on mind, to communicate significance and emphasize the importance of implementing proper ergonomics, frequent short stretch breaks and regular strengthening exercise into our daily clinical and surgical work habits; a step towards a real paradigm shift to prevent chronic pain. It can also serve as a valuable and distinct resource for healthcare professionals dealing with SLAC and CTS, accompanying challenges and emphasizing the importance of early detection and adaptation in patient care and surgical techniques. In the demanding fields of dentistry and maxillo-facial surgery, where precision and dexterity are paramount, we perform intricate procedures that require the use of our hands and wrists for long periods of time. Alas, the repetitive motions and awkward postures associated with these procedures can lead to a painful and debilitating condition known as CTS. In addition, recent studies have suggested that SLAC, a degenerative condition of the wrist joint, may increase the risk of developing CTS (more severe form), an ongoing spectre experienced by the author himself.

Train-the-trainers intervention for national capacity building in infection prevention and control for COVID-19 in Nigeria

BackgroundThe first case of COVID-19 in Nigeria was reported on February 27, 2020, and over time, spread across the country leading to many healthcare worker infections. The risk of transmission of COVID-19 within healthcare facilities makes it necessary to establish infection prevention and control measures. The World Health Organisation supported the Nigeria Centre for Disease Control to conduct a train-the-trainers workshop on infection prevention and control for key healthcare workers across Nigeria. Aim/ObjectivesThis study aims to describe the process and results of train-the-trainers as an intervention for national capacity building in infection prevention and control for COVID-19 among healthcare workers in Nigeria. MethodsEight-hour sessions were held over three days with face-to-face instruction and practical hands-on experience in April 2020. A total of 61 healthcare workers participated across the six geographic zones of Nigeria: North Central, North East, North West, South West, South East, and South South. The training included slide presentations, case-based scenarios, and practical hands-on sessions with plenary discussions. Pre- and post-test assessments were used to evaluate knowledge of COVID-19, triage, and infection prevention and control among healthcare workers. Finding/Results69 % (42) of the participants were male 31 % (19) were female, and the majority (67 %) were medical doctors. Others attending were nurses or health administrators. Of the 70 % (26) of the states with existing infection prevention and control structures within the COVID emergency response, only 40 % were functional. The average percentage of pre-test and post-test scores were 60.8 ± 13.4 and 67.8 ± 9 0.3 respectively, showing a statistically significant difference (p > 0.001) in trainee knowledge. Additionally, 70 % of participants evaluated the training workshop as “satisfactory” or higher in training format, relevance for daily clinical work, active participation, learning new concepts, and logistics. ConclusionNationwide infection prevention and control training is feasible during a national health crisis. Infection prevention and control is cardinal in the containment of epidemic-prone diseases like COVID-19 and is invaluable in the prevention of healthcare-associated infections in healthcare settings.

Standardized and quality-assured predictive PD-L1 testing in the upper gastrointestinal tract.

As a result of the high approval dynamics and the growing number of immuno-oncological concepts, the complexity of treatment decisions and control in the area of cancers of the esophagus, gastroesophageal junction and stomach is constantly increasing. Since the treatment indication for PD-1 inhibitors that are currently approved in the European Union is often linked to the expression of PD-L1 (programmed cell death-ligand 1), the evaluation of tissue-based predictive markers by the pathologist is of crucial importance for treatment stratification. Even though the immunohistochemical analysis of the PD-L1 expression status is one of the best studied, therapy-relevant biomarkers for an immuno-oncological treatment, due to the high heterogeneity of carcinomas of the upper gastrointestinal tract, there are challenges in daily clinical diagnostic work with regard to implementation, standardization and interpretation of testing. An interdisciplinary group of experts from Germany has taken a position on relevant questions from daily pathological and clinical practice, which concern the starting material, quality-assured testing and the interpretation of pathological findings, and has developed recommendations for structured reporting.

Healthcare costs associated with opportunistically identifiable vertebral fractures.

Vertebral fractures (VFs) are often available on radiological imaging undertaken during daily clinical work, yet the healthcare cost burden of these opportunistically identifiable fractures has not previously been reported. In this study, we examine the direct healthcare costs of subjects with vertebral fractures available for identification on routine CT scans. Thoracolumbar vertebral fractures were identified from 2000 routine CT scans. Subjects with VF on the scan were matched 1:2 against subjects with no VF on the scan, and similarly in a 1:3-ratio against a general population cohort. We excluded those subjects who received treatment with osteoporosis medication(s) in the year prior to baseline. Direct healthcare costs, identified from the national Danish registers, were accrued over up to 6years of follow-up, and reported per day at risk and per year. In subjects undergoing a CT scan, costs were initially high, yet declined over time. Comparing subjects with prevalent vertebral fracture (n=321) against those subjects with no vertebral fracture (n=606), mean total healthcare costs per day at risk was numerically higher in the first three years after baseline, while healthcare costs per year were similar between the cohorts. No differences reached statistical significance. When compared to the general population cohort, costs were significantly higher in the vertebral fracture cohort. Subjects with vertebral fractures available for identification on routine CT scans incur substantially higher healthcare costs than matched subjects representing the general population, and numerically, albeit non-significantly, higher healthcare costs per day at risk in the short term, as compared to subjects with no visible VF on the CT scan.

Understanding Gut Sensations: Irritable Bowel Syndrome and Diagnostic Fluidity in Danish Clinical Practice

ABSTRACT Irritable bowel syndrome (IBS) is a prevalent health challenge in a Danish welfare context. Drawing on ethnographic fieldwork at two Danish gastroenterology clinics, and inspired by Charles E. Rosenberg’s idea of styles of explaining widespread diseases, we outline three styles of understanding and treating gut trouble in daily clinical work: “The microbial gut,” “the mindful gut,” and “the lifestyled gut.” Moreover, we suggest the concept of fluidity to characterize IBS as a diagnostic category that allows clinicians and patients to operate through complex understandings of permeable boundaries between body, mind, and environment to negotiate personalized solutions for embodied gut sensations.

Teaching intercultural communication skills in healthcare to improve care for culturally and linguistically diverse patients

ObjectiveTo provide recommendations for adequately training healthcare providers in intercultural communication skills. DiscussionWe discuss three main recommendations concerning intercultural communication skills training. First, we give an overview of the fundamental skills in which healthcare providers should receive training, such as self-awareness and adaptability. Second, we briefly discuss how such training should be delivered, and focus on different language support methods, including those that work with different types of interpreters and digital tools. Third, we discuss how within-group differences can be taken into account to prevent stereotyping. To illustrate these recommendations, we provide certain examples of existing good practices and interventions. ConclusionIn today’s superdiverse societies, delivering culturally and linguistically sensitive healthcare tailored to the needs, values, and preferences of individual patients is a prerequisite for good quality healthcare communication. To achieve this goal, there is a need for clearer recommendations for affirmative action, guidelines, policy, and support for the topic of diversity sensitivity in healthcare, such as evidence-based interventions, than is currently the case. That is, structural changes on a system level are urgently needed to support healthcare providers to implement diversity sensitivity in their daily clinical work.

Importance of interdisciplinarity in modern oncology: results of a national intergroup survey of the Young Oncologists United (YOU).

Modern, personalized treatment concepts in oncology require an interdisciplinary and multiprofessional collaboration. In addition to its relevance in patient care, interdisciplinary collaboration is also becoming increasingly important in clinical research as well as medical education and resident training in oncology. Between November 2021 and March 2022, an online survey was conducted among German early career research groups, represented by Young Oncologists United (YOU). The aim was to identify the status and need for interdisciplinarity at clinic, educational, and research levels. A total of 294 participants completed the questionnaire in full. 90.7% of the respondents fully or predominantly agreed with the statement that interdisciplinary work plays a major role in their daily clinical work. 78.9% wished for more interdisciplinary collaboration. Of the 49.7% of participants who have never participated in an interdisciplinary research project, 80.1% said they would like to participate in such a study project in the future. Lack of time resources, too much organizational effort, and possible political conflicts between institutions were identified as factors that make practical implementation difficult. 74.1% declared their willingness to become active in an oncology early career research group. Interdisciplinary collaboration has become increasingly important in oncology. Networks that span different disciplines could help to promote interdisciplinary research projects among young scientists and improve exchange in professional practice and education with the implication of improved patient care.