Medical Colleagues Research Articles

What's Important: Applying to Orthopaedic Surgery as a Member of the LGBTQ Community.

During the first day of my orthopaedic subinternship last summer, I was excited to finally be back in the operating room. Before the case began, the surgeon briefly left the room while I stayed to get things ready. It was then that I heard disparaging remarks from OR staff about the patient, who had only gone under anesthesia seconds before. The patient was transgender, and several staff in the room were ridiculing her appearance and gender expression. I was horrified. But, worried about reprisals, I did nothing. Later, ashamed of my inaction, I became more cognizant than ever of the need for LGBTQ (lesbian, gay, bisexual, transgender, queer) representation in all medical specialties—but especially in those, such as orthopaedics, where it is so lacking. Orthopaedic surgery is often regarded as among the least diverse medical specialties. A recent analysis of the Association of American Medical Colleges graduating students survey showed that orthopaedic surgery was miles behind other specialties in LGBTQ representation1. As a gay man, I felt intimidated during the residency application process. Would I be able to find an open and accepting program that valued who I am and recognized my potential? At the time, I was not aware of a single orthopaedic surgeon identifying as LGBTQ; I certainly didn’t have access to a mentor who was also queer. Some might argue that such concerns are overblown. However, it is commonly recognized that the ranks of women and underrepresented minorities in the field lag far behind other specialties2. How then does a person find a program they can be sure will align with their values? Luckily, I had excellent mentors—although they were all straight—who coached me on application strategies. One recommended that I embrace my sexual identity and use it as a selling point, but another suggested that I apply like any other applicant and use my position to change the system from the inside out. Both advised that more accepting programs could be found in bigger cities. It appears that our field is attempting to make changes with respect to diversity. Orthopaedic societies that focus on diversifying the field, including the Ruth Jackson Orthopaedic Society and the J. Robert Gladden Orthopaedic Society, have made tremendous strides for female and Black practitioners. However, to my knowledge, no such organizations exist for queer orthopods. Furthermore, orthopaedic surgeon census data, which include gender and race, often omit sexual orientation. One silver lining of the pandemic is the increased emphasis on social media for resident recruitment. I paid close attention to the content that programs chose to highlight in their posts. Putting diversity efforts and social justice front and center suggested to me that a program would be more likely to be accepting. Conversely, a dearth of residents or faculty members of marginalized genders, sexualities, and racial groups in the resident classes or on faculty was a red flag. Obviously, when a program had an LGBTQ resident or faculty member, I immediately felt more comfortable applying there. But those instances were few. Language, too, can be a powerful signal. I found that the way programs communicated could give me helpful clues into their priorities. Using gender-neutral language—such as “partner” instead of “husband” or “wife”—made me feel safer and more welcomed. There is a certain hospitality in introductions, or even email signatures, that contain pronoun designations. I also noticed that many programs featured statements on their websites citing their commitment to diversity. It was a nice thought, and it would have been nicer had they all mentioned sexual and gender identity, but most of them did not. Orthopaedics needs big changes3,4, but making it more hospitable to LGBTQ people can start with these littlest tweaks. I urge all medical colleagues and staff to maintain a zero-tolerance policy when it comes to discriminatory language or behaviors. Our colleagues will follow our lead, and our patients will benefit tremendously. Orthopaedic surgeons need to be ready to care for all patients, and tending effectively to a diverse community requires a diverse corps of providers. Recruiting and welcoming more sexual and gender minorities into the field—as well as brushing up on the care needs of these populations5,6—will create a world in which the sort of transphobia I witnessed in the OR during my subinternship is a thing of the past. I’ve seen glimpses of this world already. I remember, during a separate subinternship, that one of the attending surgeons I worked with wore a rainbow-colored lanyard. That small action made me feel comfortable enough to put a rainbow flag pin on my own lanyard. And I remember the gratifying feeling of a young LGBTQ patient in clinic who told us, with tears in her eyes, “I like your lanyards. Thank you.”

Interdisciplinary Approach Involving Medical Colleagues in Managing Periodontitis Patient with Type 2 Diabetes: A Case Report

Introduction: Diabetes mellitus has been recognized as a systemic risk factor for periodontitis. Success in controlling periodontitis requires interdisciplinary solutions involving medical counterparts. Case report: This case report highlights the importance of a bidirectional communication between medical and periodontal specialist in the management of a 63-year-old Malay lady patient diagnosed with Generalized Periodontitis, Stage IV and Grade C. The outcome of the interdisciplinary approach was both the stabilization of her periodontal conditions and medically, the glycated haemoglobin level. Conclusions:The bidirectional communication between medical and periodontal specialist is as important as managing the patients medically for a holistic treatment approach of an uncontrolled diabetic patient.

Career satisfaction of German human genetics residents.

The aim of this survey was to investigate the career satisfaction of human genetics residents in Germany and to analyse the influence of intrinsic and extrinsic factors. We developed an online survey for the evaluation of a broad range of factors concerning the situation of human genetics residents in Germany using validated questionnaires and adding human genetics specific items to them. Human genetics residents working at institutions with an authorization for specialist training were asked to participate in the online survey. To analyse the situation of specialist training in human genetics and the influence of multiple factors on career satisfaction, descriptive statistics, mean descriptive statistics and comparisons of mean values as well as multiple linear regression analyses were carried out. Of the 71 institutions contacted, 41 (58 %) provided feedback and reported the number of 114 residents in human genetics. In total, 58 residents completed the questionnaire (50.9 %). Overall career satisfaction was high with a mean score of 30.8 (scale ranging from 8-40). Factors significantly influencing career satisfaction were general life satisfaction, occupational self-efficacy expectations and content with the doctors entitled to the specialty training. Except for the reduced perception to achieve their professional goals expressed by women with children, career satisfaction was influenced by neither gender nor parental status, other sociodemographic factors, variables concerning the personal professional life and the residency in general, the subjective perceived workload nor the site of specialist training. Participation in research activities differed significantly between male and female residents. The residents' assessment of their own professional prospects and the prospects of the subject were consistently positive, even though residents consider the current requirement planning by the GB-A for human geneticists as inappropriate and believe that human genetics is not yet firmly anchored as a specialist discipline in the consciousness of other medical colleagues and the general public. Career satisfaction of German human genetics residents is generally high and mainly influenced by life satisfaction, occupational self-efficacy expectations and quality of the specialist training. In contrast to other specialties career satisfaction seems to be independent from gender or parental status even though male residents were significantly more often involved in research activities. In order to keep human genetics residents in the specialty, measures that enable balanced professional and care work as well as continuous improvement of specialist education, e. g. through the implementation of structured curricula and continuing education of the doctors entitled to specialist training, is of great importance.

Patterns of Cardiac Rupture in Blunt Cardiac Injuries and Coronary Artery Disease: A Retrospective Autopsy Study

Cardiac rupture is the most severe form of blunt chest injury and coronary artery disease and that leads to a devasting medical emergency, Becker and colleagues identified three types of myocardial rupture, in Govt Stanley medical college and hospital, 2017-2019 cases with the postmortem findings and hospital records suggestive of cardiac rupture, were studied retrospectively and the Information were collected and analyzed. In the retrospective study population 426 cases had blunt chest trauma in that cardiac rupture seen in 28 cases amongst Becker type I rupture seen in 26 cases and type II rupture seen in 2 cases. Amongst 792 cases of coronary artery disease with myocardial infarction 13 cases had cardiac rupture in that Beckers type I rupture noted in 5 cases and type II were noted in 8 cases. Beckers type III rupture cases were not presented in the retrospective study population. Male cases were predominantly seen in both blunt chest injuries and in coronary artery disease and most of the cases were in the age group of 31-60 years. Among blunt chest injury traffic accidents were most common cause for cardiac rupture and in coronary artery disease left anterior descending artery occlusion was the most common cause for cardiac rupture, In the present study it has been proved that a diseased heart is more susceptible to traumatic injury than a normal one. The diseased heart is more likely to rupture at the fragile myocardium sites ,The presence of fatal cardiac trauma in head on collision cases emphasizes the utility of safety belts while driving. The present study is undertaken to identify the exact pathophysiology and bio mechanism of cardiac rupture

Aortic Dissection Auxiliary Diagnosis Model and Applied Research Based on Ensemble Learning.

Aortic dissection (AD), a dangerous disease threatening to human beings, has a hidden onset and rapid progression and has few effective methods in its early diagnosis. At present, although CT angiography acts as the gold standard on AD diagnosis, it is so expensive and time-consuming that it can hardly offer practical help to patients. Meanwhile, the artificial intelligence technology may provide a cheap but effective approach to building an auxiliary diagnosis model for improving the early AD diagnosis rate by taking advantage of the data of the general conditions of AD patients, such as the data about the basic inspection information. Therefore, this study proposes to hybrid five types of machine learning operators into an integrated diagnosis model, as an auxiliary diagnostic approach, to cooperate with the AD-clinical analysis. To improve the diagnose accuracy, the participating rate of each operator in the proposed model may adjust adaptively according to the result of the data learning. After a set of experimental evaluations, the proposed model, acting as the preliminary AD-discriminant, has reached an accuracy of over 80%, which provides a promising instance for medical colleagues.

Incidence Picture of Early Loss of Primary First Molar Teeth in 6-9 Year Old Children in Dental Hospital of Jember University

Premature loss of primary teeth is a condition where primary teeth are lost before the replacement teeth approach eruption due to caries, trauma and systemic conditions. Premature date can lead to a reduction in the length of the dental arch and migration of the opposing teeth leading to rotation, crowding and impaction of the permanent teeth. The purpose of the study: to describe the incidence picture of early loss of primary first molar teeth in 6-9 year old children in dental hospital of Jember University. The type of research carried out in this study was descriptive observational with a cross sectional approach. The research data showed that there were 42 medical records of pediatric patients aged 6-9 years. There are 5 medical records for patients aged 6 years, 15 data for medical colleagues for patients aged 7 years, 16 medical records for patients aged 8 years, and 6 medical records for patients aged 9 years. The percentage incidence of premature date of the maxillary right primary first molar was 11.9%, the premature date of the maxillary left first molar was 9.5%, while the mandibular left first primary molar had a premature date of 7.1%, and in the premature date of the mandibular right primary first molar was 19.05%. The conclusion from the results of this study is that the incidence of premature first molar dates in children aged 6-9 years at RSGM UNEJ in 2020 is most commonly found in the mandibular right first molar at 19.05%

A multidisciplinary, cross-sectional survey of burnout and wellbeing in emergency department staff during COVID-19

BackgroundEmergency department (ED) staff are at-risk of burnout, poor wellbeing and increased stress that can impact patient satisfaction, staff morale and retention. The aim of this survey was to determine level of burnout, stress and satisfaction with current employment role in ED during COVID-19. MethodsA multisite cross-sectional survey captured ED employment data, wellbeing, burnout (Maslach Burnout Inventory), stress (Health Professions Stress Inventory), work environment (WES-10) and Caring for COVID-19 Patients questions. ResultsThe response rate of 44.2% (n = 177) represented all healthcare disciplines. Only 58.8% (n = 104) of participants were happy in their role, satisfaction was low, burnout was high (M 71.0, SD 17.1) as was level of stress (M 90.6, SD 16.5). Nurses and allied health staff were more stressed than their medical or support staff colleagues. Participants perceived discriminatory behaviours from friends and family in caring for suspected or infected COVID-19 patients. ConclusionsED staff are a vulnerable group. Programmes to promote wellbeing, personal resilience, and self-care together with personal and professional growth are needed to build individual capability and a culture of organisational resilience, particularly in the context of the COVID pandemic.

Is there consensus on the perioperative management of Xa inhibitors in patients undergoing elective spine surgery?-A survey of current spine surgeon practices.

Factor Xa inhibitors (Xai) are an increasingly common consideration in perioperative anticoagulation management. However, there no existing guidelines established for use in Spine Surgery. This survey study aims to capture current practice trends regarding the perioperative management of Xai among spine surgeons. An 11-question survey was sent to all surgeon members of 3 spinal surgery societies. Responses were remitted anonymously. Questions characterized the background and experience of the respondent and inquired into their current perioperative Xai and other anticoagulant management. Questions were all single-best option, multiple-choice. A total of 116 surveys were received. Twenty-six (22.4%) were from neurosurgeons and 90 (77.6%) were from orthopedic surgeons. Practiced preoperative Xai hold length tended to be longer than recommended by the respondent's medical colleagues. Only 65.2% (P≤0.0001) of respondents practiced in agreement with the recommendations of their medical colleagues. Postoperative Xai holds trended toward longer holds than that of other anticoagulants with 37.9% (P=0.0125) of respondents showed differences within their own practice between length of Xai hold and length of other anticoagulant holds. One out of four respondents reported noticing a change in the rate of perioperative bleeding complications among Xai patients. Despite reported increased bleeding issues, only 39% of those who noted this increase in bleeding complications reported they would hold a Xai longer than other anticoagulants. There exists a wide range of recommended and practiced chronic anticoagulant hold lengths. This inconsistency likely highlights conflicting risk aversion among surgeons, between complications which are viewed as medical (i.e., thromboembolism and stroke) vs. surgical (i.e., compressive hematoma). Yet, survey responses suggest the length of Xai hold times did not necessarily reflect the surgeon's experience with postoperative bleeding complications in Xai patients. These inconsistent practices highlight the need for further research that can establish guidelines for perioperative management of Xai patients undergoing spine surgery. Anticoagulants; factor Xa inhibitors (factor Xai); spine; orthopedic surgery; neurosurgery.

Physicians' Attitudes Toward Prescribable mHealth Apps and Implications for Adoption in Germany: Mixed Methods Study.

BackgroundIn October 2020, Germany became the first country, worldwide, to approve certain mobile health (mHealth) apps, referred to as DiGA (Digitale Gesundheitsanwendungen, in German, meaning digital health applications), for prescription with costs covered by standard statutory health insurance. Yet, this option has only been used to a limited extent so far.ObjectiveThe aim of this study was to investigate physicians’ and psychotherapists’ current attitudes toward mHealth apps, barriers to adoption, and potential remedies.MethodsWe conducted a two-stage sequential mixed methods study. In phase one, semistructured interviews were conducted with physicians and psychotherapists for questionnaire design. In phase two, an online survey was conducted among general practitioners, physicians, and psychotherapists.ResultsA total of 1308 survey responses by mostly outpatient-care general practitioners, physicians, and psychotherapists from across Germany who could prescribe DiGA were recorded, making this the largest study on mHealth prescriptions to date. A total of 62.1% (807/1299) of respondents supported the opportunity to prescribe DiGA. Improved adherence (997/1294, 77.0%), health literacy (842/1294, 65.1%), and disease management (783/1294, 60.5%) were most frequently seen as benefits of DiGA. However, only 30.3% (393/1299) of respondents planned to prescribe DiGA, varying greatly by medical specialty. Professionals are still facing substantial barriers, such as insufficient information (1135/1295, 87.6%), reimbursement for DiGA-related medical services (716/1299, 55.1%), medical evidence (712/1298, 54.9%), legal uncertainties (680/1299, 52.3%), and technological uncertainties (658/1299, 50.7%). To support professionals who are unsure of prescribing DiGA, extended information campaigns (1104/1297, 85.1%) as well as recommendations from medical associations (1041/1297, 80.3%) and medical colleagues (1024/1297, 79.0%) were seen as the most impactful remedies.ConclusionsTo realize the benefits from DiGA through increased adoption, additional information sharing about DiGA from trusted bodies, reimbursement for DiGA-related medical services, and further medical evidence are recommended.

Palliative Care in Neurology

Palliative Care in Neurology Abstract. Neurology as a discipline clearly overlaps with palliative care. Nevertheless, an early integration of palliative care accompanying neurological treatment rarely takes place, and there are still misunderstandings with regard to the timing of the inclusion of palliative care and its role beyond pure end-of-life care and hospice care. A further expansion and use of synergies should become an integral part of both disciplines in the coming years, and training should focus on appropriate training, especially for our young medical colleagues.

Barriers to cross-disciplinary knowledge flow: The case of medical education research.

IntroductionThe medical education research field operates at the crossroads of two distinct academic worlds: higher education and medicine. As such, this field provides a unique opportunity to explore new forms of cross-disciplinary knowledge exchange.MethodsCross-disciplinary knowledge flow in medical education research was examined by looking at citation patterns in the five journals with the highest impact factor in 2017. To grasp the specificities of the knowledge flow in medical education, the field of higher education was used as a comparator. In total, 2031 citations from 64 medical education and 41 higher education articles published in 2017 were examined.ResultsMedical education researchers draw on a narrower range of knowledge communities than their peers in higher education. Medical education researchers predominantly cite articles published in health and medical education journals (80% of all citations), and to a lesser extent, articles published in education and social science journals. In higher education, while the largest share of the cited literature is internal to the domain (36%), researchers cite literature from across the social science spectrum. Findings suggest that higher education scholars engage in conversations with academics from a broader range of communities and perspectives than their medical education colleagues.DiscussionUsing Pierre Bourdieu’s concepts of doxa and field, it is argued that the variety of epistemic cultures entering the higher education research space contributes to its interdisciplinary nature. Conversely, the existence of a relatively homogeneous epistemic culture in medicine potentially impedes cross-disciplinary knowledge exchange.Supplementary InformationThe online version of this article (10.1007/s40037-021-00685-6) contains supplementary material, which is available to authorized users.

Constructing the advanced nurse practitioner identity in the healthcare system: A discourse analysis.

To explore how Advanced Nurse Practitioners (ANP) are positioned within current nursing and health system structures in Ireland by making explicit the discourses that construct ANPs' identities and how they both enable and constrain their roles. Ambiguity and confusion characterize debates about the ANP role having a profound impact on ANP identity and how they realize their roles. Without clear definitions, boundaries are difficult to ascertain, the full potential of the ANP is not realized and, consequently, ANPs are underutilized. Although this study is relevant outside Ireland's borders, it is of particular concern in the Irish setting as current policy aims to increase ANP numbers. A qualitative discourse analysis using Gee's Tools of Inquiry. Data were collected between April 2019 and January 2020 through seven in-depth interviews and four focus groups and analysed using Gee's Tools of Inquiry. Participants included ANPs, nurses, doctors and allied healthcare professionals. Five key discourses emerged. Language-in-use established, first, that ANPs add value to the healthcare system and, second, highlighted the centrality of nursing to ANPs' identity. The third discourse builds an educated and skilled identity for ANPs, one that, however, lacked the expertise and influence of their medical colleagues. The fourth discourse constructs an identity for ANPs as medical substitutes, lesser roles, yet innovative additions to the system and a threat to existing structures. The final discourse constructs tensions between independence and autonomy, on the one hand, and control, on the other. This study alerts healthcare professionals to ways in which discourses influence opinion and frame ANPs' identity. Healthcare professionals should challenge Conversations and Discourses that disparage the ANP role. ANPs need to clearly articulate their role, the value that it adds to the healthcare system and demonstrate how it aligns with and complements other healthcare professionals' roles. By identifying and critiquing extant Discourses and Conversations, healthcare professionals, and health system leaders and managers will gain a better understanding of the issues that both enable and constrain the ANP role.

Supporting a patient with fibromyalgia in general practice

Catherine is an advanced nurse practitioner working alongside her medical colleagues in a large general practice in the North of England. She receives and treats patients with undifferentiated complaints. She welcomes her patient Louise and her husband Tom.

Cell programming to protect the ischemic heart and limb

New strategies for myocardial protection and regeneration after myocardial infarction are urgently needed to counter the heart failure pandemic. To address this unmet medical need, Kaur and colleagues (in this issue of Molecular Therapy)1 have identified in a preclinical proof-of-concept study a cocktail of modified RNA (modRNA) to endow stromal cells with angiogenic growth factor releasing activity (Figure 1). Sustained angiogenic programming was realized by lipid-nanoparticle (LNP) delivery, using formulations that have been employed safely and efficaciously in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccinations.

Stephen Walter Metcalf

Stephen Walter Metcalf (“Steve”) grew up in London and was proud of his working class background; he attended the William Ellis grammar school. From there, he studied pharmacology and toxicology...

MP12-09 LANGUAGE DIFFERENCES IN LETTERS OF RECOMMENDATION BASED ON GENDER OF LETTER WRITER

You have accessJournal of UrologyEducation Research II (MP12)1 Sep 2021MP12-09 LANGUAGE DIFFERENCES IN LETTERS OF RECOMMENDATION BASED ON GENDER OF LETTER WRITER Asha Sidhu, Samantha Freeman, Priya Dave, Nitya Abraham, and Kara Watts Asha SidhuAsha Sidhu More articles by this author , Samantha FreemanSamantha Freeman More articles by this author , Priya DavePriya Dave More articles by this author , Nitya AbrahamNitya Abraham More articles by this author , and Kara WattsKara Watts More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001985.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Letters of Recommendation (LOR) play an integral role when considering applicants for a position in the medical profession. Applicant gender may influence language used, with studies showing potential disadvantage to female applicants. While many studies have examined how LOR language varies based on applicant gender, few have evaluated this based on LOR writer. We sought to investigate how the gender of the letter writer contributes to differences in LORs. METHODS: LORs written for medical students, residents, or colleagues by our full-time Urology faculty were requested on a voluntary basis as part of a faculty development initiative. Using the licensed text analysis software, Linguistic Inquiry and Word Count program, LOR were analyzed based on 16 word categories. T-tests assuming equal variances were used to compare continuous variables. RESULTS: Fifty-four LOR were voluntarily submitted and analyzed from 8 different full-time Urology faculty, of whom 4 writers were female and 4 were male. There was a significant difference in 3 of the 16 word categories by LOR author gender: Female authors wrote longer LORs (486.1 vs 364.1 words, p= .006) and included more risk (“danger, doubt” p-value = .047) and achieve words (“win, success, better” p-value= .049) than male writers. CONCLUSIONS: Differences in LOR language based on applicant gender have been well-studied, however to date there is a lack of data identifying differences due to the gender of the letter writer. We found gender of the LOR author impacted the length of the letter and the frequency of achieve and risk words. By exposing these differences and increasing awareness of potential subconscious biases observed in linguistic patterns between male and female authors, we hope to identify areas for faculty development that could potentially mitigate the gender disparity gap in medical fields such as urology. Source of Funding: N/A © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e191-e191 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Asha Sidhu More articles by this author Samantha Freeman More articles by this author Priya Dave More articles by this author Nitya Abraham More articles by this author Kara Watts More articles by this author Expand All Advertisement Loading ...

National Infant Screening for Hearing Program in India: Necessity, Significance and Justification.

Hearing impairment is one of the most prevalent disorder in children and adults worldwide, which not only interferes with the acquisition, development and maintenance of speech and language skills but also adversely deprive the auditory nervous system for future learning. It can have long term harmful effect on educational, social, emotional and cognitive skills in young children; restrict the vocational options and employment opportunities in adults; and can cause isolation, loneliness and depression in older adults, if remain undetected and intervened at the earliest. However, early identification and intervention is known to greatly reverse the ill effects and improve the quality of life of children and adults with hearing impairment. Current clinical means and methods to identify and intervene hearing loss are convenient, cost effective, reasonably accurate beneficial and evidenced based, can be easily employed nation-wide for early identification and intervention of hearing loss. This paper attempts to convince medical colleagues, public health care experts and policy makers by justifying the hearing, as public health issue and relevance of medical screening criteria for hearing. It also discusses the preferred model of hearing screening and intervention strategies in India.

Tibetan Medical Paradigms for the SARS-CoV-2 Pandemic

Abstract As prophesized in early Tibetan medical works, the emergence of a pathogen such as SARS-CoV-2 that could inflict such a virulent infectious disease such as COVID-19 provided conditions for an expected yet alarming new phenomenon to threaten the health of inhabitants on the Tibetan Plateau. As SARS-CoV-2 spread into a global pandemic, Tibetan physicians worldwide engaged in symposiums, conferences, and clinical exchanges to situate the virus and its disease within Tibetan medical nosology. They sought to reconcile prophesies of global impact and develop critical treatment protocols for their communities. This article presents this particular perspective on COVID-19 as discussed among Tibetan medical colleagues in early April 2020, with follow-up discussions a year later. It introduces the disease’s nosology as a specific type of virulent infection (gnyan rims), and describes the etiology, diagnosis, and treatment as explicated in the Tibetan classic Four Medical Treatises and related commentaries. As Tibetan physicians gain attention for their treatments of mild- and medium-severity COVID-19 cases, understanding the Tibetan medical paradigm for the condition highlights distinctions of therapeutic and investigative relevance compared to biomedical and other traditional Asian medical approaches.

Implementing a Novel Nursing Site Manager Role in the Pediatric Emergency Department for Patient and Staff Safety During the COVID-19 Pandemic

Implementing a Novel Nursing Site Manager Role in the Pediatric Emergency Department for Patient and Staff Safety During the COVID-19 Pandemic

Radiographers in ultrasound: Motivation and role expansion. A survey of European Federation of Radiographer Societies (EFRS)

IntroductionVariability in non-medical ultrasound practice across Europe has been highlighted in studies. Meanwhile, advanced practice in radiography has undergone rapid development in the United Kingdom (UK). This survey aimed to review results relating to extended role and advanced practice skills, motivation and job satisfaction from a wider survey of radiographers undertaking ultrasound examinations across the European Federation of Radiographer Societies’ (EFRS) community. MethodsFollowing a pilot study, a SurveyMonkey™ on-line questionnaire was disseminated to EFRS member societies to share with their members, and via social media platforms. Quantitative questions for this article related to extended and advanced practice skills, communication of results, job satisfaction, motivation and career development. Theme analysis was used to assess qualitative feedback concerning priorities for future developments within the ultrasound role. ResultsThere were 561 responses, mainly from the UK, Ireland and Spain (81%). The majority (83.4%) of UK sonographers communicate findings to patients, compared with 27.1% in other EFRS countries. More engage with teaching (UK = 90.1%, non-UK 72.9%) compared with activities in the other advanced practice domains. The lowest involvement was the research domain, with only 33% actively involved in research. Radiographers were motivated to undertake ultrasound to develop their knowledge and skills and assume more responsibility. ConclusionWide variations in ultrasound practice were seen across respondent countries. Generally, radiographers are happy with their ultrasound roles, although priorities include legislation for the sonographer role, remuneration, respect or support from medical colleagues, high quality education and role progression opportunities. Implications for practiceThe findings provide a better understanding of radiographer views which can assist radiographer societies and local teams to develop strategies to enhance advanced practice skills development and career prospects in ultrasound.