Years Of Professional Practice Research Articles

Enablers and barriers for implementation of the outpatient intravenous diuretic treatment across NHS Greater Glasgow and Clyde

Abstract Introduction The burden of heart failure is underestimated, and it has a long average inpatient stay. Many healthcare institutions have trialled the outpatient administration of intravenous diuretics, which demonstrated a reduction in hospitalisation, however the reasons for not implementing this service model more widely remain unknown. Aim The aim was to explore the qualitative views on the enablers and barriers for implementation of an outpatient intravenous diuretic service across NHS Greater Glasgow & Clyde. Methods This study was qualitative in design and participants were recruited by convenience sampling from three professional groups: doctors, nurses and pharmacists. Inclusion criteria stipulated at least 10 years of professional practice and current experience within cardiology. We aimed to recruit 12 participants as this is the minimal number needed to deliver saturation of ideas.1 Data was gathered through semi-structured, individual interviews, which were conducted via videoconferencing platform, Microsoft Teams. The interviews were recorded and transcribed. Inductive thematic analysis was undertaken using Braun and Clarke’s six phases, via the NVivo software.2 Approval from the University of Strathclyde Ethics Committee was received. Results Analysis of transcripts generated 6 main themes: system performance (staffing levels, training, inpatient stay and budgetary control, utilisation of healthcare); person factors (experience and satisfaction, physical factors, collaboration, attitude and person-centred care); treatment – procedure (practicalities, governance, referral, treatment effectiveness); environment and technology (hospital environment, designated area, transport); external factors (impact of the pandemic, support from management, vision and innovation); alternative location. Barriers and enablers were interdependent, and some themes featured both, depending on the context. The overall perspective of the service was positive due the impact on system performance and reduction of inpatient stay as well as improved wellbeing of patients related to favourable person factors. Themes, which represented barriers were limited staffing levels and unavailability of a designated area. Discussion/Conclusion Although certain themes identified through this research were expected, they reemphasise the common underpinning interactions within dynamic healthcare systems. Described themes may form an improvement framework, which could be transferrable to other therapeutic areas and aid patient care beyond cardiology. The proposed outpatient diuretic service has potential for development and may bridge a gap between current and future treatment strategies, which supports priorities related to transforming patient care during post-Covid recovery. Barriers and enablers are interdependent and unlikely to be resolved by a single intervention. It was recognized that a whole system approach with the focus on disease prevention as well as wider collaboration are required to broaden the range of available options. It may be achieved by creating more effective partnerships between healthcare settings. The study highlighted the importance of promoting innovation, as the results may narrow the evidence gap in the formation of future care pathways. Data emerging from research may empower healthcare providers to apply innovation to deliver person-centred care in accordance with national priorities. Limitations included small study sample, however the sampling strategy allowed diversity of opinions. Analysis continued until last interview to form the framework, which was not limited by pre-existing models.

Investigating the relationship between post-traumatic stress disorder and personality traits in nurses caring for patients with COVID-19

Introduction: Post-traumatic stress disorder (PTSD) can affect many years of professional practice of nurses and the quality of clinical care. This study aimed to determine the relationship between personality traits and PTSD in nurses in COVID-19 patient care.
 Mateials and Methods: We performed this cross-sectional correlational study on 316 nurses who were selected by random sampling method in 1400. The data collection tools in this study are demographic questionnaires, the Personality Traits Scale (NEO-FFI), and Mississippi Traumatic Stress Disorder Scale. Data were analyzed using PSS22 software, by statistical tests of Spearman and Pearson correlation coefficient, Paired-t test, and Wilcoxon tests. 
 Results: In this study, 13.3% of the nurses had post-traumatic stress disorder. Between subscales of personality traits with female gender, in the order of suffering (p=0.031), eagerness for new experiences (p=0.001), agreeableness (p=0.001), and age groups in the order of suffering (p=0.001), extroversion-introversion (p=0.02), eagerness for new experiences (p=0.001), agreeableness (p=0.02), history of covid-19 in the order of extroversion-introversion (p=0.05) and agreeableness (p=0.071). A significant difference was observed between PTSD with age groups (p<0.05). The dimension of suffering (r=-0.11 p<0.01), eagerness for new experiences (r=0.98 p<0.01), and agreeableness (r=0.57 p<0.01) had a significant relationship with the total PTSD score. 
 Conclusion:  we can control or reduce stress and anxiety by employing nurses with the right personality traits. Developing appropriate training-therapy programs to change and modify personality traits, and training skills to deal with stressful situations is an effective step in reducing PTSD.

Taking or creating control: A qualitative study of uncertainty among novice nurses in ambulance care

IntroductionIn emergency nursing situations, uncertainty may lead to delays, or block a decision which can have devastating consequences for a patient. The ambulance service is a complex clinical environment that often challenges the decision-making capabilities of the professionals, especially novice nurses. Novice nurses’ uncertainty may also lead to unhealthy transitions and turnover. To increase the understanding of how uncertainty affects novice nurses, this study explores novice nurses’ uncertainty during the first year of professional practice in the ambulance service. MethodA qualitative descriptive design was applied using qualitative content analysis of thirteen individual face-to-face semi-structured deep interviews. ResultFrom nine subcategories, three generic categories were derived: Reflections on contextual understanding, Strategies to create control, and Actions to take control. These were combined to form the main category Understanding what and dealing with how, while becoming a confident professional. ConclusionUncertainty is exacerbated by situations that demand rapid decisions or actions. This is especially true of newcomers to a profession. Preparing novices through study programs and encouraging continuous reflection in professional practice may increase resilience and tolerance of uncertainty, as well as benefiting professional development.

Supportive care for cancer-related symptoms in pediatric oncology: a qualitative study among healthcare providers

BackgroundThe aim of this study is to gain insight into the clinical experiences and perceptions that pediatric oncology experts, conventional healthcare providers, and complementary and alternative medicine (CAM) providers in Norway, Canada, Germany, the Netherlands, and the United States have with the use of supportive care, including CAM among children and adolescents with cancer.MethodsA qualitative study was conducted using semi-structured in-depth interviews (n = 22) with healthcare providers with clinical experience working with CAM and/or other supportive care among children and adolescents with cancer from five different countries. Participants were recruited through professional associations and personal networks. Systematic content analysis was used to delineate the main themes. The analysis resulted in three themes and six subthemes.ResultsMost participants had over 10 years of professional practice. They mostly treated children and adolescents with leukemia who suffered from adverse effects of cancer treatment, such as nausea and poor appetite. Their priorities were to identify the parents' treatment goals and help the children with their daily complaints. Some modalities frequently used were acupuncture, massage, music, and play therapy. Parents received information about supplements and diets in line with their treatment philosophies. They received education from the providers to mitigate symptoms and improve the well-being of the child.ConclusionsClinical experiences of pediatric oncology experts, conventional health care providers, and CAM providers give an understanding of how supportive care modalities, including CAM, are perceived in the field and how they can be implemented as adaptational tools to manage adverse effects and to improve the quality of life of children diagnosed with cancer and the families.

Physicians' health care

Introducción: Los programas de las Carreras de Medicina de Córdoba no describen aspectos relacionados al manejo de la relación médico paciente cuando el paciente es un colega. El objetivo principal es describir estos aspectos. Material y métodos: Se realizó un estudio observacional, prospectivo, transversal y analítico. Se envió por email una encuesta validada a médicos de Córdoba, Argentina. Resultados: El 76% de los 225 médicos que respondieron la encuesta no tenía médico de cabecera. Los más jóvenes y quienes atienden en el ámbito público conformaron este grupo (p<0,0002 y p<0,04 respectivamente). El 86,2 % se automedicó en el último año. La automedicación fue más frecuente entre los jóvenes (p<0,0008) y con menos años de ejercicio profesional (p<0,003). Este grupo, independientemente de si trabajaban en ámbito público o privado, es el que siguió trabajando a pesar de cursar alguna patología y aunque podría haber solicitado una licencia por enfermedad. Los médicos de más edad (p<0,0002) y con más de 25 años de ejercicio profesional vivenciaron la asistencia a colegas (p<0,0002). El 74,2% no modificó la atención clínica, pero 82,7% respondió que alguna vez sí se comprometió más de lo habitual. Conclusión: Los médicos jóvenes no poseen médico de cabecera, recurren a automedicación, solicitan menos licencia por enfermedad, aunque la necesiten, y tienen poca experiencia para tratar colegas. Deberían incorporarse contenidos durante la formación de Medicina de grado y posgrado que aborden los riesgos de enfermedad y automedicación en médicos, cómo buscar el mejor cuidado para su propia salud y la del colega.

Influence of the Sanitary, Economic, and Social Crisis of COVID-19 on the Emotional State of Dentistry in Galicia (Spain).

The main objective of this research was to analyze the economic, social, and emotional repercussions among Galician dentists (Spain) as a consequence of the COVID-19 pandemic. A survey was filled out by 347 professionals. After verifying the survey's reliability using Cronbach's alpha = 0.84, the professional activity and emotional state of the participants were assessed based on aspects related to their personal and family data. The economic impact of the pandemic was considerable, and all participants experienced a decrease in income. In total, 72% of the participants considered that working with personal protective equipment (PPE) made their clinical activities difficult, and 60% expressed concern about being infected during their professional practice. Among the professionals, women (p = 0.005), and separated, divorced, or single professionals (p = 0.003) were the most strongly affected. Separated or divorced professionals were the group that most frequently raised the need to make a radical change in their lives. Finally, it was observed that the emotional consequences varied substantially in the lives of these professionals, mainly among female dentists (p = 0.010), separated and divorced men (p = 0.000), and those with fewer years of professional practice (p = 0.021). The COVID-19 pandemic had an economic impact, due to the decrease in the number of patients and hours of attention, as well as an emotional impact, mostly expressed in the form of sleep disorders and stress. The most vulnerable professionals were women and professionals with fewer years of experience.

A cross-sectional survey of non-specialist Australian audio-vestibular clinical practice for traumatic brain injury and rehabilitation.

This study explored non-specialist audiological clinical practice in the context of traumatic brain injury (TBI), and whether such practices incorporated considerations of TBI-related complexities pertaining to identification, diagnosis and management of associated auditory and vestibular disturbances. A cross-sectional online survey exploring clinical practice, TBI-related training and information provision was distributed to audiologists across Australia via Audiology Australia and social media. Fifty audiologists, 80% female and 20% male, participated in this study. Years of professional practice ranged from new graduate to more than 20 years of experience. Clear gaps of accuracy in knowledge and practice across all survey domains relating to the identification, diagnosis and management of patients with auditory and/or vestibular deficits following TBI were evident. Further, of the surveyed audiologists working in auditory and vestibular settings, 91% and 86%, respectively, reported not receiving professional development for the diagnosis and management of post-traumatic audio-vestibular deficits. Inadequate resources, equipment availability and TBI-related training may have contributed to the gaps in service provision, influencing audiological management of patients with TBI. A tailored TBI approach to identification, diagnosis and management of post-traumatic auditory and vestibular disturbances is needed.

Evaluation of the Rami 4.0 architecture course offered by the campus Manaus District Industrial of IFAM

This study aimed to evaluate some fundamental aspects of the course on Rami 4.0 architecture offered by the Campus Manaus Industrial District of IFAM. These aspects include a) the sociodemographic characteristics of the participants to compose their profile (to know the subjects discussed that were most interesting to them and those that are likely to be part of their portfolios of products and services to be offered to their applicants), b) to know the degree of satisfaction with the course, and c) what needs to be done to make the course even better. The data were collected through a mixed questionnaire, prepared and tested specifically for this purpose. The course participants conducted the survey on the right day and time. The sociodemographic results were a) the predominance of young, b) people and adults in the same proportion, c) a predominance of men, d) almost all exercising professional activity, e) the majority graduating for less than ten years, and f) less than five years of professional practice. The explanatory results were that only one had prior knowledge of Rami 4.0, the main reason for taking the course was to gain a new understanding, and the most exciting and most important subject was digital connectivity. The evaluative results satisfied the course and the need to work practically on the contents. The conclusion shows that the course achieved its intended objective: to make the Rami 4.0 architecture known to the participants.

Influenza vaccination in coronavirus times: Primary Care professionals’ intention to get vaccinated in Central Catalonia (VAGCOVID). A cross sectional study

ABSTRACT Influenza vaccination is the main measure of prevention against epidemic flu. Although recommended, vaccination coverage remains low. The lack of knowledge about the evolution of influenza in the context of the SARS-CoV-2 coronavirus pandemic led to the recommendation of influenza vaccination to people at risk and professionals to avoid a greater burden than the one already posed by SARS-CoV-2. The aim of the study is to determine health professionals’ intention to vaccinate against seasonal flu in the 2020-2021 campaign, in the context of the SARS-CoV-2 pandemic, and to analyse the factors that influence it. Cross-sectional study through a structured survey aimed at Primary Care professionals in Central Catalonia. A total of 610 participants responded to the survey, 65.7% of whom intended to get vaccinated against influenza in this campaign, and 11.1% did not know or did not answer. The intention to get vaccinated is associated with the professional category and the number of years of professional practice. The profile of the professionals who intend to get vaccinated against flu includes professionals with a history of vaccination, who participate in on-call duties and perceive that their dependents were at risk of becoming ill. During the SARS-CoV-2 pandemic, although almost two-thirds of the respondents showed a clear intention to get vaccinated against influenza, 11% were doubtful. To improve influenza vaccination uptake among health professionals, strategies need to be devised to target those professionals who are hesitant or reluctant to vaccinate.

Dentist´s attitude and criteria in the diagnosis and treatment of caries lesions: Survey about a clinical case.

BackgroundThe diagnosis of caries, the stage of the disease and the indication of treatment are among the most controversial issues in dentistry. Studies comparing the diagnosis and treatment indication of different professionals show the lack of a unifying criterion in the diagnosis and treatment plan of the disease. The Objectives of this research is to evaluate the attitude of a group of odontostomatologists to a clinical case with lesions compatible with caries, evaluating whether their criteria and attitude in diagnosis and treatment depend on their academic level, years of professional practice, the application of minimal intervention dentistry criteria and the usual practice in conservative restorative treatments. Material and MethodsA survey was applied to dentists registered at the Illustrious Official College of Dentists of the Balearic Islands. The questionnaire was developed by the researchers from a real clinical case. A descriptive statistical analysis was performed of all the generated data and, to evaluate the association between the survey responses and the variables of interest, the χ^2 of independence test was performed. In addition, tests comparing the corresponding proportions were conducted using Fisher’s exact test. ResultsRegarding pit and fissure significant differences were found in the diagnosis in 46 in terms of dentists’ qualifications and in the treatment between the application of minimal intervention dentistry criteria and the usual practice in conservative restorative treatments. No significant differences were found in the other variables analyzed. As regards caries lesions on proximal surfaces, no significant differences were found in the diagnosis or treatment in any of the variables analyzed. ConclusionsThat there is no change in the professional attitude towards the diagnosis and treatment of caries lesions in this group of professionals, having very interventionist criteria and attitudes in all variables analyzed. Key words:Atraumatic restorative treatment, caries detection, demineralization, non-cavitated caries lesions, radiography.

Analysis of the pharmaceutical care activities practiced by private homeopathic pharmacies located in Rio de Janeiro North Zone

The complexity of homeopathic treatment delegates to the Pharmacist the need and the responsibility of pharmaceutical care. This paper had the objective of verifying the practices of pharmaceutical care in homeopathy. The study was conducted in homeopathic pharmacies situated in Rio de Janeiro North Zone, during March and April, 2011, where 15 pharmacists were interviewed, with the help of a semi-open questionary self-administered. For the survey were investigated variables related to pharmaceutical: sex, age, nature of the institution where he graduated, having completed post-graduate and working ties. Information professionals for the pharmaceutical care were collected in 14 questions grouped into three areas: attitudes, perceptions and satisfaction. Attending the ethical aspects, the study was submitted to and approved by the Ethics Committee of University Estácio de Sá. The results demonstrated that 33% of the pharmacists have less than 5 years of professional practice, and 53% are specialists graduated by the Hahnemann’s Institutite of Brasil. All Pharmacists claim to orient patients, mostly during dispensation and through phone contacts. Most pharmacists oriented patients passively and actively. The elderly were pointed as the ones, who most often sought orientation. During dispensation of homeopathic drugs, all patients elicit some orientation. 67% of the pharmacies keep material for pharmaceutical guidance to the patients, usually leaflets. The verbal and written orientation was predominanted on homeopathic pharmacist. Posology and instructions of use for the pharmaceutical form dispensed were described as the most common doubts of the patients. Of all pharmacists interviewed, 67% pointed to self-medication practices in the pharmacy. The questions which measure the position and perception of the pharmacists related to pharmaceutical assistance scored over 3. The question which scored higher was related to the patient trust regarding the pharmacist guidance. We concluded that there was a mobilization on the pharmacists side to overcome obstacles and focus on the patient through the practices of pharmaceutical care.

Mental well-being and future career intentions of new graduate nurses and midwives in their first year of entry into the workforce: a cross sectional survey

Objective: To explore mental well-being and future career intentions of new graduate nurses and midwives (NGs) in their first year of work. Background: Mental well-being is important for people to feel good and function well in their daily life. However, little is known about changes in mental well-being and future workforce intentions of nurses and midwives in their first year of professional practice. Study design and methods: A cross-sectional study was conducted at a large Local Health District in New South Wales, Australia. Nurses and midwives (N=170) who commenced a transition program in February 2017 were invited to complete a survey using the Warwick-Edinburgh Mental Well-being Scale after four to six weeks (Group 1) and again at 10-11 months (Group 2). Unpaired t-tests for independent samples were used to compare differences between time-points. Results: Response rates were 47% for Group 1 and 29% for Group 2. The mean (median) mental wellbeing score was 52.1 (52) for Group 1 and 48.7 (50) for Group 2. While the majority of respondents retained a moderate/high sense of well-being, decreases were significant for the items, ‘feel relaxed’ and ‘interested in new things’. Being located in rural areas, being aged between 20-29 years and being female was related to a lower well-being score for Group 2. The main factors contributing to NGs wellbeing were: a supportive environment, resilience, self-efficacy, and sense of achievement. Respondents with higher total well-being scores were significantly more likely to continue working at the current organisations and significantly less likely to seek employment in other organisations. Discussion: This study provides valuable insight into the mental well-being and future career intentions of new graduate nurses and midwives. Most of them retain a moderate to high sense of well-being over their first year of practice which suggests sufficient support is provided, or that they are an inherently resilient population. Building supportive environments that assist resilience, self-efficacy and sense of achievement is critical. Conclusion: With the current COVID pandemic situation, addressing factors impacting on the mental well-being and future career intentions of new graduate nurses and midwives in their first year may be more critical to enhance job satisfaction, leading to improved workforce resilience and capability and therefore the provision of quality healthcare. Implications for research, policy and practice: The findings of the study reinforce the importance of mental well-being to retain new graduate nurses and midwives in the future workforce. What is already known about the topic? Positive mental well-being supports people to feel good and function well. Entering into a new workforce as a novice practitioner is stressful and maintaining positive mental well-being in the workplace enhances the capacity to provide safe quality healthcare. Little is known about changes in mental well-being and future workforce intentions of new graduate nurses and midwives (NGs) in their first year of professional practice. What this paper adds? Findings show that the majority of NGs retained a moderate/high sense of well-being throughout their first year of their professional life. Providing a supportive environment, increasing resilience, self-efficacy and sense of achievement will enhance maintenance of positive mental wellbeing and retention of NGs in the workforce.

Is Academic Attainment or Situational Judgment Test Performance in Medical School Associated With the Likelihood of Disciplinary Action? A National Retrospective Cohort Study.

Disciplinary action imposed on physicians indicates their fitness to practice medicine is impaired and patient safety is potentially at risk. This national retrospective cohort study sought to examine whether there was an association between academic attainment or performance on a situational judgment test (SJT) in medical school and the risk of receiving disciplinary action within the first 5 years of professional practice in the United Kingdom. The authors included data from the UK Medical Education Database for 34,865 physicians from 33 U.K. medical schools that started the UK Foundation Programme (similar to internship) between 2014 and 2018. They analyzed data from 2 undergraduate medical assessments used in the United Kingdom: the Educational Performance Measure (EPM), which is based on academic attainment, and SJT, which is an assessment of professional attributes. The authors calculated hazard ratios (HRs) for EPM and SJT scores. The overall rate of disciplinary action was low (65/34,865, 0.19%) and the mean time to discipline was 810 days (standard deviation [SD] = 440). None of the physicians with fitness to practice concerns identified as students went on to receive disciplinary action after they qualified as physicians. The multivariate survival analysis demonstrated that a score increase of 1 SD (approximately 7.6 percentage points) on the EPM reduced the hazard of disciplinary action by approximately 50% (HR = 0.51; 95% confidence interval [CI]: 0.38, 0.69; P < .001). There was not a statistically significant association between the SJT score and the hazard of disciplinary action (HR = 0.84; 95% CI: 0.62, 1.13; P = .24). An increase in EPM score was significantly associated with a reduced hazard of disciplinary action, whereas performance on the SJT was not. Early identification of increased risk of disciplinary action may provide an opportunity for remediation and avoidance of patient harm.

The Influence of School Context Factors on the Induction Support as Perceived by Newly Qualified Teachers

This study explores the relationship between school demographic characteristics and the amount of provided induction activities, as perceived by beginning teachers (BTs), with special attention for Professional Development Schools and non-Professional Development Schools. The aim is to provide information that is useful to improve induction arrangements to particular school contexts. Data were collected in a Dutch national induction program in which qualified BTs are supported in their first 3 years of professional practice. The support monitor measures multiple induction activities with regard to the implementation of workload reduction, school enculturation, professional development plans and lessons support. 1,670 BTs working in 195 schools reported on these activities. Linear regression analyses revealed that less induction activities were associated with schools with multiple locations, more enrolled students and number of BTs employed, and with schools with older male teaching staff. No significant differences were found between the amount of support perceived by BTs in PDSs and non-PDSs. Yet school characteristics revealed stronger predictive values for the amount of support provided in non-PDS settings. These insights are relevant for mapping school differences in induction arrangements in order to enhance the equity of support across schools to assure the development of teaching skills of BTs.

A qualitative study exploring community pharmacists’ perspectives of child and adolescent mental healthcare

Community pharmacists are involved in the health delivery sector through the provision of services that result in improved patient outcomes and optimization of pharmaceutical care. With growing concern about increasing prevalence of mental disorders in children and adolescents, the expanded roles of pharmacists in providing mental health services may be essential. This study aimed to explore the perspective of community pharmacists in child and adolescent mental healthcare (CAMH) service provision. A qualitative study employing semi-structured face-to-face individual interviews was conducted among 25 community pharmacists in Accra to explore their perspectives and experiences in service provision for children and adolescents with mental illness. Interviews were audio recorded, transcribed, and thematically analyzed in line with the study objective. Emerging themes from the results are presented and supported by narratives from the community pharmacists. Most of the participants were female (n = 15, 60%), 32.32 ± 10 years old and have an average of 7.68 ± 9.4 years of professional practice. The m main themes identified from the findings were (1) Illness perception (2) Use of medicines (3) CAMH service provision practices and (4) Barriers to CAMH service provision. The participants' perception about child and adolescent mental illness was along the dimensions of causal beliefs. They also acknowledged the role of medications in symptom reduction and improved mental health outcomes while indicating their safety concerns about these medicines. Community pharmacists were involved in CAMH activities by providing medication-related support, triaging, and appropriate referrals. However, barriers such as inadequate training, lack of subsidies for psychotropic medications for community pharmacies and poor linkage with health providers and facilities, limit community pharmacists’ involvement in the provision of these services.CAMH service provision by community pharmacists could be facilitated by training, psychotropic medicines subsidy support and enhanced linkage with hospitals while highlighting greater recognition of these services at the community level to support the policy agenda of deinstitutionalizing mental healthcare.

Desenvolvimento profissional de professores de Educação Física iniciantes: continuidades/descontinuidades entre a formação inicial e a iniciação à docência

This article presents the results of a research whose main objective was to analyze the perceptions that Physical Education teachers have about the Teacher undergraduate degree, taking in to account the challenges and dilemmas faced in the period of induction. This is a qualitative descriptive research. Thirteen teachers trained by Universidade Federal de Minas Gerais (UFMG) participated in the study, with a maximum of three years of professional practice in the school. Teachers report that pre-service training was fundamental to the early years of the profession, but they point out weaknesses in pedagogical didactic training.

Role of long interspersed nuclear element-1 in the regulation of chromatin landscapes and genome dynamics.

LINE-1 retrotransposon, the most active mobile element of the human genome, is subject to tight regulatory control. Stressful environments and disease modify the recruitment of regulatory proteins leading to unregulated activation of LINE-1. The activation of LINE-1 influences genome dynamics through altered chromatin landscapes, insertion mutations, deletions, and modulation of cellular plasticity. To date, LINE-1 retrotransposition has been linked to various cancer types and may in fact underwrite the genetic basis of various other forms of chronic human illness. The occurrence of LINE-1 polymorphisms in the human population may define inter-individual differences in susceptibility to disease. This review is written in honor of Dr Peter Stambrook, a friend and colleague who carried out highly impactful cancer research over many years of professional practice. Dr Stambrook devoted considerable energy to helping others live up to their full potential and to navigate the complexities of professional life. He was an inspirational leader, a strong advocate, a kind mentor, a vocal supporter and cheerleader, and yes, a hard critic and tough friend when needed. His passionate stand on issues, his witty sense of humor, and his love for humanity have left a huge mark in our lives. We hope that that the knowledge summarized here will advance our understanding of the role of LINE-1 in cancer biology and expedite the development of innovative cancer diagnostics and treatments in the ways that Dr Stambrook himself had so passionately envisioned.

AB0871-HPR WOMEN IN RHEUMATOLOGY: BARRIERS, LIMITATIONS, AND GENDER INEQUALITY

Background:In the last decades there has been a great progress towards gender equality in medicine, and this can be reflected in the proportion of women in Rheumatology, which has been on the rise recently. However, there continues to be a need for women to be able to succeed on equal opportunities with men (1).Objectives:The aim of this study was to recognize the professional limitations and barriers that Mexican female rheumatologists must face.Methods:Female rheumatologists were invited to participate. An online survey was applied anonymously, consisting of questions regarding demographic characteristics, professional, academic and research activities, as well as perceptions of gender discrimination and limitations of their profession.Results:A total of 127 female rheumatologists voluntarily answered the electronic survey. Most of them were aged between 30 and 35 years (40.9%) and had 1-5 years of professional practice (40.2%) (Table 1); 52% have children and 42.4% of them consider that motherhood has had a negative impact on their professional life; 75.6% of female rheumatologists do not work on research activities and only 20.5% have participated in international congresses in the last 5 years; 80.5% report not participating in medical colleges (as leaders or board members). The three main reasons female rheumatologists refer as limitations on their profession are: having other priorities (34.6%), lack of time (32.3%) and lack of support from their peers/bosses (23.6%). Almost half women (45.7%) consider not being discriminated because of their gender in their profession, while the rest of them consider that they are or may be.Table 1.Demographic characteristics.Age, n (%)Younger than 35 years52 (40.9%)From 35 to 40 years29 (22.8%)From 40 to 45 years16 (12.6%)From 45 to 50 years12 (9.4%)Older than 50 years18 (14.2%)Marital status, n (%)Married66 (52%)Single38 (29.9%)Free union13 (10.2%)Divorced8 (6.3%)Widowed2 (1.6%)Years of professional practice, n (%)From 1 to 5 years51 (40.2%)From 5 to 10 years31 (24.4%)From 10 to 15 years16 (12.6%)From 15 to 20 years10 (7.9%)More than 20 years19 (15%)Conclusion:We found that most female rheumatologists are young and with a few years of professional practice, which coincides with the recent increase in the proportion of women in Rheumatology; and perhaps this is the reason why there is low participation in research activities and medical colleges. It is relevant that almost half of them perceive their gender as a reason of discrimination in their professional life. We consider that initiating the conversation of gender equality in Rheumatology, in national and international forums, and to actively search for a strategy to support and encourage our colleagues, are priorities at this moment.

Factors Driving the Acquisition of University Postgraduate Degrees among Resident Doctors in Nigeria

The study examined the characteristics and factors driving the acquisition of postgraduate academic degrees among resident doctors in Nigeria. About 10% of the respondents had a form of university postgraduate degree with majority being master’s degree. Having more than seven years of professional practice was the only factor predicting the acquisition of postgraduate academic degrees amongst the respondents [AOR: 0.243 (95% CI: 0.069,0.856; p = 0.028)]. The acquisition of postgraduate degree is not common among the surveyed resident doctors; and those that will acquire it do so in the later part of their career.

The impact of introducing a videolaryngoscope in the initial training of laryngoscopy for undergraduate medical students: a simulation randomized trial

IntroductionAdequate and continuous airway management by health professionals is fundamental to ensure patient safety and protection. Among several techniques, laryngoscopy for orotracheal intubation is considered a basic skill, so it is taught and learned in medical school and used during the future years of professional practice. However, in some clinical scenarios, physical and anatomical characteristics can make laryngoscopy exceedingly difficult. In the last decade, some new devices have emerged to apply indirect or video-assisted imaging systems, so-called videolaryngoscopes. They have shown great efficiency in difficult intubation cases and have improved teaching and training. Our study introduced a videolaryngoscope, the McGrath... MAC, in the regular laryngoscopy training rotation for 3rd-year undergraduate medical students and evaluated whether there was any associated optimization of the students... performance. MethodStudents from two different classes and years (2017 and 2018) were randomly divided into two groups and received theoretical and practical training in the techniques of Direct Laryngoscopy (DL) and Videolaryngoscopy (VL). The students in each group applied the manoeuvres and simulated three tracheal intubation attempts on mannequins. They were evaluated for their success rate on the first attempt, the time required to finalize the intubation, and the visualization of the glottic structures according to the classification of Cormack-Lehane (C&L). ResultsTwo hundred and four students with an average age of 21.ß...ß2 years participated in the study; the groups were similar. There was a significant difference between the VL and DL groups in the 1st attempt success rate (97% and 89.4%, respectively, p.ß=.ß0.0497 ... 95% CI), but such a difference was not seen for the other attempts or regarding the number of oesophageal intubations (3% and 7.7%). The students in the VL group were faster than those in the DL group in all intubation attempts; in parallel, the vast majority of the VL group reported excellent visualization conditions, with 75% of the attempts classified as Cormack-Lehane grade 1. ConclusionThe introduction of a videolaryngoscope in medical students... training improved the visualization of anatomical structures and allowed tracheal intubation maneuvers to be performed faster and with a higher success rate on the first attempt. Thus, under the conditions of this prospective study, the videolaryngoscope had a positive impact on training and proved to be a promising tool for teaching laryngoscopy.