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Bogner MS, Eschevins C, Faulks D. Identifying people requiring special care dentistry: A scoping review. Spec Care Dentist 2024; 44:269-279. [PMID: 37254590 DOI: 10.1111/scd.12880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 05/11/2023] [Accepted: 05/12/2023] [Indexed: 06/01/2023]
Abstract
AIMS This scoping review aimed to document tools designed to identify persons requiring special care dentistry (SCD) and to provide a better understanding of the factors that justify adaptation in the provision of care. METHODS A scoping review methodology was applied. An electronic search was performed in April 2021 using Pubmed and Embase. Additional tools were sought using hand searches and informal professional networking. RESULTS Ten tools were identified that either predict the complexity of dental management or that retrospectively judge the complexity of care, of which two are as yet unpublished. Some had been developed for a specific population (e.g., patients with Alzheimer's disease, with learning disability, elderly persons) whilst others were applicable for any population (case mix tools). Factors considered included the patient's medical history, ability to cooperate, physical and cognitive autonomy, communication skills, anxiety, need for sedation, oral risk factors, ability to consent and the administrative burden for the dentist. CONCLUSION Identifying persons requiring SCD is possible by looking at various factors that influence the provision of dental care. There may be need for adaptation of tools to local circumstances and to the intended usage of the tool at a health services, systems or policy level.
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Affiliation(s)
- Marie-Sophie Bogner
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Caroline Eschevins
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Denise Faulks
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, Clermont-Ferrand, France
- Service d'Odontologie, CHU Clermont-Ferrand, CHU Estaing, Clermont-Ferrand, France
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2
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Dharmarajah K, Macaulay C. Integrated care: putting principles into practice and becoming the paediatrician of the future. Arch Dis Child 2023; 108:174-175. [PMID: 35045968 DOI: 10.1136/archdischild-2021-322930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 12/23/2021] [Indexed: 11/03/2022]
Affiliation(s)
- Kate Dharmarajah
- General Paediatrics, Evelina London Children's Hospital, London, UK
| | - Chloe Macaulay
- General Paediatrics, Evelina London Children's Hospital, London, UK
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3
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Affiliation(s)
- Sonia Singh
- Department of Paediatrics, The University of Melbourne Faculty of Medicine Dentistry and Health Sciences, Melbourne, Victoria, Australia .,Emergency Medicine, University of California Davis Medical Center, Sacramento, California, USA
| | - Franz E Babl
- Department of Paediatrics, The University of Melbourne Faculty of Medicine Dentistry and Health Sciences, Melbourne, Victoria, Australia.,Emergency Research, Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Li Huang
- School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Stephen Hearps
- Child Neuropsychology, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - John Alexander Cheek
- Department of Paediatrics, The University of Melbourne Faculty of Medicine Dentistry and Health Sciences, Melbourne, Victoria, Australia.,Emergency Department, Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Jeffrey S Hoch
- Department of Public Health Sciences, University of California Davis, Davis, California, USA.,Center for Healthcare Policy and Research, University of California Davis Health System, Sacramento, California, USA
| | - Vicki Anderson
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Psychology, Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Kim Dalziel
- School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.,Health Services, Centre for Community Child Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
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4
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Abstract
In 2022, the British Cardiovascular Society celebrates the centenary of its foundation. Starting out as a small group of government-appointed physicians interested in heart disease, the Cardiac Club has grown and adapted to represent all those working in cardiovascular care and research. The historical stages of the organisation's development are outlined, alongside major innovations in science and technology providing context for a rapidly changing medical world. Only a small part of the history of cardiology in Britain is told, with greater emphasis on describing the broader need for services, skilled workforce, healthcare policy and continuing education. Above all, the history of the British Cardiovascular Society is a story of people and places. The people are those with vision, attitude and leadership to improve the care of communities across the world. The places are those that enabled conversation, innovation and freedom to bring about change. It is hard to believe the remarkable progress in diagnosis, prevention and treatment of heart disease over 100 years, but a thriving modern Society must be the greatest legacy of its founders.
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Affiliation(s)
- Caroline J Coats
- Department of Cardiology, Queen Elizabeth University Hospital, Glasgow, UK
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5
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Sarri G, Patorno E, Yuan H, Guo JJ, Bennett D, Wen X, Zullo AR, Largent J, Panaccio M, Gokhale M, Moga DC, Ali MS, Debray TPA. Framework for the synthesis of non-randomised studies and randomised controlled trials: a guidance on conducting a systematic review and meta-analysis for healthcare decision making. BMJ Evid Based Med 2022; 27:109-119. [PMID: 33298465 PMCID: PMC8961747 DOI: 10.1136/bmjebm-2020-111493] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/03/2020] [Indexed: 12/17/2022]
Abstract
INTRODUCTION High-quality randomised controlled trials (RCTs) provide the most reliable evidence on the comparative efficacy of new medicines. However, non-randomised studies (NRS) are increasingly recognised as a source of insights into the real-world performance of novel therapeutic products, particularly when traditional RCTs are impractical or lack generalisability. This means there is a growing need for synthesising evidence from RCTs and NRS in healthcare decision making, particularly given recent developments such as innovative study designs, digital technologies and linked databases across countries. Crucially, however, no formal framework exists to guide the integration of these data types. OBJECTIVES AND METHODS To address this gap, we used a mixed methods approach (review of existing guidance, methodological papers, Delphi survey) to develop guidance for researchers and healthcare decision-makers on when and how to best combine evidence from NRS and RCTs to improve transparency and build confidence in the resulting summary effect estimates. RESULTS Our framework comprises seven steps on guiding the integration and interpretation of evidence from NRS and RCTs and we offer recommendations on the most appropriate statistical approaches based on three main analytical scenarios in healthcare decision making (specifically, 'high-bar evidence' when RCTs are the preferred source of evidence, 'medium,' and 'low' when NRS is the main source of inference). CONCLUSION Our framework augments existing guidance on assessing the quality of NRS and their compatibility with RCTs for evidence synthesis, while also highlighting potential challenges in implementing it. This manuscript received endorsement from the International Society for Pharmacoepidemiology.
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Affiliation(s)
- Grammati Sarri
- Real World Evidence Sciences, Visible Analytics Ltd, Oxford, UK
| | - Elisabetta Patorno
- Division of Pharmacoepidemiology and Pharmacoeconomics, Dept. of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Hongbo Yuan
- Canadian Agency for Drugs and Technologies in Health (CADTH), Ottawa, Ontario, Canada
| | - Jianfei Jeff Guo
- Department of Pharmacy Practice & Administrative Sciences, University of Cincinnati College of Pharmacy, Cincinnati, Ohio, USA
| | | | - Xuerong Wen
- Pharmacy Practice, College of Pharmacy, University of Rhode Island, Kingston, Rhode Island, USA
| | - Andrew R Zullo
- Health Services, Policy, and Practice, Brown University, Providence, Rhode Island, USA
| | - Joan Largent
- Real-World Solutions, IQVIA, California, Colorado, USA
| | - Mary Panaccio
- Epidemiology and Outcomes Research, Research Outcomes Innovations LLC, New York City, New York, USA
| | | | - Daniela Claudia Moga
- University of Kentucky, Department of Pharmacy Practice and Science, Lexington, Kentucky, USA
| | - M Sanni Ali
- NDORMS, Center for Statistics in Medicine, University of Oxford, Oxford, UK
- Department of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine (LSHTM), London, UK
- Department of Public Heath, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine (LSHTM), London, UK
| | - Thomas P A Debray
- Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
- Smart Data Analysis and Statistics, Utrecht, The Netherlands
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6
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Affiliation(s)
| | - Alfredo Mariani
- National Guideline Centre, Royal College of Physicians, London, UK
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7
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Chin P, Palchik GA. In the room when it happens. J Med Ethics 2022; 48:31. [PMID: 34937761 DOI: 10.1136/medethics-2021-108090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 12/15/2021] [Indexed: 06/14/2023]
Affiliation(s)
- Paul Chin
- Department of Psychiatry, Sutter Health California Pacific Medical Center, San Francisco, California, USA
| | - Guillermo A Palchik
- Department of Psychiatry, Sutter Health California Pacific Medical Center, San Francisco, California, USA
- Department of Advanced Organ Therapies and Transplantation, Sutter Health California Pacific Medical Center, San Francisco, California, USA
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8
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Polanczyk CA, de Quadros AM, Fontanella AT, Zanotto AD, Rodrigues FDA, Vianna DA, Toscano CM, Riera R, Reis LFL. EBM distance learning course to support judicial decisions on healthcare: a case study. BMJ Evid Based Med 2021; 26:266-267. [PMID: 33087450 DOI: 10.1136/bmjebm-2020-111551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/21/2020] [Indexed: 11/03/2022]
Affiliation(s)
- Carisi Anne Polanczyk
- Instituto de Avaliação de Tecnologia em Saúde, Porto Alegre, Brazil
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | | | - Fernanda D Athayde Rodrigues
- Instituto de Avaliação de Tecnologia em Saúde, Porto Alegre, Brazil
- Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
| | - Denizar Araujo Vianna
- Instituto de Avaliação de Tecnologia em Saúde, Porto Alegre, Brazil
- Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Cristiana Maria Toscano
- Instituto de Avaliação de Tecnologia em Saúde, Porto Alegre, Brazil
- Universidade Federal de Goias, Goiania, Brazil
| | - Rachel Riera
- Discipline of Evidence-based Medicine, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
- Center of Health Technology Assessment, Hospital Sírio-Libanês, São Paulo, São Paulo, Brazil
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9
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Affiliation(s)
- Catherine M Otto
- Division of Cardiology, University of Washington, Seattle, Washington, USA
| | - Peter J Kudenchuk
- Department of Medicine/Cardiology, University of Washington, Seattle, Washington, USA
| | - David E Newby
- Centre for Cardiovascular Sciences, University of Edinburgh, Edinburgh, UK
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10
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Garbi M. National Institute for Health and Care Excellence clinical guidelines development principles and processes. Heart 2021; 107:949-953. [PMID: 33622678 DOI: 10.1136/heartjnl-2020-318661] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 02/09/2021] [Accepted: 02/10/2021] [Indexed: 11/03/2022] Open
Abstract
Clinical guidelines are developed by professional societies and also, in England, by an independent non-departmental public body, the National Institute for Health and Care Excellence (NICE). Similarities and differences between these guidelines should be viewed in the context of different objectives, responsibilities and roles of guideline developers. This review describes the NICE clinical guidelines development principles and processes with the aim to provide the reader an informed perspective on the recommendations made. NICE clinical guidelines are developed by an appointed independent advisory committee comprising healthcare professionals as well as lay members, supported by a professional team comprising project managers, information specialists, systematic reviewers and health economists. Furthermore, registered stakeholders comprising organisations that have an interest in the guideline topic, or represent people whose practice or care may be directly affected by the guideline, are consulted on the draft scope and draft guidelines. NICE selects a limited number of high impact questions to be answered by the review of evidence, rather than cover a certain topic exhaustively as the clinical guidelines developed by professional societies may do. NICE clinical guidelines recommendations reflect both the clinical effectiveness and the cost-effectiveness of interventions.
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Affiliation(s)
- Madalina Garbi
- Department of Cardiology, Royal Papworth Hospital, Cambridge Biomedical Campus, Cambridge, UK
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11
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Hamshere S, Comer K, Choudhry F, Rathod K, Mills G, Ferguson G, Lambourne J, Akhtar M, Wragg A, Ozkor M, Guttmann O, Mullen M, Baumbach A, Smith E, Mathur A, Jones D. Reintroduction of elective cardiac interventions in the era of COVID-19: the Barts experience. Open Heart 2021; 8:openhrt-2020-001446. [PMID: 33879506 PMCID: PMC8061558 DOI: 10.1136/openhrt-2020-001446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 10/29/2020] [Accepted: 12/07/2020] [Indexed: 11/23/2022] Open
Abstract
Background The response to COVID-19 has required cancellation of all but the most urgent procedures; there is therefore a need for the reintroduction of a safe elective pathway. Methods This was a study of a pilot pathway performed at Barts Heart Centre for the admission of patients requiring elective coronary and structural procedures during the COVID-19 pandemic (April–June 2020). All patients on coronary and structural waiting lists were screened for procedural indications, urgency and adverse features for COVID-19 prognosis and discussed at dedicated multidisciplinary teams. Dedicated admission pathways involving preadmission isolation, additional consent, COVID-19 PCR testing and dedicated clean areas were used. Results 143 patients (101 coronary and 42 structural) underwent procedures (coronary angiography, percutaneous coronary intervention, transcatheter aortic valve intervention and MitralClip) during the study period. The average age was 68.2; 74% were male; and over 93% had one or more moderate COVID-19 risk factors. All patients were COVID-19 PCR negative on admission with (8.1%) COVID-19 antibody positive (swab negative). All procedures were performed successfully with low rates of procedural complications (9.8%). At 2-week follow-up, no patients had symptoms or confirmed COVID-19 infection with significant improvements in quality if life and symptoms. Conclusion We demonstrated that patients undergoing coronary and structural procedures can be safely admitted during the COVID-19 pandemic, with no patients contracting COVID-19 during their admission. Reassuringly, patients reflective of typical practice, that is, those at moderate or higher risk, were treated successfully. This pilot provides important information applicable to other settings, specialties and areas to reintroduce services safely.
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Affiliation(s)
| | - Katrina Comer
- Barts Heart Centre, Barts Health NHS Trust, London, UK
| | - Fizzah Choudhry
- Barts Heart Centre, Barts Health NHS Trust, London, UK.,Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, NIHR Cardiovascular Biomedical Research Unit at Barts, Queen Mary University of London, London, UK
| | - Krishna Rathod
- Barts Heart Centre, Barts Health NHS Trust, London, UK.,Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, NIHR Cardiovascular Biomedical Research Unit at Barts, Queen Mary University of London, London, UK
| | - Gordon Mills
- Barts Heart Centre, Barts Health NHS Trust, London, UK
| | | | | | - Majid Akhtar
- Barts Heart Centre, Barts Health NHS Trust, London, UK
| | - Andrew Wragg
- Barts Heart Centre, Barts Health NHS Trust, London, UK
| | - Mick Ozkor
- Barts Heart Centre, Barts Health NHS Trust, London, UK
| | - Oliver Guttmann
- Barts Heart Centre, Barts Health NHS Trust, London, UK.,Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, NIHR Cardiovascular Biomedical Research Unit at Barts, Queen Mary University of London, London, UK
| | - Michael Mullen
- Barts Heart Centre, Barts Health NHS Trust, London, UK.,Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, NIHR Cardiovascular Biomedical Research Unit at Barts, Queen Mary University of London, London, UK
| | - Andreas Baumbach
- Barts Heart Centre, Barts Health NHS Trust, London, UK.,Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, NIHR Cardiovascular Biomedical Research Unit at Barts, Queen Mary University of London, London, UK
| | - Elliot Smith
- Barts Heart Centre, Barts Health NHS Trust, London, UK.,Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, NIHR Cardiovascular Biomedical Research Unit at Barts, Queen Mary University of London, London, UK
| | - Anthony Mathur
- Barts Heart Centre, Barts Health NHS Trust, London, UK.,Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, NIHR Cardiovascular Biomedical Research Unit at Barts, Queen Mary University of London, London, UK
| | - Dan Jones
- Barts Heart Centre, Barts Health NHS Trust, London, UK.,Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, NIHR Cardiovascular Biomedical Research Unit at Barts, Queen Mary University of London, London, UK
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12
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Ahmed R, Dayani K, Amir HA, Mian A. Zero cost approach to fostering multidisciplinary engagement and innovation in an academic medical centre during COVID-19: experience from the Jugaar Innovation Challenge. BMJ Innov 2021; 7:302-307. [PMID: 37556241 PMCID: PMC7754668 DOI: 10.1136/bmjinnov-2020-000542] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 11/11/2020] [Accepted: 11/29/2020] [Indexed: 11/03/2022]
Affiliation(s)
- Rafeh Ahmed
- CCIT and
TISC, Aga Khan University, Karachi, Sind,
Pakistan
| | - Komal Dayani
- CCIT,
Aga Khan University, Karachi, Sind,
Pakistan
| | | | - Asad Mian
- CCIT,
Aga Khan University, Karachi, Sind,
Pakistan
- Emergency
Medicine, The Aga Khan University Hospital,
Karachi, Pakistan
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13
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Jaijee SK, Kamau-Mitchell C, Mikhail GW, Hendry C. Sexism experienced by consultant cardiologists in the United Kingdom. Heart 2021; 107:895-901. [PMID: 33722825 DOI: 10.1136/heartjnl-2020-317837] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 01/20/2021] [Accepted: 01/28/2021] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVES The aims were to compare the frequency with which male and female cardiologists experience sexism and to explore the types of sexism experienced in cardiology. METHODS A validated questionnaire measuring experiences of sexism and sexual harassment was distributed online to 890 UK consultant cardiologists between March and May 2018. χ2 tests and pairwise comparisons with a Bonferroni correction for multiple analyses compared the experiences of male and female cardiologists. RESULTS 174 cardiologists completed the survey (24% female; 76% male). The survey showed that 61.9% of female cardiologists have experienced discrimination of any kind, mostly related to gender and parenting, compared with 19.7% of male cardiologists. 35.7% of female cardiologists experienced unwanted sexual comments, attention or advances from a superior or colleague, compared with 6.1% of male cardiologists. Sexual harassment affected the professional confidence of female cardiologists more than it affected the confidence of male cardiologists (42.9% vs 3.0%), including confidence with colleagues (38% vs 10.6%) and patients (23.9% vs 4.6%). 33.3% of female cardiologists felt that sexism hampered opportunities for professional advancement, compared with 2.3% of male cardiologists. CONCLUSION Female cardiologists in the UK experience more sexism and sexual harassment than male cardiologists. Sexism impacts the career progression and professional confidence of female cardiologists more, including their confidence when working with patients and colleagues. Future research is urgently needed to test interventions against sexism in cardiology and to protect the welfare of female cardiologists at work.
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Affiliation(s)
- Shareen Kaur Jaijee
- Cardiology, Imperial College Healthcare NHS Trust, London, UK .,MRC, Imperial College London, London, UK
| | | | - Ghada W Mikhail
- Cardiology, Imperial College Healthcare NHS Trust, London, UK.,Cardiology, Imperial College London, London, UK
| | - Cara Hendry
- Cardiology, Manchester Royal Infirmary, Manchester, UK
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14
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Messori A, Angileri M, Chiumente M, Agnoletto L, Baldo P, Bartoli L, Cirino M, Damuzzo V, Ferracane E, Giron MC, Laudisio C, Mengato D, Palozzo AC, Trippoli S. SARS-COV-2 pandemic: establishing three risk levels for 19 Italian regions and two autonomous provinces. Eur J Hosp Pharm 2021; 29:e3. [PMID: 33558220 PMCID: PMC9047933 DOI: 10.1136/ejhpharm-2021-002692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
| | - Manuela Angileri
- Hospital Pharmacy, Azienda Sanitaria di Firenze, Firenze, Toscana, Italy
| | | | - Laura Agnoletto
- Hospital Pharmacy, Azienda ULSS 5 Polesana, Rovigo, Veneto, Italy
| | - Paolo Baldo
- Hospital Pharmacy, Centro di Riferimento Oncologico, Aviano, Italy
| | | | - Mario Cirino
- Hospital Pharmacy, Azienda Sanitaria Universitaria Giuliano Isontina, Presidio Ospedale Maggiore, Trieste, Italy
| | - Vera Damuzzo
- Pharmaceutical Sciences, Universita degli Studi di Padova, Padova, Veneto, Italy
| | | | - M Cecilia Giron
- Department of Pharmaceutical Sciences, Universita degli Studi di Padova, Padova, Veneto, Italy
| | - Carolina Laudisio
- Pharmacy, Azienda Sanitaria Locale Salerno, Salerno, Campania, Italy
| | | | - Angelo Claudio Palozzo
- Presidency, SIFaCT President, Italian Society for Clinical Pharmacy and Therapy, Milano, Milano, Italy
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15
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Ingham G, Plastow K, Kippen R, White N. Tell me if there is a problem: safety in early general practice training. Educ Prim Care 2019; 30:1-8. [PMID: 31130089 DOI: 10.1080/14739879.2019.1610078] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 03/15/2019] [Accepted: 03/27/2019] [Indexed: 10/26/2022]
Abstract
In contrast to other comparable countries, trainees commencing general practice in Australia can see patients without being required to contact their supervisor. To understand how patient safety in early training is managed a qualitative study design using semi-structured interviews was used. A lead medical educator from each of the nine Australian Regional Training Organisations (RTOs) was interviewed. Transcriptions of interviews were analysed to identify themes. RTOs do not mandate a period of direct observation of trainees and the use of safety checklists for supervision is variable and not monitored. The oversight of training practices by RTOs mirrors that of trainees by supervisors. The onus falls on those being supervised to identify the need for assistance. Despite this, lead medical educators still consider the commencement of general practice training to be safe. Other factors found potentially to impact on safety include the variability of training practices and supervision; the complex RTO-practice relationship; quota-driven selection of doctors into general practice; and the negative impact on education of the funding model. Patient safety may be improved by a period of direct observation of potential trainees prior to the commencement of general practice training and the use of checklists to encourage supervision of high risk activities.
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Affiliation(s)
- Gerard Ingham
- a Research , Murray City Country Coast GP Training , Melbourne , Australia
| | - Kayty Plastow
- a Research , Murray City Country Coast GP Training , Melbourne , Australia
| | | | - Nicky White
- a Research , Murray City Country Coast GP Training , Melbourne , Australia
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