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Purpose: Mastering technical procedures is a key component in succeeding as a newly graduated medical doctor and is of critical importance to ensure patient safety. The efficacy of simulation-based education has been demonstrated but medical schools have different requirements for undergraduate curricula. We aimed to identify and prioritize the technical procedures needed by newly graduated medical doctors.Methods: We conducted a national needs assessment survey using the Delphi technique to gather consensus from key opinion leaders in the field. In the first round, a brainstorm was conducted to identify all potential technical procedures. In the second round, respondents rated the need for simulation-based training of each procedure using the Copenhagen Academy for Medical Education and Simulation Needs Assessment Formula (CAMES-NAF). The third round was a final elimination and prioritization of the procedures.Results: In total, 107 experts from 21 specialties answered the first round: 123 unique technical procedures were suggested. Response rates were 58% and 64% in the second and the third round, respectively. In the third round, 104 procedures were eliminated based on the consensus criterion, and the remaining 19 procedures were included and prioritized. The top five procedures were: (i) insert peripheral intravenous catheter, (ii) put on personal protection equipment, (iii) perform basic airway maneuvers, (iv) perform basic life support, and (v) perform radial artery puncture.Conclusion: Based on the Delphi process a final list of 19 technical procedures reached expert consensus to be included in the undergraduate curriculum for simulation-based education. Purpose: Mastering technical procedures is a key component in succeeding as a newly graduated medical doctor and is of critical importance to ensure patient safety. The efficacy of simulation-based education has been demonstrated but medical schools have different requirements for undergraduate curricula. We aimed to identify and prioritize the technical procedures needed by newly graduated medical doctors.Methods: We conducted a national needs assessment survey using the Delphi technique to gather consensus from key opinion leaders in the field. In the first round, a brainstorm was conducted to identify all potential technical procedures. In the second round, respondents rated the need for simulation-based training of each procedure using the Copenhagen Academy for Medical Education and Simulation Needs Assessment Formula (CAMES-NAF). The third round was a final elimination and prioritization of the procedures.Results: In total, 107 experts from 21 specialties answered the first round: 123 unique technical procedures were suggested. Response rates were 58% and 64% in the second and the third round, respectively. In the third round, 104 procedures were eliminated based on the consensus criterion, and the remaining 19 procedures were included and prioritized. The top five procedures were: (i) insert peripheral intravenous catheter, (ii) put on personal protection equipment, (iii) perform basic airway maneuvers, (iv) perform basic life support, and (v) perform radial artery puncture.Conclusion: Based on the Delphi process a final list of 19 technical procedures reached expert consensus to be included in the undergraduate curriculum for simulation-based education.

Background: Low back pain (LBP) is the 5th leading cause of physician consultation and is a significant cause of lost workforce hours with tremendous economic implications in every society. These findings suggest that medical practice in Nigeria is a potential risk factor for developing low back pain. Few studies have attempted to evaluate the medical specialties as risk factors for LBP. This study evaluates the prevalence of low back pain among various Specialist Medical Consultants in a typical Teaching Hospital. Methodology: This is a descriptive cross-sectional study performed using self-administered questionnaires. The study population comprised Specialist Medical Consultants working at the University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State. The questionnaires were distributed among consultant physicians regardless of their departments. Information about their age, sex, medical specialties, presence frequency and severity of LBP; interventions received, and outcome were obtained. Result: There were 98 respondents, 56 (57%) males and 42 (43%) females who participated in the study. The modal age of the respondents is the 41-50 years age group (45%). 44%, were from the surgical specialties (surgery, anaesthesia, oral and maxillofacial surgery, ophthalmology); 33% from the internal and family medicine specialties; (11) 11% pediatricians and (12) 12.2 % were pathologists. The prevalence of low back pain was 60.2%, slightly more prevalent in males (62%) than females (58%). Of those who have experienced low back pain, 35.6% suffered mild pain (VAS 1-4), 49% suffered moderate pain (VAS 5-7) while 17% suffered severe pain (VAS 8-10). The majority (57.6%) had suffered more than 3 episodes of LBP while 84.8% sought treatment for their symptom mostly using NSAIDS. Conclusion: LBP has a high prevalence among Specialist Medical Consultants in UPTH potentially affecting patient treatment and student education. Most consultants take NSAIDS as treatment for low back pain.

Jordanian healthcare institutes have launched several programs since 2009 to establish health information systems (HISs). Nowadays, the generic expectation is that the use of HIS resources is performed on daily basis among healthcare staff. However, there can be still a noticeable barrier due to a lack of knowledge if medical doctors do not receive proper training on existing HISs. Moreover, the lack of studies on this area hinders the clarity about the received versus the required training skills among medical doctors. To support this research initiative, survey data have been collected from specialized medical doctors who are currently affiliated with five Jordanian universities to assess their need for HIS training. The results also aim to explore the extent of medical doctors’ use of HIS resources in Jordan. Moreover, they examine whether medical doctors require additional training on using HIS resources or not, as well as the main areas of required training programs. Specifically, this paper highlights the main topics that can be suitable subjects for enhanced training programs. The results show that most respondents use HISs in their daily clinical practices. However, most of them have not taken professional training on such systems. Hence, most of the respondents reported the need for additional training programs on several aspects of HIS resources. Moreover, based on the survey results, the most significant areas that require training are biomedical data analysis, artificial intelligence in medicine, health care management, and recent advances in electronic health records, respectively. Therefore, specialized medical doctors in Jordan need training on extracting useful and potential features of HISs. Education and training professionals in healthcare are recommended to establish training programs in Jordanian healthcare centers, which can further improve the quality of healthcare.

Physical and mental well-being are important determinants of medical doctors’ lives, including their professional activity, which has a direct impact on the health and lives of patients. The aim of the study was to assess the health condition of medical doctors from the Silesian Voivodeship. The physical health condition, including the prevalence of chronic diseases, drug therapy, and pro-health activities, was assessed. Data on mental health according to the HADS scale (hospital anxiety and depression scale) referred to the selected socio-economic and professional aspects of life, as well as life and job satisfaction. The doctors most often reported diseases of the circulatory system and diseases of endocrine system, nutritional status and metabolic changes, allergies, and degenerative changes in the musculoskeletal system and connective tissue. Chronic diseases and anxiety or depressive disorders affected doctors aged 50–80 years more frequently, and those doctors undertook preventive pro-health activities more often. The higher risks of anxiety and depression were related to their social and professional roles, lower economic status, overweight or obesity, chronic diseases, pharmacotherapy, diets, and chronic fatigue. On the other hand, frequent physical activity, a longer sleep duration, smaller weekly workload, type of rest, a higher sense of job satisfaction, and a higher level of life satisfaction reduced the risk of disorders. The health condition of medical doctors in the Silesian Voivodeship requires decisive remedial actions in the professional and non-professional spheres.

Aim: To describe the challenges for optimum resuscitation processes in Emergency Departments in Limpopo Province, South Africa. Design: A qualitative explorative research approach was adopted to explore the resuscitation team’s experiences in Emergency Departments. Method: Five medical doctors and twelve professional nurses were purposively sampled to participate in the study. The depth of the information obtained from the participants determined the sample size. Data collected from semi-structured individual interviews were analyzed using thematic analysis. Data quality was ensured by applying four elements: credibility, transferability, dependability, and confirmability. Results: The study findings indicated diverse challenges for optimum resuscitation processes that include: A general shortage of emergency personnel, the lack of material resources and the unavailability of funds for payment of national and international trauma symposiums, the poor maintenance of emergency equipment, the lack of a continuous training program and the resuscitation team receiving different instructions from various team leaders about the standardized procedures and policies of the resuscitation process. The team leaders and managers often blamed, depreciated and disregarded the resuscitation team for failed resuscitation efforts. Public contribution: The study findings are a point of reference for the emergency resuscitation team and the department of health policymakers. Trained and well-equipped emergency resuscitation teams can improve the quality of life for patients with cardiac arrest.

ObjectivesImplementation of ultrasound in antenatal care (ANC) in low-income countries has been shown to increase pregnant women's compliance with ANC visits, and facilitate detection of high-risk pregnancies. In Rwanda, as in other low-income countries, access to ultrasound has increased significantly, but lack of training is often a barrier to its use. The aim of this study was to investigate Rwandan health professionals' experiences and views of obstetric ultrasound in relation to clinical management, resources and skills.MethodsA cross-sectional questionnaire study was undertaken between November 2016 and March 2017, as part of the CROss Country UltraSound Study (CROCUS). Data were collected at 108 health facilities located in both rural and urban areas of Rwanda, including provincial, referral, district and private hospitals as well as health centres. Participants were obstetricians (n = 29), other physicians (n = 222), midwives (n = 269) and nurses (n = 387).ResultsObstetricians/gynecologists/other physicians commonly performed ultrasound examinations but their self-rated skill levels implied insufficient training. Access to ultrasound when needed was reported as common in hospitals, but available to a very limited extent in health centres. The vast majority of participants, independent of health profession, agreed that maternity care would improve if midwives learned to perform basic ultrasound examinations.ConclusionsBarriers to provision of high quality ultrasound services include variable access to ultrasound depending on health facility level and insufficient skills of ultrasound operators. Physicians in general need more training to perform ultrasound examinations. Implementation of a general dating ultrasound examination seems to be a relevant goal as most health professionals agree that pregnant woman would benefit from this service. To further improve maternity care services, the possibility of educating midwives to perform ultrasound examinations should be further explored.

The topic of the paper is the role and communication potential of social networks in the personal branding of leaders in the health sector (medical doctors) in the Republic of Croatia. The change in the communication paradigm due to digitization has enabled an individual to turn from an object that the media writes about into a subject that creates content, as well as the medium that distributes that content. Hence, the importance of analysing the impact of communication skills of individuals is growing, as well as relations with the media in general. The research was conducted through a quantitative survey among medical doctors of different specialisations who work in different institutions in the Republic of Croatia. The main goal of the research was to investigate the role of social networks in the personal branding of medical doctors through the attitudes, opinions and experiences of medical doctors in the Republic of Croatia. Four secondary objectives emerged from the main objective: (1) to determine how important media relations and communication skills are in their professional career, (2) to determine if doctors have profiles on social networks and on which the most ; (3) to identify who manages the profiles of medical doctors on social networks and the frequency in which the respondents update their profiles, and (4) to determine the purpose of using social networks, by identifying the ways in which social networks have so far helped the respondents, namely in their work and in personal branding. The results show that leaders in the health sector in the Republic of Croatia consider LinkedIn to be the most useful social network and that they are aware of the importance of using social networks, but in practice, they rarely update them, they are not educated for it, and they mostly do not use the help of communication experts.

Background and Aim: The COVID-19 pandemic was a global and major health crisis with terrible implications worldwide. The current study's aim was to investigate the relationship between death anxiety and life satisfaction among doctors and psychologists during Covid-19, with the role of optimism as a moderator. Method: The current research was based on a cross-sectional survey research method. Data from 200 medical doctors and psychologists were collected by using the Purposive Sampling Technique by using measures of the Death anxiety scale, satisfaction with life scale, and life orientation test revised for optimism. Findings: The results indicated that the reliability of the three scales used in the present research with descriptive analysis. The results also indicated that death anxiety has a significant (p = .01) but negative correlation with life satisfaction (r = -.37, p < .01) and optimism (r = - .42, p < .01). It was found that the direction of the relationship between death anxiety and life satisfaction become negative for optimism. There was significant gender difference and professional difference in death anxiety, life satisfaction, and optimism. Conclusion: Death anxiety is inversely but significantly associated with life satisfaction and optimism among health workers during COVID-19. Whereas health workers with high levels of optimism showed higher levels of life satisfaction. Optimism was also found significant moderator between death anxiety and life satisfaction among health workers. Female health worker was found to have more prevalent death anxiety as compared to male health workers. Still, male health workers showed a higher level of life satisfaction and optimism as compared to female health workers. The contrast between doctors and psychologists revealed a significant in deathanxiety, life satisfaction, and optimism during COVID-19. Doctors reported higher levels of death anxiety and psychologist reported a higher level of life satisfaction and optimism.

Background: The loss of health workers through death is of great importance and interest to the public, media and the medical profession as it has very profound social and professional consequences on the delivery of health services. Objective: To describe the profile, causes and patterns of death among medical doctors and dental surgeons in Uganda between 1986 and 2016. Methods: We conducted a retrospective descriptive study of mortality among registered medical doctors and dental surgeons. Information on each case was collected using a standard questionnaire and analysed. Cause of death was determined using pathology reports, and if unavailable, verbal autopsies. We summarized our findings across decades using means and standard deviations, proportions and line graphs as appropriate. Cuzick’s test for trend was used to assess crude change in characteristics across the three decades. To estimate the change in deaths across decades adjusted for age and sex, we fit a logistic regression model, and used the margins command with a dy/dx option. All analyses were done in Stata version 14.0 (Stata Corp, College Station, TX). Results: There were 489 deaths registered between 1986 and 2016. Of these, 59 (12.1%) were female. The mean age at death was 48.8 years (Standard Deviation (SD) 15.1) among male and 40.1 years (SD 12.8) among females. We ascertained the cause of death for 468/489 (95.7%). The most common causes of death were HIV/AIDS (218/468, 46.6%), cancer (68/468, 14.5%), non-communicable diseases (62/48, 13.3%), alcohol related deaths (36, 7.7%), road traffic accidents (34, 7.3%), gunshots (11, 2.4%), among others. After adjusting for age and sex, HIV/AIDs attributable deaths decreased by 33 percentage points between the decade of 1986 to1995 and that of 2006 to 2016 –0.33 (–0.44, –0.21. During the same period, cancer attributable deaths increased by 13 percentage periods 0.13 (0.05,0.20). Conclusion: The main causes of death were HIV/AIDS, cancer, non-communicable diseases, alcohol-related diseases and road traffic accidents. There was a general downward trend in the HIV/AIDS related deaths and a general upward trend in cancer related deaths. Doctors should be targeted for preventive and support services especially for both communicable and non-communicable diseases. Keywords: Profile and causes of death; medical doctors; dental surgeons; Uganda.

By the year 2050 Nigeria's population is projected to be the 3rd in global ranking. It is therefore important that men should be involved in family planning. Vasectomy which is a permanent method of contraception may not be welcomed in this part of the world due to myriad of reasons such as socio-cultural, religious amongst others. Perception of resident doctors towards vasectomy in Port Harcourt, Nigeria. This was a six months cross-sectional descriptive study on the perception of resident doctors towards vasectomy in Port Harcourt, Nigeria. Permission for the study was obtained from the Ethical committee of the Rivers State Hospital Management Board. Informed consent was obtained from subjects who were randomly selected. Seventy seven respondents were enrolled for the study. The information obtained was coded and analysed using SPSS version 20. Forty-eight respondents (62.3%) were males while 29 (37.7%) were females. The modal age was 35 years; the modal number of children was 3. Twenty-three (29.9%) doctors both females and males were in support of vasectomy as family planning option. Of this number 12(52.2%) were females compared to 11 (47.8%) male. A total of 54 (70.13%) doctors rejected vasectomy of which 14 (19.08%) were females compared to 40(51.95%) males. This was statistically significant. Twenty-eight (36.4%) of the respondents had personal undisclosed reasons why they rejected vasectomy. However, 4 (5.2%) of the respondents were indifferent as to why vasectomy was a contraceptive option. The study revealed that acceptance of vasectomy amongst Resident doctors was poor (29.9%). The commonest reason was due to its irreversibility in over half of the subjects (58.4%). The study indicated that in this part of the world the majority of Resident doctors have aversion for vasectomy due to its irreversibility.

Background As the use of social networking sites (SNSs) has greatly increased among health professionals, it is necessary to investigate their use of SNSs. The aim of this study was to identify the patterns of SNS use for contact with patients between medical doctors (MD) and doctors of dental medicine (DMD) in Croatia. Methods In collaboration with the Croatian Medical Chamber and the Croatian Chamber of Dental Medicine, a quantitative cross-sectional study was conducted on the use of SNSs and the attitudes of MDs and DMDs towards e-professionalism. Data were collected using online questionnaires. The data were analyzed using descriptive statistics. Results A total of 753 responses were processed, 507 (67,3%) MDs and 246 (32,7%) DMDs. DMDs were significantly more likely to visit patients or their family members’ profiles on SNSs (60,6% vs 33,3%, P < 0.001). The main reason for visiting a patient’s or family member’s profile is social communication, which is significantly more common among DMDs (46,3% vs 29,0%, P < 0.002). DMDs are significantly more likely to send friend requests from private SNS profiles to patients or their family members (15,0% DMDs vs 3,4% MDs, P < 0.001). Patients are much more likely to send friendship and connection requests on SNS to DMDs (91,1% DMDs vs 62,7% MDs, P < 0.001) who are also significantly more likely to accept these requests (76,8% DMDs vs 41,5% MDs, P < 0.001). MDs and DMDs would find the presence of e-professionalism guidelines useful (72,2% MDS vs 78,0% DMDs, P = 0.103). Conclusions The results show that DMDs are more open to communicating with patients via SNSs. Results showed a difference between MDs and DMDs in both directions - in sending requests to patients or their family members and in positive responses to their requests for connection. The findings point to the need to develop guidelines for health professionals regarding e-professionalism. Key messages • There are differences between MDs and DMDs toward communicating with patients using SNSs, DMDs being more open to the communication with patients. • There is a need to develop guidelines for health professionals on e-professionalism with emphasis regarding how to professionally communicate with patients on SNSs.

Background Physical activity is a major determinant of physical and mental health. International recommendations identify health professionals as pivotal agents to tackle physical inactivity. This study sought to characterize medical doctors’ clinical practices concerning the promotion of patients’ physical activity, while also exploring potential predictors of the frequency and content of these practices, including doctors’ physical activity level and sedentary behaviours. Methods A cross-sectional study assessed physical activity promotion in clinical practice with a self-report questionnaire delivered through the national medical prescription software (naturalistic survey). Physical activity and sedentary behaviours were estimated using the International Physical Activity Questionnaire (short form). Indicators of medical doctors’ attitudes, knowledge, confidence, barriers, and previous training concerning physical activity promotion targeting their patients were also assessed. Multiple regression analysis was performed to identify predictors of physical activity promotion frequency by medical doctors, including sociodemographic, attitudes and knowledge-related variables, and physical activity behaviours as independent variables. Results A total of 961 medical doctors working in the Portuguese National Health System participated (59% women, mean age 44 ± 13 years) in the study. The majority of the participants (84.6%) reported to frequently promote patients’ physical activity. Five predictors of physical activity promotion frequency emerged from the multiple regression analysis, explaining 17.4% of the dependent variable (p p = 0.037), having a medical specialty (p = 0.030), attributing a high degree of relevance to patients’ physical activity promotion in healthcare settings (p p p = 0.001). Conclusions The sample of medical doctors approached reported a high level of engagement with physical activity promotion. Physical activity promotion frequency seems to be influenced by the clinical practice setting, medical career position and specialty, attitudes towards physical activity, and perception of patients´ interest on the topic, as well as medical doctors’ own physical activity levels.

Background: Healthcare students that refuse to get vaccinated may expose themselves and their patients to several vaccine-preventable diseases, especially during outbreaks or at peak epidemic activity, becoming a threat to themselves and their patients. This study aimed to assess their attitudes towards and perception of vaccines and vaccination. Methods: An anonymous questionnaire was shared with medical students, pharmacy students and medical residents in Hygiene and Preventive Medicine at the University of Florence (Italy), in February 2021. The questionnaire contained 39 questions with open, multi-choice, yes–no, Likert scale answers. A Vaccine Hesitancy Index (VHI) was then calculated. A descriptive statistical analysis was performed. Results: A total of 473 students participated in this study. All students were in favour of vaccination (99.2%) but a relatively low number of participants judged their level of knowledge about vaccinations as “good” (21.8%) or “excellent” (0.6%). About half of students declared that they are not adequately trained during their academic courses. The VHI showed low levels of vaccine hesitancy (mean ± SD 0.38 ± 0.16); moreover, the students were willing to get vaccinated against SARS-CoV-2 when recommended (88.2%) and thought that these vaccines are generally safe. Few students considered the development of SARS-CoV-2 vaccines (13.1%) and the procedures for evaluating clinical trials for marketing authorisation of these vaccines (12.9%) too fast to guarantee their efficacy and safety. Conclusions: Since vaccination and vaccine hesitancy and acceptance topics are being paid increasing attention by the population, new strategies to increase future healthcare professionals’ willingness to promote vaccination and get vaccinated, as well as knowledge on vaccines and vaccination, will be of the utmost importance to fight vaccine preventable diseases.

Trabalho Final do Mestrado Integrado em Medicina apresentado à Faculdade de Medicina Conhecimento e perceção dos médicos portugueses sobre aplicações informáticas na medicina: a blockchain. Resumo: Introdução: A blockchain é uma base de dados com o potencial de introduzir na medicina uma rede mais segura, transparente e descentralizada, permitindo uma gestão otimizada dos registos de informação médica, da monitorização remota de doentes, da investigação e educação biomédicas, entre outras. No entanto, para que a blockchain possa ser introduzida com sucesso na área da saúde é importante que os vários intervenientes, nomeadamente os médicos, conheçam as caraterísticas desta tecnologia e que a aprovem. Objetivo: O objetivo deste estudo foi avaliar o conhecimento e a perceção dos médicos portugueses sobre as aplicações médicas da blockchain. Material e Métodos: Realizou-se um estudo observacional transversal em amostra de conveniência, através de um questionário de 12 perguntas, aplicado via convite em redes sociais específicas médicas. Resultados: Numa amostra de 81 médicos, 75,3% revelaram desconhecer a blockchain, as mulheres significativamente conhecendo menos a tecnologia. Globalmente, a perceção dos médicos desta amostra sobre a blockchain na medicina é positiva. As médicas apresentaram uma perspetiva menos otimista em relação a algumas aplicações da blockchain. Conclusão: Para uma introdução bem-sucedida da blockchain na medicina em Portugal, é importante promover um maior conhecimento sobre o tema junto dos médicos, especialmente das profissionais do sexo feminino. Knowledge and perception of Portuguese medical doctors on informatic applications in medicine: the blockchain. Abstract: Introduction: The blockchain is a database that can potentially introduce a safer, more transparent, and decentralized network in healthcare. So, an optimized management of eletronic health information, remote patient monitoring and biomedical research, among others is securely feasible. However, to successfully introduce a new technology like blockchain in the Portuguese healthcare, it is important that patients and healthcare professionals, particularly medical doctors, know what the characteristics of this technology are to approve it and to use it. Objective: This study aimed to evaluate the knowledge and perception of Portuguese medical doctors on the use of blockchain in healthcare. Methods: Cross-sectional study through a 12-question survey, via social professional networks’ invitation, in a convenience sample. The sample size was previously determined. Results: In a n=81 sized sample, 75,3% of the respondents didn’t know what blockchain is. Women revealed significantly less knowledge about this technology. A positive perception on the blockchain in healthcare was found in this sample. Female medical doctors had a less optimistic view on some of the applications of the blockchain. Conclusion: To a successful introduction of the blockchain in Portuguese healthcare, it is important to promote a better knowledge about this topic among medical doctors, especially female doctors.

Background Social networking sites (SNSs) have penetrated all aspects of health care professionals’ (HCPs’) professional and private lives. A new term, e-professionalism, has emerged, which describes the linking of traditional values with this new dynamic online environment for HCPs. The four aims of this study were: (1) to examine their SNS prevalence and usage habits, (2) to examine their perception of e-professionalism, (3) to develop an e-professionalism assessment compatibility index and (4) to investigate their tendencies and differences in values of the e-professionalism assessment compatibility index (ePACI). Methods A cross-sectional study was conducted among MDs and DMDs in Croatia via email using a questionnaire. The questionnaire was distributed to all MDs and DMDs who were members of their respective chambers. In addition to descriptive statistics, Chi-square or Fisher’s exact test when appropriate, t-test, ANOVA and Mann–Whitney U tests were used to determine differences between groups. A principal component analysis (PCA) with varimax rotation was used to investigate dimensionality. Results of the PCA were compared to the coding based on the Social Media e-Professionalism rubric in order to create the ePACI. Results Of the 1013 gathered responses, 753 were from valid SNS users and suitable for further analysis. Facebook (91.6%) and Instagram (63.1%) were the predominant SNSs used. Both groups have a good understanding of e-professionalism. The newly developed ePACI deviates slightly in the “conservative” direction in the cases of both, MDs (t506 = 19.033, p 245 = 12.991, p p s = −0.142, p p Conclusions MDs and DMDs in Croatia are frequent SNS users, with Facebook and Instagram being the main SNSs used. Both groups have a good understanding of e-professionalism. The newly developed ePACI deviates slightly towards the conservative side regarding perception of the e-professionalism content for both groups. The development of the ePACI, and its subsequent usage in further research, will have a direct influence in its validation, gathering comparable data, and be able to direct efforts in oversight, regulation and education.

Background Increasing feminization of medical professions is well-acknowledged. However, this does not always equate to equitable representation of women within medicine, regarding their socio-demographic indicators, regions, sectors and fields of practice. Thus, this paper quantifies the gap in supply of female medical doctors in relation to demand, towards reaching different gender equity scenarios. Methods A retrospective review of the Health Professions Council of South Africa’s (HPCSA) database on registered medical doctors (medical practitioners and medical specialists) from 2002 until 2019 was utilized as an indicator of supply. Descriptive statistics were used to summarize data, and inferential statistics (considering a significance level of 0.05) were utilized to determine the association between the number of male and female doctors, disaggregated by demographic variables. We forecasted future gaps of South African male and female doctors up to 2030, based on maintaining the current male-to-female ratio and attaining an equitable ratio of 1:1. Results While the ratio of female doctors per 10 000 population has increased between 2000 and 2019, from 1.2 to 3.2, it remains substantially lower than the comparative rate for male doctors per 10 000 population which increased from 3.5 in 2000 to 4.7 in 2019. Men continue to dominate the medical profession in 2019, representing 59.4% (27,579) of medical doctors registered with the HPCSA with females representing 40.6% (18,841), resulting in a male-to-female ratio of 1:0.7. Female doctors from the Black population group have constantly grown in the medical workforce from 4.4% (2000), to 12.5% (2019). There would be a deficit of 2242 female doctors by 2030 to achieve a 1:1 ratio between male and female medical doctors. An independent-samples t-test revealed that there was a significant difference in the number of male and female doctors. The Kruskal–Wallis test indicated that there was a sustained significant difference in terms of the number of male and female doctors by population groups and geographical distribution. Conclusions Based on the investigation, we propose that HRH planning incorporate forecasting methodologies towards reaching gender equity targets to inform planning for production of healthcare workers.

Background: Although much is known about the rapidly spreading COVID-19 disease, a lot of knowledge is still evolving. The knowledge, attitude and practice (KAP) of healthcare workers (HCWs) towards COVID-19 remain key in protecting themselves and in fighting the “war” against the disease. This study assessed the KAP of HCWs in Kano, northern Nigeria. Methodology: A cross-section of different cadre of healthcare workers was recruited online via google forms. Using a link, the participants completed an adapted from a similar study, pre-tested questionnaire on KAP regarding COVID-19. Predictors of KAP were assessed using logistic regression modelling. Results: Among the 651 HCWs invited to participate, 233 respondents responded giving a response rate of 35.8%. Of these, 195 (83.7%) had good knowledge, 183 (78.9%) had a positive attitude and 180 (77.6%) had good practice towards prevention of COVID-19. The odds of having good knowledge were significantly lower among Community Health Officers/Community Health Extension workers (aOR=0.2, 95% CI: 0.1-0.6;p

We explored the psychological effects of the COVID-19 pandemic on medical doctors working in hospitals assigned to treat COVID-19 patients. An exploratory, descriptive, qualitative research design was applied with a group of 204 medical doctors working within 40 different hospitals across 15 provinces of Turkey. Results reveal that medical doctors experienced various psychological problems, such as personal stress, anxiety, fear, panic attacks, depressive tendencies, and sleep disturbances, during the pandemic period. To cope with the pandemic, the medical doctors exhibited behaviors such as religious prayer, using antidepressants, undertaking different hobbies, paying attention to social distancing and hygiene rules and guidelines, and having a balanced and healthy diet. Our findings demonstrate that COVID-19 increased medical doctors psychological pressure and associated physical symptoms. © 2021 Scientific Journal Publishers. All rights reserved.

Coronavirus disease 2019 (COVID-19) has rapidly become a global health concern after its first known detection in December 2019. As a result, accurate and reliable advance warning system for the early diagnosis of COVID-19 has now become a priority. The detection of COVID-19 in early stages is not a straightforward task from chest X-ray images according to expert medical doctors because the traces of the infection are visible only when the disease has progressed to a moderate or severe stage. In this study, our first aim is to evaluate the ability of recent \textit{state-of-the-art} Machine Learning techniques for the early detection of COVID-19 from chest X-ray images. Both compact classifiers and deep learning approaches are considered in this study. Furthermore, we propose a recent compact classifier, Convolutional Support Estimator Network (CSEN) approach for this purpose since it is well-suited for a scarce-data classification task. Finally, this study introduces a new benchmark dataset called Early-QaTa-COV19, which consists of 1065 early-stage COVID-19 pneumonia samples (very limited or no infection signs) labelled by the medical doctors and 12 544 samples for control (normal) class. A detailed set of experiments shows that the CSEN achieves the top (over 97%) sensitivity with over 95.5% specificity. Moreover, DenseNet-121 network produces the leading performance among other deep networks with 95% sensitivity and 99.74% specificity., Comment: 12 pages

This study integrates two competing views to examine whether medical doctors are satisfied with their jobs when they perceive their hospitals as being oriented toward profit (i.e., rational choice theory) or purpose (i.e., public service motivation). Using a sample of 127 doctors from 70 hospitals, this study tests these competing views. The results show that doctors who perceive their hospitals as purpose-driven are likely to experience job satisfaction, and this pattern still holds even if they also perceive their hospitals to be emphasizing profits. However, only the purpose-driven orientation results in job satisfaction via a sense of meaningfulness. Thus, this study offers comprehensive evidence that while medical doctors are likely to be satisfied with their jobs when they work at either purpose-driven or profit-driven hospitals, only purpose-driven hospitals give doctors a sense of meaningfulness. This finding suggests that both rational choice theory and public service motivation perspective are valid; however, public service motivation plays a greater role in terms of a sense of meaningfulness. Theoretical contributions and practical implications are discussed.

Due to the COVID-19 pandemic, as well as the fast progression of modern society, occupational stress has recently reached alarming levels with consequences for doctors’ psychological well-being. The aim of this study was to analyze the relationship among emotional stability, psychological well-being, and life satisfaction of medical doctors. We conducted a cross-sectional study on 280 medical doctors from Romania between February 2021 and September 2021, in the period between the third and fourth pandemic waves, who were evaluated by the DECAS, ASSET, and Satisfaction with Life scales. Our results showed that emotional stability is negatively correlated with psychological well-being (r = −0.526, p < 0.000) and positively correlated with life satisfaction (r = 0.319, p < 0.0001). Between psychological well-being and life satisfaction, we found a negative correlation (r = −0.046, p < 0.001). This study shows that there is a correlation among emotional stability, psychological well-being, and life satisfaction, which is why it can be considered that Romanian doctors have generated coping mechanisms during the COVID-19 pandemic.

PurposeDespite the fundamental role of culture in an organisational setting, little is known of how organisational culture can be sometimes determined/influenced by professional culture, particularly in the global south. Using Nigeria as a research focus, this article uses critical discuss analysis to examine the link between professional and organisational culture.Design/methodology/approachThis study uses qualitative research approach to establish the significance of professional culture as a determinant of organisational culture among healthcare organisations.FindingsWe found that the medical profession in Nigeria is replete with professional duties and responsibilities, such as professional values and beliefs, professional rules and regulations, professional ethics, eagerness to fulfil the Hippocratic Oath, professional language, professional symbols, medicine codes of practice and societal expectations, all of which conflate to form medical professionals' values, beliefs, assumptions and the shared perceptions and practices upon which the medical professional culture is strongly built. This makes the medical professional culture stronger and more dominant than the healthcare organisational culture.Research limitations/implicationsThe extent to which the findings of this research can be generalised is constrained by the limited and selected sample of the research.Practical implicationsThe primacy of professional culture over organisational culture may have dysfunctional consequences for human resource management (HRM), as medical practitioners are obliged to stick to medical professional culture over human resources practices. Hence, human resources departments may struggle to cope with the behavioural issues that arise due to the dominant position taken by the medical practitioners. This is because the cultural system (professional culture), which is the configuration of beliefs, perceived values, code of ethics, practices and so forth. shared by medical doctors, subverts the operating system. Therefore, in the case of healthcare organisations, HRM should support and enhance the cultural system (the medical professional culture) by offering compatible operating strategies and practices.Originality/valueThis article provides valuable insights into the link between professional culture and organisational culture. It also enriches debates on organisational culture and professional culture. We, therefore, contend that a strong professional culture can overwhelm and eventually become an organisational culture.

Background The paediatric Moral Distress Scale-Revised (MDS-R) was previously translated and adapted to Swedish paediatric oncology. Cognitive interviews revealed five not captured situations among the 21 items, resulting in five added items: 22) Lack of time for conversations with patients/families, 23) Parents’ unrealistic expectations, 24) Not to talk about death with a dying child, 25) To perform painful procedures, 26) To decide on treatment/care when uncertain. The aim was to explore experiences of moral distress in the five added situations in the Swedish paediatric MDS-R, among healthcare professionals (HCPs) in paediatric oncology. Methods In this national cross-sectional survey, the Swedish paediatric MDS-R, including five added items, were used. Descriptive statistics, non-parametric analysis of differences between professions and a MDS-R score for each item were calculated. Internal consistency was tested using Cronbach’s alpha and inter-item correlation test. HCPs (n = 278) at all six Swedish paediatric oncology centres participated (> 89%). The Regional Ethical Review Board had no objections. Consent was assumed when the survey was returned. Results Nursing assistants (NAs) reported higher intensity and lower frequency on all added items; registered nurses (RNs) reported a higher frequency on item 22–25; medical doctors (MDs) reported higher MDS-R score on item 26. On item 22, intensity was moderate for RNs and MDs and high for NAs, and frequency was high among all. Item 22, had the second highest MDS-R score of all 26 for all professional groups. On item 23, the level of disturbance was low but it occurred often. The 26-item version showed good internal consistency for the overall sample and for all professional groups. However, item 22 and 24 could be viewed as redundant to two of the original 21. Conclusion In accordance with other studies, the intensity was higher than the frequency, however, the frequency of the added items was higher than of the original items. In line with previous research, item 22 and 23 are important elements of moral distress. RNs experience the situations more often while NAs find them more disturbing. The results indicate that the added items are important in capturing moral distress in paediatric oncology.

Background: Vaccine hesitancy defined as “delay in acceptance or refusal of vaccination despite availability of vaccination services is a global phenomenon. There have been anecdotal evidence or rather poor documentation of hesitancy or noncompliance among medical practitioners in Northern Nigeria. Objective: We explored the perceptions and perspectives of doctors in Kebbi State, Nigeria, on immunization programs. Materials and Methods: We conducted this cross-sectional study involving 63 medical doctors, whose self-administered questionnaires were analyzed using descriptive statistics. Results: Only 43.55% of the doctors reported having under-five children with complete vaccination, whereas 84% of the doctors surveyed had a child or a relative with a child who had missed routine immunization (RI) previously. Approximately 66.67% and 67.74% of the doctors believed in the quality of the vaccine and capacity of the health workers to effectively deliver polio supplementary immunization activities (PSIAs), respectively. Adequate training of workers (26.23%) and public enlightenment campaigns (23.68%) were suggested as PSIAs enhancers. Collaboration with community and religious leaders (29.2%), education and public sensitization (28.09%), and improved government funding (13.48%) to improve RI were suggested. Others include incentives and fines (8.99%), adequate training of staff (10.11%), house-to-house vaccination (4.49%), and media publicity (5.62%). Conclusion: Vaccine hesitancy among medical doctors could be a threat to sustained polio interruption and efforts toward improving RI in Kebbi State. The state government and development partners should modify the current approaches to attaining polio-free certification standards and strengthen RI in the state. In addition, there is a need to improve sensitization of doctors in the state on vaccines and their safety profiles with a view to reducing vaccine hesitancy among them.

BackgroundBullying is public health problem globally in workplaces with untold deleterious effects on the health and well-being of individuals at the receiving end. Bullying has been found to disrupt social interaction at workplace thereby creating an unhealthy and seemingly unproductive work environment. Studies have reported varying rates of workplace bullying as high as 83% in Europe, 65% in the Americas and 55% in Asia with very little documented in the contemporary African setting and Nigeria in particular. It therefore became imperative to assess the level of bullying and its associated factors among medical doctors in residency training in a tertiary health institution in Plateau state Nigeria.MethodologyThis was a cross sectional study conducted among resident doctors in Jos University Teaching Hospital between November 2019 and February 2020 using quantitative method of data collection and SPSS version 20 was used for data analysis. Crude and adjusted odds ratios as well as 95% confidence interval were used in this study with a p-value of ≤0.05 considered statistically significant.ResultsThe mean age of the respondents was 32.3 ± 3.9 years with 78 (62.9%) being 31 years and above. Bullying was currently being experienced by 74 (59.7%) of the respondents with verbal aggression and threats as well as insult and use of derogatory remarks being the forms of bullying experienced by 85.1 and 74.3% of the respondents, respectively. Furthermore, witnessing a colleague being bullied was the sole factor found to be significantly associated with workplace bullying (AOR = 0.18; 95% CI = 0.068–0.449; p < 0.001).ConclusionWorkplace bullying has been found to be in existence and relatively high among medical doctors in residency training in this setting with witnessing someone being bullied as its sole associated factor.

The study aimed to investigate the range of experiences and attitudes of Croatian medical doctors (MDs) related to vaccination and vaccine hesitancy. In January 2021 three asynchronous online focus groups were held using MRQual, a web-based platform, which included 46 MDs from all three levels of the healthcare system in Croatia. NVivo, a qualitative data analysis software package, was used for the thematic analysis of collected data. The participants expressed a high level of support for the Croatian immunization program and vaccines in general. However, some skepticism was expressed regarding new vaccines and the regulatory processes of their approval. A significant number of participants raised concerns over the approval of COVID-19 vaccines, especially given their rapid development. The results also revealed that the process of communication with patients is often based on the very elaborate categorizations of patients based on previous experience, which leads to prioritizing and a communication breakup when dealing with “problematic patients”. MDs find themselves in a delicate situation where a fine balance between time-consuming communication with patients and the demands for maintaining satisfying vaccination uptake is needed. The situation arises from a social roles conflict that is embedded in wider social values and expectations, since communication problems do not arise in the doctor’s office, and therefore cannot be solved without addressing the social forces that cause trust deficiencies. To achieve better immunization results public health leaders need to better understand the social contexts and constraints of MDs vaccine-related behaviors.

Uvod Društvene mreže (DM) zadiru u privatnost pojedinca i ostavljaju opasnost miješanja privatnog i profesionalnog. Održavanje postavka privatnosti profila te više profila pod raznim imenima omogućava višu razinu zaštite i privatnosti. Cilj ovog rada bio je istražiti razlike u vrsti profila doktora medicine (MD) i doktora dentalne medicine (DMD) na Facebooku i Instagramu. Materijali i metode Presječno istraživanje provedeno je korištenjem online upitnika na prigodnom neprobabilističkom uzorku svih MD i DMD članova Hrvatske liječničke komore i Hrvatske komore dentalne medicine. Deskriptivna statistika i hi kvadrat test provedeni su prilikom obrade podataka. Rezultati Uzorak se sastojao od 753 ispitanika (246 DMD i 507 MD) koji koriste barem jednu DM. Na obje DM i MD i DMD imali su predominantno samo jedan profil s pravim imenom (Facebook MD 84.9% vs. DMD 79%, Instagram MD 74.1% vs DMD 85%). Statistički značajna razlika između dvije skupine postoji na Facebooku gdje 17.6% DMD ima i privatan i profesionalan profil za razliku od 5.5% MD, te značajno više MD (9%) ima samo jedan profil pod drugačijim imenom za razliku od samo 2.5% DMD (x2=34.432, df=3, P

Diagnosis of child abuse and neglect is a challenging matter: in case of misdiagnosis, the child cannot benefit from an early treatment; erroneous interpretation may generate legal issues. Some studies reported physicians' lack of knowledge in child abuse and neglect. However, it is not clear if the reasons of this lack relay on an insufficient preparation of students during medical school and/or a deficiency in continuing medical education during/after fellowships. For these reasons, the authors of the present manuscript administered a questionnaire to last year medical students to: evaluate the degree of knowledge on this thematic in a medical student sample; understand if the abovementioned lack may be due to insufficient preparation of students during medical school. Study population included 179 students. The 77.7% demonstrated a low knowledge of this thematic, but they showed a high insight of their lack. The authors pointed out that medical school education can represent a weak point in future medical doctor knowledge on child abuse and neglect. It also allowed to identify as study sample's medical students had high awareness of their lacks in this field. In addition, comparison of medical schools from different geographical areas suggested common issues independent of which accreditation system is implemented. Thus - independent of which corrective strategy will be planned - the study highlighted necessity for each medical school to define: its current ability to properly train students in child abuse and neglect; students' awareness of their level of expertise. This can help schools to identify the most suitable correctives.

Comprehensive knowledge of blood transfusion practices among clinicians has an important role in provision of safe blood but continuous education and the academic rigor is not as versatile in private sector as in tertiary hospitals. The objective of this study is to evaluate the knowledge of clinicians in private practice in Ibadan on transfusion medicine. Eighty-one medical doctors from the 5 urban local government areas were enlisted in a multistage sampling technique. Self-administered questionnaires were employed and data analyzed using SPSS. Majority of clinicians were between the ages of 30-40 years (43.2%), had practiced for 0-5 years (42.0%) and prescribed blood transfusion at least once a month (44.4%). Male: female ratio was 4:1. The proportion of correct answers to the questions about age, minimum weight, Systolic Blood Pressure and Diastolic Blood pressure as criteria for selection of blood donor were as; 56.8%, 72.8 %, 71.6% and 81.5%, respectively. The proportion of correct answers to the questions on contraindications for the transfusion of platelet and cryoprecipitate were as; 54.3% and 9.9 %, respectively. The overall Knowledge score ranged from 22.0% to 93.0% (Mean= 49.0%; SD=37.7%). The mean knowledge score of indications and contraindications for transfusion of blood components are 79.2% and 34.2%, respectively. The study demonstrated significant gaps in knowledge of transfusion medicine. This can be closed by a more deliberate review of medical curricula, continuous medical education by professional groups and relevant stakeholders, as well as, a state-wide clinical audit of transfusion services.

Background Infections due to resistant bacteria are associated with severe illness, increased risk for complications, hospital admissions, and higher mortality. Inappropriate use of antibiotics, which contributes to increased antibiotic resistance (ABR), is common in healthcare settings across the globe. In Cameroon, antibiotics have been reported as high as 45–70% of prescriptions. We sought to investigate the knowledge, attitudes, and perceptions regarding appropriate antibiotic use and ABR of medical doctors practicing in tertiary hospitals in Yaoundé, Cameroon. Methods We conducted a cross-sectional survey using a 54-item self-administered questionnaire sent via email to medical doctors working in the four major tertiary hospitals of Yaoundé. The questionnaire recorded socio-demographics, perceptions on antibiotic use and ABR, sources and usefulness of education on ABR, and clinical scenarios to appraise knowledge. Results A total of 98/206 (48%) doctors responded. Years of experience ranged between 1 and 17 years. Most participants agreed that ABR is a problem nationwide (93%) and antibiotics are overused (96%), but only one third (32%) thought that ABR was a problem in their wards. Most respondents (65%) were confident that they use antibiotics appropriately. We found a mean knowledge score of 56% (± 14), with prescribers not influenced by patient-exerted pressure for antibiotic prescribing scoring better compared to those influenced by patients (67% vs 53%, p = 0.01). Overall, most participants (99%) expressed interest for further education on both appropriate antibiotic use and ABR. Conclusion Confidence of prescribers in their ability to appropriately use antibiotics conflicts with the low level of knowledge on antibiotic use in this group of doctors. Moreover, the opinion of the majority, that ABR is not a problem in their own backyard is in keeping with similar studies in other countries and is of significant concern. Introduction of formal antibiotic stewardship programmes in Cameroon may be a useful intervention.

Although scientific publication is often mandatory in medical professions, writing the first research article for publication is challenging, especially as medical curricula have only a minor focus on scientific writing. The aim was therefore to identify facilitators and barriers experienced by medical doctors writing their first scientific article for publication. An explorative inductive approach made use of semi-structured interviews for collecting data until saturation. Data were analyzed with systematic text condensation. Several barriers were identified: (a) writing in general, (b) writing in English, (c) dealing with content, structure, and presentation, and (d) navigating in the author group. Good supervision in the initial writing phase was a facilitating factor. Medical doctors requested a course in which they could work on their own articles and give feedback to fellow students. They valued skilled lecturers and individual supervision, and they wanted to learn about author instructions, how to present text correctly, and how to sell their core message. Their goal was to create a useful end product and to obtain European Credit Transfer System (ECTS) points. The facilitators and barriers that medical doctors experience when writing their first scientific article for publication and their course requests should be reflected in the learning objectives and content of future courses.

The outbreak of coronavirus disease in 2019 (COVID-19) in Wuhan has led Chinese health authorities to recruit healthcare providers from the least-affected areas to provide care to the infected patients in Wuhan. We took further steps to explain some plausible reasons for their experiences. We used interpretative phenomenological analysis (IPA) to understand the subjective experiences, as well as the reasons for these experiences among the healthcare providers who had traveled from the least-affected parts of China to render aid during Wuhan’s COVID-19 outbreak. Using purposive and snowball sampling, healthcare professionals were recruited from three major hospitals in Jiangsu province. Semi-structured interviews were conducted from 1 September to 14 November 2020 in face-to-face contexts. Ten nurses and four doctors provided their informed consent for the study. The primary superordinate theme from the responses highlighted how social identity and individual needs were challenged by each individual’s professional ethics. COVID-19 not only presents significant risks to the health of nurses and medical doctors, it further challenges their emotional and psychosocial wellbeing. Care should be taken in allocating support and help, with the careful deployment of professional values and beliefs, so that any human resource as precious as medical doctors and nurses can be protected.

Background: Ethical problems routinely arise in the healthcare profession and more so in hospitals providing cancer diagnosis and care. Literature study indicates that almost all studies addressing ethical issues in cancer have been qualitative and reported from the developed countries, while there has been no study reported from developing countries. For the first time, we performed a questionnaire study to quantify the ethical issues plaguing the healthcare fraternity in the diagnosis and care of people with cancer. Method: This prospective study was conducted under the aegis of UNESCO Bioethics Education and Research Unit of the UNESCO Chair in Bioethics, Haifa at Mangalore Institute of Oncology Mangalore, India. The investigators approached the healthcare professionals involved in diagnosis, treating, and caring for patients with cancer and ascertained various ethical issues they faced. Data were tabulated and subjected to frequency and percentage. Result: The results indicated that discussing end-of-life issues with the patient and breaking bad news were the two most difficult ones while discussing end of life issues with family caregivers was the least. Conclusion: According to this study, oncology treatment involves a series of dilemmatic issues and breaking bad news. Based on the detailed studies and emphasis on handling these issues, it is possible to develop a teaching module for training the health care professionals and workers for managing the ethical issues effectively.

Objective: This study aimed to compare job satisfaction, burnout, and depression scores of medical doctors from different regions in Turkey. Method: A cross-sectional study was performed during October 2013 in three cities from Turkey. Participants were asked to self-administer a demographic information questionnaire, the Minnesota Satisfaction Questionnaire (Internal work satisfactionIWS and External work satisfaction-EWS), the Beck Depression Inventory (BDI), the Maslach Burnout Inventory (MBI), Maslach Emotional Exhaustion Score (MEES), and Maslach Personal Accomplishment Score (MPAS). Results: Mean (±SD) Total work satisfaction score was 66.2±12.6. 118 participants had BDI scores of 10 or less while 40 participants had 11 or higher scores. Proportions for poor depersonalization, emotional exhaustion, and personal accomplishment were 18.6% (n=29), 5.8% (n=9), and 81.9% (n=127) respectively. There were significant differences concerning some variables between the three cities. Most of the doctors in Şırnak and Hakkari were younger, single, and less experienced compared to the more developed Çanakkale (p

«Workplace violence towards healthcare workers: an observational study in the College of Physicians and Surgeons of Rome». Introduction: Aggressions to healthcare personnel are a growing and underestimated phenomenon. The damage to the individual and to the community is real, since the assaults increase work stress and can also lead to sickness absence. Moreover, the consequences on the quality of care and economic repercussions need to be taken into account. Objective: To estimate the prevalence of violence towards medical personnel of the College of Physicians and Surgeons of Rome and to evaluate its association with socio-demographic variables. Methods: Cross-sectional study. Respondents completed an online questionnaire composed of 30 questions on personal information, work, any aggression suffered and opinions about the phenomenon. Descriptive statistical analysis, univariate, bivariate and multivariate analyses were performed. Results: Out of 956 responders, 66.5% experienced at least one episode of aggression during their working life. Women were more likely victims than men (71%), especially due to verbal aggression (OR 1.53, 95%CI: 1.16-2.02). Age acts as a protective factor (OR 0.97; 95%CI: 0.96-0.99). The subjects with a full time position (OR 2.1; 95%CI: 1.46-3.05) seem to be more at risk. In addition, the doctors employed in the territorial structures of the National Health System (OR 2.08; 95%CI: 1.36-3.18), as well as in the local emergency services (OR 3.39; 95%CI: 1.14-10.05) and in social security institutions (OR 9.58; 95%CI:1.2-76.41) were more at risk. Conclusions: The results of this study reveal that the phenomenon of aggression is not negligible, and that awareness on the issue and staff training is essential.

Objective Key factors which positively influence recruitment and retention of doctors to rural practice include rural background and positive rural training experience. Despite this knowledge, there is no well‐established conceptual framework to explain how these factors influence intention. The aim of this study was to consider rural practice self‐efficacy and its influence on rural career choice by doctors. Questions relating to self‐efficacy were formulated using Bandura's four proposed sources of self‐efficacy, which include mastery experiences, vicarious experience, social persuasion and emotional and physical response to experiences. Design Cross‐sectional study. Setting and participants Medical school graduates from Flinders University, who completed a rural year as a part of the clinical component of the course between 1997 and 2015. Main outcome measures Rural self‐efficacy; current and intended location of practice in small rural communities (

Objectives To explore an understanding of medical doctors' entire process of specialty choice with a focus on the influence of personal experiences and personality traits on choices made. Methods A qualitative study was performed. Semi-structured individual interviews were conducted with medical doctors undergoing their specialty training in Sweden about their experiences and personalities. The transcribed interviews were analyzed with an inductive content analysis approach. Results A total of 15 medical doctors participated. Three themes were identified using content analysis: To be invited or not, to fit in or not and to contribute or not. Furthermore, the results refute that specialty choice is a long-term, complex process. Conclusions First, the importance of being invited to the specialty choice was stressed by the doctors, especially in their early years when they needed to feel valued and trusted. Secondly, the need to fit in was essential to make a sustainable career choice. Finally, the doctors' expressed a will to contribute to the medical field of their chosen specialty. The interviews showed that specialty choice is a long-term, complex process; therefore, one implication for the healthcare sector would be to target the entire chain of medical education to improve recruitment strategies for those specialties with recruitment difficulties. More studies are needed to understand better how positive and negative encounters within the healthcare sector can influence young doctors' specialty choice.

Malta is the only EU country where abortion remains illegal in all circumstances. This study aims to assess the previously unexplored views of Malta’s medical doctors on the legality of contraception, abortion, assisted reproductive technology and surrogacy. Following ethics approval, 1578 out of a total of 2468 registered medical doctors in Malta were invited for an anonymous survey. The response rate was 28.8% (n = 454), guaranteeing a maximum margin of error of 4.16% assuming a 95% confidence level. Responses consisted of “Yes”, “No”, and “Not sure”. In the abortion section, “Yes” responses were specific to different gestational age limits. A majority supported all contraceptive methods being legal: morning-after pill (59.7%); intra-uterine device (85.9%); surgical sterilisation (>70%). A majority also agreed with in-vitro fertilisation being legal (93.8%). Embryo freezing and surrogacy garnered less support (39.9% and 40.5% respectively). Legalising abortion for “Woman’s life in danger” and “Non-viable fetal anomaly” was supported at least up to 12 weeks gestation by 66.8% and 63.0% respectively, and in all stages of pregnancy by 54.2% and 50.2% respectively. Support, at least up to 12 weeks gestation, was less for other circumstances: “Rape or incest” (35.3%); “Preserve a woman’s physical health” (30.0%); “Preserve a woman’s mental health” (26.8%); “Viable fetal anomaly” (24.6%); “

Patients hunt for genuine empathy from their medical doctor. Empathy is an affective mode of understanding. Empathy involves being enthused by another's experiences. However, a leading group medical doctors defines empathy as 'the act of correctly acknowledging the emotional state of another without experiencing that state oneself'. Beyond the field of medicine, empathy is an approach to understanding that precisely involves emotional resonance. However, mentioned definition of empathy primarily gives emphasis to an intellectual component rather than emotional form. Medical educationist and medical professional bodies increasingly recognise the importance of empathy because there are a lot report published regarding poor empathy level among medical doctors. This article will try to discuss emphasising on educational intervention which improves empathy level and its influence on healthcare.

A large number of coronavirus disease 2019 (COVID-19) recovered patients are suffering from related symptoms. We conducted telephone interviews with 186 COVID-19 recovered medical doctors to determine the post-COVID symptoms, duration, and associated risk factors. About 70% of participants had at least one acute post-COVID symptom, including fatigue (43.0%), sleep disturbance (13.4%), lack of concentration (11.8%), breathing difficulty (10.2%), headache (6.5%), and muscle pain (6.5%). However, about 24% of participants reported having long post-COVID symptoms. Logistic regression analysis showed that female sex (odds ratio {OR}, 2.79; 95% CI, 1.28-6.06; p-value: 0.010) and comorbid conditions (OR, 2.28; 95% CI, 1.08-4.79; p: value, 0.030) are risk factors for the long post-COVID symptoms.

Supplemental Digital Content is available in the text, Purpose of review The COVID-19 outbreak has had major impact on individual's psychological health and overall well being worldwide. Evidence shows that these psychological challenges are especially prominent in healthcare workers (HCW); especially in nurses. Indeed, several studies report that nurses suffer more psychologically because of the consequences of the pandemic compared with medical doctors. To further look into this, we systematically review the recent literature to see whether the psychological impact of the COVID-19 pandemic differs between medical doctors and nurses across studies and which aspects of mental health are especially affected in nurses. Recent findings Across studies, there is solid evidence that nurses show poorer mental health outcomes compared with medical doctors during the COVID-19 pandemic. This is especially true for symptoms of depression, anxiety and posttraumatic stress disorder (PTSD). Here, prevalence rates in nurses are often higher than 50%. In contrast, general stress levels and burnout seem to be comparable between nurses and medical doctors. Summary Given that nurses suffer more from depression, anxiety and PTSD symptoms during the COVID-19 pandemic, special programs addressing their needs are required.

Väitekirja elektrooniline versioon ei sisalda publikatsioone, Tubaka tarvitamine on üks peamisi haigestumuse ja suremusega seotud tervise riskitegureid maailmas. Arstidel on ühiskonnas oluline roll suitsetamise levimuse vähendamisel, samas nende endi suitsetamiskäitumine ja hoiakud mõjutavad tähelepanu pööramist patsientide suitsetamisele. Uurimistöö eesmärk oli anda tõenduspõhine ülevaade Eesti arstide suitsetamisest, suhtumisest suitsetamiskäitumisse ja nikotiinisõltuvusest aastatel 1982–2014. Uuring põhines Eesti arstide läbilõikelistel postiküsitlusuuringute 1982., 2002. ja 2014. aasta andmetel. Uuringu tulemused näitasid, et vahemikus 1982–2014 vähenes arstide suitsetamine ligi kolm korda ja seda just alla 45-aastaste hulgas, kuid suitsetamisega alustati üha nooremas vanuses. Aastal 2014 suitsetas igapäevaselt 12% mees- ja 4% naisarstidest. Uuringuperioodi jooksul muutusid arstide hoiakud suitsetamise suhtes vähemsoosivaks ning suurenes patsientide suitsetamisele tähelepanu pööramine. Samas oli suitsetavate arstide suhtumine suitsetamiskäitumisse oluliselt leebem. Üle poole suitsetavatest arstidest soovisid suitsetamisest loobuda. Rohkem kui kolmandikul igapäevaselt suitsetavatest arstidest oli mõõdukas või kõrge nikotiinisõltuvus, mis omakorda oli seotud suitsetamise alustamisega nooremas vanuses. Uuringust saadavad teadmised on vajalikud suitsetamisest loobumise nõustamise teenuste väljatöötamisel ning suitsetamise ennetamise ja suitsetamisest loobumise nõustamise käsitlemisel meditsiinihariduses Eestis., Tobacco use is one of the main health risks related to morbidity and mortality. Physicians have an important role in reducing the smoking in society. However, physicians' own smoking behaviour and attitudes have an effect on addressing patients' smoking. The objective of the research was to provide evidence on smoking, attitudes towards smoking behaviour, and nicotine dependence among physicians in Estonia in 1982–2014. The study was based on data from cross-sectional postal surveys among Estonian physicians in 1982, 2002 and 2014. The results of the survey showed that current smoking among physicians decreased almost three times from 1982 to 2014, particularly among under 45-year-olds. However, physicians started to smoke at an earlier age. In 2014, 12% of men and 4% of women smoked daily. Over the study period, physicians became less favouring towards smoking and the addressing patients’ smoking habits increased. Physicians who smoked, were less strict about smoking and less likely to ask their patients about smoking. At the same time, more than half of currently smoking physicians expressed desire to quit smoking. More than one third of daily smoking physicians had moderate or high nicotine dependence which in turn was associated with earlier age of smoking initiation. The information obtained from the study contributes to the development of smoking cessation counselling and to the addressing smoking prevention as well as smoking cessation counselling issues in the medical education in Estonia., https://www.ester.ee/record=b5429874

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The paper investigates the critical care staff's support towards organ donation by analysing how their attitude, knowledge, confidence, engagement, and training can act as predictors of donation consent rates. Our study focused on hospitals in the Apulia Region, Italy.The study employs a quantitative methodology based on a survey of healthcare professionals. The rate of consent to organ and tissue donation at the hospital level, given as a ratio of the permissions received to the proposals performed, was extracted from GEDON software related to the year 2019 report. For each Apulian participating hospital, we calculated a median score for each of the five predictors (namely, attitude, knowledge, confidence, engagement, and training) and investigated the association with hospital consent rates.The results highlight that the engagement of the intensive care units' healthcare personnel stands as the only influential predictor of the consent rate.In Italy's Apulia Region, efforts are needed to increase consent rates for organ donation. Strategies should concentrate on continuous support, as well as specific training of hospital staff involved in the donation process.