Search

According to several recent studies, physicians in various medical branches have some differences in attitudes towards transgender and gender‐diverse (TGD) persons based on religious or political beliefs. Our study aims to uncover the attitudes of the general physician community in Turkey, which has a youthful profile, regarding TGD individuals. The attitudes towards transgender individuals scale (ATTI) and the general conservatism scale, along with a form that asks about socio‐demographic factors, political beliefs, and level of religion, were administered online to physicians. The ATTI score of physicians (mean = 77.8) is favourable and did not vary among branches. Being female, being close to TGD, having left‐wing views, low conservatism and low religious belief scores were associated with positive attitudes towards TGD individuals. The physician profile's moderate religious belief and left‐wing views can be interpreted as a country‐specific dynamic and did not prevent the approach from being positive. Despite physicians' positive attitude towards TGD individuals on a professional level, there is resistance to contacting them in their daily lives. The possibility of the partial contribution of socially desirable response behaviour to positive scores should not be ignored. [ABSTRACT FROM AUTHOR]

This paper aims to elucidate a comprehensive biographical account of Zohra Begum Kazi, the pioneering Bengali female doctor in Bangladesh. Her professional journey commenced during the British colonial time, achieved prominence during the era of Pakistan, and ultimately reached the pinnacle of her life's accomplishments in the independent Bangladesh. Despite her distinguished medical career, her life was significantly shaped by sundry historical discourses, endowing her with the attributes of a philanthropist, a revolutionist, and a nationalist. This study seeks to assess her multifaceted contributions in three distinct dimensions: firstly, her role as a medical doctor; secondly, her engagement in the nationalist movement, and thirdly, her intellectual influence as a moral and social philosopher. Through this multifaceted analysis, we aim to consign her within the annals of Bangladesh's national history as the leading Bengali female doctor. [ABSTRACT FROM AUTHOR]

In UK helicopter emergency medical services (HEMS), 20% of doctors and 24% of paramedics are women, yet women make up 49% of all doctors and 44% of all paramedics. One hundred and forty clinicians recruited through social media undertook an anonymous online qualitative survey exploring potential barriers and enablers, particularly for women, to following a career pathway into HEMS. Perceived barriers included: toxic, alpha, macho, boys' club HEMS cultures; bullying; discrimination; recruitment issues involving biases, fitness tests and degree of competition; HEMS communications depicting elitism and a lack of diversity; and poor work-life balance. Women feared skill fade and both women and men reported that exposure to traumatic incidents deterred them. Perceived enablers included: paid, rostered time to study and attend charity events; supportive or forgiving families; a lack of care commitments; and employers offering flexible working/contracts for less than full-time hours. This research may provide the opportunity for organisations to review diversity within their teams. A recommendations document has been produced that may help to close the gender gap within HEMS. [ABSTRACT FROM AUTHOR]

Copyright of Environmental & Social Management Journal / Revista de Gestão Social e Ambiental is the property of Environmental & Social Management Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Many patients consult general practitioners instead of dentists for their oral and dental problems every year. This study aims to find the reasons why patients consult general practitioners when they have dental problems. Methods: The sample consisted of patients visiting dentists and general practitioners in Kerman, Iran. A thematic interview guide, semi-structured questions, and a mind map that allowed for structured and open-ended questions were prepared and used for the interviews. All interviews were recorded and transcribed verbatim by a final-year student. Data collection, transcription, and analysis were conducted simultaneously to allow for new topics to be raised and theoretical saturation to be reached. When researchers determined that sufficient information was available for analysis and understanding of patient opinions and beliefs, the interview process was stopped. As all audio conversations were recorded with the participant's permission, no note-taking was done during the interviews, which allowed for greater focus on the participants' conversation. The obtained data was analyzed using the content analysis. Results: A total of 52 patients were included in this study. The codes related to patients participating in this research, along with the number of respondent groups related to each code were as follows: patient's perceptions of general practitioner(GP) and dental practitioner's scope of work [21], flawed dental system (34), dental anxiety [28], financial considerations [25], and more accessibility to GPs (31). Dental abscesses and dental pain were reported as the most common reasons for consulting GPs. Conclusion: Most participants agreed that dental problems are more effectively treated by dentists. Reasons for visiting a general practitioner included lack of a specific dentist, dissatisfaction with dental treatments, lack of a dentist nearby, absence of emergency dental care, and familiarity with a physician. The most common reasons for visits were toothache and dental abscesses. Patients also sought treatment for TMJ pain, referred nerve pain, wisdom tooth pain, numbness and tingling in the jaw, gum inflammation, oral lesions, and ulcers. Furthermore, other factors such as opening hours, appointment systems and waiting time can also affect patient's consult behaviors regarding dental problems. [ABSTRACT FROM AUTHOR]

Background: Penicillin allergy delabelling (PAD), the process of evaluating penicillin allergy labels, is a key target in antibiotic stewardship, but uptake of the procedure outside clinical studies is limited. We aimed to explore factors that need to be addressed to sustainably implement a clinical pathway for PAD. Methods: We conducted a qualitative study based on semi-structured interviews with focus groups consisting of a purposive sample of twenty-five nurses and physicians working in four different hospitals in Western Norway. Systematic text condensation was applied for analysis. Results: Psychological safety was reported as crucial for clinicians to perform PAD. A narrative of uncertainty and anticipated negative outcomes were negatively associated with PAD performance. Education, guidelines, and colleague- and leadership support could together create psychological safety and empower health personnel to perform PAD. Key factors for sustainable implementation of PAD were facilitating the informant's profound motivation for providing optimal health care and for reducing antimicrobial resistance. Informants were motivated by the prospect of a simplified PAD procedure. We identified three main needs for implementation of PAD: (1) creating psychological safety; (2) utilising clinicians' inherent motivation and (3) optimal organisational structures. Conclusion: A planned implementation of PAD must acknowledge clinicians' need for psychological safety and aid reassurance through training, leadership, and guidelines. To implement PAD as an everyday practice it must be minimally disruptive and provide a contextually adaptive logistic chain. Also, the clinician's motivation for providing the best possible healthcare should be utilised to aid implementation. The results of this study will aid sustainable implementation of PAD in Norway. Ethics: The study was approved by the Western Norway Regional Committee for Medical Research Ethics (Study No:199210). [ABSTRACT FROM AUTHOR]

Doctors and nurses suffer different mental health conditions following traumatic incidents. We systematically synthesized existing evidence on the prevalence of anxiety, depression, and post-traumatic stress disorder (PTSD) and their associated risk factors among doctors and nurses following mass casualty incidents (MCIs). Systematic review. Seven databases were searched (2010–2022) with peer-reviewed articles in English using the predefined keywords. Two reviewers screened the titles, abstracts, and full texts using the eligibility criteria and extracted data independently. We used the National Institutes of Health Quality Assessment Tools (NIH-QAT) and the Critical Appraisal Skills Programme checklist (CASP) to measure the quality appraisal of the included studies. A total of 5170 articles were retrieved, and 2512 articles were assessed by title and abstract (53 were eligible for full-text review). Finally, we included 19 studies. Most were assessed as of fair quality with a considerable risk of bias. PTSD was the highest-reported mental health condition. Nurses reported higher mental conditions, particularly PTSD. Two sets of risk factors (personal and workplace) are associated with anxiety, depression, and PTSD were found. MCIs have a significant impact on the mental health outcomes of emergency health workers. Preventive measures should be designed considering the high-risk group, personal, and organizational risk factors of mental health outcomes. [ABSTRACT FROM AUTHOR]

Copyright of Revista Româna de Dreptul Muncii is the property of Wolters Kluwer Romania and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Understanding and addressing dehumanization in healthcare is crucial due to its profound impact on patient care, ethical implications on patient dignity and autonomy, and its potential to affect the psychological well-being of healthcare professionals. The primary aim of this study was to establish reliable and valid instruments measuring two different types of dehumanization, namely animalistic dehumanization (i.e., stripping one of their uniquely human characteristics) and mechanistic dehumanization (i.e., stripping one of their human nature characteristics) among healthcare professionals. In this cross-sectional validation study among healthcare professionals, we tested measures of both animalistic and mechanistic dehumanization, focusing on the dehumanization of patients (hetero-dehumanization) and oneself (self-dehumanization), respectively. All measures were developed and validated based on a concept analysis, a literature review, and an appraisal of pre-existing scales. The research was conducted among 400 nurses and medical doctors employed in Greek public hospitals. Coefficient validity ratio results showed that 100% of items were acceptable for both measures. The newly established and validated hetero-dehumanization scale encompassed two factors (factor 1: animalistic dehumanization, factor 2: mechanistic dehumanization; Cronbach's alpha was equal to 0.86 for each measure). The self-dehumanization scale was a mono-factorial measure of mechanistic dehumanization (Cronbach's alpha = 0.97). Two validated measures of (self- and hetero-) animalistic and mechanistic dehumanization measures were developed for the assessment of dehumanization among health professionals, which will form the basis for future research in this important scientific field. [ABSTRACT FROM AUTHOR]

Understanding and addressing dehumanization in healthcare is crucial due to its profound impact on patient care, ethical implications on patient dignity and autonomy, and its potential to affect the psychological well-being of healthcare professionals. The primary aim of this study was to establish reliable and valid instruments measuring two different types of dehumanization, namely animalistic dehumanization (i.e., stripping one of their uniquely human characteristics) and mechanistic dehumanization (i.e., stripping one of their human nature characteristics) among healthcare professionals. In this cross-sectional validation study among healthcare professionals, we tested measures of both animalistic and mechanistic dehumanization, focusing on the dehumanization of patients (hetero-dehumanization) and oneself (self-dehumanization), respectively. All measures were developed and validated based on a concept analysis, a literature review, and an appraisal of pre-existing scales. The research was conducted among 400 nurses and medical doctors employed in Greek public hospitals. Coefficient validity ratio results showed that 100% of items were acceptable for both measures. The newly established and validated hetero-dehumanization scale encompassed two factors (factor 1: animalistic dehumanization, factor 2: mechanistic dehumanization; Cronbach’s alpha was equal to 0.86 for each measure). The self-dehumanization scale was a mono-factorial measure of mechanistic dehumanization (Cronbach’s alpha = 0.97). Two validated measures of (self- and hetero-) animalistic and mechanistic dehumanization measures were developed for the assessment of dehumanization among health professionals, which will form the basis for future research in this important scientific field.

Abstract Introduction Many patients consult general practitioners instead of dentists for their oral and dental problems every year. This study aims to find the reasons why patients consult general practitioners when they have dental problems. Methods The sample consisted of patients visiting dentists and general practitioners in Kerman, Iran. A thematic interview guide, semi-structured questions, and a mind map that allowed for structured and open-ended questions were prepared and used for the interviews. All interviews were recorded and transcribed verbatim by a final-year student. Data collection, transcription, and analysis were conducted simultaneously to allow for new topics to be raised and theoretical saturation to be reached. When researchers determined that sufficient information was available for analysis and understanding of patient opinions and beliefs, the interview process was stopped. As all audio conversations were recorded with the participant’s permission, no note-taking was done during the interviews, which allowed for greater focus on the participants’ conversation. The obtained data was analyzed using the content analysis. Results A total of 52 patients were included in this study. The codes related to patients participating in this research, along with the number of respondent groups related to each code were as follows: patient’s perceptions of general practitioner(GP) and dental practitioner’s scope of work [21], flawed dental system (34), dental anxiety [28], financial considerations [25], and more accessibility to GPs (31). Dental abscesses and dental pain were reported as the most common reasons for consulting GPs. Conclusion Most participants agreed that dental problems are more effectively treated by dentists. Reasons for visiting a general practitioner included lack of a specific dentist, dissatisfaction with dental treatments, lack of a dentist nearby, absence of emergency dental care, and familiarity with a physician. The most common reasons for visits were toothache and dental abscesses. Patients also sought treatment for TMJ pain, referred nerve pain, wisdom tooth pain, numbness and tingling in the jaw, gum inflammation, oral lesions, and ulcers. Furthermore, other factors such as opening hours, appointment systems and waiting time can also affect patient’s consult behaviors regarding dental problems.

Abstract Background Penicillin allergy delabelling (PAD), the process of evaluating penicillin allergy labels, is a key target in antibiotic stewardship, but uptake of the procedure outside clinical studies is limited. We aimed to explore factors that need to be addressed to sustainably implement a clinical pathway for PAD. Methods We conducted a qualitative study based on semi-structured interviews with focus groups consisting of a purposive sample of twenty-five nurses and physicians working in four different hospitals in Western Norway. Systematic text condensation was applied for analysis. Results Psychological safety was reported as crucial for clinicians to perform PAD. A narrative of uncertainty and anticipated negative outcomes were negatively associated with PAD performance. Education, guidelines, and colleague- and leadership support could together create psychological safety and empower health personnel to perform PAD. Key factors for sustainable implementation of PAD were facilitating the informant’s profound motivation for providing optimal health care and for reducing antimicrobial resistance. Informants were motivated by the prospect of a simplified PAD procedure. We identified three main needs for implementation of PAD: (1) creating psychological safety; (2) utilising clinicians’ inherent motivation and (3) optimal organisational structures. Conclusion A planned implementation of PAD must acknowledge clinicians’ need for psychological safety and aid reassurance through training, leadership, and guidelines. To implement PAD as an everyday practice it must be minimally disruptive and provide a contextually adaptive logistic chain. Also, the clinician’s motivation for providing the best possible healthcare should be utilised to aid implementation. The results of this study will aid sustainable implementation of PAD in Norway. Ethics The study was approved by the Western Norway Regional Committee for Medical Research Ethics (Study No:199210).

Due to the specifics of its geographical and climatic location, historically formed disease structure, ethnic approach to the development of traditional medical culture, the North territories’ population possesses a range of characteristics significantly different from the national average. This determines a number of problems and contradictions in medicine. The research of medical care to indigenous minorities of Turukhansk Territory in the 1920s is chosen because of its poor study, as well as the peculiarities of social and economic life of the region and national policy of the Soviet government. The article investigates the early Soviet policy in the sphere of health protection of the indigenous minorities of Turukhansk Territory. It considers two interrelated issues: it characterizes ethnic and regional aspects of traditional medicine; it reveals peculiar traits of the developing Soviet medical care to the indigenous minorities. We conclude that during the period under study despite the lack of financing and medical personnel the forms of interaction with the indigenous minorities of Turukhansk Territory were searched for. Those concerned managed to change the peoples’ attitude to doctors and medical assistants, to involve them into the anti-infective vaccination and to start health education programme. However the problem of publicly accessible medical care was solved only in parts, since major changes in living conditions did not happen, an extensive network of health facilities available to the general public was not created. The article is designed for specialists in the sphere of national healthcare history and cultural life of peoples of the North.

Objective: To reflect on the importance of teaching formulation skills in psychiatry training and explore how creative writing, particularly writing poetry, can help achieve this goal. Conclusions: It is vital that formulation skills are embedded throughout psychiatry training. Formulations have an artistic element, and writing poetry can help foster a capacity for curiosity that can assist trainees in developing these skills. [ABSTRACT FROM AUTHOR]

Objective: This study aims to explore the association between the years of experience of emergency department doctors and the prevalence of common cognitive biases. Design: A total of 86 physicians participated, with some respondents from other institutions, who received the questionnaire via email or provided data through telephone interviews. Materials and Methods: The study population consists of emergency physicians, including general practitioners and emergency medicine specialists, who have worked or are currently working at Manisa Merkezefendi State Hospital between January 1, 2013, and May 1, 2023. Data collection took place through a questionnaire distributed between April 1, 2023, and May 1, 2023. Results: The study population comprised 49 (61.3%) male and 31 (38.7%) female participants. The age range of the participants was 24 to 56 years, with a mean age of 36.74 ± 10.08 years. Discussion: Deformation professionnelle bias, ego bias, and triage cueing error exhibited statistically significant associations with the doctor's age and years of experience in the emergency department. Conclusions: Awareness of cognitive biases is vital for enhancing patient satisfaction, expediting assessments in emergency rooms, preventing malpractice cases and ultimately benefiting patient outcomes. [ABSTRACT FROM AUTHOR]

Globally, the healthcare sector is the pivot and integral part of human lives. Any error committed in the clinic services might lead to defects or the termination of life. In the rapidly evolving field of healthcare, efficient and accessible appointment scheduling plays a crucial role in ensuring timely and quality care for patients. This article is centered around creating a Patient Appointment Scheduling System, with a focus on handling registration and management, as well as managing bookings or making appointments and scheduling sessions at Aliko Dangote University of Science and Technology, Wudil (ADUSTECH Wudil). Identification of the drawbacks of the existing traditional system leads to the design of a computerized system, which is more user-friendly and GUI-oriented. HTML, PHP, CSS, JavaScript, and MySQL were used for the development. Note that performance was improved to 92% from using the traditional system. Similarly, the productivity of participants increased to 90%. Furthermore, the waiting time for patients to be attended was enhanced to 90% in the proposed system. [ABSTRACT FROM AUTHOR]

Objective: To identify how happy are the physicians working in an Oncology setup and how different factors influence the happiness levels of these doctors working in this challenging setup. Materials and methods: This is an observational study designed to be carried out at a Tertiary Cancer Care Centre. The survey was conducted from 1st July to August 30th, 2023. Self-administered Oxford Happiness Questionnaire was used, which is a closed-ended questionnaire. Those who were not willing to participate and whose work/course duration was less than 6 months were not included in the study. Stephen Wright scoring was used. A score between 1-2 was interpreted as not happy, 2-3 meant somewhat unhappy, 3-4 was for not particularly happy, 4 represented somewhat happy, 4-5 was interpreted as rather happy or pretty happy, a score between 5-6 means very happy, 6 meant too happy. Results: Out of 93 study subjects, 54 were men (58%) and 39 (42%) were women. Of 93 doctors, 68 (73.1%) were happy. Of 68 doctors, a somewhat happy category was 31 (33.3%) doctors, followed by 29 (31.2%) being pretty happy, and 8(8.6%) doctors who were very happy. Twenty-five (26.9%) doctors were unhappy. Conclusion: The majority of doctors working in an oncology set-up were happy with no difference in gender. However, men were more likely to be very happy compared to women. [ABSTRACT FROM AUTHOR]

Background Aim Method Results Conclusion The barriers to comprehensive abortion care in Australian metropolitan tertiary hospitals are under‐researched. Previous work has suggested that negative practitioner attitudes and lack of training may play a large role; however, this remains poorly understood.The aim was to survey doctors practicing obstetrics and gynaecology to better understand their views, training experience and confidence in abortion care.The method involved a cross‐sectional study via an anonymous survey at a single metropolitan tertiary hospital not providing substantive abortion services in Melbourne, Australia. Inclusion criterion was obstetric and gynaecology medical staff working at that hospital. Data were collected regarding views, training experiences and confidence in first‐trimester medical and surgical abortion, and second‐trimester surgical abortion. Data were analysed according to levels of training, categorised as RANZCOG (Royal Australian and New Zealand College of Obstetricians and Gynaecologists) Fellows, prevocational/vocational trainees and general practitioner specialists.Sixty‐one valid responses were received from 90 eligible participants (response rate 68%). An overwhelming majority (96%) supported abortion services. The majority of RANZCOG Fellows felt confident performing first‐trimester surgical abortion (89%) and first‐trimester medical abortion (71%); however, only half felt confident performing second‐trimester surgical abortion (50%). Prevocational/vocational trainees were overall less confident but overwhelmingly expressed interest in gaining further experience in abortion.Doctors are generally confident in providing first‐trimester abortion services (medical or surgical) in the metropolitan tertiary setting. However, further work is required to understand ongoing barriers to comprehensive abortion care. There may also be a skills shortage for second‐trimester surgical abortion, requiring significant improvements in abortion training. [ABSTRACT FROM AUTHOR]

Although medical confidentiality is widely recognized as an essential principle in the therapeutic relationship, its systematic and coherent practice has been an ethically challenging duty upon healthcare providers due to various concerns of clinical, moral, religious, social, ethical and legal natures. Medical confidentiality can be breached to protect the patient and/or others if maintaining confidentiality causes serious harm. Healthcare professionals may encounter complicated situations whereby the divulgence of a patient's confidential information may pose a threat to one party whereas the concealment of such information may cause harm to another. After deliberating on the Islamic concept of harm (ḍarar), this paper focuses on the dual duty and conflicts of interests faced by healthcare professionals in the practice of medical confidentiality. Referring to serious infectious diseases with a special mention of AIDS, this study also provides discourse on how healthcare professionals deal with difficult scenarios of conflicts of interests and ethical dilemmas. [ABSTRACT FROM AUTHOR]

Background The use of locum doctors in the National Health Service is widely believed to have increased, and there have been widespread and sustained concerns among policy-makers, healthcare providers, professional associations and professional regulators about the quality/safety, cost and effective use of locum doctors. Objectives To provide evidence on the extent, quality and safety of medical locum practice and the implications of medical locum working for health service organisation and delivery in primary and secondary care in the English National Health Service, to support policy and practice. Design Four interlinked work packages involving surveys of National Health Service trusts and of general practices in England; semistructured interviews and focus groups across 11 healthcare organisations in England; analysis of existing routine data sets on the medical workforce in primary care and in National Health Service trusts in England from National Health Service Digital and National Health Service Improvement; and analysis of data from the Clinical Practice Research Datalink in primary care and of electronic patient record data from two National Health Service hospitals in secondary care. Results In primary care, about 6% of general practice medical consultations were undertaken by locums in 2010 and this had risen slightly to about 7.1% in 2021. In National Health Service trusts (mostly secondary care and mental health), about 4.4% of medical staff full-time equivalent was provided by locum doctors. But those overall national rates of locum use hide a great deal of variation. In primary care, we found the National Health Service Digital workforce returns showed the rate of locum use by Clinical Commissioning Group varied from 1% to almost 31%. Among National Health Service trusts, the reported rate of locum use varied from < 1% to almost 16%. We found that there was poor awareness of and adherence to national guidance on locum working arrangements produced by National Health Service England. Our research showed that locum working can have adverse consequences for the quality and safety of care, but that such consequences were probably more likely to result from the organisational setting and the working arrangements than they were from the locum doctors themselves and their competence, clinical practice or behaviours. Limitations Our research was hampered in some respects by the COVID pandemic which both resulted in some delays and other challenges. Our efforts to use electronic patient record data in secondary care to explore locum doctor working were stymied by the problems of data access and quality. Conclusions Locum doctors are a key component of the medical workforce in the National Health Service, and provide necessary flexibility and additional capacity for healthcare organisations and services. We found that the extent of reliance on locum doctors varied considerably, but that an over-reliance on locums for service provision was undesirable. Some differences in practice and performance between locum and permanent doctors were found, but these seemed often to arise from organisational characteristics. We found that patients were more concerned with the clinical expertise and skills of the doctor they saw than whether they were a locum or not. Organisational arrangements for locum working could be improved in many respects. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR128349) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 37. See the NIHR Funding and Awards website for further award information. Plain language summary Doctors who work in the National Health Service in temporary positions are generally known as ‘locum doctors’. They may be working for a hospital or a general practice just for a single shift or a few days, or may work there for several weeks or even months. Often, locum doctors are used to cover staff sickness or absence, or to provide for longer-term cover for staff vacancies. While some doctors just work as locums, others will have a permanent job but do some extra shifts as a locum as well. The number of doctors working as locums and the costs of this to the National Health Service have caused some concerns nationally. It has also been suggested that locum doctors may not provide as good a quality of care as permanent doctors. So we set out to find out more, through two large surveys of National Health Service trusts and general practices in England; interviews and focus group discussions across 11 National Health Service organisations; and by analysing data that had already been collected about the National Health Service workforce and about clinical care. We found that about 6% of medical care in general practices is provided by locum doctors, and about 4.4% of the medical workforce in National Health Service trusts are locums, but this varies a great deal and can be much higher in some organisations. The high and continuing use of locums in some services or areas should be a cause for concern. We found locum working could cause problems with the quality and safety of care, but that this was often because of the way organisations used locums without sufficient support. When concerns about the practice of a locum doctor arose, they were often not dealt with properly. We found that patients were generally more interested in being able to see a good doctor promptly than with whether or not they were a locum. This research has important implications for how the National Health Service uses locum doctors in future, and our recommendations are designed to help the National Health Service use locums safely and appropriately. Scientific summary Background The numbers of doctors working as locums in the NHS in England are thought to have grown substantially over the last decade, although there have been surprisingly little empirical data published on the NHS medical workforce to substantiate this trend. There have been concerns about the costs of locum working, and about the quality and safety of locum doctors’ practice. Our earlier qualitative research on the experiences of and attitudes towards locum doctors, involving interviews with locum doctors, locum agency staff and representatives of healthcare organisations who use locums, showed that locums were often perceived to be inferior to permanently employed doctors in terms of quality, competency and safety. Our findings suggested that the treatment and use of locums could have important potential negative implications for team functioning and patient safety. Objectives The overall aim of our research was to provide evidence on the extent, quality and safety of medical locum practice and the implications of medical locum working for health service organisation and delivery in primary and secondary care in the English NHS. Our three main research questions were: What is the nature, scale and scope of locum doctor working in the NHS in England? Why are locum doctors needed, what kinds of work do they undertake and how is locum working organised? How may locum doctor working arrangements affect patient safety and the quality of care? What are the mechanisms or factors which may lead to variations in safety/quality between locum and permanent doctors? What strategies or systems do organisations use to assure and improve safety and quality in locum practice? How do locum doctors themselves seek to assure and improve the quality and safety of their practice? How do the clinical practice and performance of locum and permanent doctors compare? What differences in practice and performance exist and what consequences may they have for patient safety and quality of care? Methods This was a mixed-methods study, consisting of four main work packages: Work package 1 (addressing research questions 1 and 2) involved a survey of medical directors/medical staffing leads in NHS trusts in England and a survey of general practices in England. The two surveys examined the nature, scale and scope of locum doctor working, why locums were needed, what work they undertook and how their work was organised, and sought views on the performance of locum doctors and a range of issues concerning governance and oversight of practice. Work package 2 (addressing research questions 1, 2 and 3) involved a combination of semistructured interviews and focus groups conducted across 11 healthcare organisations in both primary and secondary care in the NHS in England. We developed and used three interview schedules (for interviews with locum doctors; people who worked with locums in healthcare organisations; and patients and members of the public). Work package 3 (addressing research question 1) involved the collection and analysis of existing routine quantitative data sets on locum doctors working in the NHS in England. We used quarterly workforce returns from all general practices in England to NHS Digital to examine locum working in primary care. We used weekly locum usage returns from all NHS trusts in England to NHS Improvement to examine locum working in secondary and community services. Work package 4 (addressing research question 3) involved the collection and analysis of existing, routine quantitative data sets on doctors’ practice/performance which identify whether doctors are locum or permanent staff and so allow us to compare the practice/performance of locums and permanent doctors. We used the Clinical Practice Research Datalink (CPRD) linked to Hospital Episode Statistics to examine these issues in primary care. We sought to undertake a similar analysis in secondary care, using electronic patient record (EPR) data from two NHS hospitals: Salford Royal Hospital and the Bradford Royal Infirmary. However, we encountered a number of problems both in securing data extraction from the two hospitals' EPR systems and in identifying locum and permanent staff activity in the data sets, which severely limited our ability to examine these issues in secondary care. Results We report our results from the four work packages grouped around our three main research questions. The nature, scale and scope of locum doctor working in the NHS in England In primary care, we found from our analysis of NHS Digital workforce returns that just over 3% of medical staffing was provided by locums and that it had not changed much over the time period 2017–20. However, our analysis of CPRD data for the longer time period of 2010–21 suggested that about 6% of general practice medical consultations were undertaken by locums in 2010 and that this had risen slightly to about 7.1% in 2021. We think there are two main explanations for this discrepancy. First, locums generally only undertake consultations while permanent general practitioners do a lot of other non-consultation clinical and administrative tasks – the NHS Digital workforce returns measure staff numbers in full-time equivalent (FTE), while the CPRD data measure numbers of consultations. Second, the NHS Digital workforce returns from general practices may under-report the numbers of locum doctors, and there have been concerns about the quality and completeness of the data. But both data sources suggest a relatively low – and stable – rate of locum use in primary care. In NHS trusts (mostly secondary care and mental health), our analysis of NHS Improvement returns from NHS trusts indicated that about 4.4% of medical staff FTE was provided by locum doctors. With a much shorter time series from 2019 to 2021, it is rather more difficult to draw any conclusions about the secular trend, although in that time period the rate of locum use was fairly stable – dropping as expected in the first phase of the COVID pandemic in early to mid-2020, and then recovering. We found NHS trusts making more use of bank (rather than agency) locums over the time period, and some an increase in the reported numbers of unfilled shifts which would indicate increasing unmet need. However, those overall national rates of locum use hide a great deal of variation between organisations which it is important to consider. In primary care, we found the NHS Digital workforce returns showed the rate of locum use by Clinical Commissioning Group (CCG) varied from 1% to almost 31%. Among NHS trusts, the reported rate of locum use varied from < 1% to almost 16%. Our qualitative work suggested that there were some particularly problematic specialties in which workforce shortages were acute, such as psychiatry. Our multivariate quantitative analyses suggested that there was some variation by region/geography which might reflect workforce capacity or shortage in some parts of England. But they also showed that both smaller general practices and smaller NHS trusts made more use of locums, which might plausibly suggest that larger organisations are more able to cope with workforce gaps without having to resort to locums. In both primary care and NHS trusts, there was an association between Care Quality Commission (CQC) ratings and locum use, with organisations with lower CQC ratings making more use of locums. Our surveys of general practices and of NHS trusts showed both some similarities in their reasons for needing locums and ways of using them, as well as some notable differences. Both gave as common reasons for using locums the need to cover either planned or unplanned absences or gaps in staffing – mainly leave and sickness absence – and both reported using them to provide additional workforce capacity when it was needed. But NHS trusts were much more likely to report needing locums because of difficulties recruiting doctors. We also found some interesting differences in where general practices and NHS trusts sourced locum doctors from. Practices said they made much less use of locum agencies and tended to use trusted locums who were familiar to the practice, while NHS trusts made much more use of locum agencies and staff banks, and within that there was a lot of variation in that some NHS trusts made much more use of locum agencies rather than staff banks. Overall, NHS trusts sourced about a third of their locums from staff banks according to our analysis of NHS Improvement returns. Our qualitative research found that respondents thought an over-reliance on locums (however that might be defined) could be a ‘red flag’. Respondents suggested that the consistent use of high levels of locums was both a concern in itself, because of the implications for quality and safety (which we turn to later in this discussion) and a potential indicator of wider organisational problems in the general practice or NHS trust. How locum doctor working arrangements affect patient safety and the quality of care Our surveys of NHS trusts and general practices suggested that awareness of the national NHS England guidance on locum working was very mixed – and particularly poor among respondents from general practice. Those who were aware of it in NHS trusts generally viewed it quite favourably, but some commented that it set out an ideal model which was hard to follow in practice. Among general practices, it was often seen as less relevant to their needs and to the setting of an individual general practice. Self-reported compliance with the guidance was generally high in areas like pre-employment checks and induction, but much less good in areas like end-of-placement reporting and supporting the locum with appraisal and revalidation. Our qualitative research confirmed and extended the survey findings. For example, we found that giving locums a proper induction was viewed by locums as really important to their subsequent ability to perform in their role, and that issues not covered properly in their induction hampered them and could add to the workload of other members of the clinical team. But in our qualitative interviews with respondents who work with locums, we often found an unrealistic expectation that locums should come into the organisation and be able to start work immediately – to ‘hit the ground running’ – and that they should devote all their time to clinical work as that was what they were being paid – and paid well – to do. Locums themselves reported taking steps – like working in fewer organisations and avoiding some organisations, working at a lower level/grade and limiting their scope of practice – to deal with the problems of being inadequately inducted and supported. This was part of a wider negative and stigmatising narrative which often cast locums as less professional, less committed, less competent, less reliable and more financially motivated than permanent medical staff. By ‘othering’ locum doctors in this way, it was easier both to justify treating them differently (and less well) than other staff and to explain problems or difficulties with quality and safety as being attributable to locums and locum working. In short, it was easy to blame locums when things went wrong, and they were often either not there to defend themselves or not able to do so. The position of locum doctors was, by definition, precarious – they could be removed or have a placement ended easily. We would contrast this with the attitudes of patients to locum doctors, which were generally more accepting of locum working, and which valued access to seeing a doctor in a timely fashion over whether the doctor was a locum or not. Patients thought that traditional notions of relational continuity were not consistent with their own experiences of care, and some valued the fresh perspectives on their condition which came from seeing a different doctor. It is clear from our research that locum working can have adverse consequences for the quality and safety of care, but that such consequences were probably more likely to result from the organisational setting and the working arrangements than they were from the locum doctors themselves and their competence, clinical practice or behaviours. It is also clear that there is great variation in the characteristics both of organisations which use locums and of locums themselves. One of the concerning findings from our research was that when problems related to locum doctors’ practice arose, they were not dealt with well. How the clinical practice and performance of locum and permanent doctors compare From our surveys of NHS trusts and general practices, respondents generally reported that on a range of areas of clinical practice, they thought locum doctors performed about the same as or worse than permanent doctors. It is notable that the areas where they tended to think locums performed worse were things like continuity of care, and adherence to guidelines and protocols, which are, as we have already discussed, more influenced by the organisational setting and arrangements like induction than by the locum doctor’s own clinical expertise and fitness to practice. We were able to explore differences in practice in primary care directly through our quantitative analysis of the CPRD data set, and this provided some very interesting but quite mixed findings which should be interpreted with great caution. For example, our multivariate analysis found that patients who saw a locum doctor were less likely to make a return visit to the general practice within 7 days than those who had seen a permanent doctor. We found that locum doctors and permanent doctors had some differences in prescribing behaviour, but they were mixed (locums prescribed antibiotics and opioids more frequently but hypnotics less frequently than permanent doctors). Locum doctors were less likely to make referrals and to order tests. In terms of hospital events following a consultation with a locum, patients were more likely to visit accident and emergency within 7 days but there was no difference for hospital admission. Conclusions Locum doctors are a key component of the medical workforce in the NHS and provide necessary flexibility and additional capacity for healthcare organisations and services. We found that the extent of reliance on locum doctors varied considerably, but that an over-reliance on locums for service provision was undesirable. Some differences in practice and performance between locum and permanent doctors were found, but these seemed often to arise from organisational characteristics. We found patients were more concerned with the clinical expertise and skills of the doctor they saw than whether they were a locum or not. Organisational arrangements for locum working could be improved in many respects, and there were particular problems with the way any concerns about locum doctors were managed. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR128349) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 37. See the NIHR Funding and Awards website for further award information.

Protecting the lives of citizens and providing qualified medical care is of utmost importance in times of war. At the same time, statistics show that numerous cases of criminal offences committed by healthcare professionals do not result in them actually serving a criminal sentence. The purpose of this study was to investigate the issues of non-performance or improper performance of professional duties by medical and pharmaceutical professionals and to outline the problematic aspects of combating these criminal offences and the ways to address them. The study employed a combination of both general scientific (general dialectical, analysis, synthesis, legal, induction, and deduction) and special (systemic-structural, statistical, critical) methods of knowledge to identify, analyse, and interpret data. The study made it possible to state that there are a range of problems impeding the effective prosecution of medical and pharmaceutical professionals for criminal offences, and to classify the identified complications into subjective and objective ones, related not only to the training of medical professionals, judicial, and law enforcement agencies, but also to legislative gaps and problems in medicine, which lead to a high level of latency of medical torts, ineffective pre-trial investigation of medical torts, as well as avoidance of criminal liability by medical professionals. Therefore, combating these crimes is largely reduced to recording them by law enforcement officials. The unsatisfactory performance of professional duties by doctors not only negatively affects the quality of services provided to patients, but also leads to serious consequences in the form of their death or considerable damage to the health of the victims. The findings of this study will be useful for practitioners of investigative bodies engaged in qualification and investigation of the torts under study, will contribute to the development of a strategy to improve the effectiveness of combating such criminal offences, and will also be useful for medical professionals to prevent mistakes leading to serious consequences for the life and health of patients, as well as in the context of motivation to perform their professional duties in good faith

The Impact of Cardiac Pacemaker Education Provided to Women During Menopause on Quality of Life: A Randomized Controlled Study

Abstract Purpose The use of nutrients and food supplements is increasing worldwide. Nutrients and food supplements frequently used in the surgical period may cause complications and side effects. This study was conducted to determine the level of knowledge about sixty-one nutrients and food supplements among doctors and nurses working in surgical clinics. Design A multicentre descriptive, quantitative, cross-sectional study. Methods The study was conducted between 15 February and 31 May 2022 with a total of 410 participants, including 143 doctors and 267 nurses, working in the surgical clinics of 8 hospitals, including public, university and private hospitals, within the borders of one province in Turkey. Data were collected face-to-face using a questionnaire developed by the researchers, which included descriptive characteristics of the doctors and nurses and questions about sixty-one nutrients and food supplements. Results The median overall success score of the doctors and nurses participating in the study regarding the use of nutrients and food supplements was 3.20 out of 100 points, the median success score of complications and side effects of nutrients and food supplements in the surgical period was 7.06 out of 33 points, the median success score for discontinuation of nutrients and food supplements prior to surgery was 0.21 out of 16 points, and the median success score for drug interactions of nutrients and food supplements was 1.70 out of 51 points. In addition, it was found that the overall success scores of doctors and nurses regarding nutrients and food supplements increased statistically significantly with increasing age and working years. The total success score of doctors and nurses who received training in nutrients and food supplements was statistically significantly higher than that of doctors and nurses who did not receive training. Conclusion In conclusion, it was found that the level of knowledge of nutrients and food supplements among doctors and nurses working in surgical clinics was less than half or even close to zero. Therefore, it is recommended that training on nutrients and food supplements should be included in the undergraduate and postgraduate education of doctors and nurses in order to prevent complications, side effects, drug interactions and patient safety related to the use of nutrients and food supplements in the surgical period.

This article presents the results of a pilot study to assess the knowledge and attitudes of physicians in training about adult vaccination in pharmacies and the impact of these results on collaboration between the two communities. The Pharmacy Profession Act has changed the role and tasks of the pharmacist. Pharmacists can provide health services. Immunization is the first health service in Poland to be provided as part of pharmaceutical care by pharmacists in pharmacies. An important novelty of the pilot is to show the attitudes of young physicians toward the new competencies of pharmacists in qualifying and performing vaccinations in pharmacies. The pilot presents the point of view of physicians (mean age 33 years) who were undergoing specialty training in 2023. Physicians' knowledge of pharmacy vaccinations that may be fully or partially publicly funded, i.e. COVID-19, influenza, and pneumococcal, was assessed. The results indicate that physicians had the greatest knowledge of pharmacy vaccination against COVID-19 and influenza. In the study group, only 37% of physicians recommend pharmacy vaccination. The larger the city in which the physician works, the more often he or she recommends pharmacy vaccination. However, 63% of physicians surveyed do not recommend pharmacy vaccinations. The pilot identified reasons why young physicians do not recommend pharmacy vaccinations. Respondents most often answered that they do not recommend pharmacy vaccination because patients do not ask for it (31%), patients vaccinate at the health center (26%), physicians and do not cooperate with pharmacies on vaccination (23%). The survey shows that there is an urgent need to include training on adult immunization in the educational programs of all health professions, including physicians, which can be delivered in pharmacies. Pharmacists can support vaccination education. Therefore, collaboration at the local level is essential: community pharmacy - health center or family physician practice. Particular attention should be paid to the contact between physicians and pharmacists in large urban areas where cooperation between the two groups is lacking or limited.

The language has a great role in the communication between a doctor and a patient. Without it the process of healing is impossible and it is a fundamental component of the clinical practice. It is a system of communication that enables humans to exchange verbal or symbolic utterances. The effective doctor – patient communication is required for building a therapeutic doctor – patient relationship. The language of the good doctor – patient communication helps to regulate the emotions of the patient and facilitates the comprehension of the medical information. So the strategies while using this specific language for the effective communication are of great importance. [ABSTRACT FROM AUTHOR]

Purpose: The use of nutrients and food supplements is increasing worldwide. Nutrients and food supplements frequently used in the surgical period may cause complications and side effects. This study was conducted to determine the level of knowledge about sixty-one nutrients and food supplements among doctors and nurses working in surgical clinics. Design: A multicentre descriptive, quantitative, cross-sectional study. Methods: The study was conducted between 15 February and 31 May 2022 with a total of 410 participants, including 143 doctors and 267 nurses, working in the surgical clinics of 8 hospitals, including public, university and private hospitals, within the borders of one province in Turkey. Data were collected face-to-face using a questionnaire developed by the researchers, which included descriptive characteristics of the doctors and nurses and questions about sixty-one nutrients and food supplements. Results: The median overall success score of the doctors and nurses participating in the study regarding the use of nutrients and food supplements was 3.20 out of 100 points, the median success score of complications and side effects of nutrients and food supplements in the surgical period was 7.06 out of 33 points, the median success score for discontinuation of nutrients and food supplements prior to surgery was 0.21 out of 16 points, and the median success score for drug interactions of nutrients and food supplements was 1.70 out of 51 points. In addition, it was found that the overall success scores of doctors and nurses regarding nutrients and food supplements increased statistically significantly with increasing age and working years. The total success score of doctors and nurses who received training in nutrients and food supplements was statistically significantly higher than that of doctors and nurses who did not receive training. Conclusion: In conclusion, it was found that the level of knowledge of nutrients and food supplements among doctors and nurses working in surgical clinics was less than half or even close to zero. Therefore, it is recommended that training on nutrients and food supplements should be included in the undergraduate and postgraduate education of doctors and nurses in order to prevent complications, side effects, drug interactions and patient safety related to the use of nutrients and food supplements in the surgical period. [ABSTRACT FROM AUTHOR]

Copyright of Abant Journal of Cultural Studies is the property of Abant Journal of Cultural Studies and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This research aims to thoroughly explore the impact and practical application of Jordan's Medical and Health Liability Law No. 25 of 2018, critically analyzing its compatibility with existing criminal and civil laws and its effectiveness in addressing medical error cases. Through an analytical methodology, this study delves into the legal texts concerning medical liability, establishing criteria for liability and fault in medical acts. The findings underscore significant insights into the legislative nuances that govern medical practices within Jordan, offering a nuanced understanding of the law's implications for both medical professionals and patients. By avoiding complex terminology and maintaining a formal register, the research elucidates the intricate balance between legal requirements and medical ethics, providing a comprehensive overview of the legal landscape surrounding medical liability. The study's outcomes aim to contribute valuable perspectives to the ongoing discourse on legal reforms in the medical sector, highlighting the necessity for laws that support both patient safety and medical professionals' rights. [ABSTRACT FROM AUTHOR]

This article provides an overview of the historiography of medical education and calls for greater attention to the connections between medical schools. It begins by reviewing research on medical education in imperial metropoles. Researchers have compared medical schools in different national contexts, traced travellers between them or examined the hierarchies that medical education created within the medical profession. The article then shows how historians have emphasised the ways in which medicine in colonial empires was shaped by negotiation, exchange, hybridisation and competition. The final part of the article introduces the special issue 'Medical Education in Empires'. Drawing on a variety of sources in English, French, Dutch and Chinese, the special issue builds on these historiographies by juxtaposing cases of medical schools in imperial contexts since the eighteenth century. It considers who funded these medical schools and why, what models of medicine underpinned their creation, what social changes they contributed to, what life was like in these schools, who the students and teachers were and what graduates did with their medical careers. This special issue thus contributes to clarifying the role of medical education in empires and the long-term impact of empires on the medical world. [ABSTRACT FROM AUTHOR]

Copyright of Revista Româna de Dreptul Muncii is the property of Wolters Kluwer Romania and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BackgroundElectronic prescriptions represent a fundamental shift in service delivery, healthcare management, and associated costs, offering numerous advantages. However, akin to other electronic systems, they also present challenges. This study aimed to investigate patients’ understanding of the challenges associated with electronic prescriptions in Iran.MethodsThis study used a qualitative research design, utilizing individual and semi-structured interviews with patients referred to selected pharmacies across all 11 districts of Shiraz City. The data were analyzed using MAXQDA software (version 10), and descriptive statistics for demographic data were calculated using SPSS version 19.ResultsThe study revealed that the participants generally demonstrated a certain level of familiarity with electronic prescribing systems. However, it was evident that many were unaware of the potential implications of such technology for their relationships with healthcare providers. This underscores the urgent need for patient understanding in the context of the electronic prescription system. While patients were relatively familiar with the functionality of electronic prescribing systems, they lacked a comprehensive understanding of how using these systems could affect their interactions with healthcare providers.ConclusionPatients are significant beneficiaries of the electronic prescribing system. By addressing their needs and concerns, they can develop a positive attitude toward this system. Their active engagement can pave the way for the system’s ease of use, increase its acceptance, and ultimately enhance the quality of healthcare services.

Empathy is imperative in patient care. Besides enhancing patients’ satisfaction, comfort, and trust, which may facilitate better diagnosis, shared decision-making, and therapy adherence, empathetic doctors experience less burnout, greater job satisfaction, and better overall psychological well-being. In this article, we focus on empathy needed in modern medicine. The meaning of empathy is briefly explained, along with the concept of detached concern. The need for empathy in patient care is undebatable, but physician burnout, emotional drainage, and overburden are reasons physicians tend to drift away from it. Empathy is the need to communicate with the patient in productive ways. Educators should organize the teaching relevantly and engage the active participation of the students. Skilled physicians and empathic communicators are the need of the hour.

Abstract Background In the rapid development in prehospital medicine the awareness of the many challenges in prehospital care is important as it highlights which areas need improvement and where special attention during education and training should be focused. The purpose of this study is to identify challenges that physicians face when working in the prehospital environment. The research question is thus; what challenges do physicians face when working in prehospital care? Method This is a qualitative study with an inductive approach and is based on individual interviews. The interviews were analyzed using the Classic Grounded Theory (GT) method as an approach. The interviews were conducted as semi-structured interviews via the digital platform Zoom during winter / early spring 2022. Results Challenges for prehospital physicians can be understood as a process that involves a balancing act between different factors linked to the extreme environment in which they operate. This environment creates unique challenges not usually encountered in routine hospital practice, which results in trade-offs that they would not otherwise be faced with. Their individual situation needs to be balanced against organizational conditions, which means, among other things, that their medical decisions must be made based on limited information as a result of the constraints that exist in the prehospital environment. They must, both as individuals and as part of a team, manoeuvre in time and space for decision-making and practical tasks. This theory of balancing different entities is based on four themes; thus the theory is the relation between the four themes: leadership, environment, emotion management and organization. Conclusions With the help of previous studies and what we have found, it is reasonable to review what training is needed before starting to work prehospital as a physician. This should include components of the themes we have described: organization, environment, leadership and emotional management.

Based on the analysis of the Code of Criminal Procedure and the scientific work of scholars and practitioners, it has been established that criminal justice for juveniles (minors) should be structurally separated from adult justice, carried out in different forms, and should include their social and psychological support and rehabilitation. Such a system should recognise that children are not adults, they are largely dependent on adults and society, have a lower level of emotional, mental and intellectual maturity, and therefore require special treatment appropriate to their age and level of development. In this regard, the article identifies the main tactical approaches to the most optimal organisation of interrogation of a juvenile (minor) victim under martial law. Proposals have been made regarding the choice of place (special “friendly” premises or rooms and alternative places) and time of such investigative (detective) action, as well as the investigator (detective) or prosecutor who will conduct the interrogation. Options for providing professional assistance by a teacher, psychologist and doctor, who must be present during the interrogation of a minor or underage victim, are also suggested. The investigator (inquirer) and prosecutor are provided with practical recommendations on organising and conducting interrogation of a juvenile (minor) victim, using modern interrogation methods, and the procedure for conducting it, which will increase the efficiency of the procedural action and ensure compliance with the basic principles of child-friendly justice.

The article discusses a number of Russian films where the main characters are doctors (Ragin by K. Serebrennikov, Ward No 6 by K. Shakhnazarov, Wild Field by M. Kalatozishvili, Arrhythmia by B. Khlebnikov, and Doctor by A. Temnikov). Through such characters cinema examines society for its humanity, civic responsibility, moral values, and viability. The social sentiments of the 2000s, which can be designated as moral anxiety, find their expression on the screen in the person of a medical profession who diagnoses society for its traumatization and offers solutions. Analysing the image of a doctor on the screen, the author formulates the cultural codes behind the representation of such characters in modern Russian cinema and draws conclusions about the urgent demand of society for spirituality accumulated in artistic images.

The use of curative baths, known in Europe since the Middle Ages, especially in Italy, increased in France after the mid-16th century, but texts extolling the virtues of local springs were still rare, hence the importance of Jean Pidoux’s (1550?-1610) treatise on the therapeutic fountains of Pougues, published in 1584. As physician to the Duke of Nevers, Pidoux promoted their medicinal cold waters -- the first of their kind to be renowned in France -- to the court and aristocracy. These waters, intended for drinking cures, were often compared to those of the town of Spa. Pidoux contrasts Spa with his “regional cure,” from cold to hot, starting in Pougues. Like other contemporary scientific treatises, Pidoux’s treatise was written in French, helping to spread medical knowledge more widely. His spa regime incorporated many aspects of Italian treatises, and he was the first to advocate the widespread use of showers in France, imitating the Italian practice.

Background: In the rapid development in prehospital medicine the awareness of the many challenges in prehospital care is important as it highlights which areas need improvement and where special attention during education and training should be focused. The purpose of this study is to identify challenges that physicians face when working in the prehospital environment. The research question is thus; what challenges do physicians face when working in prehospital care? Method: This is a qualitative study with an inductive approach and is based on individual interviews. The interviews were analyzed using the Classic Grounded Theory (GT) method as an approach. The interviews were conducted as semi-structured interviews via the digital platform Zoom during winter / early spring 2022. Results: Challenges for prehospital physicians can be understood as a process that involves a balancing act between different factors linked to the extreme environment in which they operate. This environment creates unique challenges not usually encountered in routine hospital practice, which results in trade-offs that they would not otherwise be faced with. Their individual situation needs to be balanced against organizational conditions, which means, among other things, that their medical decisions must be made based on limited information as a result of the constraints that exist in the prehospital environment. They must, both as individuals and as part of a team, manoeuvre in time and space for decision-making and practical tasks. This theory of balancing different entities is based on four themes; thus the theory is the relation between the four themes: leadership, environment, emotion management and organization. Conclusions: With the help of previous studies and what we have found, it is reasonable to review what training is needed before starting to work prehospital as a physician. This should include components of the themes we have described: organization, environment, leadership and emotional management. [ABSTRACT FROM AUTHOR]

Aims: The United Kingdom (UK) Prescribing Safety Assessment (PSA) is a 2‐h online assessment of basic competence to prescribe and supervise the use of medicines. It has been undertaken by students and doctors in UK medical and foundation schools for the past decade. This study describes the academic characteristics and performance of the assessment; longitudinal performance of candidates and schools; stakeholder feedback; and surrogate markers of prescribing safety in UK healthcare practice. Methods: We reviewed the performance data generated by over 70 000 medical students and 3700 foundation doctors who have participated in the PSA since its inception in 2013. These data were supplemented by Likert scale and free text feedback from candidates and a variety of stakeholder groups. Further data on medication incidents, collected by national reporting systems and the regulatory body, are reported, with permission. Results: We demonstrate the feasibility, high quality and reliability of an online prescribing assessment, uniquely providing a measure of prescribing competence against a national standard. Over 90% of candidates pass the PSA on their first attempt, while a minority are identified for further training and assessment. The pass rate shows some variation between different institutions and between undergraduate and foundation cohorts. Most responders to a national survey agreed that the PSA is a useful instrument for assessing prescribing competence, and an independent review has recommended adding the PSA to the Medical Licensing Assessment. Surrogate markers suggest there has been improvement in prescribing safety in practice, temporally associated with the introduction of the PSA but other factors could be influential too. Conclusions: The PSA is a practical and cost‐effective way of delivering a reliable national assessment of prescribing competence that has educational impact and is supported by the majority of stakeholders. There is a need to develop national systems to identify and report prescribing errors and the harm they cause, enabling the impact of educational interventions to be measured. [ABSTRACT FROM AUTHOR]

This article explores the delegation of authority from doctors to nurses in the context of healthcare services in Indonesia. Due to a shortage of healthcare professionals, collaboration between doctors and nurses is necessary. However, understanding the legal aspects of delegation can be complex. The study examines the practice of delegation at a specific health center and the factors that influence its implementation. It emphasizes the importance of clear instructions, the doctor's confidence in the nurse's ability, and medical guidance and supervision. Challenges include a lack of clarity in the delegation process, subjective decision-making by doctors, and a need for equal partnership between doctors and nurses. The lack of legal knowledge and socialization among health workers also contributes to implementation challenges. Improvement is needed in terms of clarity, education, socialization, and supervision. [Extracted from the article]

The article analyses the history of the emergence and organization of paramedic schools for the training of medical workers in the military settlements of the cavalry during 1817-1857. It has been proven that the beginning of organized medical care for military settlers is associated with the emergence of paramedic schools. The military leadership constantly sought to ensure that the preparation of paramedics was closely linked to health needs. Therefore, the paramedic school included a training pharmacy. The management of the paramedic school was carried out by the Pedagogical Council, which was formed by the teachers of the paramedic school. The scope of the Pedagogical Council included approving curricula, coordinating the examination process, etc. All teachers of the paramedic school were highly educated, intelligent individuals who paid attention to scientific and sociopolitical work among students. The hospital priest taught subjects such as the law of God, sacred history, arithmetic, Russian, and Latin. Special (profile) subjects were taught by an experienced hospital officer with moral, business, and professional qualities. Pupils of paramedic schools received training materials at the expense of borrowed cash capital from military settlers and uniforms according to the model for cantonists. The term of study at the paramedic school was three years. The organization of the training process was based on the curriculum. The academic year included the following periods: theoretical training, intermediate and fi- nal assessments of students knowledge, certification, medical practice, holidays, and vacations. The activity of the pupils of paramedic schools during epidemics and their frequent replacement of doctors in various situations in settlements deserved high appreciation. Feldsher schools, as a special type of medical education, provided appropriate theoretical and practical training. [ABSTRACT FROM AUTHOR]