Gender inequalities in the medical profession: are there still barriers to women physicians in the 21st century?

Aim

To analyze women's advancement compared with that of men and to determine whether advancement in hierarchical status differs from advancement in the professional recognition achieved by women from 1996 to 2008.

Methods

A retrospective study was carried in Hospital Clínic in Barcelona. We analyzed data on temporary and permanent positions, hierarchy, promotions, specialty, age, and sex among the participants.

Results

The female-to male ratio among trainee medical specialists was higher than 1 throughout the study period. After completion of specialist training, the proportion of women with temporary contracts more than doubled that of men. Less than 50% of women achieved permanent positions compared with 70% of men. For permanent non-hierarchical and hierarchical positions, the female-to-male ratio gradually decreased from 0.5 to below 0.2. Although more than 50% of trainee specialists were women, the number of female consultants remained 25% lower than that of men. In 2008, the final year of the study, the percentage of women who had achieved the grade of senior consultant was one-third that of men (29.5% of men vs 10.9% of women; p < 0.0001).

Conclusions

The significant differences in medical positions held by men and women illustrate the ‘leaky pipeline phenomenon’, consisting of a disproportionately low number of women achieving leading medical positions. The full potential of the increasing number of women physicians will not be reached without continuing efforts to improve the hospital medicine environment.     

Lifelong learning in community healthcare: Testing competence after learning activities in a blended learning space

Aims and Objectives

This study reports from a municipality in Norway that implemented a competence enhancement programme for all its institutional nursing staff during the COVID-19 pandemic to fill identified competence gaps.

Background

Many Norwegian municipalities are experiencing a demand for expanded community healthcare services due to an increase in elderly patients and patients with extensive and complex needs. At the same time, most municipalities are striving to recruit and keep competent health personnel. New ways of organising and increasing the competence of the workforce may help ensure that the healthcare delivered corresponds to patients' changing needs.

Design and Methods

Nursing staff were encouraged to complete targeted competence enhancing activities with the aim of enhancing their competence in identified areas. The learning activities were blended and consisted of e-learning courses, lectures, supervision, vocational training and meetings with a superior. Competence was measured before and after the competence enhancing activities (n = 96). The STROBE checklist was applied.

Results

The results provide insight into the competence development of registered nurses and assistant nurses in institutional community health services. They show that the implementation of a workplace-based blended learning programme improved competence significantly, especially for assistant nurses.

Conclusions

Offering workplace-based competence enhancing activities seems to be a sustainable way of facilitating lifelong learning among nursing staff. Facilitation of learning activities in a blended learning space may enhance accessibility and increase the potential for participation. A combination of reorganisation of roles and simultaneous competence enhancing activities can ensure that both managers and nursing staff prioritise filling competence gaps.     

An integrative review of Enrolled Nurse recruitment and retention

BackgroundAustralia is facing a severe shortage of Enrolled Nurses. Jurisdictions have introduced strategies in attempts to recruit and retain Enrolled Nurses in the health workforce.AimTo explore factors impacting recruitment and retention of Enrolled Nurses.MethodsA systematic search of literature published in the English language from 2000 to 2018 that addressed the recruitment or retention of aspiring and current Enrolled Nurses (or global equivalents). The search yielded 6955 publications; 20 articles were retained for full-text review and eleven articles were included in the final review.FindingsThree major themes (Nursing work and the EN role, Educational structure and support, and Personal attributes) were identified that covered enablers and barriers to the recruitment of Diploma of Nursing students and Enrolled Nurses. Evidence of the efficacy of programs designed to integrate and retain Enrolled Nurses in the health workforce is scant. Enrolled Nurses viewed participation in a Transition to Practice Program as an integral step in the pathway to becoming a registered nurse.DiscussionContinued debate around scope of practice is contributing to organisational and collegial confusion and discriminatory practices with negative consequences for the recruitment and retention of Enrolled Nurses.ConclusionThe value of Enrolled Nurse Transition to Practice Programs for recruitment and retention is questionable. Greater recognition of Enrolled Nurses’ contributions to patient care is essential and could provide Assistants in Nursing with a career opportunity.     

Decrease in selenium status in relation to coal dust exposure

Selenium (Se) plasma levels were studied 222 coal miners to assess whether selenium is decreased in relation to coal dust exposure, taking age, alcohol, and tobacco consumption into account. Selenium levels decreased significantly with age and current tobacco consumption, among miners aged 34–50. Long-term and current exposure to coal dust were studied. The lowest Se values were observed for those with both long-term and current exposure (60.2 ng/ml), the highest for those never or slightly exposed (64.1 ng/ml); those with long-term exposure not currently exposed fell in an intermediate position (61.3 ng/ml). No relation was observed with alcohol consumption. The association of coal dust with low selenium remained significant after adjustment for age and smoking. © 1996 Wiley-Liss, Inc.     

Morphology and Chemical Composition of Magnetic Particles Separated from Coal Fly Ash

Iron and other metal compounds are the materials that often appear in coal seams, because they also appear as a component of former organic matter in coal rocks. Although iron is the dominant element in coal rocks, other metals such as titanium, lead, cobalt, nickel, and copper are also present. In this study, the properties of magnetic particles of a size between 1 and 20 µm of globular structure and iron containing, were separated from coal fly ash, and studied using a scanning electron microscopy, energy disperse spectroscopy, and X-ray diffraction spectroscopy. The investigations were comprised of micrographs of the structure of these particles, their elemental composition, and phase analysis.     

667例中老年医务工作者脂肪肝发病率临床分析

目的:分析中老年医务工作者脂肪肝发病情况。方法:对667名中老年医务人员进行早晨空腹仰卧腹部B超检查。结果:脂肪肝总检出率为18.7%,其中男性检出率为21.2%;女性检出率为12.4%。医护人员检出率20.7;后勤人员检出率13.3。结论:中老年医务工作者脂肪肝患病较为严重,应引起足够重视,重建饮食结构,加强体育锻炼,重视健康体检等。     

Microstructure Evolution and Improved Permeability of Ceramic Waste-Based Bricks

The resource and large-scale utilization of waste ceramic materials, magnesium slag, and coal gangue are one of the important ways for the sustainable development in metallurgy, coal, and other related enterprises. In this paper, waste ceramic materials were used as aggregates; coal gangue and magnesium slag were used as mixed binder; and the all solid-waste-based permeable bricks with excellent performance were prepared by forming pressure at 5 MPa. The mechanical properties and water permeability of the all-solid-waste-based permeable bricks were evaluated. The results proved that the porous channel of permeable brick is mainly composed of waste ceramic materials with a particle size of 2–3 mm. Pore structures below 200 μm were mainly composed of fine aggregate and mixed binder. Using 60% coarse aggregate, 20% fine aggregate, 10% coal gangue, and 10% magnesium slag as raw materials, the all-solid-waste-based permeable bricks were obtained by pressing at 6 MPa and sintering at 1200 °C, which exhibited the best performance, and its water permeability, compressive strength, and apparent porosity were 1.56 × 10⁻² cm/s, 35.45 MPa, and 13.15%, respectively. Excellent water permeability, compressive strength, and apparent porosity of the all solid-waste-based permeable bricks were ascribed to the high content of connecting open pores, and closely adhesive force were ascribed to the porous microstructure constructed by the grading of waste ceramic materials and the tight conjoined points of the liquid phases in coal gangue and magnesium slag at a high sintering temperature.     

援鄂抗击新型冠状病毒肺炎医护人员的皮肤损伤和皮肤病调查

目的：对援鄂抗击新型冠状病毒肺炎医护人员的皮肤损伤和皮肤病发生情况进行调查分析。方法：利用问卷网制作调查问卷,通过微信群发放二维码在线填写。内容包括受访者的基本情况、皮肤症状和皮肤病发生情况。结果：共155名医护人员完成调查,其中医生52名（33.55%）,护士103名（66.45%）;男64名（41.29%）,女91名（58.71%）,平均年龄35.32岁。援鄂期间每天洗手大于10次的140名（90.32%）。最常见的皮肤症状为压痕（88.39%）、皮肤干燥（63.23%）、多汗（50.97%）。压痕和压疮最常见的部位是鼻梁（83.94%）。最常见的皮肤病为湿疹（24.52%）、痤疮（21.94%）和毛囊炎（21.29%）。结论：援鄂医护人员皮肤损伤和皮肤病发生率高,需要进行干预。