No evidence of citation bias as a determinant of STEM gender disparities in US Biochemistry, Genetics and Molecular Biology research

The lack of females in many Science Technology, Engineering and Mathematics (STEM) subjects in the USA is an ongoing concern, with many initiatives attempting to redress this imbalance. Some life sciences are apparently areas of relatively good practice, with higher proportions of female researchers than most other STEM subjects. This paper assesses gender differences in research contributions to 14 biochemistry, genetics or molecular biology specialisms in the USA 1996–2014/8, seeking evidence of trends in publishing and citation impact that may give insights into female success. With four exceptions (biochemistry, biophysics, biotechnology, and structural biology), the fields achieved or maintained at least 40% female first authors by 2018, with developmental biology and endocrinology both attaining female first author majorities. A regression analysis found close to gender parity overall in citation impact but a small male first author citation advantage in more fields than the opposite: an up to 3% increase in logged citation ratio to the world mean. This was partly due to males first authoring with larger teams. Fields with relatively many females did not favour female-led research with more citations, however

Pre-hospital trauma assessment and management of older patients and their association with patient outcomes: challenges and barriers

BACKGROUND: Saudi Arabia faces an increasing prehospital healthcare burden from older people with injuries, but little is known about their characteristics and current treatment. METHODS: This was a sequential explanatory mixed-methods design, preceded by a scoping review on the prehospital geriatric trauma care. A retrospective quantitative study was conducted using registry data from older patients (≥55 years) admitted by ambulances from 01/08/2017 to 31/10/2021 at a major trauma centre in Saudi Arabia. A qualitative study was conducted using a purposive sample of Saudi paramedics and ambulance technicians from Riyadh and Makkah using online semi-structured interviews and analysed using the framework method. The quantitative and qualitative findings were integrated. RESULTS: The quantitative study recruited 452 eligible cases and found most of them were admitted with low falls (53.7%), normal physiology, and extremities injuries (53.1%). The study identified no significant predictors of in-hospital death (p>0.05 for all predictors), although statistical power was limited. The qualitative study recruited twenty participants and identified that they reported age-related challenges including physiological changes, polypharmacy, and communication difficulties. They all wanted training and guidelines to improve their knowledge. They reported struggling with communication difficulties, inaccurate adverse outcomes predictions, difficult intravenous cannulations, and cultural restrictions affecting care provision for female patients. I identified organisational barriers (e.g. lack of shared patient records and lack of guidelines) and cultural barriers (e.g. barriers to assessing women, attitudes towards older people, and attitudes towards paramedics) that influenced implementation of knowledge. This study also found that the participants' perceptions aligned with the retrospective study’s cohort, and they acknowledged the difficulty of predicting death in older trauma patients. CONCLUSION: Ambulance clinicians in Saudi Arabia want guidelines and training in managing older trauma patients but these need to take into account the characteristics of older trauma patients and the cultural barriers that I identified

Reshaping Higher Education for a Post-COVID-19 World: Lessons Learned and Moving Forward

No abstract available

Assessing and addressing unmet needs in people affected by brain tumours

Introduction Guidelines recommend that brain tumour patients have their unmet needs assessed by a Holistic Needs Assessment (HNA), followed by appropriate support and care to maximise self-management. The aim of this study was to determine the role of HNA amongst brain tumour patients and their families. Methods A sequential mixed methods approach with three distinct phases was used. The first phase undertook a systematic review of available tools for HNA in brain tumours to determine if there was a psychometrically valid tool. This was followed by qualitative interviews and focus groups that explored patients’ and carers’ experiences and perceptions of unmet needs as well as strategies and support to assess and address these. The next phase was a realist synthesis of the HNA programmes in brain tumour patients which explored how HNA programmes could work. The thesis was underpinned by realist methods which were used to draw each of the phases of the thesis together. Results It was determined that there was no psychometrically valid tool that could be recommended for HNA in this group. Furthermore, there are significant challenges in using a patient completed HNA due to cognitive difficulties. Patients with brain tumours have diverse needs, but also unique compared to most other cancers due to the neurocognitive impairments. These also impact the carers as neurocognitive changes can be distressing but also cause a higher carer burden, therefore carers need specific support in their role. While the HNA as a process is useful in addressing unmet needs and enabling more self-management; the existing programme for HNA in UK is not suitable. Conclusions This thesis supported that a modified HNA programme may be beneficial in meeting the needs of brain tumour patients. Due to neuro-cognitive impairments, an assessment of the patient’s ability to self-manage, combined with inclusion and support of carers in HNA programmes for brain tumour patients, is needed to maximise the potential for self-management. The assessment and management of distress as well as increased access to the neuro-oncology team is also recommended. This research has proposed an alternative, novel practice-based model integrating the findings of this research