Male and female emirati medical clerks’ perceptions of the impact of gender and mobility on their professional careers

Background: Medicine has undergone profound changes in terms of the number of women entering the profession with postulated implications of this ‘feminization’ for the profession. The present phenomenological study sought to gain insight into the experiences of final year male and female Emirati medical students (clerks) in terms of the impact of gender on their careers. Methods: Semi-structured interviews were conducted with 24 of the 27 clerks. Interviews were transcribed and analyzed thematically. Findings: There was consensus that the gender profile of medicine in the United Arab Emirates was changing as opportunities emerged for Emirati women to branch into different medical specialties. These opportunities were, however, local or regional due largely to travel restrictions on women. Females would thus receive a less highly regarded board certification than males who were encouraged to specialize abroad. On their return, males would be appointed as consultants or as high-ranking administrators. Participants also acknowledged that like their roles in their society, some medical specialties were ‘gendered’, e.g., surgery (male) and pediatrics and obstetrics and gynecology (female). Conclusion: Although religious and cultural traditions around gender and mobility will influence the professional careers of male and female Emirati medical graduates, the situation is, however, changing

Playing with food: Maternal feeding style and perceptions of how preschoolers interact with toy foods in the home environment

Maternal feeding styles have been linked to dietary intake patterns in young children. Additionally, pretend play with toy foods provides a promising means of promoting development of healthy eating patterns in this age group and the potential of it to play a positive role in the home environment may, in part, be related to maternal interactions with the child during pretend play. The purpose of the present study was to explore maternal perceptions of pretend play with toy foods in the home environment relative to maternal feeding style. Specifically, our objectives were to employ a mixed-methods approach to 1) describe maternal observations of their preschool-aged children while engaged in pretend play with toy foods and related materials, 2) describe maternal perceptions as to how pretend play with toy foods relates to real life experiences of preschool-aged children, and 3) describe mothers’ observations and perceptions regarding pretend play with toy foods and relate these to maternal feeding style. Mothers of two to five-year-old children (n=25) were recruited via Facebook posts, online mother’s groups, recruitment flyers to childcare centers, and emails sent to a local database of mothers. Eligible mothers were invited to complete an online survey to collect sociodemographic data, classify the mothers as one of the four feeding styles, and gather their observations and perceptions regarding pretend play activities with toy food and related materials in the home via a series of open-ended questions. Patterns emerging from qualitative analysis of the mothers’ responses in combination with information on feeding style from the Caregiver’s Feeding Styles Questionnaire (CFSQ) suggest that mother’s interactions with their children and perceptions of the role of pretend play contrast by the dimensions of demandingness and responsiveness. Further exploration of the interplay between mothers and children in the pretend play environment will help to clarify how the role of pretend play with toy foods in promoting healthy eating may vary with maternal feeding styles

The Epidemiology of Cryptosporidiosis in Victoria, 2001-2009

Cryptosporidiosis is a protozoan parasitic infection that most commonly presents as gastroenteritis and less commonly infects the respiratory and biliary tracts. Enteric symptoms usually include diarrhoea, bloating, cramping, abdominal pain, vomiting and fever. The disease is usually mild and self-limiting but in immunocompromised individuals is prolonged and can lead to death. The infective dose in humans is low and the incubation period ranges from one to 12 days, with an average of seven days. The infectious period lasts from the onset of symptoms, as the oocysts are excreted in the stool, until several weeks after symptoms resolve. The oocysts are widespread and may remain infective outside the body for two to six months, particularly if the environment is moist. They are highly resistant to standard levels of chemical disinfection of water such as chlorine. Outbreaks have been reported in day care centres, and been associated with drinking water, recreational water (waterslides, swimming pools and lakes) and consumption of contaminated beverages. In Australia, increases in notifications tend to occur in the warmer months and over irregular cycles, with more than 3000 cases notified in Australia in 2002, 2005 and 2006. Cryptosporidiosis became notifiable in both Australia and Victoria in 2001, with more than 15,000 cases notified between 2002 and 2009. The aim of this study was to describe the epidemiology of notified cases of cryptosporidiosis in Victoria for the period 2001 to 2009 in terms of age, sex, location and season

A Positive Association Between Cryptosporidiosis Notifications and Ambient Temperature, Victoria, Australia, 2001-2009

Increased temperatures provide optimal conditions for pathogen survival, virulence and replication as well as increased opportunities for human-pathogen interaction. This paper examined the relationship between notifications of cryptosporidiosis and temperature in metropolitan and rural areas of Victoria, Australia between 2001-2009. A negative binomial regression model was used to analyse monthly average maximum and minimum temperatures, rainfall and the monthly count of cryptosporidiosis notifications. In the metropolitan area, a 1°C increase in monthly average minimum temperature of the current month was associated with a 22% increase in cryptosporidiosis notifications (IRR 1.22; 95% CI 1.13 – 1.31). In the rural area, a 1°C increase in monthly average minimum temperature, lagged by 3 months, was associated with a 9% decrease in cryptosporidiosis notifications (IRR 0.91; 95% CI 0.86 – 0.97). Rainfall was not associated with notifications in either area. These relationships should be considered when planning public health response to ecological risks as well as when developing policies involving climate change. Rising ambient temperature may be an early warning signal for intensifying prevention efforts, including appropriate education for pool users about cryptosporidiosis infection and management, which might become more important as temperatures are projected to increase as a result of climate change

Clinicopathological characteristics of histiocytic sarcoma affecting the central nervous system in dogs.

BackgroundHistiocytic sarcoma affecting the central nervous system (CNS HS) in dogs may present as primary or disseminated disease, often characterized by inflammation. Prognosis is poor, and imaging differentiation from other CNS tumors can be problematic.ObjectiveTo characterize the clinicopathological inflammatory features, breed predisposition, and survival in dogs with CNS HS.AnimalsOne hundred two dogs with HS, 62 dogs with meningioma.MethodsRetrospective case series. Records were reviewed for results of cerebrospinal fluid (CSF) analysis, CBC, treatment, and outcome data.ResultsPredisposition for CNS HS was seen in Bernese Mountain Dogs, Golden Retrievers, Rottweilers, Corgis, and Shetland Sheepdogs (P ≤ .001). Corgis and Shetland Sheepdogs had predominantly primary tumors; Rottweilers had exclusively disseminated tumors. Marked CSF inflammation was characteristic of primary rather than disseminated HS, and neoplastic cells were detected in CSF of 52% of affected dogs. Increased neutrophil to lymphocyte ratios were seen in all groups relative to controls (P <.008) but not among tumor subtypes. Definitive versus palliative treatment resulted in improved survival times (P < .001), but overall prognosis was poor.Conclusions and clinical importanceClinicopathological differences between primary and disseminated HS suggest that tumor biological behavior and origin may be different. Corgis and Shetland Sheepdogs are predisposed to primary CNS HS, characterized by inflammatory CSF. High total nucleated cell count and the presence of neoplastic cells support the use of CSF analysis as a valuable diagnostic test. Prognosis for CNS HS is poor, but further evaluation of inflammatory mechanisms may provide novel therapeutic opportunities

The MAGEC System for Spinal Lengthening in Children with Scoliosis: A NICE Medical Technology Guidance

Scoliosis—structural lateral curvature of the spine—affects around four children per 1,000. The MAGEC system comprises a magnetically distractible spinal rod implant and an external remote controller, which lengthens the rod; this system avoids repeated surgical lengthening. Rod implants brace the spine internally and are lengthened as the child grows, preventing worsening of scoliosis and delaying the need for spinal fusion. The Medical Technologies Advisory Committee at the National Institute for Health and Care Excellence (NICE) selected the MAGEC system for evaluation in a NICE medical technologies guidance. Six studies were identified by the sponsor (Ellipse Technologies Inc.) as being relevant to the decision problem. Meta-analysis was used to compare the clinical evidence results with those of one conventional growth rod study, and equal efficacy of the two devices was concluded. The key weakness was selection of a single comparator study. The External Assessment Centre (EAC) identified 16 conventional growth rod studies and undertook meta-analyses of relevant outcomes. Its critique highlighted limitations around study heterogeneity and variations in baseline characteristics and follow-up duration, precluding the ability to draw firm conclusions. The sponsor constructed a de novo costing model showing that MAGEC rods generated cost savings of £9,946 per patient after 6 years, compared with conventional rods. The EAC critiqued and updated the model structure and inputs, calculating robust cost savings of £12,077 per patient with MAGEC rods compared with conventional rods over 6 years. The year of valuation was 2012. NICE issued a positive recommendation as supported by the evidence (Medical Technologies Guidance 18)

Singing for Health in Morecambe: 2019

The International Centre for Community Music (ICCM) was invited to respond to an existing brief that sought to understand how two new singing groups were developing. This was part of a pilot project established to connect with older people experiencing isolation, and, young people who were connected with the Children and Adolescent Mental Health Service (CAMHS). These singing groups were set up in partnership with a local GP practice and a local CAHMS team to explore possible arts partnerships as a way to challenge health inequalities relating to mental health experiences in Morecambe

Revisiting a Water Conflict in Southeastern Oklahoma 6 Years Later: A New Valuation of the Willingness to Pay for Ecosystem Services

In recent years, researchers have begun to adopt a perspective evaluating “winners and losers” regarding the consumption and value of ecosystem services. “Winners” tend to benefit from the ecosystem service and “losers” absorb most associated costs. Our study focuses on water use in Oklahoma (USA) and a plan to divert water from the Kiamichi River in southeastern Oklahoma for consumption at residences in the Oklahoma City metropolitan area. Our study is, in part, a follow-up from an initial 2013 survey of Oklahoma City residents and residents of the Kiamichi. For this paper, a survey was distributed within the state of Oklahoma to evaluate changes to ecosystem service willingness to pay and valuation. This survey also included an experimental element assessing if exposure to additional information about ecosystem services influenced respondents on ecosystem service valuation, or willingness to pay. Our results generally aligned with those found in the 2013 survey. Oklahoma City residents are not aware of where their water is coming from and are not willing to pay to protect ecosystem services, despite an overall increase in activism. Our results indicate that a smaller number of significant factors determining willingness to pay for ecosystem service maintenance were identified than the study in 2013. Exposure to additional information had no effect on peoples’ preferences. We found that public opinion surrounding environmental support is context-specific, political conservatism may not always impede valuation of environmental protections. We conclude that cultural, moral, and political values interact in their influence on expressions of valuation and willingness to pay for ecosystem services.This manuscript was supported by funding from the US National Science Foundation (NSF DGE-1545261). Open Access fees paid for in whole or in part by the University of Oklahoma Libraries.Ye

Subjective and Objective Assessment of Taste and Smell Sensation in Advanced Cancer

Context: Taste and smell abnormalities (TSA) occur throughout the cancer trajectory regardless of cancer primary site and contribute to cancer-associated malnutrition. TSA etiology is poorly understood. Tumor-related inflammation is a possible cause. Objective: This study examined the prevalence, characteristics, and severity of TSA in advanced cancer and explored the relationship between TSA and nutritional status. No previous study combined subjective and objective measures for both taste and smell assessment in this population. Method: Consecutive advanced cancer hospice patients were recruited. A modified version of the “Taste and Smell Survey” assessed subjective TSA. Validated taste strips and “Sniffin’ Sticks” were the objective measures. The abridged patient-generated subjective global assessment evaluated nutritional status. Results: A 93% prevalence of TSA in 30 patients with advanced cancer was identified. When subjective and objective evaluations were combined, 28 had taste abnormalities, 24 smell abnormalities, and 24 both. Taste changes included “persistent bad taste” (n ¼ 18) and changes in how basic tastes were perceived. Half reported smell was not “as strong” as prediagnosis, while more than half (n ¼ 16) had an objective smell abnormality. Most (97%) were at risk of malnutrition. Fatigue, dry mouth, early satiety, and anorexia were common nutrition-impact symptoms. No statistically significant relationship was found between TSA and malnutrition scores. Conclusions: TSA were highly prevalent. Subjective taste and smell changes did not always accord with objective TSA, suggesting both assessments are valuable. TSA characteristics varied, and particular foods tasted and smelled different and were not enjoyed as before. TSA are common, high-impact problems in advanced cancer

The challenges confronting clinicians in rural acute care settings: a participatory research project

In Australia, as in many other developed countries, the current healthcare environment is characterised by increasing differentiation and patient acuity, aging of patients and workforce, staff shortages and a varied professional skills mix, and this is particularly so in rural areas. Rural healthcare clinicians are confronted with a broad range of challenges in their daily practice. Within this context, the challenges faced by rural acute care clinicians were explored and innovative strategies suggested. This article reports the findings of a study that explored these challenges across disciplines in acute healthcare facilities in rural New South Wales (NSW), Australia. METHODS: A mixed method approach, involving a consultative, participatory 3 stage data collection process was employed to engage with a range of healthcare clinicians from rural acute care facilities in NSW. Participants were invited to complete a survey, followed by focus group discussions and finally facilitated workshops using nominal group technique. RESULTS: The survey findings identified the respondents' top ranked challenges. These were organised into four categories: (1) workforce issues; (2) access, equity and opportunity; (3) resources; and (4) contextual issues. Participants in the focus groups were provided with a summary of the survey findings to prompt discussion about the challenges identified and impact of these on their professional and personal lives. The results of the final workshop stage of the study used nominal group process to focus the discussion on identifying strategies to address identified challenges. CONCLUSIONS: This study builds on research conducted in a large metropolitan tertiary referral hospital. While it was found that rural clinicians share some of the challenges identified by their metropolitan counterparts, some identified challenges and solutions were unique to the rural context and require the innovative solutions suggested by the participants. This article provides insight into the working world of rural healthcare clinicians and offers practical solutions to some of the identified issues. The findings of this study may assist rurally based healthcare services to attract and retain clinical staff