Exploring gender differences in doctors' working lives

Background: As the proportion of women in medicine draws towards parity, long-standing questions about gender differences in the way that doctors work become more pertinent. Gender differences in medical working patterns and career choices are well documented; but there is a lack of understanding of everyday differences in the working lives of male and female doctors, particularly in UK hospital medicine. In this thesis, potential sources of gender variations in activity rates, previously reported in the literature, are identified. Methods: Multiple methods were employed to explore potential gender differences in doctors’ working lives. Systematic review methods synthesised existing literature on gender differences in the communication style, content and length of medical consultations. Qualitative methods were used to develop in-depth and contextualised understanding of potential gender differences in UK hospital consultants’ working lives, using observation and interviews. Potential variations in clinic length data were analysed quantitatively and synthesised with the existing literature using meta-analysis. Finally, a pilot questionnaire was designed and tested to build on qualitative findings and investigate variations in a wider sample. Results: Doctors’ gender appears to influence their working lives, and the interface between home and work, and these influences may partly explain variations in activity rates. Specifically, female doctors appear to spend longer on consultations; adopt different styles of communication such as lowered dominance and greater use of psychosocial communication; experience greater barriers in their careers such as gender discrimination and problems with work-family conflict; and may experience lower levels of cooperation from colleagues. Conclusions: This research provides important and timely understanding about the sources of gender differences in the working lives of hospital consultants, which may affect both the quality and quantity of care provided by male and female doctors

Improving Patient Safety by Reducing Falls

In the microsystem setting of this project, there have been two patient falls, within the last year. These falls did not result in injury, hence, did not create additional cost for the hospital, nor the patient. Evaluation of the patient’s charts concluded that the fall risk assessments for the patients in question were not entirely indicative of their risk for falls. Additionally, the fall risk care plans were not patient specific in that they did not fully address the designated fall risks of the patient. An abundance of evidence exists supporting the need to reduce falls, and that fall reduction can be attained by adequately assessing fall risk, as well as by care planning in a multidisciplinary manner. The aim of this project is to improve patient safety by reducing falls. To attain this goal, staff teaching was done regarding the necessity of patient-specific fall risk assessments, as well as care planning specifically for these individualized fall risks. The duration of the evaluation of the process began upon admission to the microsystem, and ended upon discharge from the same microsystem. The resulting conclusion of this process improvement project is projected to be that the fall incidence rate will be reduced to zero, and will remain at zero, through the end of the year. However, final outcomes remain pending

Autobiographical memory narratives in psychotherapy: A coding system applied to the case of Cynthia

Recent cognitive and psychodynamic oriented therapies have converged on the powerful role that narrative processing plays in psychotherapy. Although previous coding systems have examined specific aspects of memory narratives, there are no comprehensive methods for coding segments of clinical evaluations or psychotherapy sessions that zero in on the unit of a briefly recounted autobiographical memory narrative. The present single case study aims to introduce and to demonstrate the Coding System for Autobiographical Memory Narratives in Psychotherapy (CS-AMNP; Singer & Bonalume, 2008) with a young female client whom we call Cynthia. We applied this autobiographical memory narrative approach to the diagnostic interview of Cynthia in evaluation for psychotherapy and compared predictions based on its results to the clinician’s report of Cynthia\u27s actual therapeutic outcome. This study demonstrates the utility of the coding system for personality assessment and case conceptualization in the service of ongoing treatment. In addition, implications of this coding system for future research, clinical practice, and training are discussed

Building Health Equity One Institution at a Time: The Research Infrastructure in Minority Institutions Project

Developing a well-trained workforce interested in, and prepared for, conducting health equity research is an important national priority. Scientists from Minority-Serving Institutions (MSIs) bring unique perspectives and experiences with racial, ethnic and social inequities in health and health status but often lack access to training and mentoring opportunities, which is crucial for increasing the diverse pool of investigators who are adequately prepared to conduct health disparities research and to compete for National Institutes of Health research funding. The focus of the California State University, Long Beach (CSULB) Research Infrastructure in Minority Institutions (RIMI) Project was to: (a) enhance CSULB’s infrastructure and research capacity, (b) conduct applied community health research on health conditions disproportionately affecting disadvantaged populations, and (c) support faculty to embark on careers in reducing health disparities. Faculty received training, mentorship, and release time support to participate in research-related activities. Select faculty also received funding to conduct a two-year health disparities research project. Within a relatively short period of time, the RIMI Project made important strides toward strengthening the research infrastructure at CSULB by enhancing faculty capacity, improving research utilization to address health disparities, and strengthening campus and community collaborations. MSIs are encouraged to apply for opportunities to build their institution’s research capacity. The lessons learned from this project may be used as a guide for other teaching institutions that have the goal to develop minority faculty researchers

toward the scientific study of autobiographical memory narratives in psychotherapy

 In responding to Adler (2010) and Moertl, Boritz, Bryntwick, and Angus (2010), we elaborate three areas of discussion: (1) Defining the autobiographical memory narrative unit; (2) Clarifications regarding our approach to coding narrative memories; and (3) Potential future research.  Our response highlights the importance of a coding system specific to long-term narrative memories, the need to distinguish clearly what is meant by narrative memory, and the value of creating a bridge between the study of narrative memory in psychotherapy and research in cognitive science and personality psychology.    Â

General practitioner well-being during the COVID-19 pandemic : a qualitative interview study

OBJECTIVES: The COVID-19 pandemic presented new challenges for general practitioners' (GPs') mental health and well-being, with growing international evidence of its negative impact. While there has been a wide UK commentary on this topic, research evidence from a UK setting is lacking. This study sought to explore the lived experience of UK GPs during COVID-19, and the pandemic's impact on their psychological well-being. DESIGN AND SETTING: In-depth qualitative interviews, conducted remotely by telephone or video call, with UK National Health Service GPs. PARTICIPANTS: GPs were sampled purposively across three career stages (early career, established and late career or retired GPs) with variation in other key demographics. A comprehensive recruitment strategy used multiple channels. Data were analysed thematically using Framework Analysis. RESULTS: We interviewed 40 GPs; most described generally negative sentiment and many displayed signs of psychological distress and burnout. Causes of stress and anxiety related to personal risk, workload, practice changes, public perceptions and leadership, team working and wider collaboration and personal challenges. GPs described potential facilitators of their well-being, including sources of support and plans to reduce clinical hours or change career path, and some described the pandemic as offering a catalyst for positive change. CONCLUSIONS: A range of factors detrimentally affected the well-being of GPs during the pandemic and we highlight the potential impact of this on workforce retention and quality of care. As the pandemic progresses and general practice faces continued challenges, urgent policy measures are now needed

Estudio de trabajo para incrementar la productividad en la instalación de gas en una empresa de servicios, Pisco, 2023

En el presente estudio, titulado “Estudio de trabajo para incrementar la productividad en la instalación de gas en una empresa de servicios, Pisco, 2023”, se tiene como objetivo general, determinar cómo el estudio de trabajo incrementa la productividad en la instalación de gas en una empresa de servicios, Pisco, 2023. Nuestro tipo de investigación es aplicada, enfoque cuantitativo, nivel de investigación explicativa y un diseño de investigación experimental de tipo preexperimental. La población de esta investigación está conformada por las instalaciones de gas, en un periodo de 2 meses, los cuales fueron medidos en pretest y post-test. La implementación del estudio del trabajo se realizó en el mes de agosto. La técnica de investigación fue observación directa, mientras que los instrumentos fueron hoja de registro de tiempos, cinta métrica, cronómetro para control de tiempo ficha de registro de eficiencia, eficacia y productividad, diagrama de flujo y diagrama de operaciones. Cabe mencionar que los instrumentos fueron validados mediante el juicio de expertos por tres ingenieros expertos del tema. Posterior a ello, se tuvo un incremento de productividad en un 27%, eficiencia en un 4% y eficacia en un 21%

Elaboración de carbón activado a partir del endocarpio del coco

Este estudio se centra en la elaboración y caracterización de carbón activado a partir del endocarpio del coco, proponiendo su uso como una alternativa sostenible y económica a los carbones activados comerciales utilizados en el tratamiento de aguas. Se exploraron diferentes metodologías de activación, tanto física como química, para optimizar las propiedades adsorbentes del carbón activado producido. El proceso de pirólisis se empleó como etapa inicial para la carbonización del endocarpio del coco, seguido de tratamientos de activación con agentes químicos como el ácido fosfórico. Se llevó a cabo una serie de experimentos para evaluar las propiedades fisicoquímicas del carbón activado, tales como la humedad, la densidad aparente y el contenido de cenizas. Además, se realizaron pruebas de adsorción para determinar la eficiencia del carbón activado en la remoción de contaminantes. Los resultados obtenidos demostraron que el carbón activado derivado del endocarpio del coco posee características adsorbentes comparables a las de los carbones activados comerciales, con una alta capacidad para remover contaminantes del agua. Estos hallazgos sugieren que el uso de residuos agroindustriales como el endocarpio del coco para la producción de carbón activado no solo es una solución económica y efectiva para el tratamiento de aguas, sino también una estrategia sustentable que contribuye a la reducción de residuos y al aprovechamiento de recursos naturales.This study focuses on the elaboration and characterization of activated carbon from coconut endocarp, proposing its use as a sustainable and economical alternative to commercial activated carbons used in water treatment. Different activation methodologies, both physical and chemical, were explored to optimize the adsorptive properties of the activated carbon produced. The pyrolysis process was used as the initial stage for the carbonization of the coconut endocarp, followed by activation treatments with chemical agents such as phosphoric acid. A series of experiments were carried out to evaluate the physicochemical properties of the activated carbon, such as moisture, bulk density and ash content. In addition, adsorption tests were carried out to determine the efficiency of the activated carbon in the removal of contaminants. The results obtained showed that the activated carbon derived from coconut endocarp has adsorption characteristics comparable to those of commercial activated carbons, with a high capacity to remove contaminants from water. These findings suggest that the use of agro-industrial wastes such as coconut endocarp for the production of activated carbon is not only an economical and effective solution for water treatment, but also a sustainable strategy that contributes to the reduction of waste and the use of natural resources