scholarly journals Responding to Patient-Initiated Verbal Sexual Harassment: Outcomes of a Pilot Training for Ophthalmologists

2020 ◽  
Vol 12 (02) ◽  
pp. e175-e180
Author(s):  
Lauren E. Hock ◽  
Brittni A. Scruggs ◽  
Patrick B. Barlow ◽  
Thomas A. Oetting ◽  
Michael D. Abràmoff ◽  
...  
Keyword(s):  
Sexual Harassment ◽  
Body Part ◽  
Bystander Intervention ◽  
Survey Study ◽  
Pilot Training ◽  
Academic Center ◽  
Retrospective Pretest ◽  
The Moment ◽  
The Impact

Abstract Background Sexual harassment of physicians by patients is highly prevalent and rarely reported. Little is known on how to prepare physicians to handle verbal sexual harassment that detracts from their ability to provide care but does not meet the threshold for reporting. Purpose To assess the impact of a sexual harassment workshop and toolkit for ophthalmologists and ophthalmology trainees on responding to patient-initiated verbal sexual harassment. Methods A survey study of ophthalmology faculty, fellows, and residents who participated in workshops on responding to patient-initiated verbal sexual harassment was performed at an academic center. A toolkit of strategies for response was distributed. Volunteer participants completed a retrospective pretest–posttest evaluation at the conclusion of the workshop and follow-up survey 3 weeks after the workshops on whether they experienced harassment and intervened. The pretest–posttest surveys assessed the workshop's effect on ophthalmologists' perceptions of and preparedness to respond to sexual harassment in the moment using a 5-point Likert scale, including bystander intervention. Participants described their responses observing and/or experiencing patient-initiated sexual harassment in the 3 weeks following the workshop and whether they had intervened toward the harassment. Results Ophthalmologists (n = 31) felt significantly more prepared to respond to patient-initiated sexual harassment directed toward themselves or a trainee in the moment after participating in the workshop (4.5 ± 1.63) than before (3.0 ± 1.3) with a mean change of 1.6 (95% confidence interval: 0.98–2.2, p < 0.001). After the workshop, 86.3% of participants felt mostly or completely prepared to respond to comments about their age, gender, marital status, appearance, attractiveness, a specific body part, and sexual or inappropriate jokes. Most participants (83.9%) said that they had not previously received training on techniques for responding to patient-initiated sexual harassment. Two-thirds (66.7%) of participants who experienced (n = 8) or observed (n = 13) harassment (n = 15) following the workshop intervened. All participants who intervened toward patient-initiated harassment behavior after the workshop (n = 10) found the Sexual Harassment Toolkit helpful in addressing harassment in the moment. Conclusion Participation in a brief skills-based workshop significantly improved ophthalmologists' preparedness to respond to verbal sexual harassment by patients.

scholarly journals Postponing Pregnancy Through Oocyte Cryopreservation for Social Reasons: Considerations Regarding Clinical Practice and the Socio-Psychological and Bioethical Issues Involved

Medicina ◽  
2018 ◽  
Vol 54 (5) ◽  
pp. 76 ◽  
Author(s):  
Mara Simopoulou ◽  
Konstantinos Sfakianoudis ◽  
Panagiotis Bakas ◽  
Polina Giannelou ◽  
Christina Papapetrou ◽  
...  
Keyword(s):  
Reproductive Age ◽  
Future Expectations ◽  
The Social ◽  
Wide Range ◽  
Bioethical Issues ◽  
The Moment ◽  
The Impact ◽  
Complex Matter ◽  
Oocyte Freezing

Oocyte freezing for ‘social reasons’ refers to women of reproductive age who are aiming to prolong, protect and secure their fertility. The term emerged to describe application of the highly promising technique, namely vitrification on oocytes retrieved through controlled ovarian stimulation (COS) from women intending to preserve their fertility for social reasons. These women opt to cryopreserve their oocytes at a point in their life when they need to postpone childbearing on the grounds of so called ‘social’ reasons. These reasons may include a highly driven career, absence of an adequate partner, financial instability, or personal reasons that make them feel unprepared for motherhood. This is a sensitive and multifaceted issue that entails medical, bioethical and socio-psychological components. The latest trend and the apparent increase noted on oocyte freezing for ‘social reasons’ has prompted our team of fertility specialists, embryologists, obstetricians, gynecologists and psychologists to proceed with a thorough, critical and all-inclusive comprehensive analysis. The wide range of findings of this analysis involve concerns of embryology and epigenetics that shape decisions made in the IVF laboratory, issues regarding obstetric and perinatal concerns on the pregnancy concluding from these oocytes and the respective delivery management and neonatal data, to the social and bioethical impact of this trend’s application. This literature review refers to matters rising from the moment the ‘idea’ of this option is ‘birthed’ in a woman’s thoughts, to proceeding and executing it clinically, up until the point of the pediatric follow up of the children born. We aim to shed light to the controversial issue of oocyte freezing, while objectively exhibit all aspects regarding this complex matter, as well as to respectfully approach how could the prospect of our future expectations be shaped from the impact of its application.

scholarly journals "Fit in or F#$@ off": the (non) disclosure of sexual harassment in rural workplaces

2012 ◽  
pp. 1-17
Author(s):  
Skye Saunders ◽  
Patricia Lynn Easteal
Keyword(s):  
Rural Communities ◽  
Sexual Harassment ◽  
Rural Women ◽  
Cultural Dimensions ◽  
Social Constructionist ◽  
Or Education ◽  
Female Employees ◽  
Sexual Harassment Policies ◽  
The Impact

In this paper we consider the complexities associated with the internal workplace disclosure of sexual harassment for rural employees. We acknowledge the existence of certain accompanying ‘special issues’ for rural women and predict that these elements (such as the traditionally conservative bush attitudes about violence against women, the added cultural dimensions of small-town gossip and self-reliance and the impact of isolation) would have some impact on the inclination of rural women to report workplace sexual harassment. To test that hypothesis, a sample of female employees and a sample of employers from different areas considered as ‘rural’ were interviewed. In defining ‘rural’ for this purpose we adopted a social constructionist approach. We report on participants’ experiences and attitudes about making an internal sexual harassment complaint. We discuss the barriers to disclosure that respondents perceive. We identify the types of rural workplaces (occupation, rurality, gender ratios) which tend to utilise sexual harassment policies and offer training, and we consider the impact of these on the likelihood of reporting. We also investigate whether other variables, such as the type of harassment experienced, employees’ attitude about what constitutes sexual harassment and reporting, age, seniority and/or education affect reporting. We conclude that disclosure practices could be improved by the implementation of visiting sexual harassment consultants/officers who would visit rural communities to educate, hear complaints, help with the development of policies, provide advice referral to counseling mediation and provide follow up.

Impact of Biological Variables on Need of Treatment in B-CLL: Study of 347 Patients in a Single Institution

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 4188-4188
Author(s):  
Mj Garcia-Rodriguez ◽  
Raquel de Paz ◽  
M. Canales ◽  
M. Morado ◽  
F. Hernandez-Navarro
Keyword(s):  
Lymphocytic Leukemia ◽  
Clinical Staging ◽  
Free Survival ◽  
Cd38 Expression ◽  
Biological Variables ◽  
Positive Expression ◽  
Binet Stage ◽  
The Moment ◽  
The Impact

Abstract Background: Chronic lymphocytic leukemia (CLL) has an extremely variable clinical course. Some patients have a rapid and fatal evolution, and die earlier after diagnosis, whereas others have an indolent disease, and live for 10–20 years without symptoms. Ray and Binet system have been classically considered standard clinical staging method, but have a recognised limitation to identify the real risk to start treatment in patients with initial stage of disease (Rai 0–2, Binet A). Objetive: Our objective was to evaluate the impact of biological variables (cytogenetic analyses and CD38 and ZAP70 expression) independently of Rai and Binet stage at diagnosis, in the need of treatment. Moreover we analyzed the treatment-free survival at 12 and 60 months. Patients and methods: Our study includes 347 patients with B-CLL, 167 men and 180 women, with a median age of 70 years (range 35–97 years) who were retrospectively analyzed. All patients were diagnosed in our center during a period of 20 years, on the basis of a clinical examination as well as morphological and immunological criteria. Chromosomal abnormalities were studied using FISH cytogenetic methodology in 79.3% of patients. Patients with normal karyotype or single abnormality of 13q-, were considered in the group of favourable prognosis. Patients with other abnormalities such as trisomy 12, 17p- and 11q-, were considered as high risk of progression. CD38 expression was analyzed by flow cytometry in 90.2% of patients. A cut-off ≥30% was defined to distinguish positive and negative expression. ZAP70 expression was studied in 64.8% and we considered positive a cut-off ≥20%. Results: 78.9% of patients were classified by FISH in the good risk prognosis group. CD38 positive expression was detected in the 24.6% and ZAP70 was positive in the 56%. When we analysed the biological characteristics of treated patients we observed that they expressed CD38, ZAP70 and unfavourable karyotype more frequently than total population studied. These differences were more significant than the relationship with Rai and Binet stage. At 12 months of follow-up, we found that only 21% of patients with CD38 negative expression need treatment versus 40% of patients with positive expression. 25% of patients with ZAP-70 negative expression and 35% of ZAP-70 positive expression need treatment at this moment. 27% of patients with favourable kariotype and 29% of patients with unfavourable cytogenetic were treated (Figure 1). At 5 years since the moment of diagnostic, these differences were more significant. 82% of patients with CD38 positive expression need treatment versus 64% of patients with CD38 negative expression; 80% of patients with unfavourable cytogenetic need treatment versus 64% of patients with favourable kariotype. No differences were found in the two groups of the ZAP70 expression (Figure 1). Conclusions: We observed that biological markers, fundamentally CD38 expression, predict need of treatment. The percentage of treated patients was significantly higher in the group of CD38 positive expression at the moment of diagnosis. The follow-up of our patients shows that the treatment-free survival is lower in patients with CD38 positive expression, so this marker could be used to predict need of treatment and separate those cases of smouldering B-CLL that no need to be observed so intensively in which the best option of treatment is “watch and wait”. Figure 1. Treatment-free survival in 347 patients with B-CLL according to karyotype, CD38 and ZAP70 expression. Figure 1. Treatment-free survival in 347 patients with B-CLL according to karyotype, CD38 and ZAP70 expression.

MO925VALVULAR HEART DISEASE EVOLUTION IN KIDNEY TRANSPLANT RECIPIENTS AND RELATED RISK FACTORS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Isabel Galceran ◽  
M Dolores Redondo Pachón ◽  
María José Pérez Sáez ◽  
Carlos Arias Cabrales ◽  
Carla Burballa Tarrega ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Graft Survival ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Disease Evolution ◽  
Related Risk ◽  
The Moment ◽  
The Impact

Abstract Background and Aims Cardiovascular diseases remains the leading cause of death in recipients of kidney transplantation (KT). Valvular heart disease (VHD) is not an exclusion criteria for KT, however it’s repercussion on KT follow-up has been less studied. Our objective was to analyse the impact of VHD in KT recipients and related risk factors of VHD progression (VHDp). Method Observational retrospective cohort study of all patients who underwent KT at Hospital del Mar (Barcelona, Spain) between January 1980 and December 2018. VHD was defined as presence of aortic stenosis (AS), aortic regurgitation, mitral stenosis, mitral regurgitation, tricuspid stenosis, tricuspid regurgitation or double valve injury of any degree diagnosed by echocardiography. We analysed the VHDp, defined as worsening of the initial valvular degree on heart ultrasound after KT, risk factors related with VHDp, recipients and graft survival. Results During the study period, 1422 patient underwent KT and 48 of them (3.4%) had VHD diagnosed prior to KT. In the median time of follow-up of 56.3 months (IQR25-75 17.7-119 month), 17 patients (35.4%) presented VHDp and 31 patients did not (64.6%). Figure 1 shows the primary outcome in the different types of VHD, AS was the valve with more VHDp after KT. Statistical evaluation revealed that recipients with VHDp had a higher body mass index (BMI) (27.4 ± 6.3 vs 24.3 ± 3.8 kg/m2, p=0.04) and worse PTH control (427.0 ± 309.3 vs 186.2 ± 140.6 pg/ml, p=0.02) at the moment of the KT. Also, patients with VHDp reached a worse nadir glomerular filtration rate (GFR) (44.1 ± 17.5 vs 56.0 ± 13.9 ml/min/1.73m2, p=0.01) during the follow-up, needed more time to reach their nadir GFR (4 [2-13] vs 1.2 [1.0-4.7] months, p&lt;0.001) and required more furosemide dose at that time (72.7 ± 21.7 vs 15.8 ± 5.6 mg/day, p=0.02). At the end of follow-up, 213 KT recipients had died, 16 with preKT-VHD (33.3% of all patients with VHD) and 197 without preKT-VHD (14.3% of all cases without VHD). There was a statistical significant association between preKT-VHD status and all-cause mortality after KT (log rank &lt; 0.001). However, there wasn’t statistical association between preKT-VHD status and death-censored graft survival (log rank = 0.2). Conclusion VHD has a significant impact on increased pos-KT mortality but it is not associated with graft survival. More than one third of recipients with preKT-VHD presented deterioration after KT. We found that increased preKT BMI and PTH, nadir GFR after KT, time to reach this nadir GFR and diuretic dose at that time are related with VHD progression.

A Survey Study of a Public School Voice Clinic Program

1984 ◽  
Vol 15 (4) ◽  
pp. 275-280 ◽  
Author(s):  
Charles L. Madison ◽  
Deborah L. Meadors ◽  
Sandra Q. Miller
Keyword(s):  
Public School ◽  
Public Understanding ◽  
Survey Study ◽  
Follow Up Study ◽  
The Impact ◽  
The Voice ◽  
Clinic Program

This is a follow-up study to previous reports on a 10-year public school voice clinic program. Parents of children seen at voice clinics and referring clinicians were surveyed regarding the impact and effectiveness of the voice clinics. The program appears to have increased public understanding of voice problems and is useful in expediting management.

scholarly journals Music Therapy May Increase Breastfeeding Rates Among Mothers of Premature Newborns: A Randomized Controlled Trial

2012 ◽  
Vol 12 (3) ◽  
Author(s):  
Martha N S Vianna ◽  
Arnaldo P Barbosa ◽  
Albelino S Carvalhaes ◽  
Antonio J L A Cunha
Keyword(s):  
Randomized Controlled Trial ◽  
Music Therapy ◽  
Therapy Group ◽  
Controlled Trial ◽  
Premature Newborns ◽  
Randomized Controlled ◽  
Breastfeeding Rates ◽  
The Moment ◽  
The Impact

OBJECTIVE: To evaluate the impact of music therapy on breastfeeding rates among mothers of premature newborns. METHOD: In an open randomized controlled trial, mothers of premature neonates weighting ≤1750g were submitted to music therapy sessions three times a week for 60 minutes. The primary endpoint was breastfeeding rate (exclusive, predominant or continuous) at the moment of infant discharge and at the first follow-up visit (7-15 days after discharge). RESULTS: A total of 94 mothers (48 in the music therapy group and 46 in the comparison group) were studied. Breastfeeding was more frequent in the music therapy group at the moment of the infant hospital discharge (RR: 1.22; 95% CI: 0.99-1.51; P = .06; NNT = 6.3) and at the first follow-up visit (RR: 1.26; 95% CI: 1.01-1.57; P = .03; NNT = 5.6).  Breastfeeding rates were higher in the intervention group at day 30 and day 60 after discharge, but these results were not statistically significant (RR: 1.21; 95% CI: 0.73-5.6 and RR: 1.28; 95% CI: 0.95-1.71 respectively).  CONCLUSIONS: Music therapy increased breastfeeding rates in premature newborns at discharge, as well as 7-15 days later. This approach could be useful for increasing breastfeeding rates among premature newborns.[Editors note: The article presented here is republished from Jornal de Pediatria, 2011, 87(3), 206-212, doi: 10.2223/JPED.2086, with the kind permission from the publisher and the authors.]

Sound Production Treatment for Acquired Apraxia of Speech: An Examination of Dosage in Relation to Probe Performance

2020 ◽  
pp. 1-16
Author(s):  
Julie L. Wambaugh ◽  
Lydia Kallhoff ◽  
Christina Nessler
Keyword(s):  
Retrospective Analysis ◽  
Sound Production ◽  
Apraxia Of Speech ◽  
Practice Schedule ◽  
Practice Schedules ◽  
Baseline Performance ◽  
The Mean ◽  
Number Of Treatment ◽  
The Impact

Purpose This study was designed to examine the association of dosage and effects of Sound Production Treatment (SPT) for acquired apraxia of speech. Method Treatment logs and probe data from 20 speakers with apraxia of speech and aphasia were submitted to a retrospective analysis. The number of treatment sessions and teaching episodes was examined relative to (a) change in articulation accuracy above baseline performance, (b) mastery of production, and (c) maintenance. The impact of practice schedule (SPT-Blocked vs. SPT-Random) was also examined. Results The average number of treatment sessions conducted prior to change was 5.4 for SPT-Blocked and 3.9 for SPT-Random. The mean number of teaching episodes preceding change was 334 for SPT-Blocked and 179 for SPT-Random. Mastery occurred within an average of 13.7 sessions (1,252 teaching episodes) and 12.4 sessions (1,082 teaching episodes) for SPT-Blocked and SPT-Random, respectively. Comparisons of dosage metric values across practice schedules did not reveal substantial differences. Significant negative correlations were found between follow-up probe performance and the dosage metrics. Conclusions Only a few treatment sessions were needed to achieve initial positive changes in articulation, with mastery occurring within 12–14 sessions for the majority of participants. Earlier occurrence of change or mastery was associated with better follow-up performance. Supplemental Material https://doi.org/10.23641/asha.12592190

Research Participation Experiences of Informants of Suicide and Control Cases

Crisis ◽  
2010 ◽  
Vol 31 (5) ◽  
pp. 238-246 ◽  
Author(s):  
Paul W. C. Wong ◽  
Wincy S. C. Chan ◽  
Philip S. L. Beh ◽  
Fiona W. S. Yau ◽  
Paul S. F. Yip ◽  
...  
Keyword(s):  
Ethical Issues ◽  
Research Participation ◽  
Self Report ◽  
Initial Contact ◽  
Psychological Autopsy ◽  
Autopsy Study ◽  
The People ◽  
And Control ◽  
The Impact

Background: Ethical issues have been raised about using the psychological autopsy approach in the study of suicide. The impact on informants of control cases who participated in case-control psychological autopsy studies has not been investigated. Aims: (1) To investigate whether informants of suicide cases recruited by two approaches (coroners’ court and public mortuaries) respond differently to the initial contact by the research team. (2) To explore the reactions, reasons for participation, and comments of both the informants of suicide and control cases to psychological autopsy interviews. (3) To investigate the impact of the interviews on informants of suicide cases about a month after the interviews. Methods: A self-report questionnaire was used for the informants of both suicide and control cases. Telephone follow-up interviews were conducted with the informants of suicide cases. Results: The majority of the informants of suicide cases, regardless of the initial route of contact, as well as the control cases were positive about being approached to take part in the study. A minority of informants of suicide and control cases found the experience of talking about their family member to be more upsetting than expected. The telephone follow-up interviews showed that none of the informants of suicide cases reported being distressed by the psychological autopsy interviews. Limitations: The acceptance rate for our original psychological autopsy study was modest. Conclusions: The findings of this study are useful for future participants and researchers in measuring the potential benefits and risks of participating in similar sensitive research. Psychological autopsy interviews may be utilized as an active engagement approach to reach out to the people bereaved by suicide, especially in places where the postvention work is underdeveloped.

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