ObjectiveTo investigate the impact of the COVID-19 pandemic on the research activity and working experience of clinical academics, with a focus on gender and ethnicity.DesignQualitative study based on interviews and audio/written diary data.SettingUK study within clinical academia.ParticipantsPurposive sample of 82 clinical academics working in medicine and dentistry across all career stages ranging from academic clinical fellows and doctoral candidates to professors.MethodsQualitative semistructured interviews (n=68) and audio diary data (n=30; including 16 participants who were also interviewed) collected over an 8-month period (January–September 2020), thematically analysed.Results20 of 30 (66.6%) audio diary contributors and 40 of 68 (58.8%) interview participants were female. Of the participants who disclosed ethnicity, 5 of 29 (17.2%) audio diary contributors and 19/66 (28.8%) interview participants identified as Black, Asian or another minority (BAME). Four major themes were identified in relation to the initial impact of COVID-19 on clinical academics: opportunities, barriers, personal characteristics and social identity, and fears and uncertainty. COVID-19 presented opportunities for new avenues of research. Barriers included access to resources to conduct research and the increasing teaching demands. One of the most prominent subthemes within ‘personal characteristics’ was that of the perceived negative impact of the pandemic on the work of female clinical academics. This was attributed to inequalities experienced in relation to childcare provision and research capacity. Participants described differential experiences based upon their gender and ethnicity, noting intersectional identities.ConclusionsWhile there have been some positives afforded to clinical academics, particularly for new avenues of research, COVID-19 has negatively impacted workload, future career intentions and mental health. BAME academics were particularly fearful due to the differential impact on health. Our study elucidates the direct and systemic discrimination that creates barriers to women’s career trajectories in clinical academia. A flexible, strategic response that supports clinical academics in resuming their training and research is required. Interventions are needed to mitigate the potential lasting impact on capacity from the pandemic, and the potential for the loss of women from this valuable workforce.
Families' views can inform practical recommendations for optimising the experience of consent for tissue banking. Current guidelines for obtaining consent should be revisited to take account of families' preferences.
Clinical inertia is common in all chronic diseases, including diabetes. Despite the advent of newer agents for the management of hyperglycemia, hypertension, and dyslipidemia, the number of people with diabetes hitting all three targets remains small. The causes of clinical inertia are multifactorial, with contributory elements from people with diabetes, physicians, and the system within which they work. Every health care provider should have the best interest of their patients at heart; most people with diabetes want to maintain their health for as long as possible, and the maintenance of good health is not only the purpose of the system, but also the most cost-effective strategy. It is the thesis of this article that a potential reversible contributor to clinical inertia is the communication among these individual elements, which can be called "coproduction." The coproduction model of open communication encourages discourse, allowing the person with diabetes to understand their diagnosis and therefore better engage in treatment options. Improving engagement allows the healthcare team, including the physician and the person with diabetes, to establish shared goals that are important to all team members and to agree to acceptable side effects or risks of interventions in order to achieve these goals. Everyone needs to acknowledge that non-adherence exists and can be an issue, thereby allowing reasons to be explored. Only once the person with diabetes is allowed to take full ownership of their disease and actively participate in decision making can they take control of their disease, thereby improving outcomes.
ObjectiveCentral venous access devices (CVADs), often known as central lines, are important for delivering medically complex care in children, and are increasingly used for children living at home. Central line-associated bloodstream infection (CLABSI) is a serious, life-threatening complication. Although the physical consequences of CLABSIs are well documented, families’ views and experiences of CLABSI are poorly understood.DesignQualitative study using semistructured interviews with participants from 11 families of a child living at home with a CVAD.ParticipantsParents of children aged 4–12 years living at home with a CVAD. Four fathers and nine mothers participated in interviews.ResultsThe risk of CLABSI is a constant fear for families of a child with a CVAD. Though avoiding infection is a key priority for families, it is not the only one: maintaining a sense of ‘normal life’ is another goal. Infection prevention and control require much work and expertise on the part of families, contributing significantly to families’ physical and emotional workload.ConclusionsLiving with the risk of CLABSI poses additional burdens that impact on the physical and emotional well-being of families. Services to better support families to manage these burdens are needed.
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