Stemming the 'Leaky Pipeline': an investigation of the relationship between work-family conflict and women's career progression in academic medicine.

BACKGROUND: Even though women outnumber men enrolled in medical school, making up 59% of entrants in the UK, they are significantly under-represented in academic medicine and senior positions. In the UK, 28.6% of academics overall are women. In the USA, while 51% of instructors are women, only 20% make it through the 'leaky pipeline' to become professors. One attributable factor is work-family conflict. The purpose of this study is to gain a deeper understanding of the relationship between work-family conflict and women's career progression in academic medicine, and to provide a model to inform and change perceptions and practice in order to improve the 'leaky pipeline'. METHODS: A systematic literature search was performed to identify qualitative studies which investigated this relationship. Studies were critically appraised, and data were analysed using thematic analysis. Themes identified in the data were used to develop a model to build on the understanding of this issue. FINDINGS: The findings of this research highlighted two main themes, one related to perceptions of gender (intrinsic or extrinsic), the way it impacts on work-family conflict and its relationship to women's career progression. The second theme relates to structures which hinder or support women's ability to have work-life balance. A model was developed that represents the inter-relationship between these factors. INTERPRETATION: Changes in both organisational culture and individuals' perception in regard to gender roles, especially of those in leadership, are necessary to create an environment where the best talent in academic medicine is selected regardless of gender.

A hospital-wide response to multiple outbreaks of COVID-19 in Health Care WorkersLessons learned from the field

ObjectiveTo describe COVID-19 infections amongst healthcare workers at the Royal Melbourne Hospital from 1st July to 31st August 2020 DesignProspective observational study SettingA 550 bed tertiary referral hospital in metropolitan Melbourne ParticipantsAll healthcare workers identified with COVID-19 infection in the period of interest Results262 healthcare worker infections were identified over 9 weeks. 68.3% of infected healthcare workers were nurses and the most affected locations were the geriatric and rehabilitation wards. Clusters of infection occurred in staff working in wards with patients known to have COVID-19 infection. Staff infections peaked when COVID-19 infected inpatient numbers were highest, and density of patients and certain patient behaviours were noted by staff to be linked to possible transmission events. Three small outbreaks on other wards occurred but all were recognised and brought under control. Availability of rapid turn-around staff testing, and regular review of local data and obtaining feedback from staff helped identify useful interventions which were iteratively implemented. Attention to staff wellbeing was critical to the response and a comprehensive support service was implemented. Conclusion(s)A comprehensive multimodal approach to containment was instituted with iterative refinement based on frontline workers observations and ongoing analysis of local data in real time. O_TEXTBOXThe known: Healthcare workers are a group recognized to be at risk of acquisition of infection in the workplace during the current COVID-19 pandemic The new: This describes the experience of the largest Australian outbreak to date of COVID- 19 infection amongst healthcare workers in a hospital environment The implications: This paper should assist healthcare services to prepare for surges in COVID-19 infection to help limit future transmissions to healthcare workers C_TEXTBOX

Homegrown Ultraviolet Germicidal Irradiation for Hospital-Based N95 Decontamination during the COVID-19 Pandemic

Coronavirus disease (COVID-19), the disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, is responsible for the 2020 global pandemic and characterized by high transmissibility and morbidity. Healthcare workers (HCWs) are at risk of contracting COVID-19, and this risk is mitigated through the use of personal protective equipment such as N95 Filtering Facepiece Respirators (FFRs). The high demand for FFRs is not currently met by global supply chains, potentially placing HCWs at increased exposure risk. Effective FFR decontamination modalities exist, which could maintain respiratory protection for HCWs in the midst of the current pandemic, through the decontamination and re-use of FFRs. Here, we present a locally-implemented ultraviolet-C germicidal irradiation (UVGI)-based FFR decontamination pathway, utilizing a home-built UVGI array assembled entirely with previously existing components available at our institution. We provide recommendations on the construction of similar systems, as well as guidance and strategies towards successful institutional implementation of FFR decontamination.