Prevalence and forms of gender discrimination and sexual harassment among medical students and physicians in French-speaking Switzerland: a survey.

OBJECTIVES: The aim of this study was to determine the prevalence and forms of gender discrimination and sexual harassment experienced by medical students and physicians in French-speaking part of Switzerland. DESIGN AND SETTING: We conducted an online survey using a questionnaire of 9 multiple-choice and 2 open questions between 24 January 2019 and 24 February 2019. Our target population was medical students and physicians working at hospitals and general practitioners from the French-speaking part of Switzerland. The online survey was sent via social media platforms and direct emails. We compared answers between male-determined and female-determined respondents using either χ2 or Fisher's exact tests. RESULTS: Among 1071 responders, a total of 893 were included (625 females, 264 males, 4 non-binary and 1 non-binary and male). 178 were excluded because they did not mention their working place or were working only outside Switzerland. Because of the small number of non-binary participants, they were not contemplated in further statistical analysis. Of 889 participants left, 199 (31.8%) women and 18 (6.8%) men reported having personally experienced gender discrimination, in terms of sexism, difficulties in career development and psychological pressure. Among women, senior attendings were the most affected (55.2%), followed by residents (44.1%) and junior attendings (41.1%). Sexual harassment was equally observed among women (19.0%) and men (16.7%). Compared with men (47.0%), women (61.4%) expressed the need to promote equality and inclusivity in medicine more frequently (p<0.001), as well as the need for support in their professional development (38.7% women and 23.9% men; p<0.001). CONCLUSIONS: Gender discrimination in medicine in French-speaking Switzerland affects one-third of women, in particular, those working in hospital settings and senior positions.

[Consequences of discrimination and harassment in the workplace]. / Conséquences des discriminations et harcèlement en milieu professionnel.

Discrimination and moral and sexual harassment occurring in the workplace can undermine personal integrity and, more generally, have workplace and social repercussions. At the individual level, they have an impact on well-being, self-confidence, and the ability to perform in the workplace. They can also permanently deteriorate the health of the individual, with the onset of chronic diseases such as hypertension and obesity and the increase in the cardiovascular risk; moreover, they can alter mental health, (anxiety-depressive disorder, self-destructive behaviours) and negatively impact sexual health. This article aims to help primary care general practitioners recognize, identify and treat the consequences of harassment and discrimination.

Les discriminations sociales et le harcèlement moral et sexuel survenant en milieu professionnel peuvent porter atteinte à l'intégrité de la personne et entraîner des répercussions dans le monde du travail et au niveau sociétal. On peut observer au niveau individuel un impact sur le bien-être, la confiance en soi et la capacité de rendement en milieu de travail, ainsi qu'une détérioration durable de la santé physique avec l'apparition de maladies chroniques telles que l'hypertension, l'obésité, l'augmentation du risque cardiovasculaire et l'altération de la santé mentale et sexuelle. Cet article a pour but d'aider les médecins généralistes de premier recours à reconnaître et prendre en charge les conséquences globales du harcèlement et des discriminations.

[Particularities of coronary syndrome in women]. / Particularités du syndrome coronarien chez les femmes.

Cardiovascular disease, including myocardial infarction, has been less studied in the female population, leading to higher mortality among women. Differences between the sexes exist in terms of clinical presentation, pathophysiology and even management. This article is a non-systematic review of literature of recent articles addressing this theme. A broader understanding of the peculiarities of coronary syndrome in women improves their management and reduces the inequality of prognosis for women.

Les maladies cardiovasculaires, dont l'infarctus du myocarde, ont été moins étudiées dans la population féminine. Des différences entre les sexes existent en termes de présentation clinique, de physiopathologie et même de prise en charge. Cet article est une revue non systématique de la littérature des articles récents abordant ce thème. Une meilleure compréhension des particularités du syndrome coronarien chez les femmes peut contribuer à améliorer leur prise en charge et réduire l'inégalité de pronostic actuellement en leur défaveur.

[How to prepare an oral presentation†?] / Comment se préparer à une présentation orale?

Oral presentations are an important means of transmitting knowledge. Good preparation is essential to succeed in this exercise. Some steps are necessary, such as defining the main objective, focusing on the audience, managing the time, choosing the first and last words, or anticipating the audience's questions, while using the visual aids appropriately. The purpose of this article is to lead young doctors in the process of creating an oral presentation.

Les présentations orales sont un moyen important de transmission du savoir. Une bonne préparation est essentielle pour réussir cet exercice. Certaines étapes sont nécessaires, comme définir l'objectif principal, s'intéresser à son audience, gérer le temps, choisir les premiers et derniers mots ou encore anticiper les questions du public, le tout en utilisant de manière adaptée les supports visuels. Cet article a pour objectif d'accompagner les jeunes médecins dans le processus de création d'une présentation orale.

Near fatal intoxication by nicotine and propylene glycol injection: a case report of an e-liquid poisoning.

BACKGROUND: Concern about intoxication by e-liquid is growing as calls to poison control centers have increased since their introduction. Only three cases of intoxication by injection have been reported worldwide. Our case is unique because of the precise follow-up of a patient who survived a lethal dose of self-injected e-liquid, without other co-intoxication. CASE PRESENTATION: A 51-year-old male presented to the Emergency Department after injecting himself intravenously (IV) in the forearm with 10 mL of e-liquid (1000 mg of nicotine diluted in propylene glycol). An agitation phase was followed by coma and bradypnoea requiring mechanical ventilation. The patient developed a transitory neurological impairment with the appearance of tetraparesis, gaze palsy and myoclonus due to nicotinic syndrome. The arterial blood gas (ABG) analysis confirmed uncompensated lactic acidosis with an elevated anion gap, which is an expected effect of propylene glycol. The toxicology screen indicated the presence of nicotine and cotinine in the blood and excluded the presence of concomitant intoxication. The patient recovered without sequelae. CONCLUSION: Even a small quantity of intravenous (IV) e-liquid can lead to an acute intoxication and fatal outcomes due to the toxic effects of nicotine. This case might help emergency doctors cope with acute intoxication by injection of e-liquid and increase their comprehension of the two main substances, nicotine and propylene glycol with overview of their pharmacodynamics and kinetic effects.

Effectiveness of influenza vaccine in aging and older adults: comprehensive analysis of the evidence.

Foremost amongst the diseases preventable by vaccination is influenza. Worldwide, influenza virus infection is associated with serious adverse events leading to hospitalization, debilitating complications, and death in elderly individuals. Immunization is considered to be the cornerstone for preventing these adverse health outcomes, and vaccination programs are timed to optimize protection during the annual influenza season. Trivalent inactivated influenza virus vaccines are believed to be both effective and cost-saving; however, in spite of widespread influenza vaccination programs, rates of hospitalization for acute respiratory illness and cardiovascular diseases have been increasing in this population during recent annual influenza seasons. From meta-analyses summarizing estimates of influenza vaccine effectiveness from available observational clinical studies, this review aims to examine how effective current influenza vaccine strategies are in the aging and older adult population and to analyze which are the most important biases that interfere with measurements of influenza vaccine effectiveness. Furthermore, consideration is given to strategies that should be adopted in order to optimize influenza vaccine effectiveness in the face of immune exhaustion.