Healthcare professionals' experiences and perceptions about LGBTIQA+ safety and responsiveness in a mainstream Australian health service: Qualitative findings.

OBJECTIVE: To explore experiences and perspectives of healthcare workers regarding LGBTIQA+ safety and responsiveness. METHODS: Thematic analysis of semi-structured, in-depth interviews, and pre-surveys to collect demographics and knowledge self-rating scales. RESULTS: Of 38 multidisciplinary healthcare staff, 44.7 % identified as LGBTIQA+ and 55.3 % as heterosexual and cisgender allies. Participants discussed experiences, noting strengths and gaps in affirming practice and organisational support, and training and education opportunities. CONCLUSIONS: Health services need to prioritise LGBTIQA+ safety and responsiveness for staff, patients, carers and families. LGBTIQA+ healthcare staff report that they have had experiences of trauma, minority stress, discrimination, homophobia and/or transphobia, and look for visible safe spaces at work and see safer clinical care.

Speaking with Frankenstein.

This collaborative essay experimentally applies the insights of Mary Shelley's 1818 gothic fantasy Frankenstein to clinical interactions between present-day physicians and the patients they, akin to Shelley's human protagonist, so often seem to bring (back) to life. Because that process is frequently fraught with unspoken elements of ambivalence, disappointment, frustration, and failure, we find in Shelley's speculative fiction less a cautionary tale of overreach than a dynamic parable of the role that the unspoken, the invisible, and the unknown might play in contemporary physician/patient relationships. Playing with that parable, we consider its relevance to four often unacknowledged dynamics that shape physician/patient interaction: commitment to a false binary of life and death; the tyranny of normative aesthetics; shared negative affect; and the ethics of care and care-denial. To "speak with Frankenstein" is, we show, to make space for the otherwise unspeakable. The result is a more complete model of narrative medicine that accommodates to its ideal of open communication and full attention the persistence of what cannot be said, seen, or known--only imagined and approximated.

Exploring the accuracy and practicality of a new two-step algorithm for C. difficile testing.

Clostridium difficile infection is a major cause of morbidity and mortality in hospitalised patients. Rapid, accurate diagnosis is crucial to provide optimal care for affected patients and implement infection-control strategies. This article reports on the results of a study that examined the use of a two-step algorithm to improve the diagnosis of C. difficile.