BACKGROUND: Many people experience persistent symptoms for more than 12 weeks following SARS-CoV-2 infection, which is known as post-COVID-19 condition (PCS) or Long COVID (LC). PCS can impair people\'s quality of life and daily functioning. However, there is a lack of in-depth research exploring the PCS patient journey, as well as gendered aspects of patients\' experiences.
METHODS: Nineteen semi-structured qualitative interviews were conducted with people living with PCS in the United Kingdom (13 women, 6 men). Interviews were transcribed verbatim and analysed inductively using reflexive thematic analysis.
RESULTS: Five main themes were identified: \'Symptom dismissal\', \'Lack of information and support\', \'Life before and after Long COVID\', \'Psychological impact\' and \'Acceptance\'. A shift overtime to self-management of symptoms was evident. These themes represent different stages of patients\' PCS journey. Narratives indicated that women highlighted dismissal by healthcare professionals (HCPs), which was not as prominent in men\'s narratives. In addition, women went into more detail about the psychological impact of PCS compared to men.
CONCLUSIONS: Women with PCS reported symptom dismissal by HCPs, which may have delayed their diagnosis and negatively affected their well-being. We were not able to explore the experiences of people from non-conforming gender groups. Raising awareness of these issues among HCPs, particularly general practitioners, could improve patient care in PCS.
UNASSIGNED: Patient and public involvement consisted of people who took part in the interviews and commented on the themes\' interpretation and study conclusions.

暂无摘要。

UNASSIGNED: Insufficient introspection as part of the 4I\'s model of medical professionalism (introspection, integrity, interaction, and involvement) is considered an important impediment in trainees. How insufficient introspection relates to decisions to terminate residency training remains unclear. Insights into this subject provide opportunities to improve the training of medical professionals.
UNASSIGNED: We analysed the Dutch Conciliation Board decisions regarding residents dismissed from training between 2011 and 2020. We selected the decisions on residents deemed \'insufficient\' regarding introspection as part of the CanMEDS professional domain and compared their characteristics with the decisions about residents without reported insufficiencies on introspection.
UNASSIGNED: Of the 120 decisions, 86 dismissed residents were unable to fulfil the requirements of the CanMEDS professional domain. Insufficient introspection was the most prominent insufficiency (73/86). These 73 decisions described more residents\' insufficiencies in CanMEDS competency domains compared to the rest of the decisions (3.8 vs. 2.7 p < 0.001), without significant differences regarding gender or years of training.
UNASSIGNED: Insufficient introspection in residents correlates with competency shortcomings programme directors reported in dismissal disputes. The 4I\'s model facilitates recognition and description of unprofessional behaviours, opening avenues for assessing and developing residents\' introspection, but further research is needed for effective implementation in medical education.

BACKGROUND: In the Netherlands, 2 to 10% of the residents terminate training prematurely. Infrequently, termination of training is by dismissal. Incidentally, residents may disagree, dispute and challenge these decisions from the programme directors. Resident dismissal is always a difficult decision, most commonly made after, repeated assessments, and triangulation of the resulting assessment data and one or more remediation attempts. Nevertheless, the underlying reasons for dismissal and the policies for remediation and dismissal may differ between training programmes. Such differences may however impact the chance of remediation success, the chance of dismissal and subsequent residents\' appeals.
METHODS: We included a total of 70 residents from two groups (community-based and hospital-based specialties) during 10 years of appeals. Subsequently, we compared these groups on factors potentially associated with the outcome of the conciliation board decision regarding the residents\' dismissal. We focused herein on remediation strategies applied, and reasons reported to dismiss residents.
RESULTS: In both groups, the most alleged reason to dismiss residents was lack of trainability, > 97%. This was related to deficiencies in professionalism in community-based practice and medical expertise in hospital-based specialties respectively. A reason less frequently mentioned was endangerment of patient care, < 26%. However, none of these residents accused of endangerment, actually jeopardized the patients\' health, probably due to the vigilance of their supervisors. Remediation strategies varied between the two groups, whereas hospital-based specialties preferred formal remediation plans in contrast to community-based practice. A multitude of remediation strategies per competency (medical expertise, professionalism, communication, management) were applied and described in these law cases.
CONCLUSIONS: Residents\' appeals in community-based practice were significantly less likely to succeed compared to hospital-based specialties. Hypothesised explanatory factors underlying these differences include community-based practices\' more prominent attention to the longitudinal assessment of professionalism, the presence of regular quarterly progress meetings, precise documentation of deficiencies, and discretion over the timing of dismissal in contrast to dismissal in the hospital-based specialties which is only formally possible during scheduled formal summative assessment meetings.

UNASSIGNED: Endometriosis is a common condition with average delays to diagnosis in New Zealand of almost 9 years.
UNASSIGNED: In total, 50 endometriosis patients participated in anonymous, asynchronous, online group discussions about their priorities, and their experiences with the development of symptoms, seeking a diagnosis, and receiving appropriate treatment.
UNASSIGNED: Higher subsidy of care was the top change endometriosis patients wanted, followed by more research funding. When asked to choose whether research should be focused on improving diagnosis or improving treatment methods, the results were evenly split. Within this cohort, patients highlighted that they did not know the difference between normal menstrual discomfort and pathological endometriotic pain. If, upon seeking help, medical practitioners classified their symptoms as \"normal,\" these dismissals could instill doubt in patients, which made it more difficult for them to continue to seek a diagnosis and effective treatments. Patients who did not express dismissal had a significantly shorter delay from symptom onset to diagnosis of 4.6 ± 3.4 years vs. 9.0 ± 5.2 years.
UNASSIGNED: Doubt is a frequent experience for endometriosis patients in New Zealand, which was reinforced by some medical practitioners who were dismissive of their pain and thus prolonged the patient\'s delay to diagnosis.

Becoming unfit for work or losing one\'s job because of multiple sclerosis is not inevitable. Many tools are available and occupational health professionals are now specifically mandated to support workers, whether or not they are employees, in maintaining their jobs, thanks in particular to the prevention of professional displacement unit, the recommendations of the French National Authority for Health and better coordination.

To report key characteristics and patterns of captive insurance claims not publicly reported in otolaryngology across a large tertiary-level academic health system over the previous 2 decades.
Case series.
The tertiary care health system.
The internal captive insurance database at a tertiary level healthcare system was queried to identify otolaryngology-related malpractice claims regardless of final disposition (settled or dismissed) filed from 2000 to 2020. The date of the incident, date of claim, error type, patient outcome, provider subspecialty, total expenses, disposition, and final reward amount were recorded.
Twenty-eight claims were identified. There were 11 (39.3%) claims from 2000 to 2010 and 17 (60.7%) claims from 2011 to 2020. Head and neck surgery was the most frequently implicated subspecialty (n = 9, 32.1% of all cases), followed by general otolaryngology (n = 7, 25.0%), pediatrics (n = 5, 17.9%), skull base/rhinology (n = 4, 14.3%), and laryngology (n = 1, 3.6%). Improper surgical performance was cited in 35.7% of cases (n = 10), followed by failure to diagnose (n = 8, 28.6%), to treat (n = 4, 14.3%), and to obtain informed consent (n = 3, 10.7%). While 2 cases are ongoing, a total of 17/26 (65.4%) cases were settled and 20/26 (76.9%) dismissed some or all parties. Dismissed claims had significantly higher expenses (p = .022) and duration from incident to disposition (p = .013) compared to settled claims.
This study expands the malpractice landscape in otolaryngology by including data not readily available through public sources and compares it to national trends. These findings encourage otolaryngologists to better gauge current quality and safety measures that best protect patients from harm.

OBJECTIVE: Dutch psychiatry residents who are dismissed from their training program have the opportunity to appeal the decision. Those appeals are publicly available. This report explores the appeals of residents dismissed for unprofessional behavior.
METHODS: The authors analyzed caselaw of dismissed psychiatry residents brought before the conciliation board of The Royal Dutch Medical Association and compared them to a control group of caselaw of dismissed family medicine residents.
RESULTS: From 2011 to 2020, 19 psychiatry residents were dismissed for failing to meet the competencies of the CanMEDS professional domain and matched with 19 family medicine residents. Most psychiatry residents deficient in professionalism were considered deficient in their attitude, in reliability of keeping agreements, or in their ability to profit from supervisors\' feedback. Insufficient professional behavior overlapped with insufficient communication, collaboration, and management. Half of the psychiatry residents with deficits in professionalism went on sick leave at some time. Between residents in psychiatry and family medicine, or between psychiatry residents with and without a favorable conciliation board decision, no statistical differences were found regarding gender, year of residency, and number of insufficient competencies.
CONCLUSIONS: The deficiencies in the professionalism of residents who challenged their program director\'s decision to be dismissed mostly consisted of inadequate attitude or the inability to profit from feedback, suggesting that these residents lack empathy, introspection, or both.

Program directors dismiss a small percentage of residents from residency training programs, presumably due to underperformance or lack of progress. Whether underperformance in competency domains differs by residents\' specialty is unknown.
In 2021, we analysed the case law of Dutch residents who were dismissed from training by the program director, and who challenged this dismissal before the national conciliation board between 2011 and 2020. Across medical specialties we compared which of the CanMEDS competency domains these residents failed to meet.
We found 116 cases of residents dismissed from their training programmes who challenged the decision of the program director before the board. In general, most residents were unable to meet the requirements of several CanMEDS competency domains (usually: medical expert, communicator, and professional). In surgery, all dismissed residents failed to meet the competency domain of the medical expert, while most of the dismissed psychiatry residents met this domain. In specialties with a primarily diagnostic task, more dismissed residents failed to meet the competency domain of the scholar, while dismissed general medicine residents (for example family medicine and nursing homecare) were less likely to do so. Residents in general medicine, more often than other specialties, however, failed to meet the competency domain of the professional.
Residents dismissed from training, who challenged their dismissal, failed to meet the requirements of multiple CanMEDS competency domains. Competency domain failures differ by specialty.

New work is used as a general term to summarize professional developments in contemporary work style, structure and modus of organizations and society-this means collaborative work and flexible working hours on individual levels, and flat hierarchies and participatory decision-making on organizational levels. Contemporary corporations strive to orient toward the concept of new work to keep up with stakeholder demands, for instance in their branding strategies as an employer. However, studies on organizational practices indicate that alongside explicit values and agendas, organizations tend to slyly exert power to secure their (economic) interests. Constructive dismissal is one such instance where contractually protected employees are made to resign their positions because the work environment is altered to become increasingly unbearable. This research analyzes two case studies to explicate routine dismissal procedures at the managerial level in two internationally operating German corporations. Both corporations explicitly profile as new work environments and are structured according to democratic principles including flat hierarchies, feature institutionalized diversity management including control committees for equal opportunities, and emphasize values such as workplace dignity, employee agency, and equality. The data contain long-term participatory observation collected over a 6-month period from two managers of 5 and 8 years of experience in managerial duties. The content analysis of data reveals characteristics of everyday processes in these organizations especially in terminating managers. The findings are presented as the \'model of the silent dismissal,\' containing seven types of managerial termination carried out by implicit power and symbolic conventions that circumvent subject participation and litigation in an effortless manner. After exposing the model\'s mechanisms, we turn to discuss its meaning for both terminated and surviving subjects against a critical theoretical framework of neoliberalism, democracy, and power.