The fact that this was published, in multiple editions, proves that more women need to be involved in publishing.
-@SharonneHayes
Gender harassment is more pervasive than overt acts of sexual coercion.
-@SharonneHayes
Busting Myth #1: Sexual harassment doesn't just happen to a few women - it's pervasive. And generally unreported.
-@SharonneHayes
Busting myth #2: It's not just a few "bad apples." Rather, organizational climates allow harassment ("structural sexism"?)
-@SharonneHayes
Busting myth #3: The impact is very real, in multiple dimensions. Sexual harassment is a severe occupational hazard which (within the research realm) constitutes research misconduct (potentially meriting defunding researchers).
-@SharonneHayes
UVM is a signatory at Time's Up Healthcare. @UVMMedCenter
Policies and training can help staff deal with sexual harassment. Good intentions aren't enough. Centralizing processes within an organization can help as well.
-@SharonneHayes
Incidents should be investigated systematically. Implementing a system to deal with reporting at Mayo led to a temporary surge in reports. Internally *posting* data changed the institutional culture, by demonstrating that incidents were taken seriously.
-@SharonneHayes
Most reports were substantiated, largely relating to male physicians in positions of power. Mayo is tracking out sexual harassment the way everyone else is tracking COVID.
-@SharonneHayes
Harassment is a marker for other dimensions of inequity (e.g. under-representation in leadership).
-@SharonneHayes
*Equity* is analogous to tailoring heart failure therapy specific to different genders. Alternatively, *equality* would involve treating every patient exactly the same way.
-@SharonneHayes
Mothership Penality: Women may be less likely to be hired or offered a high salary.
-@SharonneHayes
how to place a consult: you MUST understand the five stages of consultant grief.
once you can understand this painful and natural process, requesting consults will make a LOT more sense
buckle up, it can be a little rough…
🧵 1/6…
stage 1: denial
- You dont need a consult.
- You called the wrong service.
- 18 years old? consult pediatrics
- I’m not actually on call now
- Everything’s fine, just walk it off…
stage 2: anger
- you should have consulted us earlier/later
- you should have checked this test before calling us
- you’re a terrible doctor/student/human being
this is much better than MINDS (which contained ~90% hypoactive), but probably still not ideal.
(at this point, does anyone actually think that haloperidol helps with hypoactive delirium ??)
other than dilution of the patient population by patients with hypoactive delirium (who are unlikely to benefit & might conceivably be harmed by over-sedation), the methodology seems pretty solid.
I think it's time for a difficult discussion, folks.
Let's talk about CSF lactate 🫣
CSF lactate has been shown to be *superior* to traditional CSF studies in sorting out viral vs. bacterial meningitis in several studies & meta-analyses...
a subset of patients with viral meningitis will initially have a *neutrophilic* pleocytosis.
this can lead to unnecessary admissions & antibiotics
some patients are subjected to repeat LPs 😩
a low CSF lactate could avoid all of this, allowing patients to go home from the ED
CSF lactate measurement is recommended in guidelines from the United Kingdom, Europe, and France.
(it's not recommended in the ID society of America guidelines, but they're from *2004* and require revisions)