Retaining Providers with Women's Health Expertise: Decreased Provider Loss Among VHA Women's Health Faculty Development Program Attendees.

BACKGROUND: The Veterans Health Administration (VHA) provides care for over 500,000 women. In 2010 VHA instituted a policy requiring each facility to identify a designated women's health provider (WH-PCP) who could offer comprehensive gender-specific primary care. Access to WH-PCPs remains a challenge at some sites with high turnover among WH-PCPs. Faculty development programs have been demonstrated to foster professional development, networks, and mentorship; these can enhance job satisfaction and provide one potential solution to address WH-PCP turnover. One such program, the VHA's Women's Health Mini-Residency (WH-MR), was developed in 2011 to train WH-PCPs through case-based hands-on training. OBJECTIVE: The objective of this program evaluation was to determine the association of WH-MR participation with WH-PCP retention. DESIGN: Using the Women's Health Assessment of Workforce Capacity-Primary Care survey, we assessed the relationship between WH-MR participation and retention of WH-PCP status between fiscal year 2018 and 2019. PARTICIPANTS: All WH-PCPs (N = 2664) at the end of fiscal year 2018 were included. MAIN MEASURES: We assessed retention of WH-PCP status the following year by WH-MR participation. For our adjusted analysis, we controlled for provider gender, provider degree (MD, DO, NP, PA), women's health leadership position, number of clinical sessions per week, and clinical setting (general primary care clinic, designated women's health clinic, or a combination). KEY RESULTS: WH-MR participants were more likely to remain WH-PCPs in FY2019 in both unadjusted analyses (OR 1.91, 95%CI 1.54-2.36) and adjusted analyses (OR 1.96, 95%CI 1.58-2.44). CONCLUSIONS: WH-PCPs who participate in WH-MRs are more likely to remain WH-PCPs in the VHA system. Given the negative impact of provider turnover on patient care and the significant financial cost of onboarding a new WH-PCP, the VHA should continue to encourage all WH-PCPs to participate in the WH-MR.

Adult conjunctivitis secondary to dual infection with Chlamydia trachomatis and Neisseria gonorrhoeae - A case report.

PURPOSE: Although Chlamydia trachomatis and Neisseria gonorrhoeae are the commonest sexually transmitted infections in England, reports of ocular co-infection in the literature are limited. We report such a case which responded well to treatment, and discuss the literature and evidence currently available with regards to management of these cases. OBSERVATIONS: The patient is a 48-year-old bisexual gentleman who presented to the eye clinic of a UK hospital with redness, discharge and blurred vision in his left eye for one week. Initially he had mucopurulent discharge but his cornea was clear. He did not comply with prescribed treatment and returned two days later with bilateral symptoms and corneal thinning in his left eye peripherally.PCR tests for Chlamydia trachomatis and Neisseria gonorrhoeae were positive and the patient was commenced on intravenous ceftriaxone, oral and topical levofloxacin eye drops. After 48 hours of inpatient treatment the patient showed clinical improvement. CONCLUSIONS AND IMPORTANCE: Ophthalmologists should be aware of the possibility that Chlamydia trachomatis and Neisseria gonorrhoeae can cause co-infection in adult conjunctivitis, and of the straightforward method of treatment for such individuals. Delayed diagnosis and treatment of affected patients can lead to corneal complications and potential blindness. It is advisable to discuss these cases with the local microbiology service wherever possible, and referral to a sexual health service is imperative.

Attitudes and perceptions of workers to sexual harassment.

The authors investigated how individual factors (age, gender, gender role, past experiences of sexual harassment) and organizational factors (gender ratio, sexual harassment policies, the role of employers) related to workers' attitudes toward and perceptions of sexual harassment. In Study 1, participants were 176 workers from a large, white-collar organization. In Study 2, participants were 75 workers from a smaller, blue-collar organization. Individuals from Study 2 experienced more sexual harassment, were more tolerant of sexual harassment, and perceived less behavior as sexual harassment than did individuals from Study 1. For both samples, organizational and individual factors predicted workers' attitudes toward and experiences of sexual harassment. Individual factors-such as age, gender, gender role, past experiences of sexual harassment, and perceptions of management's tolerance of sexual harassment-predicted attitudes toward sexual harassment. Workers' attitudes, the behavioral context, and the gender of the victim and perpetrator predicted perceptions of sexual harassment. The authors discussed the broader implications of these findings and suggested recommendations for future research.