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There is an unmet clinical need for the development of novel treatment strategies to improve the outcome of children with frequent relapsing or steroid-dependent nephrotic syndrome. Obinutuzumab (OBI) is a second-generation anti-CD20 monoclonal antibody that has demonstrated its superiority to rituximab (RTX) in vitro and in vivo. Our assumption is that a single infusion of low-dose OBI will induce longer B-cell depletion, longer sustained remission and reduce the frequency of relapses and the use of oral immunosuppressors compared with a single infusion of RTX.
We conduct a double-blind, multicentre, randomised, parallel group in a 1:1 ratio controlled trial. In the experimental group, patients receive 1 infusion of OBI (300 mg/1.73 m2) and in the control group, the patients receive 1 infusion of RTX (375 mg/m2). The primary outcome of the study is the occurrence of the first relapse within 12 months following the initiation of treatment and secondary outcomes include the time to first relapse, the total number of relapses during the 24-month follow-up period, and any adverse events such as infusion-related complications, infectious complications, hypogammaglobulinaemia and neutropenia.
The study has been approved by the ethics committee (Comité de Protection des Personnes) of Sud Méditerrannée 2 and authorised by the French drug regulatory agency (Agence Nationale de Sécurité du Médicament et des Produits de Santé). Results of the primary study and the secondary aims will be disseminated through peer-reviewed publications.
2022-003336-59.
by Laura Maniscalco, Marco Enea, Peter de Winter, Neeltje de Vries, Anke Boone, Olivia Lavreysen, Kamil Baranski, Walter Mazzucco, Adriano Filadelfio Cracò, Malgorzata Kowalska, Szymon Szemik, Lode Godderis, Domenica Matranga
According to the World Health Organization (WHO), in 2022 there was a shortfall of approximately 1.2 million doctors, impacting healthcare system and patient care. Understanding turnover intentions is crucial for managing the healthcare workforce and ensuring continuous, and high-quality patient care. This study investigates the prevalence of physicians planning to leave their hospital or the profession, and risk factors such as job demand, resources, satisfaction, and burnout across four European countries. A cross-sectional multicenter study was conducted in eight hospitals across Belgium, the Netherlands, Poland and Italy, including both academic and non-academic institutions. Data from Poland were excluded due to a low response rate, to preserve respondent anonymity. Multivariable logistic regression analyses were performed, adjusted for country, demographics, and work context, using significant variables from the univariable analysis. The overall intention to leave the hospital was 16.5%, with the highest rates in Belgium (19.6%) and Italy (19%), and the lowest in the Netherlands (9.8%). The intention to leave the profession was 9.1%, with the highest rate in the Netherlands (16.1%), followed by Belgium (6.3%) and Italy (5.7%). Physicians at higher risk of leaving the hospital were younger (adjOR = 0.90, 95%CI = 0.86–0.93), lacked colleague support (adjOR = 3.18, 95%CI = 1.06–9.36), and were dissatisfied with job prospects (adjOR = 2.38, 95%CI = 1.02–5.54) and overall work (adjOR = 2.71, 95%CI = 1.09–6.69). Those more likely to leave the profession were from the Netherlands (adjOR = 4.14, 95%CI = 1.62–11.4), surgeons (adjOR = 2.90, 95%CI = 1.22–6.78), working in non-academic hospitals (adjOR = 2.43, 95%CI = 1.01–5.97), lacked development opportunities (adjOR = 5.97, 95%CI = 1.01–36.2), or were dissatisfied with career prospects (adjOR = 2.77, 95%CI = 1.04–7.27). Health system managers and relevant stakeholders involved in the planning, implementation, or evaluation of health policies and reforms aimed at improving healthcare job retention should take into account the key determinants of the intention to leave identified in this study.To identify and understand the barriers and enablers influencing medical students’ engagement with research and consideration of academic careers.
This was a mixed-methods explanatory sequential study comprising two surveys (Phase 1 and Phase 2), followed by semistructured interviews (Phase 3).
The School of Medicine at Newcastle University.
All students from all year groups at The School of Medicine, Newcastle University (UK) were invited to participate, with data collected from 343 survey respondents and 25 students in semistructured interviews.
Survey responses from 188 students in Phase 1 (exploratory survey) and 155 students in Phase 2 (general student survey) identified barriers which reflect personal experience (eg, lack of knowledge and confidence), practical constraints (eg, time constraints and academic pressures) and institutional contexts (eg, insufficient research teaching and lack of formal opportunities). Enablers included mentors and other sources of information about research.
Interview data emphasised that academic mentoring relationships are often emergent rather than planned. The limited visibility of research opportunities and of mentors was a significant barrier and perpetuated a culture where research was not normalised within the curriculum. Conversely, enablers included intrinsic motivations (eg, intellectual curiosity and desire to contribute to knowledge) and extrinsic motivations (eg, career advancement). Social dynamics between peer groups emerged, whereby these could act as either a barrier or an enabler, depending on the normalisation of research within their networks.
To enhance engagement with research and promote the attractiveness of a clinical academic career, research should become a ‘normal’ part of undergraduate medical education. Visible integration of research into the undergraduate curriculum, providing structured mentorship programmes and ensuring equitable access to research opportunities will aid this. Addressing these factors may sustain the pipeline of students pursuing clinical academic careers.
FreshRSS 