scholarly journals EP.TU.310Dancing in the rain: early experience of Enhanced Stress Resilience Training

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Oliver Luton ◽  
Osian James ◽  
Katie Mellor ◽  
Catherine Eley ◽  
Richard Egan ◽  
...  
Keyword(s):  
Qualitative Data ◽  
Primary Outcome ◽  
Maslach Burnout Inventory ◽  
Clinical Work ◽  
Medium Term ◽  
Before And After ◽  
Resilience Training ◽  
Stress At Work ◽  
Evident Difference ◽  
Failure To Progress

Abstract Aim Core Surgical Training (CST) programs are associated with a 60% risk of burnout and failure to progress. This study aimed to assess the influence of a novel Enhanced Stress and Resilience Training (ESRT) course delivered alongside a focused induction at the start of CST in a single UK Statutory Education Body. Method All CST1s were invited to participate in a six-week ESRT course teaching mindfulness-based exercises to develop tools to deal with stress at work and burnout. Primary outcome measures were compliance with ESRT programme and degree of burnout measured using Maslach Burnout Inventory (MBI) scoring. Results Of 43 boot camp attendees, 38 trainees completed questionnaires, with 24 choosing to participate (63.2%; male 13, female 11, median age 28 yr.) Burnout was identified in 23 trainees (60.5%) with no evident difference in baseline MBI scores between participants or not (p = 0.77, median 4 [0-11] vs. 4 [1-11]). MBI scores were comparable before and after ESRT in the intervention cohort (p = 0.63, median 4 [0-11] vs. 4 [1-10]). Qualitative data reflected challenges delivering ESRT because of arduous and inflexible clinical on-call rotas and time pressures related to academic curriculum demands. Despite these challenges, 22 (91.6%) considered the course valuable, 14 (58.3%) continued to use the techniques in daily clinical work there was and unanimous support to continue the program in future. Conclusion ESRT was feasible and further research is warranted to determine its medium-term efficacy.

scholarly journals SP4.1.16 V is for vicious: a COVID burnout vector perspective

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Osian James ◽  
Chris Bowman ◽  
Oliver Luton ◽  
David Robinson ◽  
Sarah Hemington-Gorse ◽  
...  
Keyword(s):  
Emotional Exhaustion ◽  
Maslach Burnout Inventory ◽  
Clinical Work ◽  
Personal Accomplishment ◽  
Work Environments ◽  
Surgical Trainee ◽  
Employment Sector ◽  
Surgical Trainees ◽  
Resilience Training ◽  
Observational Cohort

Abstract Aims No employment sector has been more heavily pressed by COVID-19 than healthcare. This study aimed to characterise surgical trainee burnout related to the pandemic, following a previous observational cohort study reporting 59% burnout. Methods A 36-point survey, including the 22-point Maslach Burnout Inventory evaluated emotional exhaustion, depersonalisation, and personal accomplishment amongst all surgical trainees within a UK Statutory Education Body, with responses received from 121 (75 Core (CST), 46 Higher Surgical Trainees (HST)). Results High burnout levels were evident across one, two, or all three domains in 60.3% (n = 73), 32.2% (n = 39) and 13.2% (n = 16), respectively. Median emotional exhaustion, depersonalisation and personal accomplishment scores were 19 (range 0-48), 7 (0-25) and 36 (6-48), respectively. Median emotional exhaustion score was related to age (25-29yr 25 vs. >40yr 4; p = 0.016), trainee grade (CST 23 vs. HST 13; p = 0.001) and parenthood (parents 13 vs. not parents 21; p = 0.011), as was depersonalisation: 9 (25-29yr) vs. 1 (>40yr; p = 0.001), 8 (CST) vs. 6 (HST; p = 0.006) and 5 (parents) vs. 8 (not parents; p < 0.001), respectively. COVID-19 induced curriculum working pattern disruption was observed in 82.6% (n = 100), with 31.4% (n = 38) redeployed away from surgery. Barriers to training and career development were the commonest stressors (71.9%) and more prevalent among younger trainees (25-29yr. 76.8% vs. >40yr. 28.6%; p = 0.045) and CST (80.0% vs. HST 58.7%; p = 0.011). Clinical workload concerns were associated with emotional exhaustion (OR 3.12; p = 0.008). Conclusions Burnout endures, though unique adverse clinical work environments may have boosted resilience. Countermeasures including Enhanced Stress Resilience Training remain a priority.

scholarly journals Nurses’ Clinical Work Experience during Pregnancy

Healthcare ◽  
2020 ◽  
Vol 9 (1) ◽  
pp. 16
Author(s):  
Hyunjung Lee ◽  
Hyoung Eun Chang ◽  
Jiyeon Ha
Keyword(s):  
Work Experience ◽  
Qualitative Data ◽  
Clinical Work ◽  
Working Environment ◽  
Organizational Characteristics ◽  
Main Question ◽  
Field Notes ◽  
Colaizzi's Method ◽  
Induced Changes ◽  
Depth Interviews

The working environment of nurses contains numerous hazards that can be particularly harmful to pregnant women. In addition, pregnancy-induced changes can themselves cause discomfort. Therefore, it is necessary to analyze pregnant nurses’ experiences of clinical work. This qualitative study analyzed data collected through in-depth interviews. From January to June in 2020, 12 shift-work nurses who had experienced pregnancy within three years were interviewed. The main question was “Could you describe your clinical work experience during pregnancy?” Qualitative data from field notes and transcriptions of the interviews were analyzed using Colaizzi’s method. Six categories were extracted that described the nurses’ clinical work experience during pregnancy, as follows: “enduring alone,” “organizational characteristics of nursing,” “risky work environment,” “strengths that sustain work during pregnancy,” “growth as a nurse,” and “methods to protect pregnant nurses.” Pregnant nurses experienced various difficulties due to physical and mental changes during pregnancy, and the clinical working environment did not provide them with adequate support. The findings of this study will be helpful for developing and implementing practical maternity protection policies and work guidelines.

scholarly journals Coronary risk of patients with valvular heart disease: prospective validation of CT-Valve Score

Open Heart ◽  
2020 ◽  
Vol 7 (2) ◽  
pp. e001380
Author(s):  
Rasmus Bo Hasselbalch ◽  
Mia Marie Pries-Heje ◽  
Sarah Louise Kjølhede Holle ◽  
Thomas Engstrøm ◽  
Merete Heitmann ◽  
...  
Keyword(s):  
Heart Disease ◽  
Valvular Heart Disease ◽  
Primary Outcome ◽  
Multislice Ct ◽  
Cost Effective ◽  
University Hospital ◽  
Before And After ◽  
History Of ◽  
Artery Disease

ObjectiveTo prospectively validate the CT-Valve score, a new risk score designed to identify patients with valvular heart disease at a low risk of coronary artery disease (CAD) who could benefit from multislice CT (MSCT) first instead of coronary angiography (CAG).MethodsThis was a prospective cohort study of patients referred for valve surgery in the Capital Region of Denmark and Odense University Hospital from the 1 February 2015 to the 1 February 2017. MSCT was implemented for patients with a CT-Valve score ≤7 at the referring physician’s discretion. Patients with a history of CAD or chronic kidney disease were excluded. The primary outcome was the proportion of patients needing reevaluation with CAG after MSCT and risk of CAD among the patients determined to be low to intermediate risk.ResultsIn total, 1149 patients were included. The median score was 9 (IQR 3) and 339 (30%) had a score ≤7. MSCT was used for 117 patients. Of these 29 (25%) were reevaluated and 9 (7.7%) had CAD. Of the 222 patients with a score ≤7 that did not receive an MSCT, 14 (6%) had significant CAD. The estimated total cost of evaluation among patients with a score ≤7 before implementation was €132 093 compared with €79 073 after, a 40% reduction. Similarly, estimated total radiation before and after was 608 mSv and 362 mSv, a 41% reduction. Follow-up at a median of 32 months (18–48) showed no ischaemic events for patients receiving only MSCT.ConclusionThe CT-Valve score is a valid method for determining risk of CAD among patients with valvular heart disease. Using a score ≤7 as a cut-off for the use of MSCT is safe and cost-effective.

scholarly journals Detection of hysteroscopic fluid in the pouch of Douglas: a prospective cohort study about the predictability of bilateral tubal occlusion

2021 ◽  
Author(s):  
Marlene Hager ◽  
Johannes Ott ◽  
Christian Göbl ◽  
Iris Holzer ◽  
Rudolf Seemann ◽  
...  
Keyword(s):  
Cohort Study ◽  
Primary Outcome ◽  
Fluid Shift ◽  
Tubal Patency ◽  
Tubal Occlusion ◽  
Hysteroscopic Surgery ◽  
Before And After ◽  
Vaginal Sonography ◽  
Pouch Of Douglas ◽  
Medical University

Abstract Purpose To determine whether an increase in cul de sac (CDS) fluid after hysteroscopy is predictive of tubal patency. Methods In a prospective clinical cohort study, 115 subfertile women undergoing laparoscopic and hysteroscopic surgery at the Medical University of Vienna were invited to participate. The primary outcome was determining whether an increase in fluid in the pouch of Douglas was reflective of unilateral or bilateral tubal patency. Vaginal sonography before and after hysteroscopy was performed to detect fluid in the pouch of Douglas, directly followed by laparoscopy with chromopertubation. Results Laparoscopic chromopertubation revealed bilateral Fallopian tube occlusion in 28 women (24.3%). Twenty-seven/40 patients (67.5%) with no fluid shift had bilateral occlusion during the consecutive laparoscopy (p < 0.001). One/75 patients (1.3%) showing a fluid shift had bilateral occlusion (sensitivity of a present fluid shift for uni- or bilateral patency 85.1%, 95% CI: 81.7–99.9, specificity: 96.4%, 95% CI: 75.8–91.8). Intracavitary abnormalities (odds ratio, OR, 0.038; p = 0.030) and adhesions covering one or both tubes (OR 0.076; p = 0.041) increased the risk for a false abnormal result, i.e., uni- or bilateral tubal patency despite the lack of a fluid shift. Conclusion When CDS fluid does not change after hysteroscopy, this is a sensitive test for tubal occlusion and further testing may be warranted. However, if there is an increase in CDS fluid after hysteroscopy, particularly for a patient without fluid present prior, this is both sensitive and specific for unilateral or bilateral tubal patency.

PENERAPAN MODEL PEMBELAJARAN RCCDE UNTUK MENINGKATKAN HASIL BELAJAR SISWA PADA MATERI INTERAKSI MAKHLUK HIDUP DENGAN LINGKUNGAN

2021 ◽  
Vol 10 (1) ◽  
pp. 10-13
Author(s):  
Anita Wulandari ◽  
Siti Roudlotul Hikamah ◽  
Umi Nurjanah
Keyword(s):  
Student Learning ◽  
Learning Outcomes ◽  
Qualitative Data ◽  
Student Learning Outcomes ◽  
Learning Model ◽  
Research Subjects ◽  
Model Learning ◽  
Cognitive Score ◽  
Living Things ◽  
Before And After

Learning model is a whole series of teaching material presentation which includes all aspects before and after learning. The problem in this study is that student learning outcomes are still lo and lacking enthusiasm in the learning process, where the value of student learning outcomes is still much below the KKM. This type of research uses PTK, with a quantitative data collection in the from of student learning outcomes tests and qualitative data obtained from intervies and studend documentation data. With 23 students as research subjects. Based on the results of this study, the average cognitive score of srtudentd in cycle I was 73. In the first cycle the average cognitive score of students II was 82, so there was an increase of 9%. So the application of the RCCDE learning model can improve students learning outcomes in the material of interaction of living things with the environment so that it can help in the student learning proses.Keywords: RCCDE model, learning outcomes, the interaction of living things with the environment

Reduced electroencephalogram complexity in postoperative delirium

2021 ◽  
Author(s):  
Sean Tanabe ◽  
Maggie Parker ◽  
Richard Lennertz ◽  
Robert A Pearce ◽  
Matthew I Banks ◽  
...  
Keyword(s):  
Postoperative Delirium ◽  
Primary Outcome ◽  
Rating Scale ◽  
Monocyte Chemoattractant Protein 1 ◽  
Monocyte Chemoattractant ◽  
Monocyte Chemoattractant Protein ◽  
Eeg Data ◽  
Before And After ◽  
Electroencephalogram Eeg ◽  
Multiple Comparison Correction

Abstract Delirium is associated with electroencephalogram (EEG) slowing and impairments in connectivity. We hypothesized that delirium would be accompanied by a reduction in the available cortical information (i.e. there is less information processing occurring), as measured by a surrogate, Lempil-Ziv Complexity (LZC), a measure of time-domain complexity. Two ongoing perioperative cohort studies (NCT03124303, NCT02926417) contributed EEG data from 91 patients before and after surgery; 89 participants were used in the analyses. After cleaning and filtering (0.1-50Hz), the perioperative change in LZC and LZC normalized (LZCn) to a phase-shuffled distribution were calculated. The primary outcome was the correlation of within-patient paired changes in delirium severity (Delirium Rating Scale-98 [DRS]) and LZC. Scalp-wide threshold free cluster enhancement was employed for multiple comparison correction. LZC negatively correlated with DRS in a scalp-wide manner (peak channel r 2=0.199, p&lt;0.001). This whole brain effect remained for LZCn, though the correlations were weaker (peak channel r 2=0.076, p=0.010). Delirium diagnosis was similarly associated with decreases in LZC (peak channel p&lt;0.001). For LZCn, the topological significance was constrained to the midline posterior regions (peak channel p=0.006). We found a negative correlation of LZC in the posterior and temporal regions with monocyte chemoattractant protein-1 (peak channel r 2=0.264, p&lt;0.001, n=47) but not for LZCn. Complexity of the EEG signal fades proportionately to delirium severity implying reduced cortical information. Peripheral inflammation, as assessed by monocyte chemoattractant protein-1, does not entirely account for this effect, suggesting that additional pathogenic mechanisms are involved.

Serious game, lectures or simulation-based mastery learning course which is the best method for training students about cardiac arrest management?

2019 ◽  
Author(s):  
Giuliana Scarpati ◽  
Paolo Remondelli ◽  
Ornella Piazza
Keyword(s):  
Cardiac Arrest ◽  
Medical Students ◽  
Primary Outcome ◽  
Serious Game ◽  
Training Time ◽  
Simulation Based ◽  
Before And After ◽  
Second Year ◽  
Cpr Training ◽  
Passing Score

"Background and aim: This study aimed to compare a serious game and lectures for the pretraining of medical students before learning about simulation-based management of cardiac arrest. Methods: Participants were 150 volunteer second-year medical students between April and June 2018 randomly assigned to CPR training using either lectures (n = 75) or a serious game (n = 75). Each participant was evaluated on a scenario of cardiac arrest before and after exposure to the learning methods. The primary outcome measures were the median total training time needed for the student to reach the minimum passing score. This same outcome was also assessed three months later. Results: The median training time necessary for students to reach the minimum passing score was similar between the two groups (p=0,45). Achieving an appropriate degree of chest compression was the most difficult requirement to fulfill for students in both groups. Singing the refrain of the song ""staying alive"" significantly increased the number of compressions with the correct rate. Three months later, the median training time decreased significantly in both groups. However, students have remained interested in the serious game for a longer time showing a preference for using this method. Conclusions: The serious game was not superior to lectures to pretraining medical students in the management of a cardiac arrest."

scholarly journals A report on an acute, in-hours, outpatient review clinic with ultrasonography facilities for the early evaluation of general surgical patients

2016 ◽  
Vol 98 (7) ◽  
pp. 468-474 ◽  
Author(s):  
TE Pidgeon ◽  
U Shariff ◽  
F Devine ◽  
V Menon
Keyword(s):  
Computed Tomography ◽  
Primary Outcome ◽  
Surgical Patients ◽  
Clinic Attendance ◽  
Early Evaluation ◽  
Admission Rates ◽  
Before And After ◽  
Age Range ◽  
Surgical Clinic

Introduction In 2013 our hospital introduced an in-hours, consultant-led, outpatient acute surgical clinic (ASC) for emergency general surgical patients. In 2014 this clinic was equipped with a dedicated ultrasonography service. This prospective cohort study evaluated this service before and after the introduction of ultrasonography facilities. Methods Data were recorded prospectively for all patients attending the clinic during 2013 and 2014. The primary outcome was patient destination (whether there was follow-up/admission) after clinic attendance. Results The ASC reviewed patients with a wide age range and array of general surgical complaints. In 2013, 186 patients attended the ASC. After the introduction of the ultrasonography service in 2014, 304 patients attended. In 2014, there was a reduction in the proportion of patients admitted to hospital from the clinic (18.3% vs 8.9%, p=0.002). However, the proportion of patients discharged after ASC review remained comparable with 2013 (30.1% in 2013 vs 38.8% in 2014, p=0.051). The proportion of patients undergoing computed tomography (CT) scans also fell (14.0% vs 4.9%, p<0.001). Conclusions The ASC assessed a wide array of general surgical complaints. Only a small proportion required hospital admission. The introduction of an ultrasonography service was associated with a further reduction in admission rates and computed tomography.

scholarly journals Psikoeduakasi C4ME Untuk Mengatasi Gangguan Sindrom Pramenstruasi Pada Taruni Militer

2020 ◽  
Vol 11 (1) ◽  
pp. 32
Author(s):  
Eunike Setiawati ◽  
Andri Adi Wijaya ◽  
Sri Wahyuningsih
Keyword(s):  
Premenstrual Syndrome ◽  
Quantitative Data ◽  
Qualitative Data ◽  
Military Education ◽  
Health Counseling ◽  
Randomized Design ◽  
Behavioral Techniques ◽  
Before And After ◽  
Knowledge And Attitude ◽  
The Military

Different situations and lifestyles in the military education academy require the women Navy cadets to adapt to high levels of stress. Stress can potentially disrupt the menstrual cycle and worsen the symptoms of premenstrual syndrome (PMS) which can reduce their performance as military cadets. This study aims to determine the effect of psychoeducation of Care For Menstruation (C4ME) on overcoming PMS problems in the Navy Academy. C4ME covers health counseling activities that provide information about menstruation and involves interventions based on cognitive-behavioral techniques to cope with PMS symptoms. This quasi-experiment used non-randomized one-group pretest-posttest design. Fifteen women Navy cadets were recruited. Quantitative data were collected using questionnaires of knowledge and attitude towards menstruation and were analyzed using a parametric statistical t-correlated sample. Qualitative data were collected from interviews before and after the intervention and were analyzed using a content analysis. The results show that C4ME psychoeducation is effective in increasing knowledge of menstruation (p = 0.01), changing participants' attitudes toward menstruation being more positive (p <0.01) and decreasing the symptoms of PMS experienced by participants.Keywords:  C4ME Psychoeducation, premenstrual syndrome, women navy cadet Abstrak: Perbedaan situasi dan gaya hidup di akademi pendidikan militer menuntut para taruni Akademi Angkatan Laut (AAL) untuk beradaptasi dengan level stres yang tinggi. Stres berpotensi dapat mengganggu siklus menstruasi dan memperparah gejala sindrom pramenstruasi (PMS) yang dapat menurunkan produktifitas taruni. Penelitian ini bertujuan untuk menguji pengaruh psikoedukasi Care For Menstruation (C4ME) dalam mengatasi masalah PMS pada taruni AAL. Program psikoedukasi meliputi kegiatan penyuluhan kesehatan dan intervensi dengan teknik kognitif-perilaku untuk mengatasi gejala PMS. Metode kuasi-eksperimen dengan non-randomized design one-grup pretest-posttest digunakan. Partisipan penelitian adalah lima belas orang taruni AAL. Data kuantitatif tentang pengetahuan dan sikap terhadap menstruasi diukur menggunakan kuesioner, sedangkan data kualitatif diperoleh melalui wawancara sebelum dan sesudah dilakukan intervensi. Data kuantitatif dianalisis dengan statistik parametrik t-correlated sample, sedangkan data kualitatif dianalisis menggunakan analisis konten. Hasil menunjukkan bahwa psikoedukasi tentang menstruasi efektif dalam meningkatkan pengetahuan (p=0,01), mengubah sikap partisipan menjadi lebih positif terhadap menstruasi (p<=0,01), dan menurunkan gejala PMS pada para taruni.

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