scholarly journals The Prevalence of Burnout Among US Neurosurgery Residents

Neurosurgery ◽  
2017 ◽  
Vol 83 (3) ◽  
pp. 582-590 ◽  
Author(s):  
Hakeem J Shakir ◽  
Matthew J McPheeters ◽  
Hussain Shallwani ◽  
Joseph E Pittari ◽  
Renée M Reynolds
Keyword(s):  
Descriptive Analysis ◽  
Nonparametric Tests ◽  
Early Career ◽  
Personal Accomplishment ◽  
Lower Prevalence ◽  
Cross Sectional ◽  
Exact Test ◽  
Increased Risk ◽  
Significant Difference ◽  
Practicing Physicians

Abstract BACKGROUND Burnout is a syndrome of emotional exhaustion, depersonalization, and reduced personal accomplishment. Its prevalence among US physicians exceeds 50% and is higher among residents/fellows. This is important to the practice of neurosurgery, as burnout is associated with adverse physical health, increased risk of substance abuse, and increased medical errors. To date, no study has specifically addressed the prevalence of burnout among neurosurgery residents. OBJECTIVE To determine and compare the prevalence of burnout among US neurosurgery residents with published rates for residents/fellows and practicing physicians from other specialties. METHODS We surveyed 106 US neurosurgery residency training programs to perform a descriptive analysis of the prevalence of burnout among residents. Data on burnout among control groups were used to perform a cross-sectional analysis. Nonparametric tests assessed differences in burnout scores among neurosurgery residents, and the 2-tailed Fisher's exact test assessed burnout between neurosurgery residents and control populations. RESULTS Of approximately 1200 US neurosurgery residents, 255 (21.3%) responded. The prevalence of burnout was 36.5% (95% confidence interval: 30.6%-42.7%). There was no significant difference in median burnout scores between gender (P = .836), age (P = .183), or postgraduate year (P = .963) among neurosurgery residents. Neurosurgery residents had a significantly lower prevalence of burnout (36.5%) than other residents/fellows (60.0%; P < .001), early career physicians (51.3%; P < .001), and practicing physicians (53.5%; P < .001). CONCLUSION Neurosurgery residents have a significantly lower prevalence of burnout than other residents/fellows and practicing physicians. The underlying causes for these findings were not assessed and are likely multifactorial. Future studies should address possible causes of these findings.

P20 Parental understanding of concussion in youth rugby is significantly improved by viewing the RFU concussion education video

2019 ◽  
Vol 90 (3) ◽  
pp. e31.1-e31
Author(s):  
T Samuel ◽  
K Aquilina ◽  
W Dawes
Keyword(s):  
Parental Education ◽  
Cross Sectional Study ◽  
Educational Video ◽  
Sectional Study ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Parental Experience ◽  
Increased Risk ◽  
Significant Difference ◽  
Composite Scores

ObjectivesTo investigate the current understanding parents have of concussion in their rugby-playing children aged 9–17.DesignCross-sectional studySubjects86 parents from four clubs completed an online questionnaireMethodsAreas covered (1) Parental experience of concussion (2) Rate of viewing of the RFU concussion educational video (RFUCEV), (3) Identification of symptoms of concussion (4) Understanding of the risk of concussion. Each participant was given a composite score, out of 19, based on their performance in symptom identification and true/false questions. Independent-sample two-tailed t-tests were conducted to analyse scores, primarily controlling for viewing of the RFUCEVResultsThere was a significant difference in the scores between the group that had viewed the RFUCEV (n=32, M=14.75, SD=2.55) and those who had not (n=54, M=13.05, SD=2.87); t(84)=2.75, p=0.00721. Additionally, over 25% of parents reported that their child had suffered a concussion, and this was also found to significantly improve the awareness score (p=0.04678)ConclusionsStatistically significant improvement in composite scores after viewing the RFUCEV makes it reasonable to require compulsory parental education prior to signing up a child to play rugby. This would build on the protocol changes made by the RFU in 2014 and further progress the safety of the sport. We suggest the video be improved to emphasise the areas highlighted as inadequately understood, including the increased risk of concussion in under-18s compared to adults.

scholarly journals Evaluation of neurodevelopment of preterm infants using Bayley III scale

2015 ◽  
Vol 15 (1) ◽  
pp. 47-55 ◽  
Author(s):  
Fernanda Veiga de Góes ◽  
Maria Dalva B. B. Méio ◽  
Rosane Reis de Mello ◽  
Denise Morsch
Keyword(s):  
Preterm Infants ◽  
Motor Development ◽  
High Frequency ◽  
Expressive Language ◽  
Cross Sectional Study ◽  
Receptive Language ◽  
Abnormal Development ◽  
Cross Sectional ◽  
Increased Risk ◽  
Significant Difference

Objectives: to assess cognitive, motor, and language development in preterm infants, and perinatal, neonatal and socioeconomic factors associated with abnormal development. Methods: a cross-sectional study was carried out with 104 preterm infants (gestational ages < 33 weeks) (17 - 30 months corrected ages) using the Bayley III Scale. Logistic regression analysis was performed and prevalence ratios calculated. Results: the average language score (81.9) was low, while cognitive (93.7) and motor (91.1) scores were within normal values. There were deficiencies in receptive but not in expressive language. Male sex (OR 2.55 CI 1.01-6.44) and neonatal pneumonia (OR 33.85 CI 3.3-337.8) were associated with abnormal language scores. No factor was associated with abnormal cognitive scores; male gender indicated an increased risk of abnormal motor scores. The lack of a father was a risk factor for impaired motor development (PR: 2.96, CI: 5.6 - 1.55). There was no statistically significant difference in the development of small and appropriate for gestational age children. Conclusions: the Bayley III Scale was useful for assessing language and cognition separately, discriminating between receptive and expressive language. There was a high frequency of language deficiencies, especially in receptive language. Although motor and cognitive average scores were within the normal range, there was a high frequency of children with delayed development in these areas, especially motor development.

The influence of varying maxillary central incisor vertical dimension on perceived smile aesthetics

2019 ◽  
Vol 46 (2) ◽  
pp. 137-142
Author(s):  
Elis Janaina Lira dos Santos ◽  
Alana Moura Xavier Dantas ◽  
Raíssa Marçal Vilela ◽  
Karina Jerônimo Rodrigues Santiago de Lima ◽  
Rejane Targino Soares Beltrão
Keyword(s):  
Age Groups ◽  
Educational Background ◽  
Cross Sectional Study ◽  
Central Incisor ◽  
Chi Square ◽  
Cross Sectional ◽  
Exact Test ◽  
Maxillary Central Incisor ◽  
Significant Difference ◽  
Chi Square Test

Objective: To evaluate patient perception of the smile focused on analysis of the upper incisors. Design: Cross-sectional study. Setting: Department of Clinical and Social Dentistry at Federal University of Paraíba, João Pessoa, Brazil. Participants: The sample consisted of 135 individuals (73 women and 62 men). Methods: Images with different characteristics associated with the incisal edges were shown at random and analysed using a Likert scale. Data were analysed using the Chi-square test or Fisher’s exact test with a statistically significant difference ( P < 0.05). Results: Smile I (difference of 1.5 mm in relation to the central incisor and lateral) was considered the most aesthetic, while Smile III (no difference in height between the central and lateral incisors) was the least aesthetic. A significant difference was found between perception of smile II (difference of 1 mm in relation to the central incisor and lateral) and age groups ( P < 0.005), with 31% (n = 13) of individuals aged 45–64 years considering smile II as not pleasant, 4.4% (n = 2) aged 15–24 years and 8.3% (n=4) aged 25–44 years and 4.4% (n = 2) aged 15–24 years considering the same. A significant difference was also found in relation to educational background of the assessor and smile perception, with smile III ( P = 0.0441) and smile IV ( P = 0.0053) considered the most aesthetic ( P = 0.0116). Conclusion: The smile considered most attractive among the sample was that with 1.5 mm steepness between the central and lateral incisors, while a flat smile arc was considered least attractive.

scholarly journals Phosphatase Regenerating Liver3 and ECadherin Expression in Epithelial Ovarian Cancer

2017 ◽  
pp. 170-175
Author(s):  
Risma Maharani ◽  
Syahrul Rauf ◽  
Rina Masadah
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Early Stage ◽  
Cross Sectional Study ◽  
Teaching Hospitals ◽  
Advanced Stage ◽  
Cross Sectional ◽  
Exact Test ◽  
Significant Difference ◽  
E Cadherin

Objective: To determine the expression of Phosphatase Regenerating Liver-3 (PRL-3) and E-Cadherin in the epithelial ovarian cancer on various stages and differentiation grades. Method: This was a cross-sectional study design conducted at Obstetrics and Gynecology Department of several teaching hospitals, Faculty of Medicine Universitas Hasanuddin from January to June 2015. The expression of PRL-3 and E-cadherin was assessed immunohistochemically in 40 patients with epithelial ovarian cancer including 15 patients in early stage and 25 patients in advanced stage. We used the Fisher’s exact test with the significance of p0.05). The significant difference was found in the expression of E-cadherin whereas the high expression was shown at early stage than advanced stage (p0.05). This study also pointed out no correlation between the expression of PRL-3 and E-cadherin in epithelial ovarian cancer (p>0.05). Conclusion: PRL-3 overexpression does not decrease E-cadherin expression in epithelial ovarian cancer. Keywords: E-cadherin, epithelial ovarian cancer, PRL-3

scholarly journals The Latent Tuberculin Test after 1-year Therapy with Anti-TNF in Babylon, Iraq

2018 ◽  
Vol 26 (8) ◽  
pp. 144-150
Author(s):  
Ali Alkazzaz ◽  
Murtadha Najah Jawad ◽  
Zeyad Tareq Kareem
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Medical History ◽  
Demographic Data ◽  
Latent Tuberculosis ◽  
Tuberculin Test ◽  
P Value ◽  
Cross Sectional ◽  
Increased Risk ◽  
Significant Difference

Background: Rheumatoid arthritis (RA) patients receiving receive anti-TNF agents are at increased risk of reactivation of latent tuberculosis infection (LTBI). The tuberculin skin test (TST) is widely used to screen LTBI and providing preventive treatment, in an effort to meet the WHO target of a 90% reduction in TB by 2035. Objectives: To determine the proportion of TST conversion among RA patients after 1 year of anti-TNF treatment and association of positive TST result with patients’ socio-demographic characteristics and medical history. Methods: This community-based cross-sectional study was conducted at the Department of Rheumatology of Marjan Teaching Hospital in Iraq, for a period of 1 year. Patients with RA/and spondyloarthropathy, and who received anti-TNF therapy for >1 year, underwent TST. Their demographic data and medical history were also obtained. All statistical analysis was performed using SPSS (Version 20) and, p < 0.05 was considered as a sign. Data from the baseline and 1 year follow-up was subjected to the Kolmogorov-Smirnov test to determine whether they were normally distributed. Chi-Square test used to test significance of TST among etanrecept and infliximab at the end of the study. Results: A total of 96 patients were enrolled, including 55 (57.3%) males and 41 (42.3%) females with an average age of 41.1, and mostly 68 (70.8%) from Babylon Governorate of Iraq. A total of 40 (41.7%) patients had rheumatoid arthritis alone, and the remaining 56 (58.3%) had a comorbidity of spondyloarthropathy. Majority of the patients 65 (67.7%) received the biological agent infliximab, while 31 (32.3%) patients received Etanercept for RA for a period of 1 year. There was a statistically significant decreasing in the median ESR and disease activity  from the baseline to the end of the study (p-value <0.01). There was no significant difference in TST results based on gender or age. Both infliximab and etanercept were significantly associated with a decreasing  in ESR and disease activity Conclusion: This study has shown that there was very low TST conversion among RA patients after 1 year of anti-TNF treatment and, age and gender were not associated with TST.

scholarly journals Healthcare Workers Infection Rate in the Era of Coronavirus Disease 2019 - in Tertiary Teaching Hospital

2021 ◽  
Vol 9 (A) ◽  
pp. 651-658
Author(s):  
Mona Mohiedden ◽  
Aml M. Said ◽  
Ahmed M. Ali ◽  
Mohammed M. Abdel Razik ◽  
Maha Ali Gad
Keyword(s):  
Healthcare Workers ◽  
Statistical Significance ◽  
Descriptive Analysis ◽  
Control Measures ◽  
University Hospitals ◽  
Cross Sectional ◽  
Infection Control Measures ◽  
Increased Risk ◽  
Tertiary Teaching ◽  
Potential Risk Factors

BACKGROUND: Healthcare workers (HCWs) are at the frontline defense against coronavirus disease 2019 (COVID-19) pandemic. AIM: The study aimed to describe the characteristics and appraise potential risk factors of COVID-19 transmission among HCWs who tested positive for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in one of Cairo University Hospitals. METHOD: Cross-sectional descriptive analysis of confirmed polymerase chain reaction (PCR) positive versus negative cases for COVID-19. RESULTS: Through March–June 2020, (145/846; 17%) suspected HCWs were tested for COVID-19 by PCR; out of them (70/145; 48.3%) were confirmed as positive, these positive cases represented (70/846; 8.3%) of all HCWs of the hospital. About 33% of confirmed COVID-19 positive HCWs acquired the infection from the healthcare while only (13/70; 19%) from community settings, and no clear exposure data were identified in (34/70; 48%) of cases. Most of symptomatic cases showed a positive PCR test for SARS-CoV-2 versus asymptomatic cases, p < 0.001. There was no statistical significance regarding gender, age, presence of comorbidity, workload or the type of acquisition. CONCLUSION: HCWs are at an increased risk of COVID-19 infection at the workplace. Strict implementation of infection control measures is of crucial role in preventing transmission of COVID-19 infection in health-care settings.

AISLAMIENTO POR COVID-19 EN EL AMBA Y EN EL RESTO DEL PAÍS: ESTUDIO TRANSVERSAL DE CAMBIOS EN HÁBITOS Y ESTILO DE VIDA

2021 ◽  
Vol 22 (4) ◽  
Author(s):  
Jorge F. Elgart ◽  
◽  
Luis Flores ◽  
Analía G. Abraham ◽  
Graciela L. Garrote ◽  
...  
Keyword(s):  
Physical Activity ◽  
Online Survey ◽  
Eating Habits ◽  
Descriptive Analysis ◽  
Caloric Intake ◽  
Nonparametric Tests ◽  
Cross Sectional ◽  
Healthy Habits ◽  
Obesity And Diabetes ◽  
Desire To Eat

ABSTRACT Introduction: the confinement imposed to reduce the spread of COVID-19 induces changes in habits and unhealthy lifestyles. Objectives: to verify changes associated with confinement in eating habits and lifestyle in the Argentine population and their differences between the metropolitan area of Buenos Aires (AMBA) and the rest of the country. Materials and methods: cross-sectional, descriptive, and analytical study, through an “online” survey (December 2020) carried out on adults residing in Argentina. Age, gender and place of residence were surveyed, as well as the changes registered regarding weight, eating habits, physical activity, desire to eat and quality of sleep. A descriptive analysis of the valid surveys received (N=1,536) was carried out, verifying differences between the regions using parametric and nonparametric tests, considering significant p<0.05. Results: 75.1% of the participants were women (38.8±13.1 years), 60.5% from the AMBA and 39.5% from the rest of the country. Isolation was associated with changes that impacted on the psychological, stress, healthy habits, and sleep, with some significant regional differences. However, the common end result between AMBA and the rest of the country was the greater increase in caloric intake and the decrease in physical activity that led to 39.7% of the participants increasing their weight (mean 4.8±2,8 kg). Conclusions: isolation was associated with undesirable side effects, which could be diminished through the virtual promotion of healthy habits that would simultaneously decrease the growth of obesity and diabetes. Key words: COVID-19; social isolation; eating habits; lifestyle; physical activity.

An Evaluation of Burnout Among Foundation Doctors in Malta

2021 ◽  
Author(s):  
Marco Grech
Keyword(s):  
Work Performance ◽  
Medical Profession ◽  
Internal Validity ◽  
Personal Accomplishment ◽  
Cross Sectional ◽  
Work Related ◽  
Medical Trainees ◽  
Increased Risk ◽  
The Individual ◽  
High Level

Abstract BackgroundPostgraduate medical trainees are at an increased risk of burnout. Burnout has been defined as “a psychological condition of emotional exhaustion, depersonalization and reduced personal accomplishment occurring in people persistently exposed to emotional and interpersonal stressors at work”. It can arise either from within the individual, from the medical profession itself or from healthcare organisations. Burnout is associated with mental health issues in trainees, impaired work performance and suboptimal patient outcomes.MethodsA cross-sectional observational study of three cohorts of the Malta Foundation Programme was conducted using the Copenhagen Burnout Inventory (CBI) to evaluate incidence of personal-, work-related and client related burnout. The cohorts were at 3-months, 1-year and 2-years of training respectively. The CBI was administered via Google Forms after ethical clearance. Descriptive statistics and non-parametric comparative statistics were used to analyse the results through SPSS v25.0.ResultsA global response rate of 26.5% was achieved. CBI and its sub scales showed good internal validity. High scores for burnout in all three scales were identified except for client-related burnout in First Year doctors. Burnout peaked midway through the 2-year period. High numbers reported “feeling “tired” and “physically exhausted”. Males reported more burnout than females.ConclusionThe high level of burnout so early in the career of Maltese postgraduate medical trainees is of concern. More studies are needed on the causality of this burnout and what factors are associated with burnout in this population.

scholarly journals The effect of curricula approaches to the development of the student’s clinical reasoning ability

Curationis ◽  
2005 ◽  
Vol 28 (2) ◽  
Author(s):  
T Khanyile ◽  
F Mfidi
Keyword(s):  
Nursing Students ◽  
Clinical Reasoning ◽  
Survey Design ◽  
Traditional Approach ◽  
Descriptive Analysis ◽  
Problem Based Learning ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Jump Exercise ◽  
Significant Difference

A comparative analysis was undertaken using descriptive and cross sectional survey design, to explore the effect of Problem Based Learning and Traditional approach on the development of clinical reasoning abilities of nursing students. Using quota sampling, a sample of 87 subjects was used from two University Nursing Departments, each using these curricula approaches. Students from their first, second and fourth year were interviewed, using the Triple Jump Exercise as an instrument to collect data. Data analysis using the SAS computer software package was employed to obtain both descriptive and statistical summarizations. Though descriptive analysis of the scores of clinical reasoning showed a slight difference between the two curricular approaches, this was not confirmed statistically as the two factor ANOVA and Tukey’s methods revealed no significant differences by approaches. The only significant difference was revealed between the students’ levels of study with senior levels (4th years) outperforming their juniors. These findings therefore conclude that, students using Problem Based Learning and Traditional approach perform on a similar level in clinical reasoning.

scholarly journals Prevalence of microalbuminuria and associated factors among HIV − infected ART naïve patients at Mulago hospital: a cross-sectional study in Uganda

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Thomas Kiggundu ◽  
Robert Kalyesubula ◽  
Irene Andia-Biraro ◽  
Gyaviira Makanga ◽  
Pauline Byakika-Kibwika
Keyword(s):  
Antiretroviral Therapy ◽  
Cross Sectional Study ◽  
Cd4 Count ◽  
P Value ◽  
Mulago Hospital ◽  
Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Exact Test ◽  
Increased Risk

Abstract Background HIV infection affects multiple organs and the kidney is a common target making renal disease, one of the recognized complications. Microalbuminuria represents an early, important marker of kidney damage in several populations including HIV-infected antiretroviral therapy (ART) naïve patients. Early detection of microalbuminuria is critical to slowing down progression to chronic kidney disease (CKD) in HIV-infected patients, however, the burden of microalbuminuria in HIV-infected antiretroviral therapy (ART) naïve patients in Uganda is unclear. Methods A cross-sectional study was conducted in the Mulago Immune suppression syndrome (ISS) clinic among adult HIV − infected ART naïve outpatients. Data on patient demographics, medical history was collected. Physical examination was performed to assess body mass index (BMI) and hypertension. A single spot morning urine sample from each participant was analysed for microalbuminuria using spectrophotometry and colorimetry. Microalbuminuria was defined by a urine albumin creatinine ratio (UACR) 30-299 mg/g and macroalbuminuria by a UACR > 300 mg/g. To assess the factors associated with microalbuminuria, chi-square, Fisher’s exact test, quantile regression and logistic regression were used. Results A total of 185 adult participants were consecutively enrolled with median age and CD4+ counts of 33(IQR = 28–40) years and 428 (IQR = 145–689) cells/μL respectively. The prevalence of microalbuminuria was 18.9% (95% CI, 14–25%). None of the participants had macroalbuminuria. CD4+ count <350cells/μL was associated with increased risk of microalbuminuria (OR: 0.27, 95% CI: 0.12–0.59), P value = 0.001). Diabetes mellitus, hypertension, smoking, alcohol intake were not found to be significantly associated with microalbuminuria. Conclusion Microalbuminuria was highly prevalent in adult HIV − infected ART naive patients especially those with low CD4+ count. There is need to study the effect of ART on microalbuminuria in adult HIV − infected patients.

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