1108 Civility saves lives: educating colleagues about the impact of incivility within a paediatric department

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has brought about additional challenges beyond the usual transitional stresses faced by a newly qualified doctor. We aimed to evaluate the impact of COVID-19 on interns’ stress, burnout, emotions, and implications on their training, while exploring their coping mechanisms and resilience levels. Methods: Newly graduated doctors interning in a Paediatric department in Singapore, who experienced escalation of the pandemic from January to April 2020, were invited to participate. Participants completed the Perceived Stress Scale (PSS), Maslach’s Burnout Inventory (MBI), and Connor Davidson Resilience Scale 25-item (CD-RISC 25) pre-pandemic and 4 months into COVID-19. Group interviews were conducted to supplement the quantitative responses to achieve study aims. Results: Response rate was 100% (n=10) for post-exposure questionnaires and group interviews. Despite working through the pandemic, interns’ stress levels were not increased, burnout remained low, while resilience remained high. Four themes emerged from the group interviews – the impacts of the pandemic on their psychology, duties, training, as well as protective mechanisms. Their responses, particularly the institutional mechanisms and individual coping strategies, enabled us to understand their unexpected low burnout and high resilience despite the pandemic. Conclusion: This study demonstrated that it is possible to mitigate stress, burnout and preserve resilience of vulnerable healthcare workers such as interns amidst a pandemic. The study also validated a multifaceted approach that targets institutional, faculty as well as individual levels, can ensure the continued wellbeing of healthcare workers even in challenging times.

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Impact of additional abdominal approach to transanal one stage endorectal pull-through in treatment of Hirschsprung’s disease

International Surgery Journal ◽

10.18203/2349-2902.isj20193313 ◽

2019 ◽

Vol 6 (8) ◽

pp. 2712

Author(s):

Ho Huu Thien ◽

Cao Xuan Thanh ◽

Nguyen Thanh Xuan ◽

Nguyen Huu Son

Keyword(s):

Retrospective Study ◽

Length Of Hospital Stay ◽

Laparoscopic Group ◽

Open Group ◽

One Stage ◽

Abdominal Approach ◽

Paediatric Department ◽

Average Operative Time ◽

Pull Through ◽

The Impact

Background: The transanal one-stage endorectal pull-through (TOSEPT) procedure sometimes requires assistance by an abdominal approach to complete the operation. This study aims to rectify this by evaluating the impact of an assisted abdominal approach in the outcomes of the TOSEPT in children with HD.Methods: A retrospective study was conducted at surgical paediatric department of Hue central hospital. All consecutive medical records of patients operated on for HD in our department between June 2010 and June 2018 were retrieved and analysed.Results: 66/446 (14.79%) patients with HD who required TOSEPT with an additional abdominal approach to complete the operation for inclusion in this retrospective study. Length of the resected colon: 13.30±3.45 cm (open group) and 19.70±4.50 cm (laparoscopic group). Average operative time: 156±12 minutes (open group) and 170±14 minutes (laparoscopic group). No deaths or intra-operative complications were recorded in this study. No postoperative complication occured in the laparoscopic group. Grade II complication based on Dindo-Clavien classification occurred in 14 (21.21%) of the open group and one (1.51%) grade III complication. The length of hospital stay was shorter in the laparoscopic group at 5±1.5 days compared to 7±2.5 days for the open group. All of the complications were grade I or II, mainly enterocolitis at 3-month follow-up.Conclusions: Additional abdominal approach impacts on post-operative results of TOSEPT procedure for HD but not on outcome of disease. Laparoscopic surgery as the additional abdominal approach should be used to reduce the complications.

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Psychiatric Collaboration in a Paediatric Department

Australian & New Zealand Journal of Psychiatry ◽

10.3109/00048679709073823 ◽

1997 ◽

Vol 31 (2) ◽

pp. 214-218 ◽

Cited By ~ 2

Author(s):

Samuel Menahem ◽

Dina Roth ◽

Sara Haramati

Keyword(s):

Early Discharge ◽

Psychological Needs ◽

Child Psychiatrist ◽

Prospective Audit ◽

Educational Value ◽

Multidisciplinary Meeting ◽

Paediatric Department ◽

Psychiatric Staff ◽

Set Up ◽

The Impact

Objective: To review the impact of integrating child psychiatry services into a paediatric department. Method: Following the arrival of a new head of paediatrics, a mandatory multidisciplinary meeting was set up to review, diagnose and manage selected patients under the care of the paediatricians and/or a child psychiatrist. A prospective audit was undertaken of the patients discussed with a brief review of their outcome. The educational value of the meetings and their overall impact on the department was reviewed. Results: Over an 8-month period 30 patients were discussed in some detail with diagnoses ranging from a psychiatric disorder to a chronic organic illness, each subjected to the deliberations of the multidisciplinary team of the attending paediatrician, resident staff, child psychiatrist/psychologists, nurses, social worker, etc. Recommendations included further assessment by the psychiatric team, or management by the paediatricians with or without guidance of the former, involvement of an outside agency, etc. Such interventions generally had positive outcomes: at times dramatic, although early discharge often resulted in limited goals. There was also an overall increased awareness within the department of the psychological needs of the child and family and the importance of serious physical illness; this awareness is essential in the training of paediatricians and psychiatric staff. Conclusion: Closer integration of the two disciplines led to benefits both to the patients and staff. The initiation of a mandatory multidisciplinary meeting facilitated the process, overseen by a psychologically-minded new head of paediatrics. His departure led to a loss of some goals achieved, raising the question as to how such collaboration may be self-generating and ongoing. In addition, the issue of how to deal with those patients with ongoing difficulties not addressed during their limited inpatient stay was unresolved.

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Pattern of childhood pertussis in a tertiary hospital in Nigeria: a five year review (2007-2011)

Nigerian Journal of Paediatrics ◽

10.4314/njp.v42i2.2 ◽

1970 ◽

Vol 42 (2) ◽

pp. 83-87

Author(s):

IP Oloyede ◽

AM Ekanem ◽

EE Udoh

Keyword(s):

Health Facility ◽

Immunization Coverage ◽

Signs And Symptoms ◽

Tertiary Hospital ◽

Older Children ◽

Duration Of Illness ◽

Paediatric Department ◽

Health Significance ◽

Coverage Rates ◽

The Impact

Pertussis is being increasingly found in previously immunized subjects. In Nigeria, the immunization coverage rates are low. This study was therefore carried out to highlight the cases of pertussis seen in a young Nigerian tertiary health facility, with emphasis on the clinical features, complications and the impact of prior immunization in the affected children.Methods : This was a hospital based retrospective study, in which data were obtained from case notes of children seen in the Paediatric department of the University of Uyo Teaching Hospital (UUTH) from January 2007 to December 2011 with a diagnosis of pertussis. Information sought included epidemiologic data, duration of illness, signs and symptoms, treatment, complications and outcome.Results: Fifty three patients were diagnosed with pertussis during the five year period, with majority (29; 54.7%) of cases in the year 2011. Twenty one (39.6%) of the subjects were males while 32 (60.4%) were females. The mean age of the subjects was 29.71 + 27.73 months. The most common symptoms were Post-tussive vomiting and paroxysmal cough occurring in 48(90%) and 39 (73.6%) of the patients respectively. The average interval between onset of symptoms and presentation at the health facility was 3.35 + 2.84 weeks. Majority of the patients (25; 47.2%) were adequately immunized for their age. Bronchopneumonia, either alone or in combination with other complications was the commonest complication occurring in nine (52.9%) patients. There was no mortality.Conclusion: Pertussis is still of public health significance. Routine immunization should be strengthened and booster doses of vaccines should be considered for older children whose immunity may begin to wane.Key words: Pertussis, pattern, childhood

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Formation of Lunar Craters and Bright Rays as a Result of Meteorite Impacts

Symposium - International Astronomical Union ◽

10.1017/s0074180900178404 ◽

1962 ◽

Vol 14 ◽

pp. 415-418

Author(s):

K. P. Stanyukovich ◽

V. A. Bronshten

Keyword(s):

Explosive Charge ◽

The Moon ◽

Meteorite Impacts ◽

The Earth ◽

Lunar Craters ◽

The Impact

The phenomena accompanying the impact of large meteorites on the surface of the Moon or of the Earth can be examined on the basis of the theory of explosive phenomena if we assume that, instead of an exploding meteorite moving inside the rock, we have an explosive charge (equivalent in energy), situated at a certain distance under the surface.

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The Geosciences Applied to Lunar Exploration

Symposium - International Astronomical Union ◽

10.1017/s0074180900178222 ◽

1962 ◽

Vol 14 ◽

pp. 169-257 ◽

Cited By ~ 9

Author(s):

J. Green

Keyword(s):

Lunar Surface ◽

Probable Mechanism ◽

Point Of View ◽

Lunar Exploration ◽

Geological Model ◽

Apply Geophysics ◽

Surface Features ◽

The Impact

The term geo-sciences has been used here to include the disciplines geology, geophysics and geochemistry. However, in order to apply geophysics and geochemistry effectively one must begin with a geological model. Therefore, the science of geology should be used as the basis for lunar exploration. From an astronomical point of view, a lunar terrain heavily impacted with meteors appears the more reasonable; although from a geological standpoint, volcanism seems the more probable mechanism. A surface liberally marked with volcanic features has been advocated by such geologists as Bülow, Dana, Suess, von Wolff, Shaler, Spurr, and Kuno. In this paper, both the impact and volcanic hypotheses are considered in the application of the geo-sciences to manned lunar exploration. However, more emphasis is placed on the volcanic, or more correctly the defluidization, hypothesis to account for lunar surface features.

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Asteroid and Comet Impact Speeds upon Mars: Significance for Panspermia and the Supply of Organics

International Astronomical Union Colloquium ◽

10.1017/s0252921100014718 ◽

1997 ◽

Vol 161 ◽

pp. 197-201 ◽

Cited By ~ 1

Author(s):

Duncan Steel

Keyword(s):

Probability Distributions ◽

Regions Of Interest ◽

Significant Fraction ◽

Organic Chemicals ◽

Impact Speed ◽

The Mean ◽

The Impact

AbstractWhilst lithopanspermia depends upon massive impacts occurring at a speed above some limit, the intact delivery of organic chemicals or other volatiles to a planet requires the impact speed to be below some other limit such that a significant fraction of that material escapes destruction. Thus the two opposite ends of the impact speed distributions are the regions of interest in the bioastronomical context, whereas much modelling work on impacts delivers, or makes use of, only the mean speed. Here the probability distributions of impact speeds upon Mars are calculated for (i) the orbital distribution of known asteroids; and (ii) the expected distribution of near-parabolic cometary orbits. It is found that cometary impacts are far more likely to eject rocks from Mars (over 99 percent of the cometary impacts are at speeds above 20 km/sec, but at most 5 percent of the asteroidal impacts); paradoxically, the objects impacting at speeds low enough to make organic/volatile survival possible (the asteroids) are those which are depleted in such species.

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Organic Syntheses During the Impact of a Comet with a Gaseous Planet

International Astronomical Union Colloquium ◽

10.1017/s0252921100014706 ◽

1997 ◽

Vol 161 ◽

pp. 189-195

Author(s):

Cesare Guaita ◽

Roberto Crippa ◽

Federico Manzini

Keyword(s):

Polymeric Material ◽

Molecular Form ◽

Parent Compound ◽

Blue Filter ◽

Organic Syntheses ◽

The Impact

AbstractA large amount of CO has been detected above many SL9/Jupiter impacts. This gas was never detected before the collision. So, in our opinion, CO was released from a parent compound during the collision. We identify this compound as POM (polyoxymethylene), a formaldehyde (HCHO) polymer that, when suddenly heated, reformes monomeric HCHO. At temperatures higher than 1200°K HCHO cannot exist in molecular form and the most probable result of its decomposition is the formation of CO. At lower temperatures, HCHO can react with NH3 and/or HCN to form high UV-absorbing polymeric material. In our opinion, this kind of material has also to be taken in to account to explain the complex evolution of some SL9 impacts that we observed in CCD images taken with a blue filter.

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Hydrogen Cyanide Polymers from the Impact of Comet P/Shoemaker-Levy 9 on Jupiter

International Astronomical Union Colloquium ◽

10.1017/s025292110001469x ◽

1997 ◽

Vol 161 ◽

pp. 179-187

Author(s):

Clifford N. Matthews ◽

Rose A. Pesce-Rodriguez ◽

Shirley A. Liebman

Keyword(s):

Amino Acids ◽

Solar System ◽

Hydrogen Cyanide ◽

Nitrogen Heterocycles ◽

Laboratory Studies ◽

Heterogeneous Solids ◽

The Many ◽

Comet Halley ◽

The Impact ◽

By Products

AbstractHydrogen cyanide polymers – heterogeneous solids ranging in color from yellow to orange to brown to black – may be among the organic macromolecules most readily formed within the Solar System. The non-volatile black crust of comet Halley, for example, as well as the extensive orangebrown streaks in the atmosphere of Jupiter, might consist largely of such polymers synthesized from HCN formed by photolysis of methane and ammonia, the color observed depending on the concentration of HCN involved. Laboratory studies of these ubiquitous compounds point to the presence of polyamidine structures synthesized directly from hydrogen cyanide. These would be converted by water to polypeptides which can be further hydrolyzed to α-amino acids. Black polymers and multimers with conjugated ladder structures derived from HCN could also be formed and might well be the source of the many nitrogen heterocycles, adenine included, observed after pyrolysis. The dark brown color arising from the impacts of comet P/Shoemaker-Levy 9 on Jupiter might therefore be mainly caused by the presence of HCN polymers, whether originally present, deposited by the impactor or synthesized directly from HCN. Spectroscopic detection of these predicted macromolecules and their hydrolytic and pyrolytic by-products would strengthen significantly the hypothesis that cyanide polymerization is a preferred pathway for prebiotic and extraterrestrial chemistry.

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Unusual Microstructure in Shock-Compacted Graphite

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100069363 ◽

1970 ◽

Vol 28 ◽

pp. 474-475

Author(s):

Lucien F. Trueb

Keyword(s):

Mechanical Characteristic ◽

Compression Wave ◽

Gray Zone ◽

Flyer Plate ◽

Compacted Graphite ◽

The Impact

Crushed and statically compressed Madagascar graphite that was explosively shocked at 425 kb by means of a planar flyer-plate is characterized by a black zone extending for 2 to 3 nun below the impact plane of the driver. Beyond this point, the material assumes the normal gray color of graphite. The thickness of the black zone is identical with the distance taken by the relaxation wave to overtake the compression wave.The main mechanical characteristic of the black material is its great hardness; steel scalpels and razor blades are readily blunted during attempts to cut it. An average microhardness value of 95-3 DPHN was obtained with a 10 kg load. This figure is a minimum because the indentations were usually cracked; 14.8 DPHN was measured in the gray zone.

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