AYURVEDIC MANAGEMENT OF LOW BACK PAIN WITH MODIFIED ABHYANGA: A CASE STUDY

Low back pain is one of the widespread health problems and the leading cause of activity limitation and work absence worldwide. Among the types of low back pain, low back pain due to mechanical causes is more common. Abhyanga is an effective treatment for low back pain, which can be done as an OPD level treatment without causing much financial burden. Though it is a widely practised procedure, we did not explore its possibilities properly. Abhyanga can be modified by incorporating other massage techniques like Swedish massage for better application. Cupping is a variety of tapotement massage techniques of a Swedish massage. Abhyanga performed along with the cupping massage techniques is very effective in managing low back pain. A 45year old lady patient came to OPD complaining of low back pain. On examination, stooping posture during her work hours was concluded as the reason for the pain. She was treated with modified Abhyanga with moorchita tilataila for seven days. The procedure duration was 20 minutes. Treatment was found to be effective after treatment and after follow up as her symptoms wholly vanished.

Our Changing World

COVID-19 has dramatically changed our world in terms of telework specifically and remote life in general. We are still learning new things about balancing family and work; trustworthiness, performance, and accountability issues; important changes and discoveries about the way the world goes to work; and discussions of the dynamic ways people communicate. This chapter examines reasons for resistance to telework to shed light on how COVID-19 has changed us. The discussion that follows centers on qualitative interviews concerning telework, an evaluation of employee engagement now and in the future, and ideas and actions that should prove helpful to organizations. Analyzing the interviews reveals several common threads: distractions, fatigue, accountability, communication, productivity, technology, coping, work hours, resources, and plan approaches.

Who Will Take Care of Me?

Foreseeing the needs and availability of anaesthesiologists across Europe is a challenging task. This is influenced by different factors that include the composition of the workforce and the organization and structure of health services in every country. Some trends call for attention, such as changes in work patterns brought about by an ageing specialist population, the increasing numbers of women in anaesthesia, or cultural and societal shifts towards work-life balance. Anaesthesiology is a challenging specialty with an expanding scope of practice, requiring highly motivated professionals, frequent long work hours, and addressing stressful situations often. To ensure quality anaesthesia provision, the wellbeing of this diverse population of anaesthesiologists should be addressed. Achieving rational and flexible work hours, adequate compensation, and promotion of a workplace culture that fosters safety, motivation to learn, and equal opportunities for leadership or academia positions are challenges to be addressed to make sure that excellence in patient care is maintained.

Contemporary Conflicts in Perspectives on Work Hours across Hierarchical Levels in Public Accounting

Socializing personnel into accepting work hour norms has been fundamental to how accounting firms function, but is now challenged by contemporary work perspectives. Using 40 semi-structured interviews of personnel across hierarchical levels at a national firm and an international firm, we show how strangeness and contradiction expressed in work hour perspectives across different levels within both firms are reconstructed as compatible and complementary. Highlighting various firm adaptations, including alternative work arrangements, offshoring, and technological tools, our interviews suggest a major shift in firms’ approach toward work hours. This shift is fueled by work perspectives embraced by younger generations desiring work life balance and purposeful work, and enabled by technology supporting remote work and increasing work efficiencies. The question remains whether firms are evolving to genuinely embody work perspectives of younger generations or restructuring to rely on a smaller workforce willing to accept traditional work hour norms, or some combination thereof.

Characterization of EHR Use Outside Work Hours among Primary Care Pediatricians Using Electronic Health Record Access Logs (Preprint)

BACKGROUND Many of the benefits of electronic health records (EHRs) have not been achieved at expected levels due to a variety of unintended negative consequences such as documentation burden. Previous studies have characterized EHR use during and outside work hours, with many reporting physicians spending considerable time on documentation-related tasks. These studies characterized EHR use during and outside work hours using clock time versus actual physician schedules to define outside work time. OBJECTIVE This study closes a knowledge gap by characterizing EHR engagement outside work hours using actual physician schedules to define EHR work outside work hours. METHODS A retrospective exploratory descriptive task analysis of EHR access log data from primary care pediatricians in September 2019 at a large midwestern pediatric health center was conducted to quantify and identify actions completed outside work hours. Mixed effects statistical modeling was used to investigate the effects of age, sex, clinical full-time equivalent status, and EHR engagement during work hours on the use of EHRs outside work hours. RESULTS Primary care pediatricians (n=56) in this study generated a total of 1,523,872 access-log data points (across 1,069 physician workdays) and spent an average of 3.9 and 1.2 hours per physician per workday engaged in the EHR during and outside work hours, respectively. About three-quarters of the time engaged in the EHR during or outside work hours was spent reviewing data and reports. Mixed effects regression revealed no associations of age, sex, nor clinical full-time equivalent status with EHR use during or outside work hours. CONCLUSIONS For every hour primary care pediatricians in this study spent engaged with the EHR during work hours, they spent about 20 minutes interacting with the EHR outside work hours. Most of their time (both during and outside of work hours) was spent reviewing data, records, and other information in the EHR.

Workforce demographics and unit structure in paediatric cardiac critical care in the United States

Objective: To assess current demographics and duties of physicians as well as the structure of paediatric cardiac critical care in the United States. Design: REDCap surveys were sent by email from May till August 2019 to medical directors (“directors”) of critical care units at the 120 United States centres submitting data to the Society of Thoracic Surgeons Congenital Heart Surgery Database and to associated faculty from centres that provided email lists. Faculty and directors were asked about personal attributes and clinical duties. Directors were additionally asked about unit structure. Measurements and main results: Responses were received from 66% (79/120) of directors and 62% (294/477) of contacted faculty. Seventy-six percent of directors and 54% of faculty were male, however, faculty <40 years old were predominantly women. The majority of both groups were white. Median bed count (n = 20) was similar in ICUs and multi-disciplinary paediatric ICUs. The median service expectation for one clinical full-time equivalent was 14 weeks of clinical service (interquartile range 12, 16), with the majority of programmes (86%) providing in-house attending night coverage. Work hours were high during service and non-service weeks with both directors (37%) and faculty (45%). Conclusions: Racial and ethnic diversity is markedly deficient in the paediatric cardiac critical care workforce. Although the majority of faculty are male, females make up the majority of the workforce younger than 40 years old. Work hours across all age groups and unit types are high both on- and off-service, with most units providing attending in-house night coverage.

Migration and Dynamics in Men’s and Women’s Domestic Work

International migration of couples is rising. Still, there is little evidence on men’s and women’s domestic work hours before and after migration. This is despite the fact that domestic work provides deep insights into family life and, for migrants, is directly linked to integration. Therefore, this study examines how immigrant men and women change their domestic work hours following migration, using data from the German Socio-Economic Panel (SOEP). Our results show that domestic work hours increase for both genders after immigration. However, men are more responsible for running errands than women in the first years after migration. In the long term, the gender gaps return to the pre-migration state, with women shouldering a greater load than men. Accordingly, this study shows that migration only has a short-term impact on couples’ division of domestic work.

Prediction of suicidal ideation risk in a prospective cohort study of medical interns

The purpose of this study was to identify individual and residency program factors associated with increased suicide risk, as measured by suicidal ideation. We utilized a prospective, longitudinal cohort study design to assess the prevalence and predictors of suicidal ideation in 6,691 (2012–2014 cohorts, training data set) and 4,904 (2015 cohort, test data set) first-year training physicians (interns) at hospital systems across the United States. We assessed suicidal ideation two months before internship and then quarterly through intern year. The prevalence of reported suicidal ideation in the study population increased from 3.0% at baseline to a mean of 6.9% during internship. 16.4% of interns reported suicidal ideation at least once during their internship. In the training dataset, a series of baseline demographic (male gender) and psychological factors (high neuroticism, depressive symptoms and suicidal ideation) were associated with increased risk of suicidal ideation during internship. Further, prior quarter psychiatric symptoms (depressive symptoms and suicidal ideation) and concurrent work-related factors (increase in self-reported work hours and medical errors) were associated with increased risk of suicidal ideation. A model derived from the training dataset had a predicted area under the Receiver Operating Characteristic curve (AUC) of 0.83 in the test dataset. The suicidal ideation risk predictors analyzed in this study can help programs and interns identify those at risk for suicidal ideation before the onset of training. Further, increases in self-reported work hours and environments associated with increased medical errors are potentially modifiable factors for residency programs to target to reduce suicide risk.