Burnout and Well-Being Among Medical Professionals in China: A National Cross-Sectional Study

ObjectiveTo determine the profile of Chinese medical professionals with burnout symptoms at the national level and identify the association between capability well-being and burnout.Design and SettingA cross-sectional study in a nonrandom national sample of medical staff from 6 provinces across western, central and eastern China.ParticipantsPhysicians, medical laboratory scientists, nurses, and general practitioners aged 18 years or above who submitted a completed online questionnaire from June 2019 to January 2020 successfully (N = 25,120).Main Outcome MeasuresThe prevalence of burnout symptoms was assessed by the 22-item Maslach Burnout Inventory-Human Services Survey (MBI-HSS), which consists of three domains: emotional exhaustion (EE), depersonalization (DP), and personal achievement (PA). The overall high burnout was defined as EE score ≥27 or DP score ≥10. The capability well-being was measured by the Investigating Choice Experiments Capability Measure for Adults (ICECAP-A) and the overall ICECAP-A score was calculated using the UK value set, ranging from a score of 0–1. Multivariable logistic regression analysis was used to identify the association between well-being and the overall high burnout.ResultsAmong the 25,120 participants, 60.8% of the participants reported at least one symptom of burnout, whereas 11.2% reported all three symptoms of burnout. In the adjusted model, ICECAP-A score was independently associated with high burnout (AOR = 0.018, 95% CI = 0.015–0.022). Medical staff who were males, with shorter working years, working in tertiary hospitals, and those with the specialties of psychiatry, intensive care, emergency medicine, internal medicine, oncology, and pediatrics were at higher risk of reporting burnout symptoms.ConclusionThe burnout symptoms were relatively common among Chinese medical staff and they were found to be independently associated with capability well-being in health professionals. Interventions should be enhanced on vulnerable groups to reduce burnout and promote well-being in future studies.

APPLICATION OF THE GIS-BASED 3D MODELING OF MULTIFLAT BUILDINGS TO ASSESS THE PREVALENCE OF TUBERCULOSIS ON A CITY SCALE

This article is aimed at expanding and deepening knowledge in GIS analysis for medical professionals. Key task of described research is to elaborate a methodology of 3D mapping and visualization of the multiflat buildings in order to study most socially valuable diseases on the apartment scale in the St. Petersburg city. The use of this methodology allows to avoid the aggregation of geographical information within one building, and, on the other hand, allows to move from a general assessment of the prevalence of the disease to specific cases. In this case, the methodology is considered as primary health care support. The paper describes elaborated approach to detailed 3D mapping of multiple disease hotbeds in multiflat buildings. Main benefit of the proposed set of data processing and mapping techniques is the capability of apartment-scale connectivity evaluation of the hotbeds inside multiflat buildings.

Validation of a novel virtual reality simulation system with the focus on training for surgical dissection during laparoscopic sigmoid colectomy

Background Mastery of technical skills is one of the fundamental goals of surgical training for novices. Meanwhile, performing laparoscopic procedures requires exceptional surgical skills compared to open surgery. However, it is often difficult for trainees to learn through observation and practice only. Virtual reality (VR)-based surgical simulation is expanding and rapidly advancing. A major obstacle for laparoscopic trainees is the difficulty of well-performed dissection. Therefore, we developed a new VR simulation system, Lap-PASS LP-100, which focuses on training to create proper tension on the tissue in laparoscopic sigmoid colectomy dissection. This study aimed to validate this new VR simulation system. Methods A total of 50 participants were asked to perform medial dissection of the meso-sigmoid colon on the VR simulator. Forty-four surgeons and six non-medical professionals working in the National Cancer Center Hospital East, Japan, were enrolled in this study. The surgeons were: laparoscopic surgery experts with > 100 laparoscopic surgeries (LS), 21 were novices with experience < 100 LS, and five without previous experience in LS. The participants’ surgical performance was evaluated by three blinded raters using Global Operative Assessment of Laparoscopic Skills (GOALS). Results There were significant differences (P-values < 0.044) in all GOALS items between the non-medical professionals and surgeons. The experts were significantly superior to the novices in one item of GOALS: efficiency ([4(4–5) vs. 4(3–4)], with a 95% confidence interval, p = 0.042). However, both bimanual dexterity and total score in the experts were not statistically different but tended to be higher than in the novices. Conclusions Our study demonstrated a full validation of our new system. This could detect the surgeons' ability to perform surgical dissection and suggest that this VR simulator could be an effective training tool. This surgical VR simulator might have tremendous potential to enhance training for surgeons.

Intersectionality & Sexual harassment as a Minority Ethnic Female Surgeon

As a trainer, I have even taught women from certain cultures (who may find this level of contact difficult), that this is ‘normal’ in surgery. After reading the editorial and letter of response, in the Royal College of Surgeon’s Bulletin, [1] I have to think again about what I teach. I have taken for granted that surgeons have some sort of moral standing. Maybe I should be explaining also what they should not be tolerating. Even as a female surgeon, often at cultural gatherings, I feel I am perceived differently by women from my cultural or ethnic background, even if they are medical professionals themselves. I feel ostracised as being the woman who is playing with the men at their game. The younger generations however do applaud it, and I see more and more young women have a fervour for surgery. I feel now I want to protect them from this misogyny and sexual harassment more than ever.

Students or medical professionals: whose knowledge improved after social-medicine training? Results from a quasi-experimental evaluation study

Purpose Rehabilitation professionals are faced with judging and describing the social-medicine status of their patients. Rehabilitation professionals must know the core concepts of acute unfitness for work, psychological capacities, and long-term work capacity. Acquiring and applying this knowledge, requires training. The research question is if and to what extent medical professionals and students’ knowledge changes after social medicine training. Methods This quasi-experimental study was carried out in the real-life context of social medicine training. Psychology students (n = 42), physicians/psychotherapists (i.e. state-licensed health professionals) (n = 44) and medical assistant professionals (n = 29) were trained. Their social medicine knowledge was measured before and after training by a 10-min expert-approved and content valid knowledge questionnaire. Three free-text questions had to be answered on the essential aspects of present and prognostic work ability and psychological capacities. Answers were rated for correctness by two experts. Paired t tests and variance analysis have been calculated for group comparisons. Results All groups improved their social medicine knowledge from the pre- to the post-test. The students started with the lowest level of knowledge in the pre-test. After training, 69% of the physicians/psychotherapists and 56.8% of the medical assistant professionals, but only 7% of the students, obtained maximum scores for naming psychological capacities. Conclusions Social medicine knowledge increased after a training course consisting of eight lessons. The increase was greater for medical assistant professionals and physicians/psychotherapists than for students. Social medicine training must be adjusted to the trainee groups’ knowledge levels.

Multi-Level Monitoring of Vaccination Adherence of Various Population Groups in the Context of the COVID-19 Pandemic: Problematic Issues

Relevance. Despite significant progress in the prevention of many infectious diseases, a number of organizational issues remain in the area of special attention. One of them is to ensure the timeliness and completeness of vaccination coverage in the decreed age groups, which is possible only with a high level of public commitment to vaccination. During the pandemic of the new coronavirus infection (COVID-19), achieving a high level of vaccination coverage of the National Calendar of Preventive vaccinations is of particular relevance. Aim. Using state-of-the-art online resources, assess population vaccination adherence to develop effective communication risk management technologies for immunoprophylaxis in the COVID-19 pandemic. Materials and methods. To assess the commitment of various population groups and professional contingents of a large industrial city to vaccine prevention, a survey of 965 parents was conducted at the initial stage, and subsequently a survey of 2,632 employees of medical organizations, including 1,422 people in the period before the COVID - 19 pandemic, 572 people in the «first wave» of the pandemic and 638 people in the «second wave». Instagram Facebook, Instagram, and VKontakte social networks were used to quickly obtain the necessary information (Google forms, corporate e-mails, WhatsApp, Telegram messengers, etc.). The work uses epidemiological, sociological and statistical methods of research. Results and discussion. When assessing the attitude of parents to vaccination, it was found that 78.8% of respondents were positive about vaccinations, 14.6% doubted their effectiveness and safety, and 6.6% denied their need. The main source of information that forms the attitude to vaccinations of parents was the opinion of medical professionals. In a survey of 1,422 employees, 190 people (13.3%) were identified, mainly from among the trained specialists, who themselves had a negative attitude to vaccination. When assessing the commitment of employees of medical organizations to the vaccination of a new coronavirus infection, the attitude to vaccination was ambiguous, especially in the group of secondary medical personnel and female employees of non-medical specialties, who are a potential risk group for forming a negative attitude to vaccinations and can act as «opinion leaders» on this issue for other categories of the population. Insufficient adherence to COVID-19 vaccine prevention has also been observed in other countries among various population groups, which is a serious problem on a global scale, hindering the fight against the pandemic of a new disease, which requires corrective measures. Conclusion. In this study, using modern online resources, a rapid assessment of the vaccination adherence of various population groups (parents and medical professionals) was carried out. It is shown that the use of modern technologies and software tools makes it possible to analyze a large array of data to solve problems of overcoming communication risks. The results obtained point to the need for prompt corrective measures in terms of the introduction of educational programs to increase adherence to vaccination, especially in groups at potential risk of the disease, including medical professionals, which is a priority for health care in all countries.

Biasing Influence of ‘Mental Shortcuts’ on Diagnostic Decision-Making: Radiologists Can Overlook Breast Cancer in Mammograms When Prior Diagnostic Information Is Available

When making decisions under uncertainty, people in all walks of life, including highly trained medical professionals, tend to resort to using ‘mental shortcuts’, or heuristics. Anchoring-and-adjustment (AAA) is a well-known heuristic in which subjects reach a judgment by starting from an initial internal judgment (‘anchored position’) based on available external information (‘anchoring information’) and adjusting it until they are satisfied. We studied the effects of the AAA heuristic during diagnostic decision-making in mammography. We provided practicing radiologists (N = 27 across two studies) a random number that we told them was the estimate of a previous radiologist of the probability that a mammogram they were about to see was positive for breast cancer. We then showed them the actual mammogram. We found that the radiologists’ own estimates of cancer in the mammogram reflected the random information they were provided and ignored the actual evidence in the mammogram. However, when the heuristic information was not provided, the same radiologists detected breast cancer in the same set of mammograms highly accurately, indicating that the effect was solely attributable to the availability of heuristic information. Thus, the effects of the AAA heuristic can sometimes be so strong as to override the actual clinical evidence in diagnostic tasks.

Hymen ‘repair’: Views from feminists, medical professionals and the women involved in the middle east, North Africa and Europe

In Europe, hymen ‘repair’ is controversial because it is often seen as a concession to immigrant groups that do not respect women’s sexual autonomy. But how is hymen ‘repair’ viewed in societies in which the norm is that women should not have premarital sex? And why do women want hymen ‘repair’? Hymen ‘repair’ is also controversial in Middle Eastern and North African (MENA) countries because it is seen as undermining social mores about women and premarital sex. However, some Islamic leaders have defended the procedure. Women request hymen ‘repairs’ for a variety of reasons. Some have been sexually abused and may desire the surgery to overcome trauma. Some have had consensual sex and may fear sanctions, while others may see the surgery as a covert act of rebellion against the virginity rule. Still others may choose it to please their future husband. Hymen ‘repair’ is extensively discussed in MENA countries and in Europe. Feminists in MENA countries are divided over whether the surgery promotes sexual autonomy while, in the European debate, an important issue is whether the choice itself is an autonomous one that doctors should respect. Inspired by a relational approach to autonomy, I see the women involved as individuals with culturally informed identities and interests who may feel pressure to get the surgery yet are still capable of autonomy. I argue for a policy to stimulate debate in communities about the virginity norm and to make hymen ‘repair’ available to women. However, it should be combined with an attitude of sympathetic distrust, recognising that hymen ‘repair’ harms women’s dignity and authenticity.

Technologized Talk

In this study, the authors examine patient use of and feelings about wearable technologies for health attainment and management. Based on an online survey of 81 patients using wearable technologies to track and manage health, as well as interviews with three patients utilizing wearables for health management, the authors examine how wearable technologies are being used by patients to attain health, manage health, and/or prevent health issues, and what value users find in these wearable technologies. The authors also examine how such use is impacting communication between medical professionals and patients. Specifically, the authors explore how the inclusion of wearable technologies has changed the “rhetorical relationship” between patients and medical professionals. The study concludes with a discussion of the future of wearable devices in patient-medical practitioner relationships and clinical settings.