Factors underlying burnout among rural village physicians in Southwestern China

Background:Primary healthcare doctors in China often experience problems with occupational burnout,a condition known to relate to high job stress and low wages.In China,many medical alliances have recently been established in rural areas,where village physicians work as healthcare gatekeepers.However,burnout in village physicians in the context of medical alliances remains underresearched.Methods:This cross-sectional survey was conducted among 100 village physicians practicing at village clinics in Qiandongnan prefecture,Guizhou province,China.An online questionnaire was distributed to assess physicians'demographic characteristics and work situations.Burnout was measured using the Oldenburg Burnout Inventory(validated Chinese version).A multivariate linear model with stepwise procedure was used to estimate the effects of factors of interest on burnout,focusing particularly on actions within the medical alliance that involved respondents'clinics,such as training and support for village physicians provided by higher-level facilities.Results:The overall response rate was 79%.The mean burnout score was 38.09(standard deviation,4.55;range,25–47).The multivariate analysis showed that fewer working years and too much farming work were significantly related to exacerbation of burnout.Greater medical services in the total workload and greater support from higher-level facilities were associated with burnout alleviation.Conclusion:Close connections and interactions across medical alliance member facilities could facilitate reduction in burnout for village physicians practicing as primary care gatekeepers.

Bioinspired Rotation Microneedles for Accurate Transdermal Positioning and Ultraminimal-Invasive Biomarker Detection with Mechanical Robustness

Microneedle permits transdermal biosensing and drug delivery with minor pain.However,accurate microneedle transdermal positioning with minimal skin deformation remains a significant technical challenge due to inhomogeneous skin topology and discontinuous force applied to the microneedle.Here,we introduce bioinspired rotation microneedles for in vivo accurate microneedle positioning as inspired by honeybees’stingers.We demonstrate the benefits of rotation microneedles in alleviating skin resistance through finite element analysis,full-thickness porcine validations,and mathematical derivations of microneedleskin interaction stress fields.The max penetration force was mitigated by up to 45.7%and the force attenuation rate increased to 2.73 times in the holding stage after penetration.A decrease in max skin deflection and a faster deformation recovery introduced by rotation microneedles implied a more precise penetration depth.Furthermore,we applied the rotation microneedles in psoriasis mice,a monogenic disorder animal model,for minimally invasive biological sample extraction and proinflammatory cytokine monitoring.An ultrasensitive detection method is realized by using only one microneedle to achieve cytokine mRNA level determination compared to commonly required biopsies or blood collection.Thus,rotation microneedles permit a simple,rapid,and ultraminimal-invasive method for subcutaneous trace biological sample acquisition and subsequent point-of-care diagnostics with minimal damage to both microneedles and skins.