Emergency physicians’ occupational risks in China

With the rapid development of emergency medicine,emergency physicians are working around the clock,[1]including additional workloads due to sudden public health emergencies and disasters.Occupational risks for emergency physicians are significantly high due to an increasing number of patients with acute and severe diseases,an increased workload.

Professionalism education of OB/GYN resident physicians: What makes a difference?

Objective: The aim of this study was to evaluate the efficacy of a new Professionalism curriculum in an Obstetrics and Gynecology (OB/GYN) residency after introducing Narrative Medicine and Professional Development/Support Group (PDSG) programs. Methods: 32 OB/GYN residents participated in this IRB approved pilot study. Twenty residents were assessed with the Barry Challenges to Professionalism Questionnaire (Barry), the Jefferson Scale of Empathy-Physician Version (JSE), and the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration (JSAT) in August 2010, as controls. Five Narrative Medicine sessions and four PDSG sessions were then used from August 2010-May 2011, for resident physician professionalism education. Seventeen residents then underwent post-testing with the Barry, JSE, and JSAT in May 2011. Results: The pre-test/post-test Barry comparison showed an improvement in scores after introduction of the new Narrative Medicine and PDSG curriculum (7.6 +/- 2.1 versus 8.4 +/- 1.6;p = 0.10) though this was not statistically significant. Pre-test/post-test comparison of JSAT scores showed a statistically significant decline in collaboration (52.3 +/- 4.1 versus 49.7 +/- 3.7;p = 0.028) while JSE scores showed a downward trend in empathy (109.3 +/- 10.0 versus 104.8 +/- 9.2;p = 0.086). Conclusion: Narrative Medicine and PDSG small group sessions could be an effective component of OB/GYN resident physician Professionalism curriculum. This pilot project was underpowered, due to limited resources.

Comparison of posttraumatic growth and posttraumatic stress of nurses with physicians and medical students after caring of COVID‑19 patients

Objectives:The present study compared the prevalence and psychosocial factors affecting posttraumatic growth(PTG),posttraumatic stress disorder(PTSD),and psychological distress in nurses,physicians,and medical students.Materials and Methods:In a cross‑sectional study,three groups of medical staff including nurses(n=57),physicians(n=40),and medical students(n=34)who were responsible for the care/treatment of COVID‑19 patients admitted to a general hospital for 4 months responded to Posttraumatic Growth Inventory,Brief Symptom Inventory‑18,Resilience Questionnaire,PTSD Screen,and Social Capital‑Integrated Questionnaire.Results:After the exposure of medical staff to at least 4 months of treatment/care of COVID‑19 patients,PTG prevalence was higher than PTSD(38.2%vs.14.6%),but they experienced some degrees of psychological distress(65.5%).The nurses had 8.33(confidence interval[CI]:2.5–26.7)times higher PTG rate than medical students(P<0.001).Physicists also experienced 5.00(CI:1.4–26.7)times higher PTG than medical students(P<0.001).PTG was aided by age,married status,strong resilience,and high social capital,but gender had no influence.Resilience played an important protective role to prevent the incidence of psychological distress in nurses,medical students,and physicians.Conclusion:Despite the fact that the PTSD and psychological distress were same in the three groups of medical staff,the nurses had a greater rate of PTG than physicians and medical students.

Compliance of Physicians with Standard Precautions of Handling Patients with Infectious Respiratory Disease

Background: Standard precautions (SPs) are the minimum infection prevention practices that aim to protect Health care workers (HCWs) including physicians and prevent them from transmitting the infections to their patients. Purpose: To assess the level of compliance of physicians with standard precautions of handling patients with infectious respiratory disease. Method: A cross sectional questionnaire-based study was conducted in two tertiary level hospitals named M Abdur Rahim Medical College and Hospital, Dinajpur, Bangladesh and Rajshahi Medical College and Hospital, Rajshahi, Bangladesh to assess the level of compliance of physicians with standard precautions. Purposive sampling technique was applied as per inclusion criteria and data was collected by face to face interview from 285 physicians. Statistical analysis of the results was done by SPSS and a p value less than 0.05 was considered as significant. Result: The study revealed that maximum physicians (76.5%) handling patients with infectious respiratory disease had a moderate level of compliance with standard precautions. 78.6% of the physicians had moderate level of awareness about standard precautions. Only 20.35% of the physicians had training on infection control. 94.4% of the respondents didn’t know the component of standard precaution and most of the physicians were not aware of the sequence of wearing and removing the different components of PPEs. Conclusion: The study result implies that with increased awareness, the compliance of the physicians with standard precautions increased. The main reasons of non-compliance with standard precautions were found to be lack of resources, lack of regular training and excess workload.

Occurrence of Boerhaave's syndrome after diagnostic colonoscopy:what else can emergency physicians do?

Dear editor,Boerhaave’s syndrome is a barogenic tear of the esophagus,typically at the gastroesophageal junction,caused by a sudden increase in intraluminal pressure in the distal esophagus.[1]In recent years,the number of Boerhaave’s syndrome cases has increased,and a growing proportion of clinicians have recognized this rare but life-threatening disease.

Adjuvant therapy for hormone receptor-positive breast cancer: Perspective from a survey on breast cancer physicians' acceptance of practice-changing data

A cross-sectional online survey was conducted.A high proportion of the Chinese breast cancer(BC)physician respondents(n=77)would prescribe extended adjuvant endocrine therapy(AET)with aromatase inhibitors(AI)beyond 5 years for postmenopausal females with BC,especially those with higher risk.Respondents with≥15 years of clinical experience were more likely to prescribe a longer duration of AET for low-risk patients.Half of the respondents considered intermittent letrozole as an acceptable option.Most respondents would prescribe adjuvant chemotherapy to genomic high-intermediate risk[Oncotype DX recurrence score(RS)21-25]females aged≤50 years regardless of the clinical risk classification.

Views of South Asian Physicians on Climate Related Health Effects: A Multinational Cross-Sectional Pilot Study

Background: South Asian populations are vulnerable to poor health outcomes associated with climate due to the region’s complex topography, poverty, lack of education, and population density. Physicians, being highly trusted members of society, can help mitigate climate change effects in their countries. Objectives: The present study assessed perceptions of physicians from four South Asian countries (Bangladesh, Bhutan, India, and Pakistan). We hypothesized that physicians from these countries will be aware and knowledgeable about health effects of climate change. Methods: We conducted a cross-sectional online survey of physicians between March and July 2022. Data of 201 physicians was analyzed using the Kruskal-Wallis test and Dunn’s post hoc method. Results: Physicians from four South Asian countries were attuned to the health risks associated with climate change. A majority of physicians (86.6%) believed that climate change would make health conditions in their countries more severe or frequent (Bangladesh 83.3%;Bhutan 70%;India 91% and Pakistan 90.8%). The most common health effect related to climate change was illnesses related to reduced outdoor air quality (54.3%). Common barriers to discuss climate change with patients from all four countries were physicians’ lack of knowledge (strongly agree, 13.8%;agree 47.7%) in how to approach the issue with patients, lack of time (strongly agree, 12%;agree, 48%) and their perception that patients were not interested in knowing about climate change (strongly agree, 8.6%;agree, 42.6%). More than half (56.2%) of the physicians reported no training (Bangladesh, 51.7%;Bhutan, 80%;India, 44.6%;Pakistan, 63.1%) and approximately 30% reported less than 20 hours of training (Bangladesh, 28.3%;Bhutan, 15.0%;India, 39.3%;Pakistan, 27.7%) in climate-change-related health effects. Conclusion: While additional large-scale research is needed to understand the trends observed in our pilot study, our findings identify the need to introduce interventions to improve physicians’ knowledge of the health impacts of climate crisis.

Underrecognition and un-dertreatment of stress-related psychiatric disorders in physicians:Determinants,challenges,and the impact of the COVID-19 pandemic

Medical practitioners’duties are highly stressful and performed in a particularly challenging and competitive work environment.Stress and burnout among physicians have emerged as a worldwide public health problem in recent years.A high level of distress and burnout can lead to clinically significant behavioral health problems,such as stress-related psychiatric disorders.Mounting evidence shows that physicians have higher risks of insomnia,anxiety,and depression than the general population,especially during the coronavirus disease 2019 pandemic.However,the behavioral health problems of these vulnerable healthcare professionals are noteworthy for being underrecognized and undertreated.In this minireview,we summarize the current progress of studies on the prevalence and determinants of distress and stress-related psychiatric disorders among physicians and their healthcare-seeking behaviors.We discuss future research directions and the clinical approach that may maximize self-awareness and promote prompt and adequate treatment for clinically significant behavioral health problems of physicians.

Study of Resistance to Stress and Burnout among Public Health Professionals: The Case of Nurses and Physicians at Ibn Sina Hospital in Rabat Morocco

Occupational stress presents a major public health problem. It is the subject of many works in Morocco and in the world. Our work focuses on the study of stress resistance among nurses and physicians working in services at Ibn Sina Hospital in Rabat, Morocco. The aim of this study is to analyze the relationship between resistance status, burnout and level of psychological distress. A self-questionnaire is provided to all respondents. It includes questions about socio-demographic and professional, clinical, also neuropsychological tests such as the stress resistance test (CTRS), the burnout scale (MBI) and the general health questionnaire (GHQ12). This study shows that 42% of nurses and physicians have a high level of emotional exhaustion, high level of depersonalization affects 49% of nurses and physicians and subjects with low professional achievement account for 67% and 54% of nurses and physicians suffer from psychological distress. The stress test reveals that 88% of subjects have a low or moderate level of stress resistance and only 12% have good resistance. Thus, our study sheds new light on the understanding of stress at work by using new measurement and evaluation methods such as TRS, with the aim of reducing or eliminating the impact of occupational stress in hospitals.

Quantitative assessment of the impact of a triage physician on the Accreditation Council for Graduate Medical Education resident milestones in the emergency department

The “door-to-doctor” time for patients to be seen by a physician is an increasingly studied metric.Hospitals may shorten this time by implementing a triage physician (TP).The exact role of a TP may vary across departments.TPs put in preliminary orders for lab work,imaging,and treatment,and decide treatment location for further evaluation.As the prevalence of TPs grows,its effect on resident education in academic emergency departments (EDs) remains unclear.We implemented a TP in the spring of 2016 and assessed resident physicians before and after implementation.

An approach to the development of the humanistic capacities of physicians

Introduction There is growing interest in the need for a deeper integration of the human aspects of health care in the curriculum of physicians.The student during his training starts from the basic sciences(physics,chemistry,physiology,pathophysiology,etc.)and later goes to the clinical symptoms and the patient;that is,for example,they first learn about the glucose molecule,then the clinical entity of diabetes and finally the diabetic patient.

Community Needs Assessment for a Professional University Health Counselling Course in Cambodia

Developing health and counselling professionals remains an important part of supporting mental health services in Cambodia.This paper aims to identify how the key stakeholders and mental health experts in Cambodia consider how a university level health counselling course could contribute to addressing the needs/treatment gap for mental health services in Cambodia.In order to do this,the study consists of semi-structured interviews with stakeholders,community needs assessment,and community resource mapping.The data were drawn from 15 NGOs,various profit and not-for-profit organizations as well as two key government stakeholders.The participants were invited to take part in a stakeholders/expert semi-structured interview that lasted between 30-60 minutes at the participants’organizations.The findings revealed that all participants believe that a university level health counseling course was crucial in Cambodia to address pressing mental health issues in the country.Most participants believed that a graduate or post-graduate level program such as a B.A.or M.A.was necessary to train qualified counsellors.The program should be internationally benchmarked,with a Cambodian context.Topics should include psychopathology,professional ethics and competencies,counselling theories and interventions,trauma treatment,as well as emotional intelligence and addiction.Other topics might need to include parenting,support system for suicidal patients,self-care,staff wellbeing programs,and school counselor programs.

Comparative Perception of Pharmacovigilance by Physicians versus Paramedical Professions in Ivory Coast

Objective: To assess the perception of pharmacovigilance by healthcare professionals practicing at the University Teaching Hospital of Cocody (Ivory Coast) in 2017. Methodology: A descriptive and analytic cross-sectional survey has been conducted in 2017 at the University Teaching Hospital of Cocody. This survey involved a sample of healthcare professionals practicing in 17 services who are prescribing medications and gave their oral consent. Results: A response rate of 54.08% (106/196) among physicians versus 43.87% (86/196) for the nurses and 27.61% (21/76) for the mid-wives. 57.94% (62/107) of paramedics versus 94.33% (100/106) of physicians had already heard about pharmacovigilance, during their basic training (40.18% of paramedics versus 73.58% of doctors). However, the main obstacles to the practice of pharmacovigilance were it teaching hours considered insufficient (94.39% of paramedics versus 75.47% of physicians), the lack of knowledge on the location of the pharmacovigilance unit (80.37% of paramedics versus, 40% of physicians) and the reporting of the adverse drug reactions to a hierarchical supervisor (60.60% of paramedics versus 37.25% of physicians). A regular visit of pharmacovigilance monitors in the hospital services (34.57% of paramedics versus 29.24% of physicians) and the availability of reporting forms (30.84% of paramedics versus 27.35% of physicians) could improve the perception of pharmacovigilance by the healthcare professionals. Conclusion: Our investigational survey has highlighted some factors that may influence the perception of pharmacovigilance by the healthcare professionals in Ivory Coast.

Experience of Mental Health Professionals Collaborating with Peer Supporters in a Community Mental Health Service Team

This study explored how mental health professionals collaborate with peer supporters with mental disabilities in a community mental health institution.From January 19 to February 23,2021,three 60 min interviews were conducted with six mental health professionals working at a Korean community center.The results were qualitatively analyzed and divided into four themes and eight categories.The four themes were the perceptions of and challenges in working with peer supporters with mental disabilities,conflict and confusion about working with peer supporters,forming partnerships with peer supporters,and policy support for peer supporters’job security.Participants reported vague anxiety about working with a peer supporter and difficulties with the trial-and-error process of adjusting to the role as challenging.Over time,however,they realized that they needed to make an effort to develop meaningful relationships with peer supporters and mental health professionals.Thus,through this study,we realized that there was a need to improve the system,such as building infrastructure for job stability for peer support workers and capacity building tailored to the mental disorders.Although peer supporters play various roles while working with mental health professionals,this study showed the possibility of mutual growth through communication and cooperation.These findings will help prepare systems necessary for collaboration between the two teams amidst the increasing institutionalization of peer support for mental disorders.

Innovation and Practice of Training Mode for Professional Postgraduates of Acupuncture and Tuina Based on Artificial Intelligence

In view of the common problems of integrating artificial intelligence into the training of postgraduates in Acupuncture and Tuina major,this paper reviews the related research progress both at home and abroad.It puts forward the innovative reform paths for integrating artificial intelligence into postgraduate training mode of Acupuncture and Tuina major:construct the teaching staff of artificial intelligence graduate students;innovating artificial intelligence to promote the integration of classics and scientific research;constructing the ideological and political case base of artificial intelligence courses;implementing artificial intelligence platform blended teaching;building a domestic and foreign exchange platform for artificial intelligence.Through practical research in teaching,it has achieved good teaching results and played a good demonstration,leading and radiation role in similar majors in China.

The Emergence of Loving Pedagogy in the L2 Affective Domain:How Affective Pedagogy Accounts for Chinese EFL Teachers’Professional Success and Job Satisfaction?

The success of teachers in professional environments has a desirable influence on their mental condition.Simply said,teachers’professional success plays a crucial role in improving their mental health.Due to the invaluable role of professional success in teachers’mental health,personal and professional variables helping teachers succeed in their profession need to be uncovered.While the role of teachers’personal qualities has been well researched,the function of professional variables has remained unknown.To address the existing gap,the current investigation measured the role of two professional variables,namely job satisfaction and loving pedagogy,in Chinese EFL teachers’professional success.To do this,three validated scales were provided to 1591 Chinese EFL teachers.Participants’answers to the questionnaires were analyzed using the Spearman correlation test and structural equation modeling.The data analysis demonstrated a strong,positive link between the variables.Moreover,loving pedagogy was found to be the positive,strong predictor of Chinese EFL teachers’job satisfaction and professional success.The findings of the current inquiry may help educational administrators enhance their instructors’professional success,which in turn promotes their mental and psychological conditions at work.

Research and Practice on the Construction of Professional Cluster in Application-Oriented Local Undergraduate Universities:Taking Environ-mental Chemical Engineering Professional Cluster in Pingdingshan University as an Example

Based on the analysis of the importance of professional cluster construction by ecological theory,with the change of social demand for talents,this paper explores the practice of environmental chemical professional cluster construction in Pingdingshan University,including gradually perfecting teaching conditions and reforming teaching mode,breaking through the limitations of resources,integrating the boundaries of colleges and departments,integrating multiple resources,innovating systems and mechanisms,reconstructing professional clusters,decon-structing professional connotations,reorganizing curriculum systems,etc.,in order to better build the ecological chain network of education in application-oriented colleges and universities,realize the deep integration of industry and education,train future-oriented interdisciplinary applied talents of new engineering,and realize the construction of characteristic professional cluster in application-oriented colleges.

Review and update on the management of triangular fibrocartilage complex injuries in professional athletes

Triangular fibrocartilage complex injuries are common in amateur and professional sports.These injuries are mainly caused by acute or chronic repetitive axial loads on the wrist,particularly on the ulnar side and in association with rotations or radial/ulnar deviations.In order to treat professional athletes,a detailed specific knowledge of the pathology is needed.Moreover,the clinician should fully understand the specific and unique environment and needs of the athletes,their priorities and goals,the type of sport,the time of the season,and the position played.An early diagnosis and appropriate management with the quickest possible recovery time are the uppermost goals for both the athlete and the surgeon.A compromise between conservative vs surgical indications,athletes’needs and expectations,and financial implications should be achieved.Arthroscopic procedures should be timely planned when indicated as they could allow early diagnosis and treatment at the same time.Conservative measures are often used as first line treatment when possible.Peripheral lesions are treated by arthroscopic repair,whilst central lesions are treated by arthroscopic debridement.Further procedures(such as the Wafer procedure,ulnar osteotomies,etc.)have specific indications and great implications with regard to rehabilitation.

Professional Development of Rural PE Teachers from the Perspective of PCK:A Case Study of Huaiji County

Based on the four dimensions of PCK,this paper investigates the professional development of rural PE teachers in Huaiji County by using the research methods of literature,questionnaire,interview and mathematical statistics.Based on PCK related theories,this paper analyzes the current situation of professional development of rural PE teachers in Huaiji County,explores the problems existing in the process of professional development,and provides an optimal path for the professional development of rural PE teachers,so as to improve the teaching ability and classroom quality of rural PE teachers,and promote the further development of rural PE education under the background of new curriculum reform.Through the research,it is found that the shortcomings of rural PE teachers are:lack of situational knowledge;lack of understanding of the course content;not flexible use of teaching representation;low ability to identify the differences of students learning styles;lack of understanding of social environment,etc.

Profile of Factors of Arduous Work among Healthcare Professionals in Healthcare Facilities in Northern Benin in 2021

Introduction: Work environments create the basis for arduous nursing work. This is what led us to research the factors of arduousness in the exercise of the health profession in North Benin, through this study. Methods: This is a cross-sectional and descriptive study which focused on health professionals in the health zones of Parakou-N’dali and Tchaourou. The sampling was an exhaustive census. All health workers who had given their free and informed consent were included. The data was collected using a questionnaire. The variables studied were the factors of arduous work and socio-professional characteristics. The data collected was processed and analyzed with the Epi info 7.2.0.1 software. Results: A total of 692 were surveyed, the participation rate was 85.11% and the sex ratio (M/F) equal to 0.7. The average age was 38 years old. Nurses made up 32.66% of the sample. They were 86.42% subject to night work and 82.66% to alternating work. Overall, 70.23% worked more than 40 hours per week. Between 78.12% and 96.46% of non-specialist doctors, nurses, midwives and biomedical analysis technicians were required to work night shifts. Nurses, midwives, radiology and laboratory technicians were between 89.53% and 97.35%, organized in alternating work. In the sample, 55.20% complained about the insufficient number of work materials, 26.29% handled harmful chemical substances. Among those surveyed, 58.14% had been attacked. Conclusion: All professional categories of caregivers are subject to arduous work. Measures are needed to reverse the situation.