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Burnout, job satisfaction, and intention to leave among midwives in Western Switzerland: The role of caseload and hospital-based practice models.
Full text linkBackground Burnout and job dissatisfaction among midwives compromise healthcare quality and workforce retention. Practice models, such as hospital-based versus caseload models, may influence midwives' well-being and warrant further exploration. Aim To examine the association between midwifery practice models (caseload vs. hospital) and burnout, job satisfaction, and the intention to leave the profession among midwives in Western Switzerland. Method A cross-sectional survey was conducted with 392 midwives, using the Copenhagen Burnout Inventory to assess personal, work-related, and patient-related burnout. Multivariable logistic regression explored associations between practice models and burnout levels, job satisfaction, as well as retention in the profession. Main results Hospital midwives were over nine times more likely than caseload midwives to experience moderate to high work-related burnout (OR = 9.18, p < .001) and were 80 % less likely to report above average job satisfaction (OR = 0.21, p < .001), considering differences between socio-demographic and practice-related factors between the two groups of midwives. Nearly half of all hospital-based participants expressed an intention to leave compared to one in three caseload midwives. Higher burnout and lower job satisfaction were linked to intentions to leave the profession. Discussion and conclusion Caseload models may protect midwives' well-being and promote job satisfaction and retention. These findings highlight the critical need for practice model changes and structural reforms in hospital midwifery, incorporating caseload principles, to support sustainable maternal and child healthcare in Western Switzerland and retain a resilient midwifery workforce
Molecular regulation of mammalian proteasomal degradation in therapy-resistant cancer cells
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Efficacy of Air Powder Water‐Jet Devices in Cleaning Implant Surfaces in a Non‐Surgical Peri‐Implantitis Treatment Simulation—A Laboratory Study
Full text linkObjective To evaluate the impact of implant surface and instrumentation time on the efficacy of two air powder water-jet (APWJ) devices in cleaning the implant surface in a simulation of non-surgical peri-implantitis treatment. Materials and methods Turned and modified surface implants (28 each) were coated with a biofilm imitation and mounted on resin models replicating peri-implant intra-osseous defects, including a soft tissue replica. The entire implant periphery was instrumented for 5 or 15s per implant sextant (i.e., in total 30 or 90s per implant), with one of two different APWJ devices using either a glycine or an erythritol powder. Residual biofilm imitation was automatically assessed on standardized photographs and expressed as percentage of the exposed implant surface. Results Implant surface (ε2:0.253, p < 0.001) and instrumentation time (ε2:0.044, p = 0.036) had a moderate and small effect, respectively, on the outcome, that is, instrumenting turned compared to modified surface implants as well as using a longer compared to a shorter instrumentation time resulted in less residual biofilm imitation. Complete biofilm imitation removal was achieved only in four turned implants, treated for 15s per sextant. Every second turned implant presented with a maximum of 5% residual biofilm imitation, while only two modified implants achieved this level of cleanliness. Conclusion In a non-surgical peri-implantitis treatment simulation with APWJ devices, superior biofilm imitation removal was achieved at turned implants, and a longer instrumentation time resulted in less residual biofilm imitation. Modified implants had high chances of incomplete biofilm imitation removal, especially at the apical part of the defect. Complete biofilm imitation removal was in general largely unpredictable
Phase-Resolved Functional Lung MRI Evaluation of Dynamic Hyperinflation Induced by Metronome-Paced Tachypnea in Patients with Chronic Obstructive Pulmonary Disease.
Full text linkHyperinflation in chronic obstructive pulmonary disease (COPD) patients worsens on exertion/exercise when breathing frequency increases. Fast breathing, paced at 40 breaths per minute using a metronome (metronome-paced tachypnea, MPT), induces dynamic hyperinflation (DH) and can be performed during MRI. MPT in combination with phase-resolved functional lung (PREFUL) MRI can be used to assess stress-driven ventilation dynamics globally and regionally. A 90 s time series of one coronal slice centered to the trachea was acquired for PREFUL MRI during 60 s of resting tidal breathing (RTB) and 30 s of MPT at 40 breaths per minute in COPD patients and healthy volunteers. MPT detected DH in 12 out of 15 COPD patients and in 1 out of 15 healthy controls. During MPT, the global fractional ventilation decreased by 20% in healthy subjects (p = 0.01) and by 48% in COPD patients (p < 0.001). The end-expiratory lung area remained stable in healthy subjects and increased significantly by 7% in COPD patients over the course of MPT (p = 0.004). Younger, healthy volunteers adapted to increase breathing frequency by reducing tidal volume (global fractional ventilation), while older healthy volunteers showed less tidal volume reduction (p = 0.036). The MPT-induced change of regional ventilation homogeneity (flow volume loop cross-correlation, FVL-CCMPT/RTB) increased with age in healthy volunteers (p = 0.039) likely due to the development of compensatory dystelectasis in younger volunteers leading to reduced homogeneity during MPT. In the future, the MPT test during MR imaging may be used for COPD treatment analysis and disease monitoring
Newsletter der Klinik für Plastische, Ästhetische, Hand- und Wiederherstellungschirurgie: Ausgabe Juni / 2025
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Data CTE project.xlsx
No full textData concerning the following project/manuscript: Rodrigo Moraga-Amaro, Oscar Moreno, Jordi Llop, Marion Bankstahl, Jens P. Bankstahl Biomarkers for prediction of chronic traumatic encephalopathy-like pathology following repeated mild traumatic brain injury in rats are sex- and age-dependent Introduction. Repeated mild traumatic brain injuries (rmTBI) pose a high risk for developing chronic traumatic encephalopathy (CTE). Since this neurodegenerative disease is diagnosed only post-mortem, new biomarkers for early detection are needed. Although age at injury and biological sex are important factors in many brain pathologies, little is known about their relevance for rmTBI-induced CTE-like consequences. Hence, this study explored how biological sex and age at time of impact affect progression and changes in biomarker candidates after experimental rmTBI. Methods. Rats of both sexes, aged 7-weeks (adolescent) or 14-weeks (adult), were subjected to three mTBI at 5-day intervals. Neurological, behavioural and cognitive impairments, as well as changes in potential plasma and brain biomarkers, were assessed up to 12-weeks post-injury. The generalized estimating equation model was used to compare sexes and age groups. Results. RmTBI induced ongoing neurological impairment. While no depressive-like behaviour was observed, long-term, age-specific changes in anxiety were observed after rmTBI. A short-term increase in plasma p-tau was found after rmTBI only in male and adolescent rats. Plasma neuron-specific enolase (NSE) levels were elevated in adolescent animals at both 2-weeks and 12-weeks post-rmTBI. An increase in brain neurofibrillary tangles (NFT) was detected 12-weeks after rmTBI. Correlation analyses suggested NSE as a prospective biomarker for anhedonia-like behaviour, and brain NFT as an indicator of neurological impairment. Discussion. We found that behavioural outcomes and biomarker changes following rmTBI in rats were both age- and sex-dependent. This information will help to develop translatable diagnostics to guide CTE treatment in clinical settings. Data were acquired at MHH by Rodrigo Moraga-Amaro et al
Distinct clusters of bacterial and fungal microbiota in end-stage liver cirrhosis correlate with antibiotic treatment, intestinal barrier impairment, and systemic inflammation.
Full text linkDecompensated liver cirrhosis (dLC) is associated with intestinal dysbiosis, however, underlying reasons and clinical consequences remain largely unexplored. We investigated bacterial and fungal microbiota, their relation with gut barrier integrity, inflammation, and cirrhosis-specific complications in dLC-patients. Competing-risk analyses were performed to investigate clinical outcomes within 90 days. Samples were prospectively collected from 95 dLC-patients between 2017 and 2022. Quantitative metagenomic analyses clustered patients into three groups (G1-G3) showing distinct microbial patterns. G1 (n = 39) displayed lowest diversity and highest Enterococcus abundance, G2 (n = 24) was dominated by Bifidobacteria, G3 (n = 29) was most diverse and clustered most closely with healthy controls (HC). Of note, bacterial concentrations were significantly lower in cirrhosis compared with HC, especially for G1 that also showed the lowest capacity to produce short chain fatty acids and secondary bile acids. Consequently, fungal overgrowth, dominated by Candida spp. (51.63%), was observed in G1. Moreover, G1-patients most frequently received antibiotics (n = 33; 86.8%), had highest plasma-levels of Zonulin (p = 0.044) and a proinflammatory cytokine profile along with numerically higher incidences of subsequent infections (p = 0.09). In conclusion, distinct bacterial clusters were observed at qualitative and quantitative levels and correlated with fungal abundances. Antibiotic treatment significantly contributed to dysbiosis, which translated into intestinal barrier impairment and systemic inflammation
