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Stress From Uncertainty and Resilience Among Depressed and Burnt Out Residents: Cross-Sectional Study
No full textObjective: To determine how stress from uncertainty is related to resilience among pediatric residents and whether these attributes are associated with depression and burnout.
Study Design and Setting: Cross-sectional study of 50 residents in pediatric residency programs from four urban freestanding children’s hospitals in the United States and Canada.
Main outcome measures: Stress from uncertainty using the Physicians’ Reaction to Uncertainty Scale, resilience using the 14-item Resilience Scale, depression using the Harvard national depression screening scale, and burnout using single item measures of emotional exhaustion and depersonalization from the Maslach Burnout Inventory.
Results: There was a strong correlation between stress from uncertainty and resilience (r=-0.597; p<0.00001). 5 residents (10%) met the criteria for depression and 15 residents (31%) met the criteria for high burnout. Depressed residents were more likely to be stressed by uncertainty (mean 51.6; SD 9.07 vs. mean 38.7; SD 6.73; p=0.0003) and to lack resilience (mean 56.6; SD 10.7 vs. mean 85.4; SD 7.97; p<0.0001) compared to residents who were not depressed. Burnt out residents were also more likely to be stressed by uncertainty (mean 44; SD 8.46 vs. mean 38.3; SD 7.13; p=0.0186) and to lack resilience (mean 76.7; SD 14.8 vs. mean 85.0; SD 9,77; p=0.0242) compared to residents who were not burnt out. We were able to identify the scores at which stress from uncertainty best predicts depression and burnout.
Conclusion: Depression and burnout are major problems among pediatric residents. We found strong correlations between stress from uncertainty, resilience, depression, and burnout. Efforts to enhance tolerance of uncertainty and resilience among residents may provide opportunities to mitigate resident depression and burnout.resilience; uncertainty; depression; burnout; pediatric
Burnout in medicine: A novel approach exploring the impact of uncertainty and the use of biomarkers as a measurement tool
Full text linkBurnout constitutes a significant challenge for healthcare organisations not only in respect to individual wellbeing but also in terms of the catastrophic downstream implications to patient safety, patient satisfaction, and quality of care. This DPhil, divided into three parts, aims to explore burnout in healthcare professionals, an accelerating phenomenon that is hotly discussed but minimally understood, with a focus on the impact uncertainty has and an exploration into the novel use of neurohormones as potential biomarkers of wellbeing.
Part I: Exploration of concepts: burnout and uncertainty.
Chapter 1 presents a selective overview of the broad context of burnout in healthcare, reporting existing literature on the impact of burnout—to physicians, to patients, and to healthcare organisations—and considering the challenges that pertain to burnout research, particularly relating to challenges in measurement. Chapter 2 explores the presence of uncertainty in the healthcare environment looking at what impacts an individual’s tolerance of uncertainty and how the reaction affects provider- and patient-centred outcomes. Chapters 3 and 4 present two observational studies exploring drivers of satisfaction at work for faculty in an academic medical centre, with an analysis of the interplay between burnout and uncertainty in the clinical environment. Chapter 5 presents a study that looks at how language used in clinical hand-over affects sense of uncertainty in the receiving clinician, demonstrating how language variation can influence emotional perception of uncertainty.
Part II: Exploration of biology: exploration into use of biomarkers to measure burnout.
Chapters 6 and 7 explore the novel use of cortisol and oxytocin levels as potential biomarkers of stress and burnout in clinical faculty at a large teaching hospital.
Part III: Exploration of interventions to reduce burnout and strategies to embrace uncertainty.
Chapter 8 presents an interprofessional intervention study looking to reduce burnout through self-facilitated groups meeting monthly for three months. This study re-affirms the importance of the findings presented in this thesis and points to the need for more interventions aimed at enhancing trainee and faculty wellbeing. Chapter 9 synthesises current literature on tolerance of uncertainty alongside findings of the thesis, self-experience, and experience of colleagues and students in a narrative review to identify strategies to help clinicians thrive in the face of clinical uncertainty.
Finally, Chapter 10 presents an overview of the key findings from each study, their methodological strengths and limitations, directions for future research, and implications for clinical training, the measurement of wellbeing initiatives, and patient care
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A Global Health Curriculum at King Saud University Medical College- a Needs Assessment
No full textBackground: Global Health is an emerging field in medicine that has been introduced in many medical colleges across the world but still does not exist in Saudi Arabia’s undergraduate medical education curricula.
Objective: To carry out a needs assessment that evaluates students’ and faculty’s perceptions about introducing a Global Health Curriculum at King Saud Medical College in Riyadh, Saudi Arabia.
Methods: This paper is a cross-sectional mixed methods study that took place at King Saud University and involved a student survey (n=600) and 10 faculty interviews. A 17 item survey was emailed to 4th and 5th year medical students. Faculty interviews, consisting of 4 open-ended questions, were conducted electronically. Faculty members belonged to the Medical Education and Community Medicine departments. The survey results were used to make a connection with the qualitative data.
Results: 253/600 students completed the survey (42% response rate). 83% (210) of the students endorsed the introduction of a Global Health course while 17% (43) said they didn’t.
Half of the students 51% (129) endorsed the course as an elective, and 32% (81) as a compulsory course.
The faculty encouraged the introduction of a global health curriculum; acknowledging its benefits and stating the barriers that need to be overcome.
Conclusion: Students at King Saud Medical College are interested in a Global Health curriculum. By learning from other universities who have preceded us in this field, faculty noted the benefits of such a curriculum a expressed interest in introducing it.Master of Medical Sciences in Medical Educatio
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
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