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International Journal of Medical... Jun 2024To assess the workplace drivers of professional fulfilment, burnout and perceived impact of workplace issues on wellbeing in doctors working in a regional Australian...
OBJECTIVE
To assess the workplace drivers of professional fulfilment, burnout and perceived impact of workplace issues on wellbeing in doctors working in a regional Australian hospital, following a 6-month period of comprehensive workforce nurturing strategies.
METHODS
An online cross-sectional survey combined both qualitative feedback and quantitative measures of wellbeing including the Stanford Professional Fulfillment Index to assess professional fulfillment and burnout and a workplace issues inventory to assess the relative perceived influence on work-related wellbeing.
RESULTS
Survey responses from 124 doctors comprised approximately 60% (n=74) prevocational doctors, 12% (n=15) registrars and 28% (n=35) specialist doctors. Around 63% (n=78) of participants were international medical graduates. Overall, 25% (n=31) reported professional fulfilment and 13% (n=13) reported burnout. The top 6 workplace issues were (i) inefficient work practices and/or processes, (ii) medical officer vacancies in my department, (iii) inadequate support staff and/or excessive admin burden, (iv) inadequate workplace staff amenities, (v) poor access to nutritious onsite food, (vi) inability to access my entitled daily meal break. Factors perceived as having a minimal impact on wellbeing included learning opportunities, rostering, access to leave and support during challenging clinical situations, were directly related to the workforce nurturing strategies implemented.
CONCLUSIONS
This comprehensive evaluation of wellbeing in a regional healthcare setting provides a novel contribution to the literature by illustrating the transformative potential of workforce nurturing. Notably, the findings reflect the potential impact of workforce nurturing upon professional fulfilment and burnout, in the context of a regional hospital setting.
Topics: Humans; Burnout, Professional; Cross-Sectional Studies; Australia; Physicians; Male; Female; Job Satisfaction; Workplace; Adult; Surveys and Questionnaires; Middle Aged
PubMed: 38879880
DOI: 10.5116/ijme.6639.1a23 -
BMC Psychology Jun 2024Social media (SM), with its addictive nature and the accompanying psychosocial challenges such as stress, anxiety, and depression, is the primary factor exacerbating...
OBJECTIVE
Social media (SM), with its addictive nature and the accompanying psychosocial challenges such as stress, anxiety, and depression, is the primary factor exacerbating mental health problems and adversely impacting individuals' wellbeing. Our study's goal was to determine how SM affects employees' psychosocial behaviours and assess the various factors that contributed to the employee's excessive use of SM.
METHODS
A cross-sectional correlational analysis was conducted. Using a relevant questionnaire on employees, the study was assessed to establish the relationship or association between SM addiction and psychosocial disorders like depression, anxiety, and stress. 200 people with a minimum age of 24 were enrolled in the study. The questionnaire contained the social networking addiction scale (SNAS) and the depression, anxiety, and stress-21 (DASS-21) scales; the data were statistically assessed.
RESULTS
The association between SM addiction and psychosocial behaviours has been examined using statistical tools including descriptive statistics and the Chi-square analysis. SM addiction has a strong, statistically significant correlation with depression (p = 0.001), stress (p = 0.001), and anxiety (p = 0.001).
CONCLUSION
This study discovered a connection between SM use and depression, stress, and anxiety among working employees, raising questions regarding worries about overuse and addiction to SM. Various factors influencing excessive usage included revealed that employees also majorly over used SM for entertainment, boredom avoidance, constant knowledge sharing, and relationship-building.
Topics: Humans; Male; Adult; Female; Cross-Sectional Studies; Depression; Anxiety; Social Media; Stress, Psychological; Internet Addiction Disorder; Young Adult; Surveys and Questionnaires; Behavior, Addictive; Middle Aged
PubMed: 38879545
DOI: 10.1186/s40359-024-01850-2 -
BMC Neurology Jun 2024The application of cerebellar transcranial magnetic stimulation (TMS) in stroke patients has received increasing attention due to its neuromodulation mechanisms.... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The application of cerebellar transcranial magnetic stimulation (TMS) in stroke patients has received increasing attention due to its neuromodulation mechanisms. However, studies on the effect and safety of cerebellar TMS to improve balance capacity and activity of daily living (ADL) for stroke patients are limited. This systematic review and meta-analysis aimed to investigate the effect and safety of cerebellar TMS on balance capacity and ADL in stroke patients.
METHOD
A systematic search of seven electronic databases (PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Wanfang and Chinese Scientific Journal) were conducted from their inception to October 20, 2023. The randomized controlled trials (RCTs) of cerebellar TMS on balance capacity and/or ADL in stroke patients were enrolled. The quality of included studies were assessed by Physiotherapy Evidence Database (PEDro) scale.
RESULTS
A total of 13 studies involving 542 participants were eligible. The pooled results from 8 studies with 357 participants showed that cerebellar TMS could significantly improve the post-intervention Berg balance scale (BBS) score (MD = 4.24, 95%CI = 2.19 to 6.29, P < 0.00001; heterogeneity, I = 74%, P = 0.0003). The pooled results from 4 studies with 173 participants showed that cerebellar TMS could significantly improve the post-intervention Time Up and Go (TUG) (MD=-1.51, 95%CI=-2.8 to -0.22, P = 0.02; heterogeneity, I = 0%, P = 0.41). The pooled results from 6 studies with 280 participants showed that cerebellar TMS could significantly improve the post-intervention ADL (MD = 7.75, 95%CI = 4.33 to 11.17, P < 0.00001; heterogeneity, I = 56%, P = 0.04). The subgroup analysis showed that cerebellar TMS could improve BBS post-intervention and ADL post-intervention for both subacute and chronic stage stroke patients. Cerebellar high frequency TMS could improve BBS post-intervention and ADL post-intervention. Cerebellar TMS could still improve BBS post-intervention and ADL post-intervention despite of different cerebellar TMS sessions (less and more than 10 TMS sessions), different total cerebellar TMS pulse per week (less and more than 4500 pulse/week), and different cerebellar TMS modes (repetitive TMS and Theta Burst Stimulation). None of the studies reported severe adverse events except mild side effects in three studies.
CONCLUSIONS
Cerebellar TMS is an effective and safe technique for improving balance capacity and ADL in stroke patients. Further larger-sample, higher-quality, and longer follow-up RCTs are needed to explore the more reliable evidence of cerebellar TMS in the balance capacity and ADL, and clarify potential mechanisms.
Topics: Humans; Transcranial Magnetic Stimulation; Activities of Daily Living; Postural Balance; Stroke Rehabilitation; Cerebellum; Stroke; Randomized Controlled Trials as Topic
PubMed: 38879485
DOI: 10.1186/s12883-024-03720-1 -
Biological Psychology Jun 2024Proprioceptive accuracy (PAc), i.e., the acuity of perception of the state of different parts of the motor system, shows substantial intraindividual differences, and is...
Proprioceptive accuracy (PAc), i.e., the acuity of perception of the state of different parts of the motor system, shows substantial intraindividual differences, and is often considered a general ability. However, it is questionable whether there is an association between accuracies measured with different tests at different body sites. With the participation of 87 young individuals with regular physical activity, PAc with respect to both knee and elbow joints (joint position reproduction) and the flexors of the upper arms (weight discrimination) was measured with multiple indices. Expected and perceived performance was also assessed for each behavioral task. Frequentist and Bayesian analysis largely supported the idea that PAc with respect to various parts of the motor system are unrelated. No dominant-subdominant differences for actual performance were found; however, PAc for the dominant and subdominant limb were associated in many cases. Finally, perceived performance was related to expected but not to actual performance for all three proprioceptive modalities. In conclusion, actual accuracy of perception of the actual state of a part (i.e., joint, muscle) of the motor system cannot be generalized to other parts. Perceived accuracy, dominantly shaped by expectations, is independent from actual accuracy.
PubMed: 38878953
DOI: 10.1016/j.biopsycho.2024.108829 -
BMC Psychology Jun 2024Although postgraduate studies have been shown to be associated with stressful experiences, students reading programmes through the distance and e-learning mode...
BACKGROUND
Although postgraduate studies have been shown to be associated with stressful experiences, students reading programmes through the distance and e-learning mode experience greater levels of stress due to several reasons. These stressful encounters might be heightened in female married postgraduates on distance education programmes due to other family-work-related engagements. This study investigated the stress-related experiences and intentions to quit studies among female married students on a distance education programme in Ghana.
METHODS
Using a sequential explanatory mixed-methods design, 164 married postgraduate distance education students were sampled to participate by responding to a questionnaire. Follow-up interviews were conducted with 10 participants to offer insight into the quantitative findings. Quantitative data were analysed using descriptive statistics, including frequency and percentages, while the qualitative data were thematically analysed.
RESULTS
Stress was prevalent among the female married distance education students, with the majority having intentions of quitting their studies. The stressors identified ranged from personal (i.e., work and family demands) to institutional ones (i.e., academic load, unresolved complaints and high financial demands from the programme).
CONCLUSIONS
Key findings suggest that female married postgraduate distance education students perform multiple roles as full-time employees with family and academic demands that can negatively impact their health and academic work. Implications and recommendations of the findings are discussed.
Topics: Humans; Female; Ghana; Adult; Stress, Psychological; Education, Distance; Young Adult; Intention; Students; Surveys and Questionnaires; Marriage; Education, Graduate
PubMed: 38877581
DOI: 10.1186/s40359-024-01839-x -
BMC Women's Health Jun 2024Endometriosis affects 10-15% of women of reproductive age and is considered a critical gynecological problem. Endometriosis causes pain and infertility, both of which...
BACKGROUND
Endometriosis affects 10-15% of women of reproductive age and is considered a critical gynecological problem. Endometriosis causes pain and infertility, both of which can impair the patient's quality of life. Sleep disorders account for the most bothersome presentation of impaired quality of life. This study investigated the frequency and severity of sleep disorders in women with endometriosis.
METHODS
In this analytical cross-sectional study, 665 women referred to three hospitals in Tehran, Rasool-e-Akram, Pars, and Nikan, were included (463 patients with endometriosis and 202 women without endometriosis). All of them were informed about the study design and the aim of the research, and then they were asked to sign the consent form and complete the Pittsburgh Sleep Quality Index (PSQI). After data gathering and entering, they were analyzed by SPSS version 22 and were considered significant with P < 0.05.
RESULTS
The study population's mean age was 35.4 ± 7.9 years. The mean global PSQI score in the case group (endometriosis patients) was higher than in the control group (non-endometriosis patients) (10.6 vs. 7.1; P < 0.001). Patients with dyspareunia, dysuria, pelvic pain, and dyschezia had a significantly higher PSQI score (P < 0.05).
CONCLUSION
According to the findings of the present study, the sleep quality in endometriosis patients is low, and there is a need to pay greater attention to these patients. This may result in some changes in the therapeutic strategies for this disease.
Topics: Humans; Female; Endometriosis; Cross-Sectional Studies; Adult; Sleep Wake Disorders; Iran; Pelvic Pain; Quality of Life; Dyspareunia; Surveys and Questionnaires; Middle Aged; Severity of Illness Index; Sleep Quality
PubMed: 38877485
DOI: 10.1186/s12905-024-03185-x -
BMC Palliative Care Jun 2024Clinical evidence for the rapidity and effectiveness of fentanyl buccal soluble film (FBSF) in reducing pain intensity of breakthrough cancer pain (BTcP) remains...
BACKGROUND
Clinical evidence for the rapidity and effectiveness of fentanyl buccal soluble film (FBSF) in reducing pain intensity of breakthrough cancer pain (BTcP) remains inadequate. This study aimed to evaluate the efficacy of FBSF proportional to the around-the-clock (ATC) opioid regimens in rapidly relieving the intensity of BTcP episodes by determining the percentage of patients requiring further dose titration.
METHODS
The study procedure included a dose-finding period followed by a 14-day observation period. Pain intensity was recorded with a Numeric Rating Scale (NRS) at onset and 5, 10, 15, and 30 min after FBSF self-administration. Meaningful pain relief was defined as the final NRS score ≤ 3. Satisfaction survey was conducted for each patient after treatment using the Global Satisfaction Scale.
RESULTS
A total of 63 BTcP episodes occurred in 30 cancer patients. Only one patient required rescue medication at first BTcP episode and then achieved meaningful pain relief after titrating FBSF by 200 µg. Most BTcP episodes relieved within 10 min. Of 63 BTcP episodes, 30 (47.6%), 46 (73.0%), and 53 (84.1%) relieved within 5, 10, and 15 min after FBSF administration. Only grade 1/2 adverse events were reported, including somnolence, malaise, and dizziness. Of the 63 BTcP episodes, 82.6% were rated as excellent/good satisfaction with FBSF.
CONCLUSION
FBSF can be administrated "on demand" by cancer patients at the onset of BTcP, providing rapid analgesia by achieving meaningful pain relief within 10 min.
TRIAL REGISTRATION
This study was retrospectively registered 24 December, 2021 at Clinicaltrial.gov (NCT05209906): https://clinicaltrials.gov/study/NCT05209906 .
Topics: Humans; Fentanyl; Female; Male; Breakthrough Pain; Middle Aged; Analgesics, Opioid; Aged; Administration, Buccal; Adult; Pain Measurement; Cancer Pain; Pain Management; Neoplasms; Aged, 80 and over
PubMed: 38877477
DOI: 10.1186/s12904-024-01483-7 -
Scientific Reports Jun 2024Sound transmission to the human inner ear by bone conduction pathway with an implant attached to the otic capsule is a specific case where the cochlear response depends...
Sound transmission to the human inner ear by bone conduction pathway with an implant attached to the otic capsule is a specific case where the cochlear response depends on the direction of the stimulating force. A finite element model of the temporal bone with the inner ear, no middle and outer ear structures, and an immobilized stapes footplate was used to assess the directional sensitivity of the cochlea. A concentrated mass represented the bone conduction implant. The harmonic analysis included seventeen frequencies within the hearing range and a full range of excitation directions. Two assessment criteria included: (1) bone vibrations of the round window edge in the direction perpendicular to its surface and (2) the fluid volume displacement of the round window membrane. The direction of maximum bone vibration at the round window edge was perpendicular to the round window. The maximum fluid volume displacement direction was nearly perpendicular to the modiolus axis, almost tangent to the stapes footplate, and inclined slightly to the round window. The direction perpendicular to the stapes footplate resulted in small cochlear responses for both criteria. A key factor responsible for directional sensitivity was the small distance of the excitation point from the cochlea.
Topics: Humans; Temporal Bone; Bone Conduction; Finite Element Analysis; Cochlea; Vibration; Round Window, Ear; Stapes; Models, Biological; Acoustic Stimulation
PubMed: 38877090
DOI: 10.1038/s41598-024-64377-x -
Nature Communications Jun 2024Spatial attention is critical for recognizing behaviorally relevant objects in a cluttered environment. How the deployment of spatial attention aids the hierarchical...
Spatial attention is critical for recognizing behaviorally relevant objects in a cluttered environment. How the deployment of spatial attention aids the hierarchical computations of object recognition remains unclear. We investigated this in the laminar cortical network of visual area V4, an area strongly modulated by attention. We found that deployment of attention strengthened unique dependencies in neural activity across cortical layers. On the other hand, shared dependencies were reduced within the excitatory population of a layer. Surprisingly, attention strengthened unique dependencies within a laminar population. Crucially, these modulation patterns were also observed during successful behavioral outcomes that are thought to be mediated by internal brain state fluctuations. Successful behavioral outcomes were also associated with phases of reduced neural excitability, suggesting a mechanism for enhanced information transfer during optimal states. Our results suggest common computation goals of optimal sensory states that are attained by either task demands or internal fluctuations.
Topics: Visual Cortex; Attention; Male; Animals; Macaca mulatta; Photic Stimulation; Visual Perception; Neurons
PubMed: 38877026
DOI: 10.1038/s41467-024-49144-w -
Nature Communications Jun 2024Living organisms synchronize their biological activities with the earth's rotation through the circadian clock, a molecular mechanism that regulates biology and behavior...
Living organisms synchronize their biological activities with the earth's rotation through the circadian clock, a molecular mechanism that regulates biology and behavior daily. This synchronization factually maximizes positive activities (e.g., social interactions, feeding) during safe periods, and minimizes exposure to dangers (e.g., predation, darkness) typically at night. Beyond basic circadian regulation, some behaviors like sleep have an additional layer of homeostatic control, ensuring those essential activities are fulfilled. While sleep is predominantly governed by the circadian clock, a secondary homeostatic regulator, though not well-understood, ensures adherence to necessary sleep amounts and hints at a fundamental biological function of sleep beyond simple energy conservation and safety. Here we explore sleep regulation across seven Drosophila species with diverse ecological niches, revealing that while circadian-driven sleep aspects are consistent, homeostatic regulation varies significantly. The findings suggest that in Drosophilids, sleep evolved primarily for circadian purposes. The more complex, homeostatically regulated functions of sleep appear to have evolved independently in a species-specific manner, and are not universally conserved. This laboratory model may reproduce and recapitulate primordial sleep evolution.
Topics: Animals; Sleep; Drosophila; Species Specificity; Circadian Rhythm; Biological Evolution; Homeostasis; Circadian Clocks; Male; Female
PubMed: 38876988
DOI: 10.1038/s41467-024-49501-9