Burnout, stress and resilience of an Australian regional hospital during COVID-19: a longitudinal study

Abstract Coronavirus disease 2019 (COVID-19) has placed huge strain on hospital staff around the world. The aim of the current longitudinal study was to investigate the resilience, stress and burnout of hospital staff located at a large, regional hospital in Victoria, Australia during the COVID-19 pandemic over time via cross-sectional surveys. The surveys were disseminated six times from August 2020 to March 2021, with the first three data collection points distributed during a state-wide lockdown. A total of 558 responses from various professional roles within the hospital over the survey period were included in the sample. Analysis of variance indicated significant main effects for the psychological variables across time, age, and workload. Hospital staff reported an increase in burnout levels throughout the eight-months. Significant negative relationships were observed between resilience and burnout, and between resilience and stress. A backward regression highlighted the contribution of resilience, stress, age, and nursing roles on burnout. Hierarchical regression analysis indicated that resilience contributed to the stress-burnout relationship. This study strengthens the evidence between resilience and burnout among healthcare workers and hospital staff and highlights the need for psychological wellbeing programs to be implemented for hospital staff impacted by a prolonged worldwide pandemic

COVID-19 exposure and diagnosis among college student drinkers: links to alcohol use behavior, motives, and context

The COVID-19 pandemic is a public health crisis. College student alcohol use is highly prevalent and primarily occurs in social settings where risk for COVID-19 transmission is heightened. This study explored the associations between alcohol use frequency, quantity, motives, and context with: (i) quarantine due to COVID-19 exposure and (ii) a positive diagnosis for COVID-19. A sample of n = 409 college student drinkers completed an online survey about their health and behaviors during the Fall 2020 semester. Since the start of the semester, 36% of students quarantined and 13% of students received a COVID-19 diagnosis. More frequent alcohol use was associated with increased odds of both quarantine and COVID-19 diagnosis. More frequent drinking for social motives was associated with increased likelihood of quarantine, and more frequent drinking for conformity motives was associated with increased likelihood of COVID-19 diagnosis. Participants who often drank alone or with a small group of friends were about half as likely to have quarantined, while those who often drank with a large group of friends were almost twice as likely to have quarantined. Participants who often drank in a bar or nightclub had almost three times the odds of a COVID-19 diagnosis. Frequent alcohol use and drinking for social and conformity motives and in certain contexts are linked to increased likelihood of COVID-19 exposure and diagnosis. Alcohol use prevention efforts, coupled with messaging to discourage large social gatherings in public places, might help to mitigate the spread of COVID-19 among college students

Randomised trial of cord clamping at very preterm birth: outcomes at 2 years

Objective: To report outcomes at 2 years corrected age for children of women recruited to a trial comparing alternative policies for timing of cord clamping and immediate neonatal care at very preterm birth. Design: Parallel group randomised (1:1) trial. Setting: Eight UK tertiary maternity units. Participants: Two hundred and seventy six babies born to 261 women expected to have a livebirth before 32+0 weeks gestation. Interventions: Deferred cord clamping (≥2 minutes) and immediate neonatal care with cord intact, or immediate (≤20 seconds) clamping and immediate neonatal care after clamping. Main outcome measure: Composite of death or adverse neurodevelopmental outcome at 2 years corrected age. Results: Six babies born after 35+6 weeks were excluded. At 2 years corrected age, outcome data were not available for a further 52 children, leaving 218 for analysis (115 deferred clamping, 103 immediate clamping). Overall, 24/115 (21%) children allocated deferred clamping died or had an adverse neurodevelopmental outcome compared with 35/103 (34%) allocated immediate clamping; relative risk (RR) 0.61 (95% confidence interval [CI] 0.39 to 0.96); risk difference (RD) -13% (95% CI -25% to -1%). Multiple imputation for missing data gave a RR 0.69 (95% CI 0.44 to 1.09) and RD -9% (95% CI -21% to 2%). Conclusions: Deferred clamping and immediate neonatal care with cord intact may reduce the risk of death or adverse neurodevelopmental outcome at 2 years of age for children born very premature. Confirmation in larger studies is needed to determine the real benefits and harms

Scientific Knowledge Networks in Peripheral Regions and Local Innovation Systems: The Case of Chemistry in the State of Bahia

Scientific production and technological innovation growth in Brazil are not homogeneous in its different regions despite its public policies. The same phenomenon can be observed within the states of the Brazilian Federation. This article examines the diffusion of scientific expertise in six public institutions of science and technology in the state of Bahia between 2004 and 2008. The state is the largest in the north-east of Brazil, an area marked by a semi-arid climate and a low human development index; however, it has a large chemical and petrochemical complex. This article, focusing on the scientific field of chemistry, is based on foundations of innovation and knowledge management, as well as social network analysis, aiming to examine relations between scientific production and institutional, structural and relational characteristics of inter- and intra-institutional scientific knowledge networks. The results show that public policies on science, technology and innovation regarding the peripheral regions need to be rethought

Access and utilisation of reproductive, maternal, neonatal and child health services among women who inject drugs in coastal Kenya:findings from a qualitative study

Introduction The Kenyan government has committed to increasing access to comprehensive reproductive, maternal, neonatal and child health (RMNCH) services. However, inequalities still exist. Women who inject drugs are an important sub-population for public health interventions, yet their RMNCH needs have largely been overlooked. Additionally, there is a lack of research to inform RMNCH interventions for this sub-population. Methods In 2015, we undertook interviews and focus group discussions with 45 women who inject drugs and five key stakeholders to understand these women’s RMNCH experiences and needs. Results Women’ access to essential services across the RMNCH continuum was low. Two thirds of the women were not using contraception. Many discovered they were pregnant late, due to amenorrhea of drug use, and thus were unable to enroll for antenatal care early. Facility-based deliveries were limited with many choosing to deliver at home. Following delivery, women’s attendance to immunization services was sub-optimal. Stigma from healthcare workers was a major factor impeding women’s use of existing RMNCH services. The prospect of experiencing withdrawals at health facilities where waiting times were long, deterred utilization of these services. Additionally, women faced competing priorities, having to choose between purchasing heroin or spending their money on health-related costs. Conclusions Several barriers disrupted women’s access to services across the RMNCH continuum. Consequently, there is a need to develop equitable, comprehensive, and family-centered RMNCH interventions tailored to women who inject drugs, through a combination of supply- and demand-side interventions. For optimal impact, RMNCH services should be integrated into harm reduction programs

A regioselectively 1, 1',3 ,3'-tetrazincated ferrocene complex displaying core and peripheral reactivity

Regioselective 1,1′,3,3′-tetrazincation [C-H to C-Zn(tBu)] of ferrocene has been achieved by reaction of a fourfold excess of di-t-butylzinc (tBu2Zn) with sodium 2,2,6,6-tetramethylpiperidide (NaTMP) in hexane solution manifested in the trimetallic iron-sodium-zinc complex [Na4(TMP)4Zn4(tBu)4{(C5H3)2Fe}], 1. X-ray crystallographic studies supported by DFT modelling reveal the structure to be an open inverse crown in which two [Na(TMP)Zn(tBu)Na(TMP)Zn(tBu)]2+ cationic units surround a {(C5H3)2Fe}4- tetraanion. Detailed C6D6 NMR studies have assigned the plethora of 1H and 13C chemical shifts of this complex. It exists in a major form in which capping and bridging TMP groups interchange, as well as a minor form that appears to be an intermediate in this complicated exchange phenomenon. Investigation of 1 has uncovered two distinct reactivities. Two of its peripheral t-butyl carbanions formally deprotonate toluene at the lateral methyl group to generate benzyl ligands that replace these carbanions in [Na4(TMP)4Zn4(tBu)2(CH2Ph)2{(C5H3)2Fe}], 2, which retains its tetrazincated ferrocenyl core. Benzyl-Na π-arene interactions are a notable feature of 2. In contrast, reaction with pyridine affords the crystalline product {[Na·4py][Zn(py∗)2(tBu)·py]}∞, 3, where py is neutral pyridine (C5H5N) and py∗ is the anion (4-C5H4N), a rare example of pyridine deprotonated/metallated at the 4-position. This ferrocene-free complex appears to be a product of core reactivity in that the core-positioned ferrocenyl anions of 1, in company with TMP anions, have formally deprotonated the heterocycle

COMPOSE-HPC: A Transformational Approach to Exascale

The goal of the COMPOSE-HPC project is to 'democratize' tools for automatic transformation of program source code so that it becomes tractable for the developers of scientific applications to create and use their own transformations reliably and safely. This paper describes our approach to this challenge, the creation of the KNOT tool chain, which includes tools for the creation of annotation languages to control the transformations (PAUL), to perform the transformations (ROTE), and optimization and code generation (BRAID), which can be used individually and in combination. We also provide examples of current and future uses of the KNOT tools, which include transforming code to use different programming models and environments, providing tests that can be used to detect errors in software or its execution, as well as composition of software written in different programming languages, or with different threading patterns