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

The Effects of Strength and Conditioning on Functional Movement Screen™ Scores in Secondary School Basketball.

Purpose: Injury prevention and mitigation are among the primary responsibilities of Athletic Trainers. Research has indicated that basketball players at the secondary-school level suffer up to 2.1 time loss injuries (TLI) per 1,000 athletic exposures (AE). It has been suggested that Functional Movement Screen (FMS™) composite and individual task scores may help determine injury risk. Researchers have suggested that a variety of strength and conditioning strategies may positively alter both composite and individual FMS™ task scores and reduce movement asymmetry. Methods: During a retrospective analysis of the records of all junior varsity and varsity basketball players at one secondary school over one season, no TLI was recorded over 1900 AE following the implementation of team-specific strength and conditioning programming. Results: Significant increases in pre-season and post-season composite FMS™ scores (pre-season mean = 14.33 ± 1.84; post-season mean = 16.44 ± 1.72; p \u3c 0.001), and FMS™ individual task scores; deep squat (DS) (p \u3c 0.001), hurdle step (HS) (p = 0.002), in-line lunge (INL) (p = .011), active straight leg raise (ASLR) (p = .02), and rotatory stability (RS) (p = .005) were noted across 27 male and female participants. Among females, composite FMS™ scores changed significantly (pre-season mean = 14.92 ± 1.38; post-season mean = 17.00 ± 1.04; p \u3c 0.001), as did HS (p \u3c 0.001) and INL (p = .025). Among males, significant changes were noted in composite FMS™ scores (pre-season mean = 13.87 ± 2.07; post-season mean = 16.00 ± 2.04; p \u3c 0.001), as well as DS (p = 0.007), and RS (p = .025). Reductions in the number of scores of one and movement asymmetries were also evident during post-season FMS™ screening. Conclusions: Emphasizing movement competency and strength and conditioning training has positive effects on injury risk reduction in secondary school basketball players

Demand-Side Threats to Power Grid Operations from IoT-Enabled Edge

The growing adoption of Internet-of-Things (IoT)-enabled energy smart appliances (ESAs) at the consumer end, such as smart heat pumps, electric vehicle chargers, etc., is seen as key to enabling demand-side response (DSR) services. However, these smart appliances are often poorly engineered from a security point of view and present a new threat to power grid operations. They may become convenient entry points for malicious parties to gain access to the system and disrupt important grid operations by abruptly changing the demand. Unlike utility-side and SCADA assets, ESAs are not monitored continuously due to their large numbers and the lack of extensive monitoring infrastructure at consumer sites. This article presents an in-depth analysis of the demand side threats to power grid operations including (i) an overview of the vulnerabilities in ESAs and the wider risk from the DSR ecosystem and (ii) key factors influencing the attack impact on power grid operations. Finally, it presents measures to improve the cyber-physical resilience of power grids, putting them in the context of ongoing efforts from the industry and regulatory bodies worldwide

Democratising data to address health system inequities in Australia

Understanding the health status of a population or community is crucial to equitable service planning. Among other uses, data on health status can help local and national planners and policy makers understand patterns and trends in current or emerging health and well-being, especially how disparities relating to geography, ethnicity, language and living with disability influence access to services. In this practice paper we draw attention to the nature of Australia’s health data challenges and call for greater ‘democratisation’ of health data to address health system inequities. Democratisation implies the need for greater quality and representativeness of health data as well as improved access and usability that enable health planners and researchers to respond to health and health service disparities efficiently and cost-effectively. We draw on learnings from two practice examples, marred by inaccessibility, reduced interoperability and limited representativeness. We call for renewed and urgent attention to, and investment in, improved data quality and usability for all levels of health, disability and related service delivery in Australia

Homonegativity, Substance Use, Sexual Risk Behaviors, and HIV Status in Poor and Ethnic Men Who Have Sex with Men in Los Angeles

This study evaluates associations between internalized homonegativity and demographic factors, drug use behaviors, sexual risk behaviors, and HIV status among men who have sex with men (MSM) and with men and women (MSM/W). Participants were recruited in Los Angeles County using respondent-driven sampling (RDS) and completed the Internalized Homonegativity Inventory (IHNI) and questionnaires on demographic and behavioral factors. Biological samples were tested for HIV and for recent cocaine, methamphetamine, and heroin use. The 722 MSM and MSM/W participants were predominantly African American (44%) and Hispanic (28%), unemployed (82%), homeless (50%), and HIV positive (48%) who used drugs in the past 6 months (79.5%). Total and Personal Homonegativity, Gay Affirmation, and Morality of Homosexuality IHNI scores were significantly higher for African American men than for other ethnicities, for MSM/W than for MSM, for recent cocaine users than for recent methamphetamine users, and for HIV-seronegative men than for HIV-seropositive men. Linear regression showed the Gay Affirmation scale significantly and inversely correlated with the number of sexual partners when controlling for effects of ethnicity/race and sexual identification, particularly for men who self-identified as straight. Highest IHNI scores were observed in a small group of MSM/W (n = 62) who never tested for HIV. Of these, 26% tested HIV positive. Findings describe ways in which internalized homophobia is a barrier to HIV testing and associated HIV infection and signal distinctions among participants in this sample that can inform targeted HIV prevention efforts aimed at increasing HIV testing

A novel emergency department based prevention intervention program for people living with HIV: evaluation of early experiences

<p>Abstract</p> <p>Background</p> <p>HIV prevention is increasingly focused on people living with HIV (PLWH) and the role of healthcare settings in prevention. Emergency Departments (EDs) frequently care for PLWH, but do not typically endorse a prevention mission. We conducted a pilot exploratory evaluation of the first reported ED program to address the prevention needs of PLWH.</p> <p>Methods</p> <p>This retrospective observational cohort evaluation reviewed program records to describe the first six months of participants and programmatic operation. Trained counselors provided a risk assessment and counseling intervention combined with three linkage interventions: i) linkage to health care, ii) linkage to case management, and iii) linkage to partner counseling and referral.</p> <p>Results</p> <p>Of 81 self-identified PLWH who were approached, 55 initially agreed to participate. Of those completing risk assessment, 17/53 (32%, 95 CI 20% to 46%) reported unprotected anal/vaginal intercourse or needle sharing in the past six months with a partner presumed to be HIV negative. Counseling was provided to 52/53 (98%). For those requesting services, 11/15 (73%) were linked to healthcare, 4/23 (17%) were coordinated with case management, and 1/4 (25%) completed partner counseling and referral.</p> <p>Conclusion</p> <p>Given base resources of trained counselors, it was feasible to implement a program to address the prevention needs for persons living with HIV in an urban ED. ED patients with HIV often have unmet needs which might be addressed by improved linkage with existing community resources. Healthcare and prevention barriers for PLWH may be attenuated if EDs were to incorporate CDC recommended prevention measures for healthcare providers.</p

Determinants and gaps in preventive care delivery for Indigenous Australians: a cross-sectional analysis

Background: Potentially preventable chronic diseases are the greatest contributor to the health gap between Aboriginal and Torres Strait Islander peoples and non-­Indigenous Australians. Preventive care is important for earlier detection and control of chronic disease, and a number of recent policy initiatives have aimed to enhance delivery of preventive care. We examined documented delivery of recommended preventive services for Indigenous peoples across Australia and investigated the influence of health center and client level factors on adherence to best practice guidelines. Methods: Clinical audit data from 2012 to 2014 for 3,623 well adult clients (aged 15–54) of 101 health centers from four Australian states and territories were analyzed to determine adherence to delivery of 26 recommended preventive services classified into five different modes of care on the basis of the way in which they are delivered (e.g., basic measurement; laboratory tests and imaging; assessment and brief interventions, eye, ear, and oral checks; follow-up of abnormal findings). Summary statistics were used to describe the delivery of each service item across jurisdictions. Multilevel regression models were used to quantify the variation in service delivery attributable to health center and client level factors and to identify factors associated with higher quality care. Results: Delivery of recommended preventive care varied widely between service items, with good delivery of most basic measurements but poor follow-up of abnormal findings. Health center characteristics were associated with most variation. Higher quality care was associated with Northern Territory location, urban services, and smaller service population size. Client factors associated with higher quality care included age between 25 and 34 years, female sex, and more regular attendance. Conclusion: Wide variation in documented preventive care delivery, poor follow-up of abnormal findings, and system factors that influence quality of care should be addressed through continuous quality improvement approaches that engage stakeholders at multiple levels (including, for example, access to care in the community, appropriate decision support for practitioners, and financial incentives and context appropriate guidelines)