Relationships between work satisfaction, emotional exhaustion and mental health among Swiss primary care physicians

Background: Work-related satisfaction is an important determinant of quality of care. However, its relationship with doctors' mental health is poorly understood. It could have an independent beneficial effect on mental health (direct association) or simply reduce the impact of work stress on mental health (moderating or ‘buffering' role). Methods: One thousand seven hundred and thirty-two Swiss primary care physicians (824 board-certified generalists, 436 general internists, 162 paediatricians, 147 internal medicine specialists and 163 physicians without specialty qualification) completed a mailed questionnaire. Previously, validated instruments were used to measure mental health (SF-12), emotional exhaustion [Maslach Burnout Inventory (MBI)] and work-related satisfaction. Linear regression models with mental health as dependant variable were used to study the relationships between these variables. Differences in mental health scores were standardized to represent a one standard deviation (SD) difference in the other scales [standardized beta coefficients (SBC)]. Results: In multivariate analyses, higher levels of mental health were found in respondents with higher work-related satisfaction with current income and social prestige (SBC 1.04) and professional relations (SBC 0.57), and in respondents with lower emotional exhaustion (SBC −4.98) and higher personal accomplishment scores (SBC 1.72). Interaction terms between these dimensions of work-related satisfaction and emotional exhaustion were significant, supporting a ‘buffering' role of these dimensions. Conclusion: Work-satisfaction with current income, social prestige and professional relations are important correlates of mental health among primary care physicians, as well as emotional exhaustion. Higher levels of these dimensions of work-related satisfaction seems to mitigate the relationship between emotional exhaustion and physicians' mental healt

Use of tobacco and alcohol by Swiss primary care physicians: a cross-sectional survey

BACKGROUND: Health behaviours among doctors has been suggested to be an important marker of how harmful lifestyle behaviours are perceived. In several countries, decrease in smoking among physicians was spectacular, indicating that the hazard was well known. Historical data have shown that because of their higher socio-economical status physicians take up smoking earlier. When the dangers of smoking become better known, physicians began to give up smoking at a higher rate than the general population. For alcohol consumption, the situation is quite different: prevalence is still very high among physicians and the dangers are not so well perceived. To study the situation in Switzerland, data of a national survey were analysed to determine the prevalence of smoking and alcohol drinking among primary care physicians. METHODS: 2'756 randomly selected practitioners were surveyed to assess subjective mental and physical health and their determinants, including smoking and drinking behaviours. Physicians were categorised as never smokers, current smokers and former smokers, as well as non drinkers, drinkers (AUDIT-C < 4 for women and < 5 for men) and at risk drinkers (higher scores). RESULTS: 1'784 physicians (65%) responded (men 84%, mean age 51 years). Twelve percent were current smokers and 22% former smokers. Sixty six percent were drinkers and 30% at risk drinkers. Only 4% were never smokers and non drinkers. Forty eight percent of current smokers were also at risk drinkers and 16% of at risk drinkers were also current smokers. Smoking and at risk drinking were more frequent among men, middle aged physicians and physicians living alone. When compared to a random sample of the Swiss population, primary care physicians were two to three times less likely to be active smokers (12% vs. 30%), but were more likely to be drinkers (96% vs. 78%), and twice more likely to be at risk drinkers (30% vs. 15%). CONCLUSION: The prevalence of current smokers among Swiss primary care physicians was much lower than in the general population in Switzerland, reflecting that the hazards of smoking are well known to doctors. However, the opposite was found for alcohol use, underlining the importance of making efforts in this area to increase awareness among physicians of the dangers of alcohol consumption

Le phénomène d'hypohaptoglobinémie comme indicateur épidémiologique du paludisme

Le phénomène Hp 0, décrit tout d'abord par les généticiens, est principalement rencontré dans les régions du monde où le paludisme sévit de manière endémique. Sa relation étroite avec cette affection et ses variations d'une fréquence et d'une amplitude considérables le désignait comme un indicateur épidémiologique potentiel. Les études réalisée au Mali, en zone soudano-sahélienne de méso-endémie palustre, ont permis de mieux définir les liens qui existent entre le phénomène Hp 0 et le paludisme, et de tester sa valeur d'indicateur en le comparant aux indicateurs paludométriques classiques. Un indice Hp a été défini de manière à disposer d'un outil de travail épidémiologique comparable aux indices parasitaires et sérologiques

Nouveautés du Plan vaccinal suisse 2019 : Sept nouvelles recommandations et implications pratiques pour les praticiens

Le Plan de vaccination 2019 comprend sept nouveautés: 1) la vaccination DTPa-IPV-Hib-HBV chez le nourrisson avec le schéma simplifié à « 2+1 » doses; 2) la recommandation de la vaccination contre la rougeole, les oreillons et la rubéole (ROR) à 9 et 12 mois; 3) la vaccination contre les pneumocoques chez les enfants de moins de 5 ans comme recommandation de base; 4) le remplacement du vaccin conjugué monovalent contre le méningocoque C par le vaccin conjugué quadrivalent ACWY (Menveo); 5) l'élargissement de la vaccination contre l'encéphalite à tique verno-estivale (FSME) à tout le territoire suisse, à l'exception des cantons de Genève et du Tessin, chez les sujets présentant un facteur de risque d'exposition; 6) le remplacement de Gardasil par Gardasil 9 depuis janvier 2019 et 7) la recommandation de la vaccination contre l'hépatite B pour les nourrissons

Seroprevalence of the SARS-CoV-2 virus in the population of the southern Switzerland (Canton Ticino) – cohort study, results at 12 months

AIMS OF THE STUDY: A new emerging severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first identified in Wuhan, China, in December 2019 and then spread rapidly, causing a global pandemic. In Europe, the first case was identified in Italy on 21 February 2020, in the Lombardy region bordering on the southern part of Switzerland (Canton Ticino), where 4 days later the first case was identified . Ticino was the most affected canton in Switzerland during the first wave of pandemic. In order to provide a reliable indicator for the spread of the virus in this region and help decision making at the public health level, a seroprevalence study of SARS-CoV-2 was conducted. METHODS: A cohort study was implemented on a randomly selected sample of 1500 persons. The sample is representative of the general population of the Canton of Ticino, stratified by sex and age from 5 years old.  Antibodies against the SARS-CoV-2 nucleocapsid protein were detected using a rapid qualitative test in 4 data collection periods over the course of 12 months (from May–June 2020 to May–June 2021). RESULTS: The seroprevalence of SARS-CoV-2 was estimated at 9.0% in spring 2020 (weeks 20–26), 8.4% in summer 2020 (weeks 32–38), 14.1% in autumn 2020 (weeks 45–52) and 22.3% in spring 2021 (weeks 18–23). In none of these four phases was evidence of an association between sex or specific age groups and presence of anti-SARS-CoV-2 antibodies detected. For risk factors, the only strong and significant association found was with diabetes in the first three data collection periods but not in the fourth. Among people who participated in all four phases of the study and tested positive anti-SARS-CoV-2 antibodies in the first test, 61.8% were still positive even in the fourth, 12 months later. CONCLUSIONS: The results support the hypothesis that, after one year and despite the severe burden in terms of hospitalisations and deaths experienced by the Canton Ticino, SARS-CoV-2 infection affected only a minority of the population (20%) and also suggest that the anti-nucleocapsid antibodies persist after 12 months in the majority of infected persons