Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Estimating global injuries morbidity and mortality : methods and data used in the Global Burden of Disease 2017 study

Background While there is a long history of measuring death and disability from injuries, modern research methods must account for the wide spectrum of disability that can occur in an injury, and must provide estimates with sufficient demographic, geographical and temporal detail to be useful for policy makers. The Global Burden of Disease (GBD) 2017 study used methods to provide highly detailed estimates of global injury burden that meet these criteria. Methods In this study, we report and discuss the methods used in GBD 2017 for injury morbidity and mortality burden estimation. In summary, these methods included estimating cause-specific mortality for every cause of injury, and then estimating incidence for every cause of injury. Non-fatal disability for each cause is then calculated based on the probabilities of suffering from different types of bodily injury experienced. Results GBD 2017 produced morbidity and mortality estimates for 38 causes of injury. Estimates were produced in terms of incidence, prevalence, years lived with disability, cause-specific mortality, years of life lost and disability-adjusted life-years for a 28-year period for 22 age groups, 195 countries and both sexes. Conclusions GBD 2017 demonstrated a complex and sophisticated series of analytical steps using the largest known database of morbidity and mortality data on injuries. GBD 2017 results should be used to help inform injury prevention policy making and resource allocation. We also identify important avenues for improving injury burden estimation in the future.Peer reviewe

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Home background and secondary school students’ academic performance in Islamic Studies in Oyo North, Nigeria

The role played by home as an agent of civilization could not be overemphasized. Home is a determining factor in any child’s behaviour and thus influences his academic performance. Hence, this study examined home background and secondary school students’ academic performance in Islamic Studies in Oyo North, Nigeria. The study was a descriptive research of a survey type, stratified sampling technique was used to select 500 respondents. A researcher-designed questionnaire and Performance Test were used to elicit information from the respondents. Mean, standard deviation and chi-square were used to test the hypotheses at 0.05 level of significance. The findings revealed that there was a significant influence of home background on secondary school students’ academic performance in Islamic studies; there was a significant effect of parents’ level of education on secondary school students’ academic performance; there was a significant effect of parents’ level of occupation on secondary school students’ academic performance; there was a significant influence of parental care and commitment on secondary school students’ academic performance; it was concluded that home status, parental educational background, parents’ occupation, school type, home supports for children’s education, parental care and commitment have a significant influence on secondary school students’ academic performance. It was recommended that parents and guardians should endeavour to play their parental roles to ensure good upbringing of their children. Islamic Studies teachers should take cognizance of the various backgrounds of their students in the classroom thereby employing methods and techniques of teaching that would cater for those background differences

Homogenous electrochemical water oxidation by a nickel(II) complex based on a macrocyclic N-heterocyclic carbene/pyridine hybrid ligand

Water-soluble homogeneous nickel catalysts have been rarely investigated for catalytic water oxidation as compared to their heterogeneous counterparts. Herein, we report homogenous electrochemical water oxidation by a nickel(ii) complex, ([NiL](PF6)(2) (L = bis(2-pyridyl-methylimidazolylidene)methane), based on a macrocyclic N-heterocyclic carbene/pyridine hybrid ligand under neutral and alkaline conditions. The catalyst displayed the stable catalytic current of 0.65 mA cm(-2) at the overpotential of 0.80 V (similar to 0.55 V at GCE for CV) with a similar to 93% Faradaic efficiency at pH 9.0 for oxygen evolution in long-term bulk electrolysis. The CV, UV-vis, ESI-MS, SEM, and EDX results demonstrated that the catalyst was impressively stable even after long-term controlled potential electrolysis (CPE) (11 h) and homogeneous in nature. The synthesis of this catalyst is straightforward, and its complex is air and moisture stable. To the best of our knowledge, this is the first study on the investigation of a Ni-NHC complex for water oxidation under aqueous conditions (acetate/phosphate). According to the literature, the role of the phosphate ion in homogenous nickel-catalysed water oxidation was found to vary from catalyst poisoning to activation. Interestingly, the catalytic activity of our catalyst in phosphate buffer was significantly higher than that with acetate ions at the same pH value; this might indicate the key role of phosphate ions as proton acceptors, which boosted the catalyst activity via enhanced PCET during catalysis

Study on boil-off gas (Bog) minimization and recovery strategies from actual baseload lng export terminal: Towards sustainable lng chains

10.3390/en14123478Energies1412347