Ανθεκτικότητα και επαγγελματική εξουθένωση των φυσικοθεραπευτών σε έκτακτες καταστάσεις

Αρχικά, δεν υπάρχει αμφιβολία ότι το επάγγελμα του φυσικοθεραπευτή είναι ζωτικής σημασίας καθώς συμβάλει ουσιαστικά σε καταστάσεις που απαιτούν άμεση περίθαλψη και αποκατάσταση. Οι συνθήκες όμως που βιώνει ένας φυσικοθεραπευτής λόγω του επαγγέλματός του, τον εκθέτουν σε υψηλό κίνδυνο εμφάνισης του συνδρόμου της επαγγελματικής εξουθένωση, η οποία με τη σειρά της συνδέεται με τη μειωμένη επαγγελματική ικανοποίηση και με τα ενδεχόμενα ιατρικά λάθη στον εργασιακό χώρο. Αναφορικά με τους βασικότερες παράγοντες που οδηγούν στην ανάπτυξη αυτού του φαινομένου είναι το αυξημένο φόρτο εργασίας, η ασάφεια ρόλων, το άγχος, τα στρεσογόνα περιστατικά, η εργασιακή πίεση, η έλλειψη υποστήριξης, αυτονομίας και δεξιοτήτων. Αποκορύφωμα σε όλη αυτή την κατάσταση αποτέλεσε η πανδημία covid 19, η οποία αύξησε το φόρτο εργασίας, την ψυχολογική πίεση και σε συνδυασμό με τις ελλείψεις σε ιατρονοσηλευτικό προσωπικό οδήγησε στην εμφάνιση του εν λόγω συνδρόμου. Αυτό είχε ως αποτέλεσμα, οι φυσικοθεραπευτές να αναλάβουν ένα μεγάλο βάρος της πανδημίας αποκομίζοντας διάφορες ψυχολογικές διαταραχές. Επομένως, κρίνεται απαραίτητο να ληφθούν έγκαιρα μέτρα για τον περιορισμό ή την εξάλειψη αυτού του φαινομένου. Μία λύση σε αυτό το πρόβλημα αποτελεί η καλλιέργεια της ανθεκτικότητας στους φυσικοθεραπευτές. Συγκεκριμένα, μέσω της ανθεκτικότητας οι επαγγελματίες υγείας μπορούν να αποβάλλουν το άγχος και να αντιμετωπίσουν τις έντονες συνθήκες εργασίας τους βελτιώνοντας σημαντικά την επαγγελματική ποιότητα ζωής τους. Παράλληλα, τα άτομα που έχουν αποκτήσει ανθεκτικότητα διακατέχονται από θετικά συναισθήματα, αισιοδοξία και αίσθηση του χιούμορ. Επομένως, η παρούσα μελέτη έχει ως στόχο την εξέταση των παραγόντων που συνδέονται με την ανθεκτικότητα και την εξουθένωση των φυσικοθεραπευτών στην Ελλάδα καθώς και τη διερεύνηση της συμπεριφοράς τους. Από τα αποτελέσματα της μελέτης διαπιστώσαμε ότι η επαγγελματική εξουθένωση συνδέεται άμεσα με την ανθεκτικότητα. Τέλος, αξίζει να επισημάνουμε ότι η αντίληψη της διαφοράς των δύο αυτών φαινομένων είναι σημαντική προκειμένου να αναπτυχθούν αποτελεσματικές στρατηγικές για την αντιμετώπιση της εξουθένωσης και ενδυνάμωση της ανθεκτικότητας των φυσικοθεραπευτών που εργάζονται σε δύσκολες συνθήκες.  Initially, there is no doubt that the profession of physiotherapist is vitally important as it contributes substantially to situations that require immediate care and rehabilitation. However, the conditions experienced by a physiotherapist as a result of his or her profession expose them to a high risk of developing burnout syndrome, which in turn is associated with reduced job satisfaction and potential medical errors in the workplace. With regard to the main factors leading to the development of this phenomenon are increased workload, role ambiguity, stress, stressful incidents, work pressure, lack of support, autonomy and skills. The culmination of all this was the covid 19 pandemic, which increased workload, psychological pressure and, combined with shortages of nursing staff, led to the emergence of this syndrome. As a result, physiotherapists had to bear a heavy burden of the pandemic by contracting various psychological disorders. Therefore, it is deemed necessary to take timely measures to curb or eliminate this phenomenon. One solution to this problem is the cultivation of resilience in physiotherapists. In particular, through resilience, health professionals can eliminate stress and cope with their intense working conditions, significantly improving their professional quality of life. At the same time, individuals who have acquired resilience are possessed of positive emotions, optimism and a sense of humour. Therefore, the present study aims to examine the factors associated with resilience and burnout among physiotherapists in Greece and to investigate their behaviours. From the results of the study we found that burnout is directly related to resilience. Finally, it is worth pointing out that understanding the difference between these two phenomena is important in order to develop effective strategies to address burnout and strengthen the resilience of physiotherapists working in difficult conditions.

Cell cyclins: triggering elements of cancer or not?

Cyclins are indispensable elements of the cell cycle and derangement of their function can lead to cancer formation. Recent studies have also revealed more mechanisms through which cyclins can express their oncogenic potential. This review focuses on the aberrant expression of G1/S cyclins and especially cyclin D and cyclin E; the pathways through which they lead to tumour formation and their involvement in different types of cancer. These elements indicate the mechanisms that could act as targets for cancer therapy

It is time to define an organizational model for the prevention and management of infections along the surgical pathway : a worldwide cross-sectional survey

Background The objectives of the study were to investigate the organizational characteristics of acute care facilities worldwide in preventing and managing infections in surgery; assess participants' perception regarding infection prevention and control (IPC) measures, antibiotic prescribing practices, and source control; describe awareness about the global burden of antimicrobial resistance (AMR) and IPC measures; and determine the role of the Coronavirus Disease 2019 pandemic on said awareness. Methods A cross-sectional web-based survey was conducted contacting 1432 health care workers (HCWs) belonging to a mailing list provided by the Global Alliance for Infections in Surgery. The self-administered questionnaire was developed by a multidisciplinary team. The survey was open from May 22, 2021, and June 22, 2021. Three reminders were sent, after 7, 14, and 21 days. Results Three hundred four respondents from 72 countries returned a questionnaire, with an overall response rate of 21.2%. Respectively, 90.4% and 68.8% of participants stated their hospital had a multidisciplinary IPC team or a multidisciplinary antimicrobial stewardship team. Local protocols for antimicrobial therapy of surgical infections and protocols for surgical antibiotic prophylaxis were present in 76.6% and 90.8% of hospitals, respectively. In 23.4% and 24.0% of hospitals no surveillance systems for surgical site infections and no monitoring systems of used antimicrobials were implemented. Patient and family involvement in IPC management was considered to be slightly or not important in their hospital by the majority of respondents (65.1%). Awareness of the global burden of AMR among HCWs was considered very important or important by 54.6% of participants. The COVID-19 pandemic was considered by 80.3% of respondents as a very important or important factor in raising HCWs awareness of the IPC programs in their hospital. Based on the survey results, the authors developed 15 statements for several questions regarding the prevention and management of infections in surgery. The statements may be the starting point for designing future evidence-based recommendations. Conclusion Adequacy of prevention and management of infections in acute care facilities depends on HCWs behaviours and on the organizational characteristics of acute health care facilities to support best practices and promote behavioural change. Patient involvement in the implementation of IPC is still little considered. A debate on how operationalising a fundamental change to IPC, from being solely the HCWs responsibility to one that involves a collaborative relationship between HCWs and patients, should be opened.Peer reviewe

It is time to define an organizational model for the prevention and management of infections along the surgical pathway: a worldwide cross-sectional survey

Background The objectives of the study were to investigate the organizational characteristics of acute care facilities worldwide in preventing and managing infections in surgery; assess participants' perception regarding infection prevention and control (IPC) measures, antibiotic prescribing practices, and source control; describe awareness about the global burden of antimicrobial resistance (AMR) and IPC measures; and determine the role of the Coronavirus Disease 2019 pandemic on said awareness. Methods A cross-sectional web-based survey was conducted contacting 1432 health care workers (HCWs) belonging to a mailing list provided by the Global Alliance for Infections in Surgery. The self-administered questionnaire was developed by a multidisciplinary team. The survey was open from May 22, 2021, and June 22, 2021. Three reminders were sent, after 7, 14, and 21 days. Results Three hundred four respondents from 72 countries returned a questionnaire, with an overall response rate of 21.2%. Respectively, 90.4% and 68.8% of participants stated their hospital had a multidisciplinary IPC team or a multidisciplinary antimicrobial stewardship team. Local protocols for antimicrobial therapy of surgical infections and protocols for surgical antibiotic prophylaxis were present in 76.6% and 90.8% of hospitals, respectively. In 23.4% and 24.0% of hospitals no surveillance systems for surgical site infections and no monitoring systems of used antimicrobials were implemented. Patient and family involvement in IPC management was considered to be slightly or not important in their hospital by the majority of respondents (65.1%). Awareness of the global burden of AMR among HCWs was considered very important or important by 54.6% of participants. The COVID-19 pandemic was considered by 80.3% of respondents as a very important or important factor in raising HCWs awareness of the IPC programs in their hospital. Based on the survey results, the authors developed 15 statements for several questions regarding the prevention and management of infections in surgery. The statements may be the starting point for designing future evidence-based recommendations. Conclusion Adequacy of prevention and management of infections in acute care facilities depends on HCWs behaviours and on the organizational characteristics of acute health care facilities to support best practices and promote behavioural change. Patient involvement in the implementation of IPC is still little considered. A debate on how operationalising a fundamental change to IPC, from being solely the HCWs responsibility to one that involves a collaborative relationship between HCWs and patients, should be opened

Development of software for the improved microrobot and design of position estimation system for control of the platform

Εθνικό Μετσόβιο Πολυτεχνείο--Μεταπτυχιακή Εργασία. Διεπιστημονικό-Διατμηματικό Πρόγραμμα Μεταπτυχιακών Σπουδών (Δ.Π.Μ.Σ.) “Συστήματα Αυτοματισμού

Analysis and modeling of the deviation of Reflectorless Electromagnetic Distance Measurement

176 σ.Αντικείμενο της εργασίας αυτής είναι η μοντελοποίηση της απόκλισης της μέτρησης μήκους χωρίς τη χρήση ανακλαστήρα, μέσω ολοκληρωμένων γεωδαιτικών σταθμών. Η εργασία αυτή αποτελείται από τέσσερα κεφάλαια. Στο πρώτο κεφάλαιο παρουσιάζονται ιστορικά στοιχεία της τεχνολογίας μετρήσεων μήκους και περιγράφεται η ιστορική αναδρομή που καταλήγει στην σημερινή εποχή των ολοκληρωμένων γεωδαιτικών σταθμών με την ενσωματωμένη λειτουργία μέτρησης χωρίς ανακλαστήρα. Επίσης, περιγράφονται συνοπτικά λεπτομέρειες της τεχνολογίας των laser καθώς και οι παράγοντες που επηρεάζουν τα αποτελέσματα των μετρήσεων. Στο τέλος του κεφαλαίου γίνεται αναφορά στο αντικείμενο και στην μεθοδολογία της παρούσας εργασίας. Στο δεύτερο κεφάλαιο περιγράφονται οι μέθοδοι ομαδοποίησης και επεξεργασίας των δεδομένων και παρουσιάζονται συγκεντρωτικοί πίνακες αυτών με κατηγοριοποίηση ανά όργανο και ανά υλικό. Τα δεδομένα αυτά προέρχονται από προηγούμενες προπτυχιακές και μεταπτυχιακές εργασίες των τελευταίων ετών. Στο τρίτο κεφάλαιο περιγράφεται η μεθοδολογία μοντελοποίησης και προσαρμογής συναρτήσεων στα πειραματικά δεδομένα με την χρήση κατάλληλου λογισμικού, ενώ παρουσιάζονται σε πίνακες οι παράμετροι και το είδος των καμπυλών που προέκυψαν. Τέλος, στο τέταρτο κεφάλαιο καταγράφονται τα συμπεράσματα που εξάγονται ενώ γίνονται προτάσεις για περεταίρω έρευνα και πειραματισμό.The object of this diploma thesis is the adjustment of mathematical equations in already existed experimental data dealing with reflectorless Electromagnetic Distance Measurements, in order to correct the final results and minimize the errors. In the first chapter the operation of the modern reflectorless total stations is presented extensively. Historical elements related to the development of total stations, as well as the characteristics of distance measurement using laser radiation, are given. There is a description and comparison of the two methods that are used for the distance measurement by the total stations. A new method that combines the advantages of the two previous methods, called “System Analyzer” is also described. Moreover, the methodology of previous experiments concerning reflectorless measurements in a variety of materials, is explained. In the second chapter, the experimental data are analyzed and classified in a way that reveals the dependency between the incident angle of the laser beam to the target and the error of distance measurement. The same approach is used to determine how the magnitude of the distance affects the results. All the reflectorless measurements are compared with the result of a measurement at a prism initially placed in the same X,Y,Z position by using a specially manufactured base. With this technique the error of all reflectorless measurements can be determined with high accuracy. In the third chapter, with the help of the MATLAB software, mathematical equations were adapted to the experimental data concerning the change of the laser’s beam incident angle to the target and its impact on the distance measurement error. Each equation reflects a material measured by a specific total station. The procedure of adaptation led to exponential and polynomial mathematical equations of one or two parameters, as it was found that these best describe the phenomenon. However, the correction of the errors with this method presents technical difficulties. So, a general polynomial equation of one parameter was adjusted to all the data of each total station. In the fourth chapter, the conclusions made during the process of the current diploma thesis are presented, including proposals for future research regarding new experiments and also the metrological control of the total stations.Κωνσταντίνος Κ. Καραΐσκο

Complete Thoracoscopic Lobectomy: A new era at the ‘‘G. Papanikolaou’’ Hospital

SUMM ARY. Twenty years after the first announcement of itsapplication, thoracoscopic lobectomy has become the gold standardfor the treatment of early stage lung cancer in many large medicalcentres in other countries. This method appears to offer fasterrecovery and a lower rate of complications than the conventionalopen technique, but many thoracic surgeons, including those in theGreek national health care system, continue to argue against theeffectiveness of the method in the management of primary lungcancer. Material and Methods Between March 2009 and October2012, 17 patients with peripheral lung tumours and unrevealingbronchoscopy underwent fully thoracoscopic lobectomy. All theoperations were performed under general anaesthesia, with one-lungventilation and without the use of a rib spreader, through the creationof 3-4 ports in the ipsilateral hemithorax. Lymph node dissectionor sampling was carried out in all patients, after completion of thelobectomy. Results Specifically 4 right upper, 1 middle, 2 lowerright, 6 left upper and 4 left lower thoracoscopic lobectomies wereperformed. The mean duration of operation was 3 hours and themean duration of hospital stay was 4 days. Conclusion Thoracoscopiclobectomy is a safe, and minimally traumatic procedure that offersfaster recovery compared with the open method. The oncologicalresults are comparable to those of the open thoracotomy technique,provided that the intraoperative principles of radical resection andlymphadenectomy are maintained. Pneumon 2013, 26(2):157-161

Duloxetine Versus Citalopram and Sertraline in the Treatment of Poststroke Depression, Anxiety, and Fatigue

The authors sought to determine the relative efficacy and tolerability of duloxetine versus citalopram and sertraline in the treatment of poststroke depression (PSD), anxiety, and fatigue. A group of 60 patients with PSD were assigned to receive duloxetine, citalopram, or sertraline and were assessed over a 3-month period for depression, anxiety, and fatigue. Improvement of depression and anxiety, but not fatigue, was observed in all study groups. Duloxetine was well tolerated and significantly more effective than citalopram and sertraline for the treatment of anxiety symptoms in PSD patients. None of the antidepressants used was effective for reducing symptoms of fatigue. (The Journal of Neuropsychiatry and Clinical Neurosciences 2012; 24:349-353