Work stress and burnout among physicians and nurses in Internal and Emergency Departments

Burnout has been defined as loss of enthusiasm for work, feelings of cynicism, and a low sense of personal accomplishment. Work environment and working conditions exposes the individual to numerous factors of stress. Stress-related diseases are defined as burnout. The increased workload, the repeated reorganizations in the hospital with iterative downsizing suggestions and budget cuts, without any perspective of career progression, with a social culture of bureaucracy and blame, resulting both in subtracting direct care time with patients and in the fear by healthcare professionals from the burden of their responsibility, are the backgrounds on which more and more frequent cases of burnout may develop. We need to establish homogenous standards all over the national territory on workload and about the procedures that have to be implemented for the prevention of burnout in our wards

When interprofessionalism also involves the patient: how to provide good healthcare beyond care

The prevalence of aging-related chronic diseases makes it necessary to change organizational structures. In order to facilitate the transformation of health systems, interprofessional care teams, patient engagement, and collaborative practice will be necessary. Patient-centered interprofessional care is a process based on the collaborative relationship between healthcare professionals, patients and caregivers, as a useful strategy to “develop a shared understanding of the problem and generate a mutually acceptable assessment and management of the care plan”. Everything must take place on a collaborative level, always respecting the different skills. Although the literature provides preliminary information to support the benefits of the patient-centered approach, transformational leadership and an organizational culture are needed to foster learning, research, and the implementation of innovative models to patient care. Furthermore, in the Italian healthcare reality, the aspects of practicability and “sustainability” of this model of care should be considered and the key elements, mechanisms and stages of development necessary for its possible implementation should be better defined

Prediction and modelling of RNA structure and interactions

BMC Bioinformatics is calling for submissions to our Collection on “Prediction and modelling of RNA structure and interactions”. This Collection welcomes submissions on novel algorithms, computational methods and tools on the topics of classification, analysis, comparison and evolution of RNA molecules , approaches to RNA structure (inverse) prediction —both at the level of secondary and tertiary structure— and study of RNA interactions with other biological or synthetic molecules. Focus on particular classes of RNAs, such as ribosomal RNA, long non-coding RNAs and viral genomes, is welcome

Work stress and burnout among physicians and nurses in Internal and Emergency Departments

Burnout has been defined as loss of enthusiasm for work, feelings of cynicism, and a low sense of personal accomplishment. Work environment and working conditions exposes the individual to numerous factors of stress. Stress-related diseases are defined as burnout. The increased workload, the repeated reorganizations in the hospital with iterative downsizing suggestions and budget cuts, without any perspective of career progression, with a social culture of bureaucracy and blame, resulting both in subtracting direct care time with patients and in the fear by healthcare professionals from the burden of their responsibility, are the backgrounds on which more and more frequent cases of burnout may develop. We need to establish homogenous standards all over the national territory on workload and about the procedures that have to be implemented for the prevention of burnout in our wards

Short versus long course antibiotic therapy for acute pyelonephritis in adults: a systematic review and meta-analysis

Acute pyelonephritis (aPN) is defined as a severe form of urinary tract infection. Despite its severity and the high incidence in the community setting, there is no consensus on the optimal duration of treatment. The aim was to compare effectiveness and tolerability of short- versus long-course treatment with the same antibiotic agent in patients with aPN. We searched MEDLINE (PubMed), EMBASE and CENTRAL up to June 2016 for randomized controlled trials (RCTs). Three pairs of authors independently extracted data and appraised risk of bias. We included 4 RCTs (439 participants). Short antibiotic treatment lasted from 4 to 14 days and long treatment from 7 to 42 days but was at least 2 days longer than the corresponding short-course. At the end of treatment, we did not find any significant differences in clinical success [risk ratio (RR) 1.01; 95% confidence interval (CI), 0.96-1.07, moderate quality evidence] as well as in microbiological success (RR 0.99; 95% CI, 0.92-1.07, very low-quality evidence). At 4-6 weeks after the end of treatment there were no significant differences in clinical relapses (RR 1.20, 95% CI 0.43-3.30, very low-quality evidence) and re-infection of other germs (RR 2.40; 95% CI, 0.68-8.49, very low-quality evidence), even if short-term therapy seemed to have more risk of recurrences (RR 2.39, 95% CI 1.19-4.83, very low quality of evidence). The incidence of any adverse effect seemed to be lower with the short-term therapy, though the results are not statistically significant (RR 0.63, 95% CI 0.39-1.02, low quality evidence). Short-term treatment for aPN seems to be equivalent to long-term treatment in terms of clinical and microbiological success at the end of treatment or tolerability. The only relevant difference is the frequency of recurrence of the same biological germ up to 4-6 weeks after the end of treatment, which is significantly higher with the short-term therapy

Biogeography and shape of fungal fairy rings in the Apennine mountains, Italy

Aim Fungal 'fairy rings' (FRs) are regular bands of vegetation caused by a centrifugal expansion of fungal mycelia. It is well established that FR fungi affect both soil chemistry and microbiome, but nothing is known about the distribution of these patterns at the regional scale. Here, we assess the abundance and occurrences of different FR shapes i.e. rings, arcs and rotors, and explore their association with geomorphology and climate. Location The Apennine Mountains, 300-km latitudinal gradient along the Italian Peninsula. Taxon Basidiomycetous fungi. Methods High-resolution freely available images were gathered to study FR shapes and distribution in the Apennine region of Italy. First, 12 mountains with different elevations and geomorphology were studied to assess the colonial density and relative distribution of FR type. FR distribution and shape and size of additional 616 FRs were studied in 61 study sites and relationship with selected climatic and topographic variables were assessed using different modelling approaches. Results Overall, 1163 FR structures were found across the study area. Arcs were the most common shape followed by rings. Rotors were rare, accounting for less than 2% of all observations. Fungal colony density varied largely both among and within sites, averaging 6.7 arcs, 2.2 rings and only 0.1 rotors per ha. On average, arcs (18.8 m) were similar in size compared to rotors (18.4 m) whilst rings were smaller (11.7 m). Arcs presented a higher frequency of occurrence on steeper slopes whilst rings were mostly found on flat and moderate slopes. FRs occurred within the altitudinal range between 546 m and 2148 m a.s.l., corresponding to temperatures between 3.4 and 12.7 degrees C and rainfall between 1100 and 1300 mm per year. Main Conclusions FRs are common elements of the Apennine grassland landscape where they may contribute to the maintenance of plant and microbial diversity. Better systematic identification of the fungal species involved in the formation of FRs is required. Further research that combines long-term field manipulative experiments and modelling work would help to explain the formation of rings, arcs and rotors during the ontogenetic development of fungal fronts