Collecting Duct Carcinoma With Cardiac Metastases: A Case Report & Literature Review

AbstractCollecting duct carcinoma (CDC), is a rare and aggressive form of renal cell carcinoma (RCC) accounting for around 1% of all renal malignancy. It affects younger patients and is associated with rapid progression, distant spread and poor prognosis. Cardiac metastases from all types of RCC, without involvement of the inferior vena cava are very rare. We present the case of a 54 year old man with a history of CDC, who presents with collapse and ventricular tachycardia secondary to multifocal cardiac metastases. We are not aware of any other reports in the literature of CDC and cardiac metastases

Burnout Among Surgeons in the UK During the COVID-19 Pandemic: A Cohort Study

BackgroundSurgeon burnout has implications for patient safety and workforce sustainability. The aim of this study was to establish the prevalence of burnout among surgeons in the UK during the COVID-19 pandemic.MethodsThis cross-sectional online survey was set in the UK National Health Service and involved 601 surgeons across the UK of all specialities and grades. Participants completed the Maslach Burnout Inventory and a bespoke questionnaire. Outcome measures included emotional exhaustion, depersonalisation and low personal accomplishment, as measured by the Maslach Burnout Inventory-Human Services Survey (MBI-HSS).ResultsA total of 142 surgeons reported having contracted COVID-19. Burnout prevalence was particularly high in the emotional exhaustion (57%) and depersonalisation (50%) domains, while lower on the low personal accomplishment domain (15%). Burnout prevalence was unrelated to COVID-19 status; however, the greater the perceived impact of COVID-19 on work, the higher the prevalence of emotional exhaustion and depersonalisation. Degree of worry about contracting COVID-19 oneself and degree of worry about family and friends contacting COVID-19 was positively associated with prevalence on all three burnout domains. Across all three domains, burnout prevalence was exceptionally high in the Core Trainee 1–2 and Specialty Trainee 1–2 grades.ConclusionsThese findings highlight potential undesirable implications for patient safety arising from surgeon burnout. Moreover, there is a need for ongoing monitoring in addition to an enhanced focus on mental health self-care in surgeon training and the provision of accessible and confidential support for practising surgeons

Identification of Surgeon Burnout via a Single-Item Measure

BackgroundBurnout is endemic in surgeons in the UK and linked with poor patient safety and quality of care, mental health problems, and workforce sustainability. Mechanisms are required to facilitate the efficient identification of burnout in this population. Multi-item measures of burnout may be unsuitable for this purpose owing to assessment burden, expertise required for analysis, and cost.AimsTo determine whether surgeons in the UK reporting burnout on the 22-item Maslach Burnout Inventory (MBI) can be reliably identified by a single-item measure of burnout.MethodsConsultant (n = 333) and trainee (n = 217) surgeons completed the MBI and a single-item measure of burnout. We applied tests of discriminatory power to assess whether a report of high burnout on the single-item measure correctly classified MBI cases and non-cases.ResultsThe single-item measure demonstrated high discriminatory power on the emotional exhaustion burnout domain: the area under the curve was excellent for consultants and trainees (0.86 and 0.80), indicating high sensitivity and specificity. On the depersonalisation domain, discrimination was acceptable for consultants (0.76) and poor for trainees (0.69). In contrast, discrimination was acceptable for trainees (0.71) and poor for consultants (0.62) on the personal accomplishment domain.ConclusionsA single-item measure of burnout is suitable for the efficient assessment of emotional exhaustion in consultant and trainee surgeons in the UK. Administered regularly, such a measure would facilitate the early identification of at-risk surgeons and swift intervention, as well as the monitoring of group-level temporal trends to inform resource allocation to coincide with peak periods

Sociology and international relations: legacies and prospects

While sociological concepts have often been implicitly used in International Relations (IR), recent years have seen a more explicit engagement between IR and Sociology. As with any such interdisciplinary assignation, there are both possibilities and challenges contained within this move: possibilities in terms of reducing IR's intellectual autism and opening the discipline towards potentially fertile terrain that was never, actually, that distant; challenges in that interdisciplinary raiding parties can often serve as pseudonyms for cannibalism, shallowness and dilettantism. This forum reviews the sociological turn in IR and interrogates it from a novel vantage point—how sociologists themselves approach IR concepts, debates and issues. Three sociological approaches—classical social theory, historical sociology and Foucauldian analysis—are critically deployed to illuminate IR concerns. In this way, the forum offers the possibility of (re)establishing exchanges between the two disciplines premised on a firmer grasp of social theory itself. The result is a potentially more fruitful sociological turn, one with significant benefits for IR as a whole

The global mobile labour force in the modern/colonial world-system: analysing migrant integration in Germany

© 2019, Springer Nature Limited. Following the ‘European refugee crisis’, European states have initiated different migration and integration policies that often perpetuate and reinforce nation-state otherisation, capitalist exploitation, colonial legacies, and gendered and racialised oppression. Using an interdisciplinary approach based on decolonial theory, world-systems research, Marxist analysis, critical state theory, critical race theory and feminist critiques, this article finds that a rigorous investigation of a complex world-system and its deep structures, including modernity/coloniality, capitalism, the nation-state, racism and sexism, can shed light on the formation of a global mobile labour force that manifests itself in place- and context-specific ways. Based on this assertion, this article analyses processes of migrant integration in Germany’s domestic work force and points to its colonial, gendered and racialised dynamics. The article concludes by reviewing Napuli Langa’s account of and involvement in the migrant resistance movement in Germany which began in 2012. This resistance movement highlights alternative ways of living together in and against the modern/colonial world-system that goes beyond (neo)liberal inclusionism