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

近200年来关中地区干旱灾害时空变化研究

Adverse drug events (ADEs) impose a major clinical and cost burden on acute hospital services. It has been reported that medicines reconciliation provided by pharmacists is effective in minimizing the chances of hospital admissions related to adverse drug events.To update the previous assessment of pharmacist-led medication reconciliation by restricting the review to randomized controlled trials (RCTs) only.Six major online databases were sifted up to 30 December 2016, without inception date (Embase, Medline Ovid, PubMed, BioMed Central, Web of Science and Scopus) to assess the effect of pharmacist-led interventions on medication discrepancies, preventable adverse drug events, potential adverse drug events and healthcare utilization. The Cochrane tool was applied to evaluate the chances of bias. Meta-analysis was carried out using a random effects model.From 720 articles identified on initial searching, 18 RCTs (6,038 patients) were included. The quality of the included studies was variable. Pharmacists-led interventions led to an important decrease in favour of the intervention group, with a pooled risk ratio of 42% RR 0.58 (95% CI 0.49 to 0.67) P<0.00001 in medication discrepancy. Reductions in healthcare utilization by 22% RR 0.78 (95% CI 0.61 to 1.00) P = 0.05, potential ADEs by10% RR 0.90 (95% CI 0.78 to 1.03) P = 0.65 and preventable ADEs by 27% RR 0.73 (0.22 to 2.40) P = 0.60 were not considerable.Pharmacists-led interventions were effective in reducing medication discrepancies. However, these interventions did not lead to a significant reduction in potential and preventable ADEs and healthcare utilization

Investigation of mechanical properties and transparency of spark plasma sintered Mg2+ and Y3+ codoped α-Al2O3 nanoparticles synthesized via coprecipitation

This research aims to investigate the effect of different amounts of doping elements (magnesium and yttrium ions) on the hardness, elastic modulus, flexural strength, and transparency of alumina ceramics. For this purpose, different amounts of Mg2+ and Y3+ doped α-Al2O3 nanoparticles were synthesized via the co-precipitation method. The results revealed that the majority of Mg2+ and Y3+ doped α-Al2O3 nanoparticles have a particle size of 300–400 nm. Furthermore, the density and transparency (60% in-line transmittance at a wavelength of 5 μm, with a sample thickness of 2.4 mm) of the bulk materials prepared with doping of 100 ppm Mg2+and 400 ppm Y3+ (100M400Y) presented the best performance compared with other samples. Furthermore, the hardness and Young modulus of this sample were 28 GPa and 349 GPa, respectively. The flexural strength of the 100M400Y sample reached the highest value, 193 MPa, due to the smaller grain size and minimal porosity

Prisma flow diagram representing the selection process of articles included in the review.

<p>Prisma flow diagram representing the selection process of articles included in the review.</p

The impact of pharmacists-led medicines reconciliation on healthcare outcomes in secondary care: A systematic review and meta-analysis of randomized controlled trials - Fig 2

<p>(a) Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies. 2 (b) Risk of bias summary: review authors' judgements about each risk of bias item for each included study.</p

Characteristic of included studies.

<p>Characteristic of included studies.</p