TOWARD AN APPRAISAL OF THE FMHA FARM CREDIT PROGRAM: A CASE STUDY OF THE EFFICIENCY OF BORROWERS IN SOUTHERN ILLINOIS

A production frontier methodology is used to measure the overall efficiency of a sample of farms obtaining credit from the Farmers Home Administration (FmHA) compared to nonparticipants. The study did not find evidence that the efficiency of FmHA farms improved between 1981 and 1984. Results indicate that the overall efficiency of FmHA borrowers is associated with selected financial characteristics of the farms.Agricultural Finance,

Workplace factors associated with mental health of healthcare workers during the COVID-19 pandemic: an international cross-sectional study

BACKGROUND: The association of workplace factors on mental health of healthcare workers (HCWs) during the COVID-19 pandemic needs to be urgently established. This will enable governments and policy-makers to make evidence-based decisions. This international study reports the association between workplace factors and the mental health of HCWs during the pandemic. METHODS: An international, cross-sectional study was conducted in 41 countries. The primary outcome was depressive symptoms, derived from the validated Patient Health Questionnaire-2 (PHQ-2). Multivariable logistic regression identified factors associated with mental health outcomes. Inter-country differences were also evaluated. RESULTS: A total of 2,527 responses were received, from 41 countries, including China (n=1,213; 48.0%), UK (n=891; 35.3%), and USA (n=252; 10.0%). Of all participants, 1343 (57.1%) were aged 26 to 40 years, and 2021 (80.0%) were female; 874 (34.6%) were doctors, and 1367 (54.1%) were nurses. Factors associated with an increased likelihood of depressive symptoms were: working in the UK (OR=3.63; CI=[2.90-4.54]; p<0.001) and USA (OR=4.10; CI=[3.03-5.54]), p<0.001); being female (OR=1.74; CI=[1.42-2.13]; p<0.001); being a nurse (OR=1.64; CI=[1.34-2.01]; p<0.001); and caring for a COVID-19 positive patient who subsequently died (OR=1.20; CI=[1.01-1.43]; p=0.040). Workplace factors associated with depressive symptoms were: redeployment to Intensive Care Unit (ICU) (OR=1.67; CI=[1.14-2.46]; p=0.009); redeployment with perceived unsatisfactory training (OR=1.67; CI=[1.32-2.11]; p<0.001); not being issued with appropriate personal protective equipment (PPE) (OR=2.49; CI=[2.03-3.04]; p<0.001); perceived poor workplace support within area/specialty (OR=2.49; CI=[2.03-3.04]; p<0.001); and perceived poor mental health support (OR=1.63; CI=[1.38-1.92]; p<0.001). CONCLUSION: This is the first international study, demonstrating that workplace factors, including PPE availability, staff training pre-redeployment, and provision of mental health support, are significantly associated with mental health during COVID-19. Governments, policy-makers and other stakeholders need to ensure provision of these to safeguard HCWs’ mental health, for future waves and other pandemics

Distal junctional kyphosis in patients with Scheuermann’s disease: a retrospective radiographic analysis

Purpose To investigate the relationship between preoperative and postoperative spinopelvic alignment and occurrence of DJK/DJF. Study design/setting This was a retrospective observational cohort study. Patient sample The sample included 40 patients who underwent posterior correction of SK from January 2006 to December 2014. Outcome measures Correlation analysis between the preoperative and postoperative spinopelvic alignment parameters and development of DJK over the course of the study period were studied. Methods Whole spine X-rays obtained before surgery, 3 months after surgery and at the latest follow-up were analyzed. The following parameters were measured: maximum of thoracic kyphosis (TK), lumbar lordosis (LL), sagittal vertical axis (SVA), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lower instrumented vertebra (LIV) and LIV plumb line. Development of DJK was considered as the primary end point of the study. The patient population was split into a control and DJK group, with 34 patients and 6 patients, respectively. Statistic analysis was performed using unpaired t test for normal contribution and Mann–Whitney test for skew distributed values. The significance level was set to 0.05. Results DJK occurred in 15% (n = 6) over the study period. There was a significantly lower postoperative TK for the group with DJK (42.4 ± 5.3 vs 49.8 ± 6.7, p = 0.015). LIV plumb line showed higher negative values in the DJK group (−43.6 ± 25.1 vs −2.2 ± 17.8, p = 0.0435). Furthermore, postoperative LL changes were lower for the DJK group (33.84 ± 13.86% vs 31.77 ± 14.05, p < 0.0001.) The age of the patients who developed DJK was also significantly lower than that of the control group (16.8 ± 1.7 vs 19.6 ± 4.9, p = 0.0024.) Conclusions SK patients who developed DJK appeared to have a significantly higher degree of TK correction and more negative LIV plumb line. In addition, there may be a higher risk for DJK in patients undergoing corrective surgery at a younger age

Percutaneous suction and irrigation for the treatment of recalcitrant pyogenic spondylodiscitis.

The primary management of pyogenic spondylodiscitis is conservative. Once the causative organism has been identified, by blood culture or biopsy, administration of appropriate intravenous antibiotics is started. Occasionally patients do not respond to antibiotics and surgical irrigation and debridement is needed. The treatment of these cases is challenging and controversial. Furthermore, many affected patients have significant comorbidities often precluding more extensive surgical intervention. The aim of this study is to describe early results of a novel, minimally invasive percutaneous technique for disc irrigation and debridement in pyogenic spondylodiscitis.This article is freely available via Open Access. Click on the Additional Link above to access the full-text via the publisher's sit

The intercalated BSc in sports and exercise medicine at Barts and The London School of Medicine and Dentistry.

OBJECT: To report about the intercalated Bsc(Hons) in Sports and Exercise Medicine at Barts and The London School of Medicine and Dentistry (BLSMD), Queen Mary University of London. DESIGN: Educational study. SETTING: The course is currently in its tenth year, providing medical students with the opportunity to develop knowledge in the field of Sports and Exercise Medicine (SEM) during one academic year of full time study. PARTICIPANTS: There have been more than 150 graduates, and 22 students are enrolled for the 2012-13 academic year on what has been the most popular and largest intercalated degree at BLSMD in recent years. External applicants typically make up 30-40% of entrants. RESULTS: Equal weighting on taught modules and a portfolio of research activity provides a strong foundation in Sports and Exercise Medicine, and equips successful students with evidence based translational skills, and the opportunity to perform publishable research. CONCLUSION: This article outlines the increasing demand for Sports and Exercise Medicine education, and how the course prepares graduates for practising SEM as a sub-specialist interest or to compete for entry into the Specialist Trainee training rout