Global disparities in surgeons’ workloads, academic engagement and rest periods: the on-calL shIft fOr geNEral SurgeonS (LIONESS) study

: The workload of general surgeons is multifaceted, encompassing not only surgical procedures but also a myriad of other responsibilities. From April to May 2023, we conducted a CHERRIES-compliant internet-based survey analyzing clinical practice, academic engagement, and post-on-call rest. The questionnaire featured six sections with 35 questions. Statistical analysis used Chi-square tests, ANOVA, and logistic regression (SPSS® v. 28). The survey received a total of 1.046 responses (65.4%). Over 78.0% of responders came from Europe, 65.1% came from a general surgery unit; 92.8% of European and 87.5% of North American respondents were involved in research, compared to 71.7% in Africa. Europe led in publishing research studies (6.6 ± 8.6 yearly). Teaching involvement was high in North America (100%) and Africa (91.7%). Surgeons reported an average of 6.7 ± 4.9 on-call shifts per month, with European and North American surgeons experiencing 6.5 ± 4.9 and 7.8 ± 4.1 on-calls monthly, respectively. African surgeons had the highest on-call frequency (8.7 ± 6.1). Post-on-call, only 35.1% of respondents received a day off. Europeans were most likely (40%) to have a day off, while African surgeons were least likely (6.7%). On the adjusted multivariable analysis HDI (Human Development Index) (aOR 1.993) hospital capacity > 400 beds (aOR 2.423), working in a specialty surgery unit (aOR 2.087), and making the on-call in-house (aOR 5.446), significantly predicted the likelihood of having a day off after an on-call shift. Our study revealed critical insights into the disparities in workload, access to research, and professional opportunities for surgeons across different continents, underscored by the HDI

Low handgrip strength is associated with a higher incidence of pressure ulcers in hip fractured patients.

Introduction. Pressure ulcers (PUs) are highly frequent in hip fractured elderly patients. Handgrip strength (HGS) is an efficient, method to measure functional capacity. The aim was to analyze if low HGS is associated with higher incidence of pressure ulcers within a population of elderly patients with hip fracture.Material and Methods. A cohort study, which included 462 patients admitted at the Hip and Pelvic Surgery Department of a tertiary hospital, in Monterrey, Mexico. HGS measurement was performed using a Jamar® Hydraulic Hand Dynamometer. Patients were grouped into tertiles according to their grip strength measurement by sex, and evaluated for presence or absence of PUs during hospital admission and followed until discharge. Results. The general incidence of PUs was 25.7%. The incidence was higher in the weaker subjects. After multivariate analysis, only HGS remained associated with PUs incidence.Conclusion. Low handgrip strength is associated with a higher incidence of pressure ulcers