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

Mortalidade de adultos de 15 a 74 anos de idade em São Paulo, Botucatu e São Manuel (Brasil), 1974/1975

Submitted by Guilherme Lemeszenski ([email protected]) on 2013-08-22T19:01:02Z No. of bitstreams: 1 S0034-89101979000600001.pdf: 4629798 bytes, checksum: 87616593c4c8d0d9533dfb4004b468c4 (MD5)Made available in DSpace on 2013-08-22T19:01:02Z (GMT). No. of bitstreams: 1 S0034-89101979000600001.pdf: 4629798 bytes, checksum: 87616593c4c8d0d9533dfb4004b468c4 (MD5) Previous issue date: 1979-12-01Made available in DSpace on 2013-09-30T20:00:33Z (GMT). No. of bitstreams: 2 S0034-89101979000600001.pdf: 4629798 bytes, checksum: 87616593c4c8d0d9533dfb4004b468c4 (MD5) S0034-89101979000600001.pdf.txt: 100375 bytes, checksum: fb22745427d122988ffc9bb1b13809eb (MD5) Previous issue date: 1979-12-01Submitted by Vitor Silverio Rodrigues ([email protected]) on 2014-05-20T15:15:31Z No. of bitstreams: 2 S0034-89101979000600001.pdf: 4629798 bytes, checksum: 87616593c4c8d0d9533dfb4004b468c4 (MD5) S0034-89101979000600001.pdf.txt: 100375 bytes, checksum: fb22745427d122988ffc9bb1b13809eb (MD5)Made available in DSpace on 2014-05-20T15:15:31Z (GMT). No. of bitstreams: 2 S0034-89101979000600001.pdf: 4629798 bytes, checksum: 87616593c4c8d0d9533dfb4004b468c4 (MD5) S0034-89101979000600001.pdf.txt: 100375 bytes, checksum: fb22745427d122988ffc9bb1b13809eb (MD5) Previous issue date: 1979-12-01Universidade de São Paulo Faculdade de Saúde Pública Departamento de Prática de Saúde PúblicaUniversidade de São Paulo Faculdade de Saúde Pública Departamento de EpidemiologiaUniversidade de São Paulo Faculdade de Saúde Pública Centro Brasileiro de Classificação de DoençasUniversidade Estadual Paulista Faculdade de Medicina Departamento de Medicina Legal e Medicina em Saúde PúblicaUniversidade Estadual Paulista Faculdade de Medicina Departamento de Medicina Legal e Medicina em Saúde Públic

Management of pregnancy in autoimmune rheumatic diseases: maternal disease course, gestational and neonatal outcomes and use of medications in the prospective Italian P-RHEUM.it study

objectives: to investigate pregnancy outcomes in women with autoimmune rheumatic diseases (ARD) in the Italian prospective cohort study P-RHEUM.it. methods: pregnant women with different ARD were enrolled for up to 20 gestational weeks in 29 rheumatology centres for 5 years (2018-2023). maternal and infant information were collected in a web-based database. results: we analysed 866 pregnancies in 851 patients (systemic lupus erythematosus was the most represented disease, 19.6%). maternal disease flares were observed in 135 (15.6%) pregnancies. 53 (6.1%) pregnancies were induced by assisted reproduction techniques, 61 (7%) ended in miscarriage and 11 (1.3%) underwent elective termination. obstetrical complications occurred in 261 (30.1%) pregnancies, including 2.3% pre-eclampsia. two cases of congenital heart block were observed out of 157 pregnancies (1.3%) with anti-Ro/SSA. regarding treatments, 244 (28.2%) pregnancies were treated with glucocorticoids, 388 (44.8%) with hydroxychloroquine, 85 (9.8%) with conventional synthetic disease-modifying anti-rheumatic drugs and 122 (14.1%) with biological disease-modifying anti-rheumatic drugs. Live births were 794 (91.7%), mostly at term (84.9%); four perinatal deaths (0.5%) occurred. among 790 newborns, 31 (3.9%) were small-for-gestational-age and 169 (21.4%) had perinatal complications. exclusive maternal breast feeding was received by 404 (46.7%) neonates. the edinburgh postnatal depression scale was compiled by 414 women (52.4%); 89 (21.5%) scored positive for emotional distress. conclusions: multiple factors including preconception counselling and treat-to-target with pregnancy-compatible medications may have contributed to mitigate disease-related risk factors, yielding limited disease flares, good pregnancy outcomes and frequency of complications which were similar to the Italian general obstetric population. disease-specific issues need to be further addressed to plan preventative measures

Management of pregnancy in autoimmune rheumatic diseases: maternal disease course, gestational and neonatal outcomes and use of medications in the prospectiveItalian P-RHEUM.it study.

Objectives: To investigate pregnancy outcomes in women with autoimmune rheumatic diseases (ARD) in the Italian prospective cohort study P-RHEUM.it. Methods: Pregnant women with different ARD were enrolled for up to 20 gestational weeks in 29 Rheumatology Centres for 5 years (2018-2023). Maternal and infant information were collected in a web-based database. Results: We analysed 866 pregnancies in 851 patients (systemic lupus erythematosus was the most represented disease, 19.6%). Maternal disease flares were observed in 135 (15.6%) pregnancies. 53 (6.1%) pregnancies were induced by assisted reproduction techniques, 61 (7%) ended in miscarriage and 11 (1.3%) underwent elective termination. Obstetrical complications occurred in 261 (30.1%) pregnancies, including 2.3% pre-eclampsia. Two cases of congenital heart block were observed out of 157 pregnancies (1.3%) with anti-Ro/SSA. Regarding treatments, 244 (28.2%) pregnancies were treated with glucocorticoids, 388 (44.8%) with hydroxychloroquine, 85 (9.8%) with conventional synthetic disease-modifying anti-rheumatic drugs and 122 (14.1%) with biological disease-modifying anti-rheumatic drugs. Live births were 794 (91.7%), mostly at term (84.9%); four perinatal deaths (0.5%) occurred. Among 790 newborns, 31 (3.9%) were small-for-gestational-age and 169 (21.4%) had perinatal complications. Exclusive maternal breast feeding was received by 404 (46.7%) neonates. The Edinburgh Postnatal Depression Scale was compiled by 414 women (52.4%); 89 (21.5%) scored positive for emotional distress. Conclusions: Multiple factors including preconception counselling and treat-to-target with pregnancy-compatible medications may have contributed to mitigate disease-related risk factors, yielding limited disease flares, good pregnancy outcomes and frequency of complications which were similar to the Italian general obstetric population. Disease-specific issues need to be further addressed to plan preventative measures

Management of pregnancy in autoimmune rheumatic diseases: maternal disease course, gestational and neonatal outcomes and use of medications in the prospectiveItalian P-RHEUM.it study

Objectives: To investigate pregnancy outcomes in women with autoimmune rheumatic diseases (ARD) in the Italian prospective cohort study P-RHEUM.it. Methods: Pregnant women with different ARD were enrolled for up to 20 gestational weeks in 29 Rheumatology Centres for 5 years (2018-2023). Maternal and infant information were collected in a web-based database. Results: We analysed 866 pregnancies in 851 patients (systemic lupus erythematosus was the most represented disease, 19.6%). Maternal disease flares were observed in 135 (15.6%) pregnancies. 53 (6.1%) pregnancies were induced by assisted reproduction techniques, 61 (7%) ended in miscarriage and 11 (1.3%) underwent elective termination. Obstetrical complications occurred in 261 (30.1%) pregnancies, including 2.3% pre-eclampsia. Two cases of congenital heart block were observed out of 157 pregnancies (1.3%) with anti-Ro/SSA. Regarding treatments, 244 (28.2%) pregnancies were treated with glucocorticoids, 388 (44.8%) with hydroxychloroquine, 85 (9.8%) with conventional synthetic disease-modifying anti-rheumatic drugs and 122 (14.1%) with biological disease-modifying anti-rheumatic drugs. Live births were 794 (91.7%), mostly at term (84.9%); four perinatal deaths (0.5%) occurred. Among 790 newborns, 31 (3.9%) were small-for-gestational-age and 169 (21.4%) had perinatal complications. Exclusive maternal breast feeding was received by 404 (46.7%) neonates. The Edinburgh Postnatal Depression Scale was compiled by 414 women (52.4%); 89 (21.5%) scored positive for emotional distress. Conclusions: Multiple factors including preconception counselling and treat-to-target with pregnancy-compatible medications may have contributed to mitigate disease-related risk factors, yielding limited disease flares, good pregnancy outcomes and frequency of complications which were similar to the Italian general obstetric population. Disease-specific issues need to be further addressed to plan preventative measures