Staff Doctors Research Articles

Effects of Moonlighting on Job Satisfaction in Public Institutions in Southwest Nigeria (A Comparative Analysis)

This study investigated the effects of moonlighting on job satisfaction between academic staff and medical doctors in Southwest Nigeria. The study employed descriptive research design and multi-stage sampling technique to select the respondents. Questionnaire was adopted as the research instrument and it was administered to 393 academic staff and 348 medical doctors respectively across various Universities and hospitals in Southwest, Nigeria. The returned questionnaire were coded in Excel and IBM SPSS 23 version respectively and were further analysed through t-test, analysis of variance (ANOVA), and multivariate analysis of variance (MANOVA). The study revealed that moonlighting has positive and significant effect on job satisfaction whereas the academic staffs moonlight more often than medical doctors. The study concluded that It was suggested that Management of Universities and hospitals should develop Human Resources Management practices that has potency of satisfying their employees with the aim of getting them more committed to their primary duties and assignments. In this way, moonlighting will be drastically reduced among academic staff and medical doctors. Keywords: Moonlighting, Job Satisfaction, Public Institutions and Comparative Analysis DOI: 10.7176/JESD/11-4-02 Publication date: February 29 th 2020

Distribution, genetic characteristics and public health implications of Triatoma rubrofasciata, the vector of Chagas disease in Guangxi, China

BackgroundTriatomines are natural vectors of Chagas disease and are mainly prevalent in the Americas. In China, previous data from decades ago showed that there were two species of triatomine bugs, Triatoma rubrofasciata and T. sinica. However, the distribution, genetic characteristics and public health implications of triatomines in China are still relatively unknown. In order to gain knowledge on the distribution, genetic characteristics and public health implications of the triatomines in Guangxi, China, an entomological-epidemiological study and genetic research was conducted.MethodsDifferent methods were used to elucidate the distribution of triatomines in Guangxi including consultations with county-level Center for Disease Prevention and Control staff and village doctors, the distribution of educational material on triatomines though the internet and social media apps such as Wechat and QQ, and conducting manual inspections and light trapping to collect triatomines. The morphological characteristics of the collected triatomines were identified under light microscopy. The mitochondrial 16S rRNA, cytochrome b (cytb) genes and nuclear 28S rRNA gene were amplified, sequenced and used in phylogenetic analyses.ResultsA total of 305 triatomines were captured from 54 different sites in 13 cities in Guangxi. All collected bugs were identified as T. rubrofasciata based on morphology. Most triatomine collection sites were around or inside houses. Four triatomines bite cases were observed during the investigation indicating that triatomine bites are common, the bites can cause serious anaphylaxis and skin papules and urticaria, suggesting a systemic skin response. The 16S rRNA, 28S rRNA and cytb sequence analyses of T. rubrofasciata from Guangxi and other countries showed that T. rubrofasciata sequences from different regions exhibit a high similarity, with no geographical differences. The phylogenetic tree based on the 16S rRNA and cytb genes showed that T. rubrofasciata sequences from different regions and continents were in the same cluster, indicating no differentiation among different geographical populations.ConclusionsOur study showed that T. rubrofasciata is widely distributed in Guangxi and that people are commonly bitten by this insect in some regions. This highlights the need to enhance surveillance for and control of T. rubrofasciata and to strengthen the monitoring of imported Trypanosoma cruzi in China. The 16S rRNA, 28S rRNA and cytb sequence analyses of T. rubrofasciata from different regions and continents suggested that T. rubrofasciata populations exhibit high similarity, and the clustering in the phylogenetic analyses indicates that T. rubrofasciata has a close ancestor originating in the Americas.

Moonlighting: An Antecedent to Job Commitment Between Academic Staff and Medical Doctors in Southwest Nigeria

This study investigated the effects of moonlighting on job commitment between academic staff and medical doctors in Southwest Nigeria. The study employed descriptive research design and multi-stage sampling technique to select the respondents. Questionnaire was adopted as the research instrument and it was administered to 393 academic staff and 348 medical doctors respectively across various Universities and hospitals in Southwest, Nigeria. The returned questionnaire were coded in Excel and IBM SPSS 23 version respectively and were further analysed through t-test, analysis of variance (ANOVA), and multivariate analysis of variance (MANOVA). Evidence from these tests indicated that moonlighting has positive and significant effect on job commitment, also that there is a difference between academic staff and medical doctors whereby academic staff were found to moonlight more often than medical doctors; the study also indicated that moonlighting has positive and significant effect on job commitment however the differences indicated that academic staff enjoy benefit from moonlighting than medical doctors. The study concluded that management of Universities and hospitals should develop a Human Resources Management practice that has potency of satisfying their employees with the aim of getting them more committed to their primary duties and assignments. In this way, moonlighting will be drastically reduced among academic staff and medical doctors. Keywords: Job Commitment, Moonlighting, Public Institutions and Comparative Analysis DOI : 10.7176/EJBM/12-2-08 Publication date: January 31 st 2020

Effects and Challenges Regarding Supervision in Palliative Care Teams: Results of a 5-Year Study in South Tyrol (Italy)

Objective: Evaluating a solution-oriented clinical supervision to improve the quality of care. Design: We performed a randomized, longitudinal controlled trial. A total of 32 health districts were involved in the study. For the evaluation of the intervention, the following dimensions were collected as indicators of the quality of supervision: Quality of life (FACT-G, SF12, POS), psychological stress, depression, burn-out (HADS, BDI-II, VAS scales, HPS), sense of coherence (SOC-13), satisfaction with care, communication and support from the patients and relatives (VAS scales) and working conditions (COPSOQ) from the nursing staff and family doctors. Results: Of the 85 subscales, the SOC Nursing Sum Score (p=0.017), the SF-12 Nursing Sum Scale (p=0.036), and the COPSOQ Scales of General Practitioners showed significant differences in developmental opportunities (p=0.020), leadership (p=0.003), social support (p=0.001) and community spirit (p=0.024). At the second point time of the study, significant differences were found in the subscales of the Palliative Care Outcome Scale (POS) and the subscale of the test instrument Functional Assessment of Cancer Therapy - General (FACT-G) FUNCTIONAL WELL-BEING of the patients. The satisfaction values of nurses and general practitioners with the supervision showed an extremely positive assessment of both nurses and general practitioners regarding supervision. Conclusions: Supervision affects positively the process of palliative home care. It seems important to adjust the number of supervision meetings according to the needs of the individual team in order to achieve an optimized team performance.

Home-visit medical care for COVID-19 patients.

Dear Editor, As the number of patients with coronavirus disease 2019 (COVID-19) is increasing in Japan, we are facing a shortage of inpatient beds. Thus, the patients with mild symptoms (e.g., fever, cough, or fatigue) are asked to stay at home. However, if their health deteriorates, it becomes difficult to monitor their condition and decide on when to transfer them to a hospital, especially at night.1 To prevent unexpected deterioration, we have started home-visit medical care for COVID-19 patients from April 2020. The home-visit medical care team is composed of a doctor and several staff members of the regional public health-care center. A staff member calls each patient daily; based on the patient’s condition, the home-visit medical care team prioritizes the most serious patients for early visit and arranges the visiting order for the day accordingly. The home-visit medical care team visits each patient’s home to check the current medical condition. If the patient needs hospitalization due to deteriorating vital signs and requires oxygen, the regional public health-care center immediately arranges with a hospital that has an available bed and facilities to treat the patient. This home-visit medical care not only prevents health emergencies, but also makes it easy to find a suitable hospital for the patients, because the patients are transported during daytime. The home-visit medical care team also provides precise information about the disease and counsels the patients and families about their concerns regarding the patient’s daily care, possibility of transmission within the household, and mental stress.2 To address these concerns, we have also composed and distributed documents containing essential information about COVID-19. Because the occupancy of hospital beds for COVID-19 patients in Chiba prefecture is now over 200%, more than half of the patients remain at home.3 We need to provide care to these patients, in addition to the ones who are hospitalized. Patients at home need social support, the same as inpatients, as they tend to be socially isolated. The patients staying at home are sometimes isolated within even the family. Appropriate separation needs to be clearly distinguished from unnecessary and unethical isolation.4 Providing correct information and instructions is another important role of home-visit medical care to prevent consequent deprivation and negligence. Additionally, the home-visit care team wearing personal protective equipment may look strange to the neighbors, and the team must be considerate about this. Home-visit medical care is an effective strategy to avoid the collapse of the regional healthcare system and to maintain the health of the residents with limited resources, in COVID-19 hotspots. Approval of the research protocol: N/A. Informed consent: N/A. Registry and registration no. of the study/trial: N/A. Animal studies: N/A. Conflict of interest: None.

Admitting women in active labour: A randomised controlled trial about the effects of protocol use on childbirth method and interventions

AimTo determine the effects of protocol of admitting women in active labour on childbirth method and interventions during labour and childbirth. MethodsThis single-blind randomised clinical trial was conducted in a public hospital in Mazandaran province (Iran) in 2017. Two hundred nulliparous low-risk women were randomly assigned into intervention and control groups. The participant women were admitted in the intervention group using the admission protocol and to the group control by staff midwives and doctors. The admission criteria of the protocol were: the presence of regular, painful contractions, the cervix at least four cm dilated and at least one of the following cues: cervix effaced, and spontaneous rupture of membranes, or “show”. The primary outcome measure was childbirth method. Data were analyzed in SPSS-22 using Mann–Whitney and Chi–square tests. The level of statistical significance was set as p<0.05. FindingThere were significant differences between the intervention and control groups in the number of caesarian section (CS) (p<0.001). Two groups had a statistically significant difference in amniotomy (p=0.003), augmentation by oxytocin (p<0.001), number of vaginal examinations (p<0.001) and fundal pressure (p<0.001). ConclusionsUsing a protocol for admission of low risk nulliparous women in active labour contributed to reduction of the primary caesarean section rate and interventions during childbirth. A risk assessment and using evidence informed guidelines in admission can contribute to reduce unsafe and harmful practices and support normalisation of birth. This is essential for demedicalisation and a useful strategy for reducing primary CS.

A comparative study on patient safety attitude between nurses and doctors in operating rooms.

ObjectiveTo investigate and compare the attitudes of operating room nurses and doctors regarding patient safety, performance of surgical time-out and recognition of count error.MethodsThis cross-sectional study recruited operating room nurses, surgeons and anaesthesiologists between 1 August 2015 and 5 February 2016. A Safety Attitude Questionnaire was used to analyse the three elements in both groups of operating room staff (nurses and doctors).ResultsThe study analysed the questionnaires from 171 participants; 95 nurses (55.6%) and 76 doctors (44.4%). Differences exist between doctors and nurses regarding teamwork climate, working conditions, perception of management and the recognition of stress. On the performance of surgical time-out, nurses showed higher scores on way of counting, while doctors showed higher scores on the time-out procedure itself. Also, doctors believed they actively cooperated with the nurses, while nurses believed they did not receive cooperation. Scores for the recognition of count error were higher in nurses than in doctors. More experienced operating room staff showed higher scores than younger less experienced staff.ConclusionsPerceptual differences among doctors and nurses need to be minimized for the safety of the patient in the operating room.

Quality Improvement Efforts in Pre-Analytical Phase

In a clinical laboratory services pre-analytical phase has plays an important role in term of quality and patient safety. Pre-analytical phase is a phase before analyzing sample in laboratory which includes patient preparation, sampling, labeling, sample transportation, sample storage, and preservation of samples that might influence the laboratory results. In this phase it involves interaction between patient, doctor, laboratory personels, and other staff outside the laboratory. Therefore, it could be assumed that in this phase many sample are collected, many laboratory tests are requested, many individuals are involved and therefore laboratory errors might be occured. Laboratory errors can occur either in pre-analytical, analytical, or post analytical phases but the most frequently errors occur in pre-analytical phase. In this article, quality improvement efforts in pre-analytical phase will be discussed in order to minimize pre-analytical error.

Bolus: Targeted Specialist Haematology Education

Introduction We believe that better informed clinicians make better clinical decisions. Healthcare technology and innovation moves as fast as the rising expectations of patients. Keeping clinical knowledge up-to-date is an ever-present challenge. Often, clinicians' day-to-day experience can only provide a narrow viewpoint of a haematology patient's journey; sometimes this lacks the wider context of new therapies and advancements in treatment modalities. Formal teaching opportunities can be infrequent, difficult to organise, complicated to facilitate and require time and financial commitments many organisations can't support. Background Floor-based teaching is a time-tested way of keeping staff updated but it has to be repeated many times to reach a significant number of staff. Technologies like eLearning are expensive and time consuming to design, deploy and maintain; what is needed is a flexible, efficient contemporary solution for continuing professional development. Podcast technology, whilst not new, has not been fully explored as a core learning solution in healthcare. Surveying haematology staff (n=120) at University College Hospital in London, 80% of respondents (70, 58%) identified a suggested Podcast education delivery method as a desirable way to keep up-to-date with the latest developments in specialist haematology care. Methods A small team of senior clinical staff and practice educators assembled to develop the Podcast resource using inexpensive and easy to use equipment. Clinical experts in particular fields were recruited to deliver content in a conversational style. The format allows a host, to ask questions of the expert based partly on user feedback and partly on historical educational deficits. Primarily aimed at nursing staff and junior doctors, the podcasts have attracted a much wider audience of clinical staff. The resource became formally named, 'Bolus - Education Delivered Stat' and editions were released via popular podcast applications online. Prospective evaluation surveys were given to the clinical workforce to provide intelligence on Bolus's reception with staff and evaluate the effectiveness of the delivery method. The first season featured episodes from professors and senior consultants on the latest developments in Immunotherapy and CAR T cells, updates on Myelodysplastic Syndromes, and specialist overviews of Lymphoma and allogeneic transplantation. Evaluation The Podcast team monitors listening statistics, produced by the web hosting service. The response has been unexpectedly good with &gt;4,000 total downloads, from countries around the world (table 1), in less than two months. User evaluation survey data reports improved knowledge and increased confidence across all employee groups. Respondents identified a number of key areas that we will reported on including: accessibility, time management, resource utility and content relevance. Conclusion The Podcast format is a surprisingly viable, effective and, importantly, cost-effective education solution which has the potential to educate large groups of clinical staff across global geographical locations. The 30-minute Podcasts can be listened to anywhere and on a variety of formats and devices. The delivery method is flexible and targets specialist knowledge on-demand at a time and place that best accommodates learners' needs. Disclosures No relevant conflicts of interest to declare.

Rethinking obstetric violence and the \u201cneglect of neglect\u201d: the silence of a labour ward milieu in a South African district hospital

BackgroundResearch into the mistreatment of women during childbirth has increased over recent years. Overt violence is an important focus of research, but recently there has been increasing recognition that there are other ways in which women in labour may be uncared for or even hurt. As part of a larger study focussing on staff responses to stillbirths, we wanted to gain contextual information on how high risk pregnancies are handled in general in Khayelitsha Hospital, a district hospital in an impoverished urban setting in the Western Cape Province of South Africa. This health care system experiences an immense patient load, the poverty of the community it serves, and the numerous traumas affecting both patients and staff.MethodsIn order to obtain rich exploratory data, a qualitative research methodology was used. The primary data source was observations in the labour ward, interviewing labour ward staff (doctors, nurse, and cleaners). The secondary data source was the analysis of hospital documents, specifically those related to labour ward policy.ResultsFrom our numerous observations and discussions, it is clear that no one is being overtly mistreated in this hospital and patients are medically well attended to. Although we saw no physical abuse, we noted the silence in the ward. Beside medical related interactions, we also noted that there were limited interactions between the women and the health care providers.ConclusionsSilence can be a form of neglect as it leaves the women feeling uncared for and not seen. In an overburdened health care system where both staff and patients are often overwhelmed or traumatised, silence can be a way in which a system defends itself against what it knows it cannot provide.

TO ASSESS THE LEVEL OF CLEANLINESS, HYGIENE, AND INFECTION CONTROL PRACTICES IN PUBLIC HEALTH CARE FACILITIES.

Method: This study is conducted at Primary, Secondary and Tertiary level of health care delivery centre of Indore district. Doctors, Staff Nurses, Housekeeping Staff, Staff Members, Beneficiaries (patient/relative). One year July 2010 - June 2011 Doctor Staff and Personnel involved in all selected centers were interviewed. 120 doctors, 56 nurses, 23 Housekeeping staff and 80 patients were selected for interviews &amp; by method of Observation. Records view Hospital staff and patients interview record.&#x0D; Result: IMCHRC, BSBH, Manpur, Sanwer, Simrol, &amp; Hatod has 80% of hospital cleanliness with 72% of segregation collection, storage &amp; transportation of BMW. DH Indore has 70% of cleanliness and 72% of segregation collection, storage &amp; transportation of BMW, whereas Depalpur has 70% &amp; 68%, respectively. Total number of doctors in all facilities is 120.&#x0D; 75% &amp;70% of Cleanliness and hygiene in procedure area and ambulatory &amp; auxiliary area, respectively at IMCHRC, DH, BSBH Mhow. Sanwer &amp; Hatod with 75% in both the areas by Depalpur 50%. Only Manpur and Simrol are with 100%.&#x0D; Conclusion: Knowledge attitude and practices regarding Infection Control, benefits of hand wash &amp; 6 steps of Hand wash correct method of wearing and removing hand gloves, when to use &amp; its types, making Chlorine Solution, Decontamination &amp; Cleaning of Instruments, standard Precautions, Knowledge about Personal Protective Equipment (PPE) and its practice among nurse and staff among all health care personnel is satisfactory.&#x0D; Keywords: Cleanliness, Public Health, Care &amp; Infection.

Utilization and expenses of outpatient services among tuberculosis patients in three Chinese counties: an observational comparison study

BackgroundThe China-Gates TB project Phase II implemented case-based payment reform in three Chinese counties in 2014, designed specifically for patients diagnosed with Tuberculosis (TB). This study aimed to examine the changes in utilization and expenses of outpatient services before and after the reform implementation, among TB patients in the three counties in China.MethodsWe collected quantitative data using surveys in 2013 (baseline year) and 2015 (final year). We used outpatient hospital records to measure service utilization and medical expenses of TB patients. We conducted qualitative interviews with local health authorities, officers of health insurance agencies, and hospital managers (n = 18). We utilized three focus group discussions with hospital staff and TB doctors and nurses. The χ2 tests and Mann-Whitney U tests were used to analyse quantitative data, and the thematic analysis using a framework approach was applied to analyse qualitative data.ResultsDantu and Yangzhong counties enacted TB-specific case-based payment method in 2014. Jurong County maintained global budget payment but raised the reimbursement rate for TB care. Compared to the baseline, the percentage of TB patients in Dantu and Yangzhong with eight or above outpatient visits increased from 7.5 to 55.1% and from 22.1 to 53.1% in the final survey, respectively. Jurong experienced the opposite trend, decreasing from 63.0 to 9.8%. In the final survey, the total outpatient expenses per patient during a full treatment course in Dantu (RMB 2939.7) and Yangzhong (RMB 2520.6) were significantly higher than those in the baseline (RMB 690.4 and RMB 1001.5, respectively), while the total outpatient expenses in Jurong decreased significantly (RMB 1976.0 in the baseline and RMB 660.8 in the final survey). Health insurance agencies in Dantu and Yangzhong did not approve the original design with outpatient and inpatient expenses packaged together, revealed by qualitative interviews. Furthermore, staff at designated hospitals misunderstood that health insurance agencies would only reimburse actual expenses. Many TB doctors complained about their reduced salary, which might be due to decreased hospital revenue generated from TB care after the payment method reform.ConclusionsThe intended effect on cost containment of case-based payment was not evident in Dantu and Yangzhong. In Jurong, where the global budget payment system maintained with the reimbursement rate enhanced, we found an effect on cost containment, but the quality of TB care might be compromised. The TB-specific case-based payment method could be redesigned to combine payment on outpatient and inpatient expenses and to set an appropriate payment standard for TB care during a full treatment course. Local health insurance agencies have to provide explicit explanations on the payment method. TB care providers should be provided with proper incentives. Monitoring and evluaiton on the quality of TB care should be undertaken at regular intervals.

Data-Driven Clinical Decision Support System for Medical Diagnosis and Treatment Recommendation

This paper presents a Data-Driven Clinical Decision Support System (CDSS) using machine learning. The proposed system predicts the possibility of diseases based on the patient’s symptoms. It suggests lab tests and medication related to the disease. Lab test results are analyzed to check the probability of liver and kidney diseases. The proposed system uses face recognition to identify the patient. Face recognition module retrieves the Patient Health Record and provides patient information and health records access to the doctor and medical staff. The system is developed using Python Django for Backend, React.JS for User Interface and PostgreSQL as the relational database. The system uses Logistic Regression for possible disease prediction, Support Vector Machine for liver disease prediction, Random Forest for chronic kidney disease prediction. The result of the proposed data-driven clinical decision support system is compared with a doctor’s disease analysis to measure the effectiveness of the proposed system. This kind of system can help doctors in providing better care and predict the disease at an early stage.

Third Eye Syndrome- a gadget screen addiction among medical professionals in Chennai, Tamilnadu, India.

Background: Screen time refers to any and all time spent in front of any device with an electronic screen. Today’s youth log a total of 10 hours and 45 minutes per day on screen. Sufficient severity may result in addiction to today’s digital drug. Staring at electronic screen continuously for long time cause multitude of non-communicable diseases. Objective: 1.To deduce the Screen time among people highly proficient with the usage of electronic screen of gadget regularly 2.To investigate the degree of awareness in taking protective measures among people 3.To ascertain the impacts associated with higher screen time empirically. Methods: A cross sectional study was conducted among medical students, interns, doctor and non-medical staff using a strategically devised questionnaire prioritizing on usage and frequency Results: 1.Mean screen time accounts about 50 minutes sans disjunction 2. Night or Reading mode was used by 47% and remaining were not or used sometimes while some were oblivious 3.More than 50% staffs and students have experienced withdrawal symptoms. Inside of, 14% suffered panic, 15.7% sad, 3.9% stressed, 1% suicidal thoughts, 10% don’t get sleep. Nearly half of them check their mobile up to five times in one hour and 10% check mobile more than 30 times. Conclusion: Screen addiction is at higher risk in this high tech era and the health effects are considered merely conjecture.

ملازمت کے شرعی احکام (ایک تحقیقی جائزہ)

In our society a large number of people are associated with employment ranging from a gatekeeper, soldier, peon, clerk to prime minister, chief of army staff (COAS) Journals, chief justice, secretary, chief minister, doctors and professors all are employees infect. Most of social problems are linked to them, if all of them do their work correctly and honestly then most of our issues can be solved easily. Furthermore growth and prosperity of our economic system is dependent on the betterment of employment. Nations who ever works and shows interest in improving the employment system are the one who pave road for their economic prosperity. As an ordinary person himself needs a worker, therefore if Islamic practices are promoted in different disciplines of employment in human life then Islamic orders will revive and its effect will be seen in other departments as well. Therefore this study focuses and tends to guide Muslims working in employment sector in our society. This will help employed persons not only to up bring the Islamic teachings as well as can be helpful for human beings to guide them about Islam. It will act as a set of guidance for people working in government and non-government organizations, so that an employee could earn a true living under sharia orders and be helpful in promoting and development of a better society.

Critical care outreach: A valuable resource?

Critical Care Outreach Services (CCOS) were recommended by the Department of Health in the United Kingdom in 2000. Despite being an established service, research studies have not explicitly demonstrated its efficacy. To explore the impact of CCOS from the perspective of hospital ward staff to inform service improvement potential. A pilot formative process evaluation was used to meet the study aims, including the development of a self-completion questionnaire. The exploratory questionnaire was distributed to a purposive sample of clinical staff (health care assistants, nurses, therapists, and doctors) on two medical and two surgical wards to establish the value of CCOS from the perspective of ward staff. The questionnaire was distributed to 195 staff members, of who 58 replied (30%). A descriptive analysis of quantitative data and content analysis of free-text responses demonstrated that staff knew how and when to use the service, that it was highly valued by all members of the multidisciplinary team, and that CCOS were perceived to have diverse responsibilities. Service improvement suggestions included increased staffing and longer hours of operation. Despite the lack of quality research supporting the efficacy of CCOS in previous research studies, the results of this project support the findings of previous evaluations that the value of the service lies in the support offered to ward staff and in the quality of care provided to patients. Because of the size of this evaluation, it was impossible to draw any generalizable conclusions. However, results clearly indicate that value is given to the support that the Critical Care Outreach Service provides to ward staff.

Seroprevalence of Bordetella pertussis in pediatric healthcare workers at the Hospital Infantil de México Federico Gómez.

Bordetella pertussis is the causative agent of pertussis, a disease that is preventable by vaccination but has a high mortality, particularly in children < 6 months. Reports of pertussis outbreaks in hospitals show that the index case is usually an adult. In adults, the disease manifests mainly with persistent cough. The purpose of this study was to determine the seroprevalence of B. pertussis in the health personnel of a pediatric hospital in a country where vaccination of this staff is not considered mandatory. Nursing staff and resident doctors who were involved in direct treatment with hospitalized patients participated in the study. Each participant was screened for immunoglobulin G anti-pertussis toxin antibodies (anti-PT), and a questionnaire was applied for clinical and demographic data. Ninety-three individuals were included, of which 85% were nurses, median age 35 years (interquartile range: 29-42.5). The participants worked in the emergency department (21.5%), in the Pediatric Intensive Care Unit (8.6%), and in the Neonatal Intensive Care Unit (6.5%). Detectable titers of anti-TP antibodies were found in 18.3%, of which 53% presented titles suggestive of recent infection and only 23.5% cough > 2 weeks of duration. Health personnel are at risk of suffering from the disease and be potential transmitters to infants, who may die from this cause. This study suggests that the current vaccination policies in health personnel should be modified to determine the compulsory nature of the vaccination, especially in those individuals in charge of the care of the pediatric population.

Simultaneous Evaluation of Communication Skills by Standardized Patients and Medical Evaluators

Abstract Introduction: The present study analyzes the evaluation of communication skills by standardized patients (SPs) and medical evaluators (Es) in an OSCE setting. Methods: The OSCE involved 189 sixth-year medical students, as well as 34 SPs and 63 Es. Communications skills were evaluated in 8 stations, simultaneously by SPs and Es. The SPs were actors who had been trained in the clinical case and who acted in accordance with a standardized script in a simulated clinical situation. The evaluators, also standardized, were Resident Doctors or staff Doctors from the Hospital Services involved. Results: The global scores awarded to students for communication skills were very similar in both groups, although the score awarded by Es was significantly higher, and a direct relationship was also observed between the mean scores awarded by both groups. Evaluators awarded significantly higher scores than SPs in 7 out of the 10 items on the checklist. Female medical students also scored significantly higher than their male counterparts in many items, including external appearance, listening, cordiality, optimism, interest, expression and empathy. Discussion: Our data indicate that SPs and Es evaluated communication skills in a similar manner in an OSCE setting, a finding which suggests that health-related professionals can be used as an alternative to SPs, thus helping to lower economic costs. Our study also confirms a gender difference (in favor of women) in the evaluation of communications skills by both groups.

Assessment of the risk of obstructive sleep apnoea syndrome among healthcare workers.

Sleep deprivation is known to increase the risks for workplace accidents, neuro-behavioural symptoms and reduced quality of life. Shift work leads to sleep related problems, such as sleep deprivation, poor sleep quality and daytime sleepiness. The purpose of our study is to assess snoring prevalence and obstructive sleep apnoea risk among healthcare workers (HCWs) by using the Berlin Questionnaire. HCWs employed at different centres that agreed to take part in this study were enrolled. Employing the Berlin Questionnaire, demographic characteristics, smoking histories, comorbidities, on-call shifts, number of on-call shifts and sleep durations of the participants were surveyed. 604 HCWs including specialist, nurse, junior doctor, medical student, clinical academic, health technician and hospital staff were enrolled in this study. In terms of sleep apnoea, 92 (15.1%) participants were identified as high-risk and 512 (84.8%) as low-risk according to the findings of the questionnaire. When the two groups identified as high and low risk for sleep apnoea according to the Berlin Questionnaire were compared, significant differences were found between the two groups in terms of age, sex, height, weight, BMI value and hypertension (p< 0.001 for all variables). Multivariate logistic regression analysis has shown that on-call shifts (OR= 0.199, CI= 0.053-0.747, p= 0.017) are negative associated with sleep apnoea risk. With extended working hours and on-call shifts increasing the risk of sleep disorders among HCWs, surveys designed for screening can be used to identify the prospective cases in this population for further examination.

Cross-sectional survey on job satisfaction and its associated factors among doctors in tertiary public hospitals in Shanghai, China

ObjectivesDoctors in public hospitals in China face considerable pressure and excessive workloads, which are likely to predispose them to job dissatisfaction. We explored the job satisfaction of doctors and examined...