Burnout among paramedic students at a university in Johannesburg, South Africa

Background. Burnout has been studied in several emergency medical services contexts and has been found to be high compared with that found in other health professions. Although burnout among students has been described in several healthcare disciplines; this has not been done in the field of prehospital emergency care. Objectives. To determine the prevalence of burnout among students in a 4-year university paramedic degree programme and to assess whether there was any significant difference in the prevalence of burnout among students during the 4 years of study. Methods. In this cross-sectional survey all students enrolled in a 4-year university paramedic degree programme were invited to participate. The questionnaire consisted of 19 questions from the Copenhagen Burnout Inventory (CBI); combined with distractor questions. Responses were analysed descriptively and one-way analysis of variance was used to compare CBI scores across the 4 academic years of study. Results. An 85% (n=93) response rate was obtained. The overall prevalence of burnout was 31%. Mean CBI scores across all academic years of study were highest for personal burnout; followed by work-related burnout and patient care-related burnout.The highest prevalence of students with burnout was in the 4th year; as was the highest prevalence of work-related and personal burnout. The second highest prevalence of students with burnout was in the 1st year; as was the highest prevalence of patient care-related burnout. No significant difference was found in CBI total burnout scores across the 4 years of study. Conclusion. Although there are no directly comparable data; the prevalence of burnout in this group of students appears to be high; particularly in the 1st and 4th years of study. Steps should be taken to ensure access to social and psychological support to avoid a negative impact on academic success and student wellbeing

The Effects of Two Differing Techniques on the Accuracy of Reagent Strip Blood Glucose Testing

The use of 70 isopropyl alcohol to prepare the site of skin puncture for reagent strip blood glucose testing has been reported to produce falsely elevated blood glucose levels. The objective of this study was to identify if any significant difference existed between the capillary blood glucose levels of healthy volunteers tested using a capillary blood glucose reagent test strip and reflectance photometer; comparing results obtained (i) with and without the use of 70 isopropyl alcohol to prepare the site of skin puncture and results obtained (ii) with and without 70 isopropyl alcohol using the first and second drops of blood. Data analysis revealed a significant interaction between the two factors specified above. If 70 isopropyl alcohol using the first and second drops of blood. Data analysis revealed a significant interaction between the two factors specified above. If 70 isopropyl alcohol is used to prepare the skin there is a significant elevation of 0.39 mmol/l in mean blood glucose concentration between results obtained using the first and second drops of blood while if the first drop of blood is used there is a significant elevation in mean blood glucose concentration of 0.49 mmol/l between results obtained using and not using 70 isopropyl alcohol to prepare the skin

Intervenção fisioterapêutica hospitalar na síndrome de SAPHO / The physical therapy hospital performance in the SAPHO´s syndrome

A síndrome SAPHO (Sinovite, Acne, Pustulose, Hiperostose, Osteíte)é uma entidade clínica heterogênea que tem manifestações comuns e podem envolver a pele, os intestinos, os olhos e a uretra sendo freqüentemente, associada ao comprometimento das articulações sacroilíacas e da coluna vertebral. Este trabalho tem como objetivo geral, estabelecer uma intervenção fisioterapêutica hospitalar em um indivíduo acometido pela síndrome de Sapho e, como objetivos específicos, avaliar o indivíduo portador desta síndrome, identificar seus principais déficits motores e respiratórios. Planejou-se, com base num referencial teórico, um processo de reabilitação do indivíduo em questão; então, executou´se o tratamento proposto. Trata-se de um estudo de caso, realizado com um estudo de caso, realizado com um paciente do sexo masculino, 44 anos de idade, internado no hospital Santa Isabel, com diagnóstico de síndrome Sapho, sendo esta classificada no grupo das artropias soronegativas. O processo de reabilitação planejado para este indivíduo inclui cinesioterapia, crioterapia e peep retard, bem como exercícios visando a melhor função diafragmática e padrões respiratórios. Após aplicação do tratamento observou-se diminuição no quadro álgico e redução do derrame articular; houve também uma evolução cinesioterapêutica, visto que o paciente deixou a permanência no leito para adquirir a posição ortostática.

Litotricia extracorpórea de cálculos renales: éxito y fracaso de acuerdo a tamaño y posición / Shock wave lithotripsy of renal calculi: success and failure according to size and location

Se analiza el éxito y fracaso en el tratamiento de càlculos renales tratados con Litotricia extracorpórea (LEC), estratificados de acuerdo al tamaño de los cálculos y a su ubicación en el sistema colector. Se analiza una serie de 849 cálculos renales tratados en forma consecutiva en un período de siete años en el servicio de urología del Hospital Militar de Santiago con un Litotritor Modulith SL-20 Storz Medical. El tamaño de los cálculos tratados varió de 4-70mm. El 70.8 porciento de los cálculos tenía un tamaño menor a 14mm y sólo un 3.4 pociento de la serie, un tamaño mayor a 30 mm.La LEC es la primera alternativa terapéutica para todos los cálculos renales, cualquiera sea su tamaño y ubicación en el sistema colector. Execpción a esta regla son los cálculos coraliformes y los cálculos de cáliz inferior de un tamaño superior a los 24 mm.

Litrotricia extracorpórea de cálculos de ureter pelviano: primera opción de tratamiento / Extracorporeal shock-wave lithotripsy for stones in pelvic ureter: first first option of treatment

Cierta controversia existe en el manejo del cálculo de úreter pelviano. Tanto la Litotricia Extracorpórea (LEC) como la cirugía endoscópica parecen ser opciones válidas de tratamiento.El objetivo es analizar los resultados en el tratamiento de cálculos del uréter pelviano con LEC.Los resultados sugiern que la LEC debiera ser considerada como procedimiento de primera elección en el manejo de cálculos de uréter pelviano. Consideramos que cuando no se dispone de fácil acceso a la LEC o el equipo disponible no ha probado eficacia en el tratamiento de cálculos en esta ubicación , entonces la cirugía endoscópica pasa a ser el tratamiento de elección.

Eficacia del láser Nd: YAG en el tratamiento del adenoma prostático obstructivo: comparación de dos técnicas / Efficacy of Nd: YAG laser in obstructive prostatic adenoma treatment: comparisson between 2 technics

Se trató de comprobar la eficacia del láser Nd:YAG en el tratamiento del adenoma prostático obstructivo y comparar dos técnicas diferentes. Se trataron 31 pacientes portadores de un adenoma prostático obstructivo cuyo peso promedio fue de 41.6 grs. Se utilizó un equipo láser Sharplan 3000 con una fibra de disparo lateral Side Trak. Se crearon dos grupos; el grupo I de 16 pacientes tratados con la técnica de 60 watts por segundos y el grupo II de 15 pacientes con la técnica de 40 watts por 90 segundos. El estudio postoperatorio fue básicamente valorando el tiempo del reinicio de la micción, los síntomas inmediatos, el control del score AUA y el flujo urinario. El tiempo promedio de seguimiento fue de tres meses. La mejoría sintomática global fue del 60.8 por ciento; 56.2 por ciento en el grupo I y de 63 por ciento en el grupo II. La mejoría objetiva del flujo urinario fue de 76.8 por ciento; 62.5 por ciento y 94.9 por ciento respectivamente. El tiempo promedio para reiniciar la micción fue de 7.19 días. La gran mayoría de los pacientes (87.1 por ciento) presentaron síntomas irritativos durante las primeras dos semanas después de la operación. Luego de 3 meses de seguimiento, ningún paciente ha requerido retratamiento ni tampoco se han presentado complicaciones urológicas. La ablación prostática por láser Nd:YAG es un procedimiento sencillo, seguro y eficaz en el tratamiento del adenoma prostático obstructivo. La técnica de baja intensidad utilizada en el grupo II fue superior a la del grupo I en la mejoría del flujo urinario

Cirugía laparoscópica en quistes renales simples: un avance / Laparoscopic surgery in simple renal cysts: an advance

Los quistes renales simples sintomáticos requieren de un tratamiento quirúrgico. Con la introducción de la vía laparoscópica como un nuevo método de abordaje en cirugía urológica, se ha abierto una nueva modalidad terapéutica para estos casos evitando así la cirugía convencional por lumbotomía.En el período marzo 1993 - junio 1994 se intervinieron cinco pacientes, cuatro mujeres y un hombre con quistes renales simples por vía laparoscópica cuya técnica se describe en detalle. Hubo una conversión a cirugía abierta por adherencias secundarias a cirugía previa. Debido a los buenos resultados obtenidos sin morbimortalidad y a las ventajas evidentes, se propone esta nueva técnica quirúrgica como una alternativa en el manejo de quistes renales simples sintomáticos

Rats do react to stimulus omission

1. The great majority of data supporting the hypothesis of a systemcapable of compararing current sensorial imputs with and internal representation of the environment comes from studies about exploratory activity to new stimuli or to manipulation of features of a familiar stimulus. On the other hand, these data could also be explained simply by arousal constructs. In this context, demonstrations of exploratory behavior to the absence of a previously presented stimulus (i.e., stimulus omission) would provide stronger support for the idea of a comparator. 2. To test the reaction of rats to the absence of a stimulus, rats were submitted to 7 exploratory trials in an open-field. In the 1st trial there were only two patterns on the apparatus wall. In trials 2-6 a stimulus was presented in a designated area of the field. Finally, in the 7th trial this stimulus was omitted. Results showed that the animals reacted to the stimulus omission by spending more time in the stimulus presentation place during the 7th trial than 1) in the 1st trial (also without stimulus), 2) in the 6th trial (last trial with a stimulus present), and 3) in 3 neutral sectors of the same size as the stimulus presentation place, during the 7th trial. 3. These data indicated thath rats do react to the absence of a familiar stimulus and provide strong support for the existence of a Comparator System since the rats responded to "something that wasn't there anymore", a response that could only be due to a reaction triggered by a mismatch between internal representation of the environment and its present state