Impact of the COVID-19 pandemic on the development of burnout syndrome in frontline physicians: prevalence and associated factors

SUMMARY OBJECTIVE: To evaluate the prevalence of burnout syndrome (BS) in physicians working during the COVID-19 pandemic in Paraíba and to investigate the association between BS and the sociodemographic and labor variables of these professionals. METHODS: This was a cross-sectional study including physicians who were active during the pandemic in Paraíba, whether they were on the front line (group 1) or not (group 2). Sociodemographic and labor variables were collected, and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) questionnaire was applied. RESULTS: A total of 126 physicians were included, including 82 who were on the front line. Among the professionals with results compatible with BS, 85.5% were in group 1, compared with 14.5% in group 2, and this difference was statistically significant. At the 5% level, the variables associated with BS were age (24-33 years), not having children, working on the front line, working in the COVID-19 ICU, being on duty, and having contracted COVID-19. CONCLUSIONS: This case series found a positive association between the development of BS and medical action on the front line of the COVID-19 pandemic in Paraíba.

Subjective Well-Being in India: Socioeconomic and Demographic Determinants and Differentials

Background: In the face of impressive performance in development indicators but poor ranking in the human development indicators, the subjective well-being in India has not been increasing commensurately with the rise in income. The lack of direct long-run relationship between income and happiness in India is a paradox that needs a deeper understanding of the influence of socioeconomic and demographic factors on subjective well-being over space and time. Methodology: The data from five waves of the World Values Survey of India for 24 years over the period 1990-2014 are used. The socioeconomic and demographic determinants of subjective well-being are analysed using chi-square test. The distribution of subjective well-being indicators - happiness, life satisfaction and financial satisfaction - at the group level are examined. Results: The average levels of life satisfaction and happiness have not increased commensurately with income and economic growth over time in India. The happiness level remains constant and life satisfaction and financial satisfaction declined with sharp variations across background characteristics of people and over space and time. Happiness distribution is left-skewed and life satisfaction is related, but not uniformly, with income. Significant differences in well-being exist with respect to education, income, social class, religion, age, marital status and health, but not much with employment and gender. Conclusion: The subjective well-being levels of people of India are influenced by their socioeconomic status with varying degree among different socioeconomic and demographic groups.

An Assessment of Eating Disorder among Adolescents and Young Adults

Young males and females are highly concerned about their body image and physical appearance. They refrain themselves from eating that effect the physical and social well-being. This study aims at identifying the presence of eating disorder and to explore as well as confirm four factor solution of eating disorder among adolescents and adults. The study is conducted obtaining data from a sample of 600 adolescents and young adults studying in private and public educational institutions using EDE-Q questionnaire. Chi-square test has revealed the relationship between age and eating concern scores. Pearson correlation test suggested that age is related with global score whereas all the eating disorder scores are inter-related. No gender-wise difference between shape concern and global score is found whereas the global scores and shape concern scores are significantly different with respect to type of institution. Global score and shape concern scores are same for adolescents and young adults. Mean ranks are higher for males compared to females whereas there is significant difference among restraint scores gender-wise however shape concern, weight concern and restraint scores were significantly different in private and public institutions. Mean ranks for young adults are higher for restraint, shape concern, weight concern and eating concern scores compared to adolescents whereas the significant difference was observed between young adults and adolescents for restraint scores. EFA has identified four-factor solution for the EDE-Q subscales whereas CFA has also confirmed it. The four factor solution is weight and shape concern, fear of gaining weight, restraint and eating concern.

Study on fetomaternal outcome in short interpregnancy interval: case control study

Background: This study was carried out at a tertiary health centre with the aim of studying the effect of short interpregnancy interval on fetomaternal outcome. The maternal complications and fetal complications of short interpregnancy interval were analysed in comparison to normal interpregnancy interval.Methods: This is a case control study. 125 women with short interpregnancy interval seeking healthcare at tertiary health care centre were matched with 125 women with normal interpregnancy interval on the basis of demographic characteristics like age, height, weight and socio-economic status. These were included in the case control study.Results: Short interpregnancy interval is associated with increased risk of anemia, premature rupture of membranes (PROM), scar dehiscence and low birth weight whereas normal interpregnancy interval is associated with increased risk of PIH as compared to short interpregnancy interval.Conclusions: Short interpregnancy interval is associated with increased risk of anemia, PROM, scar dehiscence and low birth weight whereas normal interpregnancy interval is associated with increased risk of PIH.

Técnicas de correção do teste qui-quadrado para amostras não normais / Techniques for correction the chi-square test for non-normal samples / Técnicas de corrección del test chi-cuadrado para muestras no normales

Este artigo tem o objetivo de avaliar técnicas de correções para o teste Qui-Quadrado (χ2) aplicadas a modelos da análise fatorial confirmatória (CFA) em amostras não normais. Em uma abordagem simulada e exploratória, foram mensuradas distribuições distintas em termos de curtose multivariada. Na maioria das situações verificadas, observou-se uma tendência dos testes aferidos de realizar correções diferenciadas dos valores do χ2, CFI e RMSEA em contextos similares. Como conclusão, dentre outros testes avaliados, sugere-se o uso dos seguintes: teste Elíptico com Mínimos Quadrados Reponderados (Teoria Elíptica); teste da Curtose Heterogênea com Mínimos Quadrados Reponderados (Teoria Curtose Heterogênea) e teste Escalado de Satorra-Bentler com Máxima Verossimilhança (para distribuições com excesso de assimetria e/ou curtose univariadas). Porém, devido ao fator de correção, o teste Escalado de Satorra-Bentler pode aceitar modelos moderadamente mal especificados na presença de extrema curtose. (AU)

This paper aims to evaluate techniques for correcting the chi-square test (χ2) as applied to Confirmatory Factor Analysis (CFA) models in non-normal data. In a simulated and exploratory approach, distinct distributions were analyzed in terms of multivariate kurtosis. In most situations, it was observed a tendency of the analyzed tests to produce differing corrections on the χ2 values, as well as for the CFI and RMSEA values. Among other tests evaluated, this study suggested the use of the Elliptical Test with Least Squares (Elliptical Theory), Heterogeneous Kurtosis Test with Reweighted Least Squares (Heterogeneous Kurtosis Theory) and Satorra-Bentler Scaled Test with Maximum Likelihood estimation (for distributions with excessive univariate asymmetry and/or kurtosis). However, due to the correction factor, the Satorra-Bentler Scaled test can accept moderately poorly specified models in the presence of extreme kurtosis. (AU)

Este artículo tiene por objetivo evaluar las técnicas de correcciones para la prueba chi-cuadrado (χ2) aplicadas a modelos del Análisis Factorial Confirmatorio (CFA) en muestras no normales. En un enfoque simulado y exploratorio, se midieron distribuciones distintas en términos de curtosis multivariada. En la mayoría de las situaciones verificadas, se observó una tendencia de las pruebas evaluadas de realizar correcciones diferenciadas de los valores del χ2 , CFI y RMSEA en contextos similares. En conclusión, entre otras pruebas evaluadas, se sugiere el uso de las siguientes: Prueba Elíptica con Mínimos Cuadrados Reponderados (Teoría Elíptica); Prueba de la Curtosis Heterogénea con Mínimos Cuadrados Reponderados (Teoría de la Curtosis Heterogénea) y Prueba Escalada de Satorra-Bentler con Máxima Verosimilitud (para distribuciones con exceso de asimetría y/o curtosis univariadas). No obstante, por cuenta del factor de corrección, la Prueba Escalada de Satorra-Bentler puede aceptar modelos moderadamente mal especificados en presencia de extrema curtosis. (AU)

Investigation and analysis of professional ethics of clinical medical postgraduates / 中华医学教育探索杂志

Objective To understand the cognition of clinical medical postgraduates' professional ethics,in order to provide the basis for the further development of graduate professional ethics education.Methods The survey was carried out among 650 graduate students of the first hospital of Jilin University by self-designed questionnaires.The questionnaires included the general situation and the understanding of professional ethics of medicine.All data were analyzed by SPSS 17.0,using Chi-square test to compare the results in different grades about the understanding of professional ethics.Results In this study,a total of 650 questionnaires were issued,and 629 valid questionnaires were collected with a recovery rate of 96.7％.Most graduates' professional values were in line with the socialist core values.For example,for the attitude of medical workers to accept red envelopes,410 graduate students (65.2％) firmly opposed to accepting this behavior.For the purpose of the study medicine,there was no statistically significant difference among different grades (P=0.273).For the attitude of red paper,the main problem in medical ethics education and the biggest factor for graduates,there was statistically significant difference among different grades (P=0.012,P=0.002,P=0.002,respectively).Conclusion At present,the professional ethics of postgraduates in clinical medicine is in good condition,but still needs to be improved.We can give further education and guidance to students for the problems existing in graduate students of different grades.

Development of Information Skills for Reading Periodicals - A study on Village Library.

Everybody in the world is a reader. A Reader may be an individual or a group of persons who are the end users of any Library. A Reader refers and uses a large number of Books and Periodicals services to satisfy his/her needs and wants. They have much time to read everything by themselves. Hence, this paper attempts to ascertain the development of information skills and the readers’ preference towards Periodicals. For analytical purpose, statistical tools are used. The results reveal the fact that age, education, gender and monthly income do most preferable area of Periodicals in village library. Further there is no significant relationship between monthly time spent and Reader Habits of Periodicals reading.

Misunderstandings of statistics in medical research / 中华医学科研管理杂志

To explore the misunderstandings of statistics in medical research,we surveyed related papers from CNKI published in the first quarter of 2012 and analysed the statistical application in those papers.Misunderstandings were identified and solutions were proposed to avoid them.

Chi-square analysis of the reduction of ATP levels in L-02 hepatocytes by hexavalent chromium

This study explored the reduction of adenosine triphosphate (ATP) levels in L-02 hepatocytes by hexavalent chromium (Cr(VI)) using chi-square analysis. Cells were treated with 2, 4, 8, 16, or 32 μM Cr(VI) for 12, 24, or 36 h. Methyl thiazolyl tetrazolium (MTT) experiments and measurements of intracellular ATP levels were performed by spectrophotometry or bioluminescence assays following Cr(VI) treatment. The chi-square test was used to determine the difference between cell survival rate and ATP levels. For the chi-square analysis, the results of the MTT or ATP experiments were transformed into a relative ratio with respect to the control (%). The relative ATP levels increased at 12 h, decreased at 24 h, and increased slightly again at 36 h following 4, 8, 16, 32 μM Cr(VI) treatment, corresponding to a "V-shaped" curve. Furthermore, the results of the chi-square analysis demonstrated a significant difference of the ATP level in the 32-μM Cr(VI) group (P < 0.05). The results suggest that the chi-square test can be applied to analyze the interference effects of Cr(VI) on ATP levels in L-02 hepatocytes. The decreased ATP levels at 24 h indicated disruption of mitochondrial energy metabolism and the slight increase of ATP levels at 36 h indicated partial recovery of mitochondrial function or activated glycolysis in L-02 hepatocytes.

A Review of Fundamentals of Statistical Concepts in Clinical Trials

Statistical analysts engaged in typical clinical trials often have to confront a tight schedule to finish massive statistical analyses specified in a Standard Operation Procedure (SOP). Thus, statisticians or not, most analysts would want to reuse or slightly modify existing programs. Since even a slight misapplication of statistical methods or techniques can easily drive a whole conclusion to a wrong direction, analysts should arm themselves with well organized statistical concepts in advance. This paper will review basic statistical concepts related to typical clinical trials. The number of variables and their measurement scales determine an appropriate method. Since most of the explanatory variables in clinical trials are designed beforehand, the main statistics we review for clinical trials include univariate data analysis, design of experiments, and categorical data analysis. Especially, if the response variable is binary or observations collected from a subject are correlated, the analysts should pay special attention to selecting an appropriate method. McNemar's test and multiple McNemar's test are respectively recommended for comparisons of proportions between correlated two samples or proportions among correlated multi-samples.

The application value of SCS scoring system in emergency department / 中华急诊医学杂志

Objective To investigate the clinical value of the simple clinical score (SCS) in Emergency Department.Methods A total of 655 patients with critically illness admitted from July 1,2011through August 31,2011 were enrolled to evaluate the clinical application of SCS in emergency rescue room by analysis of the relationship between SCS and outcome of patients,and the correlation between each factor of SCS and the risk of death. Results The higher SCS,the higher hazard ratio for death.Differences in the hazard ratio for death among groups with different scores of SCS were statistical significance ( P ＜ 0.01 ).According to Chi-square test,there were significant differences in each factor ( except body temperature &unable standing or need Home Health Aide) among the groups of SCS ( P ＜ 0.05 ). Binary logistic regression analysis of each factor showed that age,diabetes,coma,pulse,systolic pressure and respiratory rate had significant correlation with patient mortality. After logistic regression analysis,age,diabetes,coma,pulse,systolic pressure and respiratory rate are significantly related to the mortality of patients.Conclusions The SCS scoring system is useful to make a precise evaluation of critically ill patients in the emergency department.When emergency rescue is carried out,particular stress should be focused on age,diabetes,coma,pulse,systolic pressure and respiratory rate.

Correlation of muscular fitness with intelligence in school children.

The present study was carried out to correlate muscular fitness (as measured by Kraus-Weber Tests) in Indian school children with their intelligence quotient (as measured by Porteus Maze Test). These tools have been tried and tested successfully in previous studies, don't require sophisticated equipment and are easier to administer than traditional tests like EMG (for muscular fitness) and Wechsler Tests (for intelligence quotient). The present study found a significant positive correlation between intelligence quotient and muscular fitness. Failures in Kraus-Weber Tests tend to have a lower Intelligence Quotient and vice versa.

Estimativas da qualidade de linhas poligonais topográficas / Quality estimations of topographical traverses

O objetivo deste artigo é descrever um procedimento que contribui com estimativas de qualidade de levantamento topográficos mediante a pré-análise e estimativas obtidas a partir de análise pós-ajustamento. As estimativas são dadas pelo teste qui-quadrado da forma quadrática do erro de fechamento, pelo teste qui-quadrado da forma quadrática dos resíduos obtidos no ajustamento pelo método dos mínimos quadrados, pelo teste data snooping de Baarda, pela elipse dos erros, pela elipse de confiança, pelo círculo do erro de posição e pelo círculo do erro médio. Estes conceitos são examinados por meio de valores numéricos no caso de uma linha poligonal simples implantada no campus da Universidade Federal de Santa Maria e medida com um taquímetro eletrônico.

The objective through this article is to describe a procedure that contributes with quality survey estimations by means pre-analysis survey and estimations by means post-adjustment. The estimations are given by the chi-square test of the quadratic form of misclosures, the chi-square of the quadratic form of residuals from the least-squares adjustment method, the Baarda's data snooping test, the standard ellipse, the confidence ellipse, position error circle and mean error circle. These concepts are examined through the numerical values provided in the case of a simple topographical traverse which was implanted at the Universidade Federal de Santa Maria Campus with electronic tachymeter.

Analysis on Reports of Statistical Testings for Mean Differences / 여성건강간호학회지

PURPOSE: This study aimed to evaluate the accuracy and adequacy of research papers reporting statistical testings for mean differences. METHODS: Original research articles utilized t-test, Chi-square test, and ANOVA were reviewed from Korean Journal of Women Health Nursing published from the year 2004 to 2006. Seventy-six papers were evaluated in accordance with formatted criteria in respect to an inclusiveness of research title, accuracy of statistical methods and presentation styles, and errors in reporting statistical outcomes. RESULTS: Research titles were quite comprehensive, however overall accuracy of statistical values and basic formats reached only 60 to 80% by items. Details of the presentation in the reporting of outcomes were not complied with the guidelines, which need careful concerns of the writers. Errors of English in table presentation were found in more than 30% of the papers. CONCLUSION: The outcome would be reflected in the submission guidelines for future writers. To reach the level comparable with internationally recognized nursing journals, concrete knowledge to apply statistical methods should be ensured in the processes of submission, reviews, and editing.

Design of Autocorrection Data Processing Program for Fourfold Table Chi-square Test Based on Excel / 中国药房

OBJECTIVE:To develop autocorrection data processing program for fourfold table Chi-square test program based on Excel.METHODS:Formatted fourfold table Chi-square test auto-analyzer procedure was established based on Excel.If total samples were no less than 40 and the theoretical frequency was no less than 1,Chi-square value and probability value could be obtained by using Pearson's Chi-square formula and Yates' Chi-square correction formula,otherwise,the values will be calculated by revising form cell citation based on Fisher's exact test.RESULTS & CONCLUSIONS:Fourfold Chi-square test can be realized based on Excel,furthermore,once formatted worksheet is fixed,Chi Square value can be obtained as long as sample values in worksheet are replaced.

Discrimination and explanation of statistical errors in the analysis of qualitative data / 基础医学与临床

In this paper,many examples of misusing statistics analyzing the qualitative data are unveiled.Obviously,it is extremely important for people to process the qualitative data correctly by checking the types of contingency tables and the preconditions of data.

Consanguinity and chromosomal abnormality.

BACKGROUND : Consanguinity is defined as the marriage between close relatives. The deleterious effects associated with consanguinity may be caused by the expression of rare recessive genes inherited from common ancestors. AIMS AND OBJECTIVES : The present study was undertaken to analyze the effect of consanguinity on chromosomal abnormality (CA). METHODS AND MATERIALS : During last 6 years period, a total of 1465 cases with suspected genetic etiology like bad obstetric history, mental retardation, multiple congenital anomalies, Down syndrome, primary amenorrhea and primary infertility was referred to Division of Human Genetics for karyotyping and genetic counseling. The information regarding consanguinity was obtained through pedigree analyzes up to three generations from all the patients. Chi-square test was applied to test the significance. RESULTS : Consanguinity was seen in 427 cases (29.14%), 305 cases were confirmed to have CA, among them 240 (78.7%) had numerical abnormality and 65 (21.3%) had structural abnormality. The presence of consanguinity in CA was seen in 53 cases (17%), including 43 (81.1%) with numerical and 10 (18.9%) with structural abnormality. CONCLUSION : The effect of consanguinity on CA was almost significant ( P < 0.001), whereas the effect was not significant for the type of CA. It may be because of the pooled types of consanguinity as well as the CA. Further information is needed to state categorically that there could be the effect of consanguinity on CA.

Research on ttae estimation of the fatality rate of SARS / 中华医院管理杂志

Objective To estimate the fatality rate of SARS so as to provide data for the evaluation of patient care. Methods Based on the clinical features of the death cases of SARS, the average period between the time of clinical diagnosis and the time of death was determined and a method of estimation, which was lagged in time, was thus developed. Differences in the fatality rates of SARS across the world as well as the patterns of the differences were discussed using Chi-square and trend Chi-square tests. Results The fatality rate of SARS in Beijing, which presented a progressively downward tendency, was 7.2% by June 5, 2003, ranking relatively high among the SARS-hit zones in China. Conclusion Certain achievements have been attained in the clinical treatment of SARS cases, and yet more efforts need to be exerted. It is estimated that the eventual fatality rate of SARS in Beijing will be around 8%.