GReek Anaesthesiologists's Burnout EPidemic within the COVID-19 pandemic (GRABEP study); a multicenter study on burn out prevalence among Greek anesthesiologists and association with personality traits.

COVID-19 pandemic resulted in an unprecedented crisis with extreme distress for the frontline physicians and increased risk of developing burnout. Burnout has a negative impact on patients and physicians, posing a substantial risk in patient safety, quality of care and physicians' overall wellbeing. We evaluated burnout prevalence and possible predisposing factors among anaesthesiologists in the COVID-19 referral university/tertiary hospitals in Greece. In this multicenter, cross-sectional study we have included anaesthesiologists, involved in the care of patients with COVID-19, during the fourth peak of the pandemic (11/2021), in the 7 referral hospitals in Greece. The validated Maslach Burnout Inventory (MBI) and Eysenck Personality Questionnaire (EPQ) were used. The response rate was 98% (116/118). More than half of the respondents were females (67.83%, median age 46 years). The overall Cronbach's alpha for MBI and EPQ was 0.894 and 0.877, respectively. The majority (67.24%) of anaesthesiologists were assessed as "high risk for burnout" and 21.55% were diagnosed with burnout syndrome. Almost half participants experienced high levels of all three dimensions of burnout; high emotional exhaustion (46.09%), high depersonalization (49.57%) and high levels of low personal accomplishment (43.49%). Multivariate logistic analysis revealed that neuroticism was an independent factor predicting "high risk for burnout" as well as burnout syndrome, whereas the "Lie scale" of EPQ exhibited a protective effect against burnout. Burnout prevalence in Greek anaesthesiologists working in COVID-19 referral hospitals during the fourth peak of the pandemic was high. Neuroticism was predictive of both "high risk for burnout" and "burnout syndrome".

A systematic review examining the effect of vitamin D supplementation on functional outcomes post-stroke.

OBJECTIVE: The objective of this systematic review was to explore the effect of vitamin D supplementation on functional outcomes (motor function, mobility, activities of daily living and stroke impairment) among individuals post-stroke (PROSPERO CRD42022296462). DATA SOURCES: MEDLINE, PsycINFO, EMBASE, and CINAHL were searched for all articles published up to March 5, 2023. METHODS: Only interventional studies assessing vitamin D supplementation compared to placebo or usual care in adult stroke patients were selected. After duplicate removal, 2912 studies were screened by two independent reviewers. A total of 43 studies underwent full text review; 10 studies met inclusion criteria (8 randomized controlled trials and 2 non-randomized studies of intervention). Data were extracted by two independent reviewers using Covidence software. Motor function (Brunnstrom Recovery Stage, Berg Balance Score), mobility (Functional Ambulation Category), activities of daily living (Barthel Index, Functional Independence Measure) and stroke impairment (modified Rankin Scale, National Institutes for Health Stroke Severity, Scandinavian Stroke Severity) were the outcome measures of interest reported in the included studies. RESULTS: In total, 691 patients were studied for which 11 of 13 outcome measures showed improvement with vitamin D supplementation. CONCLUSIONS: The majority of studies showed a statistical improvement in motor function, mobility, and stroke impairment with vitamin D supplementation; however, the evidence did not support an improvement in activities of daily living with treatment. Despite this, there may not be clinical significance. Strong, methodologically sound, randomized controlled trials are required to verify these findings.

Systematic Review Examining the Effect of Vitamin D Supplementation on Outcomes Post Stroke...American Congress of Rehabilitation Medicine (ACRM) Annual Conference, November 8-11, 2022, Chicago, Illinois

The objective of this systematic review was to explore the effect of vitamin D supplementation on functional outcomes among individuals post stroke(PROSPERO CRD42022296462). MEDLINE, PsycInfo, EMBASE, and CINAHL were searched for articles published in any language from database inception to January 5, 2022. Only interventional studies assessing vitamin D supplementation compared to placebo or usual care in adult stroke patients were selected. After duplicate removal, 2,825 studies were screened by two independent reviewers. A total of 41 studies underwent full text review;8 studies met inclusion criteria (6 randomized controlled trials [RCTs] and 2 observational studies). Data were extracted by two independent reviewers using Covidence software. Motor function (Brunnstrom Recovery Stage, Berg Balance Score), mobility (Functional Ambulation Category), activities of daily living (Barthel Index, Functional Independence Measure) and stroke impairment (Modified Rankin Scale, National Institutes for Health Stroke Severity, Scandinavian Stroke Severity) were the outcome measures of interest included in the studies. In total, 562 patients were studied for which 9 of 13 outcome measures showed improvement with vitamin D supplementation. The majority of studies showed an improvement in motor function, mobility, and stroke impairment with vitamin D supplementation;however, the evidence did not support an improvement in activities of daily living with treatment. Strong, methodologically sound RCTs are required to verify these findings. None.

Prevention of Osteoporotic Fractures in Residential Aged Care: Updated Consensus Recommendations.

Osteoporosis is underdiagnosed and undertreated in people living in Residential Aged Care Facilities (RACFs), even though aged-care residents are at greater risk of experiencing fractures than their community-dwelling counterparts. The first (2009) and second (2016) Consensus Conferences on the Treatment of Osteoporosis in RACFs in Australia addressed the prevention of falls and fractures in RACFs. A third Consensus Conference was held to review advances in the field of osteoporosis for people living in RACFs and to update current guidelines. The Conference was held virtually in October 2020 due to the COVID-19 pandemic. Attendance at the meeting was open to health practitioners (n = 116) (eg, general practitioners, geriatricians, rehabilitation specialists, endocrinologists, pharmacists, and physiotherapists) working in RACFs. Participants chose and/or were assigned to breakout groups to review the evidence and reach a consensus on the topic area assigned to the group, which was then presented to the entire group by a nominated spokesperson. Recommendations developed by breakout groups were discussed and voted on by all attending participants. This article updates the evidence for preventing falls and fractures and managing osteoporosis in older adults living in RACFs based on agreed outcomes from the group. We anticipate these updated recommendations will provide health practitioners with valuable guidance when practicing in RACFs.

Frailty differences across population characteristics associated with health inequality: a cross-sectional analysis of baseline data from the Canadian Longitudinal Study on Aging (CLSA).

OBJECTIVE: To evaluate the pattern of frailty across several of social stratifiers associated with health inequalities. DESIGN, SETTING AND PARTICIPANTS: Cross-sectional baseline data on 51 338 community-living women and men aged 45-85 years from the population-based Canadian Longitudinal Study on Aging (collected from September 2011 to May 2015) were used in this study. PRIMARY OUTCOMES AND MEASURES: A Frailty Index (FI) was constructed using self-reported chronic conditions, psychological function and cognitive status and physical functioning variables. Social stratifiers were chosen based on the Pan-Canadian Health Inequalities Reporting Initiative, reflecting key health inequalities in Canada. Unadjusted and adjusted FIs and domain-specific FIs (based on chronic conditions, physical function, psychological/cognitive deficits) were examined across population strata. RESULTS: The overall mean FI was 0.13±0.08. It increased with age and was higher in women than men. Higher mean FIs were found among study participants with low income (0.20±0.10), who did not complete secondary education (0.17±0.09) or had low perceived social standing (0.18±0.10). Values did not differ by Canadian province of residence or urban/rural status. After simultaneously adjusting for population characteristics and other covariates, income explained the most heterogeneity in frailty, especially in younger age groups; similar patterns were found for men and women. The average frailty for people aged 45-54 in the lowest income group was greater than that for those aged 75-85 years. The heterogeneity in the FI among income groups was greatest for the psychological/cognitive domain. CONCLUSIONS: Our results suggest that especially in the younger age groups, psychological/cognitive deficits are most highly associated with both overall frailty levels and the gradient in frailty associated with income. If this is predictive of later increases in the other two domains (and overall frailty), it raises the question whether targeting mental health factors earlier in life might be an effective approach to mitigating frailty.