ABSTRACT
Introducción: los residentes de especialidad médica están expuestos a un alto nivel de burnout lo cual impacta negativamente en el profesionalismo. Esto ha promovido que los programas de residencias instalen curricularmente actividades de bienestar y autocuidado. Este estudio busca identificar la presencia de actividades de autocuidado/bienestar en residencias de psiquiatría de Chile y conocer la opinión docente respecto del tema. Materiales y métodos: se realizó un estudio descriptivo transversal invitando vía correo electrónico a 80 docentes de 3 departamentos de psiquiatría a contestar un cuestionario sobre el tema de bienestar/autocuidado de sus residentes en sus programas de formación. Se realizó un análisis cuantitativo de los datos. Resultados: un 69,4% de los encuestados señaló que su residencia no cuenta con contenidos curriculares formales o un programa de autocuidado/bienestar para sus residentes. Las actividades existentes para las residentes relacionadas al autocuidado/bienestar y mencionadas por los docentes son: supervisión, resolución de conflictos, habilidades de comunicación y apoyo o trabajo grupal guiado. Las principales barreras son la limitación de tiempo, la falta de conocimiento y el financiamiento. Discusión: el bienestar de los residentes ha ganado relevancia en los últimos años. El Consejo de Acreditación de Educación Médica para Graduados (ACGME) lo promueve activamente. En Chile, según los programas encuestados, hay poca presencia sistemática de actividades estandarizadas o programas dirigidos al autocuidado y bienestar de este grupo. Parece necesario incluir este aspecto considerando el impacto del burnout en el personal de salud especialmente en un contexto de pandemia o crisis sanitaria.
Introduction: medical speciality residents are exposed to high burnout, which harms professionalism. This mental health situation has led to creating programs promoting well-being and self-care, which have not been installed transversally in medical education. The present study seeks to identify self-care/well-being activities in psychiatry residences in Chile and the teaching interest in implementing them. Methods: 80 professors from 3 Departments of Psychiatry were invited via email to answer a questionnaire on aspects of well-being. A quantitative analysis was performed. Results: 69.4% of those surveyed said their residence does not have formal content or a self-care/well-being program for its residents. The self-care/well-being activities most included in the residents surveyed were su-pervision, conflict resolution and communication skills, and support or guided group work. The main barriers are limited time and lack of knowledge. Discussion: The well-being of residents has gained relevance in recent years, so much so that the Accreditation Council for Graduate Medical Education (ACGME) actively promotes it. In Chile, the situation seems to be different; there is a systematic lack of standardized activities aimed at self-care and the resident's well-being. Including mental health advocating programs is an essential challenge considering the context of pandemic and the relevance of preventing burnout in health personnel.
ABSTRACT
A 20-year-old woman, without known pre-existent conditions presented with a history of dyspnea on exertion, and palpitations for 6 months. Vital signs, as well as cardiac and pulmonary examinations were normal. Routine blood tests were normal. The ECG showed nonspecific ST-T changes. The echocardiogram showed a left ventricle of normal size and function. A cystic image was shown in relation to the right ventricle, with displacement of the interventricular septum. These findings were confirmed on computed tomography. Additional cystic images on the liver or lungs were ruled out. On surgery, a cardiac hydatic cyst adhered to the pericardium next to the right ventricle was found. Puncture, drainage of the mass and surgical removal of cystic membranes were performed. The clinical course was uneventful. A four year follow up revealed no recurrence of the cyst.
Subject(s)
Humans , Female , Young Adult , Echinococcosis/surgery , Echinococcosis/diagnostic imaging , Heart Ventricles/surgery , Heart Ventricles/diagnostic imaging , Cardiac Surgical ProceduresABSTRACT
Low-probability, high-impact events are difficult to manage. Firms may underinvest in risk assessments for low-probability, high-impact events because it is not easy to link the direct and indirect benefits of doing so. Scholarly research on the effectiveness of programs aimed at reducing such events faces the same challenge. In this article, we draw on comprehensive industry-wide data from the U.S. nuclear power industry to explore the impact of conducting probabilistic risk assessment (PRA) on preventing safety-related disruptions. We examine this using data from over 25,000 monthly event reports across 101 U.S. nuclear reactors from 1985 to 1998. Using Poisson fixed effects models with time trends, we find that the number of safety-related disruptions reduced between 8% and 27% per month in periods after operators submitted their PRA in response to the Nuclear Regulatory Commission's Generic Letter 88-20, which required all operators to conduct a PRA. One possible mechanism for this is that the adoption of PRA may have increased learning rates, lowering the rate of recurring events by 42%. We find that operators that completed their PRA before Generic Letter 88-20 continued to experience safety improvements during 1990-1995. This suggests that revisiting PRA or conducting it again can be beneficial. Our results suggest that even in a highly safety-conscious industry as nuclear utilities, a more formal approach to quantifying risk has its benefits.
Subject(s)
Nuclear Reactors , Safety Management/methods , Probability , Risk Assessment , United StatesABSTRACT
El desarrollo agropecaurio de las zonas de alta heterogeniidad requiere, inicialmente, efecturar una lectura adecuada de la realidad o conocer adecuadamente la misma; este conocimiento debe tener uan visión de los actores principales de cada escenario y de diversas ópticas externas. En función de este conocimiento, se pondran plantear y planificar progrmas y/o participativos que permitan el ansiado desarrollo de las comunidades de la zona andina de Bolivia. Sin embargo , la principa restriciión del conocimiento es el tiempo y esta quiza sea una de las razones para exista uan tendencia a la homogeneización de la inofrmación, esta práctica origina inofración de base errónea que afecta negativamente en la evaluación de los logros y resultado de proyectos y/o progrmas
