Perceptions of a group of surgical and non-surgical residents at a Hispanic academic medical center of the impact of the night-float system.

OBJECTIVE: In 2003 the ACGME implemented mandatory work-hour limitations to address concerns about the negative effects of sleep deprivation on resident wellbeing and patient safety. The night-float system (NFS) is an attempt to promote a balance between optimal patient care and well-rested residents. The aim of this study was to assess and compare the perceptions of surgical and non-surgical residents with regard to the impact of the NFS on their education, their well-being, and aspects related to patient care. METHODS: After the approval from the Institutional Review Board was received, residents (241) from the UPR School of Medicine residency programs were invited to participate. Those residents who chose to take part in the study (149) completed a questionnaire with demographic questions and items related to individual perceptions of the impact of the NFS. The questionnaires, collected from April 2010 through September 2010, were categorized as having come from a surgical or nonsurgical resident. Data were analyzed. RESULTS: The response rate was almost sixty-two percent (61.8%). Of the residents who answered the questionnaire, 63% were in non-surgical programs, 51% were female, and 58% were single. Seventy-three percent of the residents had participated in an NFS. Sixty-two percent disagreed that their participation in the NFS improved their sense of well-being. Seventy-six percent agreed that their participation improved the continuity of care for the emergency room patients under their responsibility. A higher percentage of the non-surgical residents than surgical residents agreed that during their participation in the NFS, their relationships with their spouses/significant others and children (if applicable), sleep patterns and hours, peer support, and work/ rest balance were impacted negatively. CONCLUSION: This group of residents presented significant differences between the non-surgical and the surgical groups in areas related to well-being, which the majority agreed was negatively impacted during their participation in the NFS.

Video games use patterns and parenteral supervision in a clinical sample of Hispanic adolescents 13-17 years old.

Video games have become a popular entertainment among adolescents. Although some video games are educational, there are others with high content of violence and the potential for other harmful effects. Lack of appropriate supervision of video games use during adolescence, a crucial stage of development, may lead to serious behavioral consequences in some adolescents. There is also concern about time spent playing video games and the subsequent neglect of more developmentally appropriate activities, such as completing academic tasks. Self-administered questionnaires were used to assess video game use patterns and parental supervision among 55 adolescent patients 13-17 years old (mean age 14.4 years; 56.4% males) and their parents. Parental supervision /monitoring of the adolescents video games use was not consistent and gender related differences were found regarding their video game use. Close to one third (32%) of the participants reported video game playing had interfered with their academic performance. Parents who understood video games rating system were more likely to prohibit their use due to rating. These findings underscore the need for clear and consistently enforced rules and monitoring of video games use by adolescents. Parents need to be educated about the relevance of their supervision, video games content and rating system; so they will decrease time playing and exposure to potentially harmful video games. It also supports the relevance of addressing supervision, gender-based parental supervisory styles, and patterns of video games use in the evaluation and treatment of adolescents.

Prevalence of Internet addiction in Latino adolescents with psychiatric diagnosis.

Internet addiction (IA) is particularly relevant in the adolescent population. The aim of this study was to describe the prevalence of IA in a clinical sample of Latino adolescents receiving ambulatory psychiatric treatment. The correlation between their pattern of Internet use and their respective psychiatric diagnosis was also studied. Adolescent patients from the Psychiatric Ambulatory Clinic at the Pediatric University Hospital (N=71) completed the Internet Addiction Test (IAT) and a questionnaire about Internet use. Information regarding demographic and diagnostic data was retrieved from their clinical records. None of the subjects presented severe IA. A total of 71.8% (n=51) of the adolescents obtained scores reflecting no problem related to IA. Only 11.6% (n=5) of subjects have discussed Internet use with their therapist. Mood disorders showed a statistically significant (p=0.044) correlation with a higher score on the IAT. Mental health care practitioners must consider questions on Internet use as an essential part of the patients' evaluation given its significant correlation with diagnosis of a mood disorder.

Job satisfaction of a group of surgical and non-surgical physicians at a Hispanic academic medical center, 2006-2007.

BACKGROUND: Job satisfaction has been associated with motivation, job involvement, job commitment, patient's satisfaction, and quality of care. Physician's job satisfaction may improve retention and performance in clinical practice, and maximize quality of services. METHODS: Job satisfaction was assessed in a group of non-resident surgical and non-surgical married physicians of the UPR SOM during the 2006-2007 academic year. Job satisfaction was measured using an 18-item scale. RESULTS: Ninety-two (n=92) physicians completed a self-administered questionnaire for a response rate of 34.8%. Almost all (90.0%) reported being satisfied or very satisfied with their job. Satisfaction was very high in both surgical and non-surgical physicians, and similar in both males and females. The physicians who were most satisfied with their jobs were those aged 35 or less, those who had completed their residency/fellowship in the previous 10 years, those whose spouse was not a physician, those who reported being previously married, and those who were not active in their religion. CONCLUSIONS: In this study, almost all the physicians in both genders reported being satisfied or very satisfied with their job. The younger physicians, who are also probably the same that completed their residency/fellowship in the previous 10 years, were the most satisfied with their jobs. Satisfaction was very high in both the surgical and the non-surgical group. The findings in this population differ from other groups, particularly in the high level of satisfaction among younger doctors and the similar satisfaction levels among genders.

Marital and job satisfaction among non-resident physicians at a Hispanic academic medical center, 2006-2007.

Marital satisfaction has been previously associated with job satisfaction although few studies have addressed this issue among Hispanic physicians. Marital and job satisfaction were assessed in a sample of 92 legally married non-residents physicians working at a Hispanic Academic Medical Center during the 2006-2007 academic year. Marital satisfaction was assessed using the Dyadic Adjustment Scale (DAS) and job satisfaction was measured using a 18-item scale. Response rate was 34.8%. Most (70.7%) of the subjects were males. Forty- five percent (45.0%) belonged to the surgical specialties group. The mean scale value for marital satisfaction was found to be in the average range. Almost all (88.7%) the participants reported being "satisfied "to "very satisfied" with their job. Ninety percent (90.0%) of the surgical specialists and 86.9% of the non-surgical specialists reported being satisfied with their job. The percentage of participants that reported to be "very satisfied" with their job, was higher among the group of surgical specialists (23.3%) than among the non-surgical specialists (13.0%) There was no significant relationship between marital satisfaction and job satisfaction. Also, no statistically significant difference was observed in the level of marital satisfaction and job satisfaction when surgical and non-surgical physicians were compared. The findings on marital satisfaction obtained in this sample were similar to those observed in a previous study of resident physicians at the same academic medical center.

[Indicators of depression symptoms in a sample of 12 to 17 year-old youths with diabetes mellitus type I]. / Indicadores de sintomas depresivos en una muestra de jóvenes de 12 a 17 años de edad con diabetes mellitus tipo I.

The purpose of this study was to find out what percent of a group of patients 12 to 17 years old and with a diagnosis of Diabetes Mellitus type I have depressive symptomatology. We also wanted to know if there were gender differences in regard to depressive symtomatology in this group. We used a revised and adapted spanish translation of the Beck Depression Inventory, the IDB-R. It was administered to a group of 49 patients ages 12 to 17 with Diabetes Mellitus type I. The mean score of the group at the IDR-R was 9.33, which according to the instrument represents absence of depressive symptomatology. We found that 36.7% of this group obtained a score greater than 10 in the IDB-R which according to this instrument, it means that depressive symptomatology was present. The symptoms most reported by the females were difficulties taking decisions and sleep problems. The symptom most reported by the males was change in appetite.

Applicability of the Spanish Translation of the Zung Self-Rating Depression Scale in a general Puerto Rican population.

Voluntary screening has shown to be an effective way to identify depressive symptoms and to provide adequate treatment. If a screening tool was to be used in a general Puerto Rican population, it should be validated in Spanish and be consistent with the particular response style of this group. The main objective of this research study is to assess if the Spanish translation of the Zung SDS is adequate to screen for depression in Puerto Ricans, and if the translation considers the sociocultural peculiarities of this group. Although the Zung SDS is presented as a self-report scale and was found to be reliable by Alpha coefficient and manageable by both the questioner and the participant, the Spanish version used in this activity presented interpretation difficulties. It is recommendable that a Spanish translation of this scale should be developed taking into consideration the particularities of the Puerto Rican population. The use of other screening tools that have already been validated as being culturally sensitive to Puerto Ricans could also be considered.

Early detection of depression using the Zung self-rating depression scale

OBJECTIVE: Compare the findings of the application of the Zung self-rating depression scale to spanish community during the NDSD on three consecutive years (1993, 1994, 1995). METHOD: 630 adults in a spanish community filled out the Zung-Self Rating Depression Scale (spanish translation) during the NDSD in october 1993, 1994, 1995. The responders were oriented regarding the results and clinical implications. Scale results were entered on epi-info 6.0 for statistical analysis. RESULTS: The obtained data shows a female preponderance in all samples. The groups found with SDS compatible with severe to extreme depression were 9.2, 9.3 and 11.3 for the respective years. Symptoms more significantly reported by the responders with a SDS of 50 or more were psychomotor retardation, confusion and anhedonia. Suicidal ideations were reported in 17.8 (1993), 15.5 (1994) and 20.7 (1995) of the sample. CONCLUSION: Despite the limitations of this study the results suggest that the Zung self-rating depression scale can be helpful in the early detection of depression in patients seen in their initial evaluation by the primary care physician. It's usefulness with spanish speaking communities at other clinical settings should be assessed more extensively

Perfil Biosicosocial de los delincuentes juveniles referidos a una clínica de salud mental / The biopsychosocial profile of junenile delinquents referred to a mental health clinic

This study consists of a record review of the juvenile delinquents admitted to a state child and adolescent mental health clinica in Puerto Rico during 1987. the review was done using as reference models the basic findings of other researchers in Puerto Rico and theUnited States and mainly of thos of Dorothy Lewis. The purpose of the study was to descrive the bio-psychosocial profile of the juvenile delinquents admited to this clinic. Multiple characteristics were found that described the juvenile delinquents and also were found a significant number of these youngters that did not continue on treatment. Some recomendations were discussed in order to do an early identification of the high risk youngters