ABSTRACT
Introduction: Burnout among resident physicians has been an area of concern that predates the COVID-19 pandemic. With the significant turmoil during the pandemic, this study examined resident physicians' burnout, depression, anxiety, and stress as well as the benefits of engaging in activities related to wellness, mindfulness, or mental wellbeing. Methods: A cross-sectional survey of 298 residents from 13 residency programs sponsored by the University of Kansas School of Medicine-Wichita was conducted in October and November 2021. A 31-item questionnaire measured levels of burnout, depression, anxiety, and stress. A mixed method approach was used to collect, analyze, and interpret the data. Descriptive statistics, one-way ANOVA/Kruskal-Wallis tests, adjusted odds ratios (aOR), and immersion-crystallization methods were used to analyze the data. Results: There was a 52% response rate, with 65.8% (n = 102) of the respondents reporting manifestations of burnout. Those who reported at least one manifestation of burnout experienced a higher level of emotional exhaustion (aOR = 6.73; 95% CI, 2.66-16.99; p < 0.01), depression (aOR = 1.21; 95% CI, 1.04-1.41; p = 0.01), anxiety (aOR = 1.14; 95% CI, 1.00-1.30; p = 0.04), and stress (aOR = 1.36; 95% CI, 1.13-1.64; p < 0.01). Some wellness activities that respondents engaged in included regular physical activities, meditation and yoga, support from family and friends, religious activities, time away from work, and counseling sessions. Conclusions: The findings suggested that the COVID-19 pandemic poses a significant rate of burnout and other negative mental health effects on resident physicians. Appropriate wellness and mental health support initiatives are needed to help resident physicians thrive in the health care environment.
ABSTRACT
Sore throat is a common presenting complaint in the outpatient setting. Most cases are nonbacterial in origin, but those that are bacterial are usually the result of group A ß-hemolytic streptococcus. Guidelines exist to help physicians decide whether to treat with an antibiotic. Lemierre syndrome is a dangerous potential sequela of pharyngitis that results in septic thrombophlebitis of the internal jugular (IJ) vein. A high index of suspicion is needed to consider this diagnosis in the workup of pharyngitis and should be aggressively treated once identified. Consideration should be given to completing blood cultures and neck imaging because of clinical suspicion. The case study discussed here illustrates the presentation, evaluation, and treatment of Lemierre syndrome.
Subject(s)
Lemierre Syndrome/diagnosis , Pharyngitis/complications , Female , Humans , Lemierre Syndrome/etiology , Young AdultABSTRACT
BACKGROUND: Treatment studies about childhood obesity in primary care are lacking. We hypothesized that providing a paid family membership to the YMCA would be effective in reducing weight. METHODS: Patients 5 to17 years old in at least the 85th body mass index (BMI) percentile were eligible. All participants were scheduled to attend 4 nutrition classes and to return for evaluation at 2, 4, 6, 9, and 12 months. Participants were randomized to nutrition classes only (n = 39) or nutrition classes and family YMCA membership (n = 44). The primary outcome measure was year change in BMI-for-age percentile. RESULTS: Median BMI percentile at baseline was 99. Only 27 of 36 evaluable participants in the treatment group visited the YMCA. Four participants in the control group and one in the treatment group achieved the target reduction of 2 BMI percentile points (Fisher's exact, P = .17). Within the treatment group, YMCA attendees had a mean increase of 0.30 BMI points compared with an increase of 0.60 BMI points in nonattendees (P = .28). CONCLUSION: In very obese children, eliminating financial barriers to YMCA membership is insufficient to induce more weight loss during 1 year compared with nutrition classes alone. Improvements in nutrition intake were reported by both groups.
