Testing the Effectiveness of a Mobile Smartphone App Designed to Improve the Mental Health of Junior Physicians: Protocol for a Randomized Controlled Trial.

BACKGROUND: Shift (Black Dog Institute) is the first mobile health smartphone app created to support the mental health of junior physicians. Junior physicians experience demanding work conditions, leading to high levels of psychological distress and burnout. However, they are often concerned about the potential career impacts of seeking mental health support. The confidentiality and ease of access of digital interventions may be particularly suited to address these concerns. The Shift app provides therapeutic and psychoeducational content and strategies contextualized for the specific needs of physicians in training. App content includes information on mental health, help seeking, mindfulness, and common workplace-related concerns of junior physicians. OBJECTIVE: This study aims to test, at scale, the effectiveness of Shift among junior physicians working in Australia using a randomized controlled trial design. The primary aim is to examine whether junior physicians using Shift experience a reduction in depressive symptoms compared with a waitlist control group. The secondary aim is to examine whether the app intervention group experiences improvements in anxiety, work and social functioning, help seeking, quality of life, and burnout compared with the control group. METHODS: A total of 778 junior physicians were recruited over the internet through government and nongovernment medical organizations across Australia, as well as through paid social media advertisements. They were randomly allocated to one of 2 groups: (1) the intervention group, who were asked to use the Shift app for a period of 30 days, or (2) the waitlist control group, who were placed on a waitlist and were asked to use the app after 3 months. Participants completed psychometric measures for self-assessing mental health and wellbeing outcomes, with assessments occurring at baseline, 1 month after completing the baseline period, and 3 months after completing the baseline period. Participants in the waitlist control group were asked to complete an additional web-based questionnaire 1 month after receiving access to the app or 4 months after completing the baseline survey. Participants took part in the study on the internet; the study was completely automated. RESULTS: The study was funded from November 2022 to December 2024 by the New South Wales Ministry of Health. Data collection for the study occurred between January and August 2024, with 780 participants enrolling in the study during this time. Data analysis is underway; the effectiveness of the intervention will be estimated on an intention-to-treat basis using a mixed-model, repeated measures analysis. Results are expected to be submitted for publication in 2025. CONCLUSIONS: To the best of our knowledge, this is the first randomized controlled trial to examine the effectiveness of a mobile health smartphone app specifically designed to support the mental health of junior physicians. TRIAL REGISTRATION: Australia and New Zealand Clinical Trials Registry ACTRN12623000664640; https://tinyurl.com/7xt24dhk. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/58288.

Successful prolonged treatment of a carbapenem-resistant Acinetobacter baumannii hip infection with cefiderocol: A case report.

We report a 50-year-old Caucasian male with a complicated past medical history who developed extensive polymicrobial osteomyelitis, including a carbapenem-resistant Acinetobacter baumannii (CRAB). In order to streamline therapy, the patient received compassionate use cefiderocol for 6 weeks which was well tolerated. In addition, the patient's infection was considered cured at end of treatment. Few cases on the use of prolonged cefiderocol for treatment of osteomyelitis due to CRAB have been published. Our patient did not report adverse reactions, nor did he develop laboratory abnormalities which were assessed throughout and at the end of the 6-week course.

Five Times Sit-To-Stand test completion times among older women: Influence of seat height and arm position.

OBJECTIVE: To investigate the interaction of seat height and arm position with completion times for the Five Times Sit-To-Stand test (FTSTS) in older women. DESIGN: Cross-sectional study. SETTING: University-based rehabilitation centre. SUBJECTS: Thirty-three women (mean age 61.8 years, standard deviation 5.3) participated in this cross-sectional study. METHODS: Time taken to complete the FTSTS with different seat heights (85%, 100% and 115% of knee height) and arm positions (arms across chest, or hands on thighs) was measured with a stopwatch. RESULTS: FTSTS completion times differed significantly between seat heights of 85% and 115% knee height and between seat heights of 100% and 115% knee height for both arm positions. There was no significant difference between FTSTS completion times for the 2 arm positions at any seat height. CONCLUSION: A lower seat height resulted in longer FTSTS completion times in women over 55 years of age, whereas arm position did not significantly affect FTSTS completion times.

Association of seat height and arm position on the five times sit-to-stand test times of stroke survivors.

OBJECTIVES: To investigate (1) the association of seat height and (2) the association of arm position on the five times sit-to-stand test (FTSTS) times of individuals with stroke. DESIGN: A cross-sectional study. SETTING: University-based rehabilitation centre. SUBJECTS: Patients (n = 43) with chronic stroke. METHODS: The times in completing the FTSTS with different seat height (85%, 100%, and 115% knee height) and arm positions (arms across chest, hands on thighs). RESULTS: FTSTS times were significantly different between 85% and 100% seat heights, and between the 85% and 115% seat heights in both arm positions. However, there was no significant difference between the FTSTS times with the two arm positions at any seat height tested. CONCLUSION: Seat heights lower than the knee height result in longer FTSTS times, whereas arms positions did not significantly affect the FTSTS times.