Adolescents' School Burnout: A Comparative Study between Italy and Switzerland.

This study aimed to analyze and compare students' school burnout levels in Switzerland and Italy. Previous research has confirmed that female and older students in particular are highly exposed to burnout risk. Nevertheless, few studies have observed this phenomenon through a cross-national comparison. Data on burnout were collected from a sample of 840 adolescents (Italian students = 497; Swiss students = 343) (Mage = 14.98; SD = 1.06; Female = 50%). Burnout was measured using the School Burnout Inventory, and cross-cultural measurement invariance was tested. The results showed that this burnout measure was equivalent between the Italian and Swiss samples. A multivariate analysis of variance was next conducted to investigate the effects of age, gender, and nationality. Results partially confirmed our hypotheses, showing the effect of age but not of gender in explaining burnout differences among students, and between and within-group variance. In particular, the burnout risk was found to be higher in late adolescence (age 16 to 18, Mexhaution = 2.73; Mcynicism = 2.99; MInadequacy = 3.14) than in mid-adolescence (age 13 to 15 Mexhaution = 2.95; Mcynicism = 3.43; MInadequacy = 3.54). Furthermore, Italian adolescents were more exhausted and cynical (Mexhaution = 2.99; Mcynicism = 3.26) than their Swiss peers (Mexhaution = 2.52; Mcynicism = 2.93) when controlling for age and gender. Findings suggest further investigation of the role played by educational and cultural values may be warranted.

What Types of Educational Practices Impact School Burnout Levels in Adolescents?

This study explores the relationship between educational practices perceived by high school students and their level of burnout, as defined by emotional exhaustion, cynicism and inadequacy. A total of 287 adolescents (146 girls) aged between 14 and 19 years old (M = 16.08, SD = 1.01) and recruited from a public high school in French-speaking Switzerland completed a questionnaire regarding perceived educational practices and school burnout. Results from path analysis showed that the three dimensions of burnout were negatively associated with certain teacher- and school-related educational practices. More precisely, support for struggling students (ß = -0.24, p < 0.001) as well as teaching time (ß = -0.16, p < 0.05) were predictors of exhaustion (R2 =0.27). Teachers' instructional behavior (ß = -0.22, p < 0.01) and teacher motivation (ß = -0.31, p < 0.001) were predictors of cynicism (R2 = 0.20) and application of rules (ß = -0.21, p < 0.01) predicted inadequacy (R2 = 0.09). These educational practices should be of particular interest when it comes to strengthening the protective role of schools and teachers against school burnout in adolescents.

[Trends in interhospital transfers from a Swiss university hospital center]. / Evolution des transferts interhospitaliers au départ d'un centre hospitalier universitaire suisse.

OBJECTIVE: Research on interhospital transfers provides a basis for describing and quantifying patient flow and its evolution over time, offering an insight into hospital organization and management and hospital overcrowding. The purpose of this study was to conduct a qualitative and quantitative analysis of patient flow and to examine trends over an eight-year period. METHODS: A retrospective descriptive study of interhospital transfers was conducted between 2003 and 2011 based on an analysis of demographic, medical and operational characteristics. Ambulance transfers and transfers requiring physician assistance were analyzed separately. RESULTS: The number of interhospital transfers increased significantly over the study period,from 4,026 in 2003 to 6,481 in 2011 (+60.9%). The number of ambulance transfers increased by almost 300% (616 in 2003 compared to 2,460 in 2011). Most of the transfers (98%) were to hospitals located less than 75 km from the university hospital (median: 24 km, 5-44). In 2011, 24% of all transfers were to psychiatric institutions. 26% of all transfer cases were direct transfers from the emergency department. An increasing number of transfers required physician assistance. 18% of these patients required ventilatory support, whole 9.8% required vasoactive drugs. 11.6% of these transfers were due to hospital overcrowding. CONCLUSION: The study shows that there has been a significant increase in interhospital transfers. This increase is related to hospital overcrowding and to the network-based systems governing patient care strategies.

Impact of an intervention to control risk associated with patient transfer.

QUESTION UNDER STUDY: Hospitals transferring patients retain responsibility until admission to the new health care facility. We define safe transfer conditions, based on appropriate risk assessment, and evaluate the impact of this strategy as implemented at our institution. METHODS: An algorithm defining transfer categories according to destination, equipment monitoring, and medication was developed and tested prospectively over 6 months. Conformity with algorithm criteria was assessed for every transfer and transfer category. After introduction of a transfer coordination centre with transfer nurses, the algorithm was implemented and the same survey was carried out over 1 year. RESULTS: Over the whole study period, the number of transfers increased by 40%, chiefly by ambulance from the emergency department to other hospitals and private clinics. Transfers to rehabilitation centres and nursing homes were reassigned to conventional vehicles. The percentage of patients requiring equipment during transfer, such as an intravenous line, decreased from 34% to 15%, while oxygen or i.v. drug requirement remained stable. The percentage of transfers considered below theoretical safety decreased from 6% to 4%, while 20% of transfers were considered safer than necessary. A substantial number of planned transfers could be "downgraded" by mutual agreement to a lower degree of supervision, and the system was stable on a short-term basis. CONCLUSION: A coordinated transfer system based on an algorithm determining transfer categories, developed on the basis of simple but valid medical and nursing criteria, reduced unnecessary ambulance transfers and treatment during transfer, and increased adequate supervision.