Aumento del síndrome de burnout en los adjuntos de Medicina Interna durante la pandemia de COVID-19 / Burnout syndrome increase during COVID-19 pandemic in attending Internal Medicine physicians

Introducción El burnout es un síndrome psicosocial causado por situaciones estresantes en el ámbito laboral. Afecta al 30-60% de los profesionales médicos. El objetivo de este estudio es realizar un análisis comparativo de su frecuencia antes y después del brote de la COVID-19 en los médicos adjuntos de Medicina Interna españoles. Métodos Se enviaron encuestas por correo electrónico y redes sociales integradas con el Maslach Burnout Inventory a los miembros de la Sociedad Española de Medicina Interna en 2019 y 2020. Resultados Se ha observado un aumento no significativo de burnout (38,0% vs. 34,4%). Sin embargo, sí se constata un aumento en la baja realización personal (66,4% vs. 33,6%; p=0,002), dimensión asociada a la prevención de la morbilidad psiquiátrica, además de otras dos: la fatiga emocional y la despersonalización, que pueden afectar negativamente a la atención del paciente. Conclusiones Es esencial abordar este síndrome individual e institucionalmente (AU)

Introduction Burnout is a psychosocial syndrome caused by stressful situations in the workplace. It affects 30% to 60% of medical professionals. The aim of this study is to carry out a comparative analysis of its frequency before and after the COVID-19 outbreak in Spanish internal medicine attending physicians. Methods Surveys that included the Maslach Burnout Inventory were sent via email and associated social networks to physicians who were members of the Spanish Society of Internal Medicine in 2019 and 2020. Results A non-significant increase in burnout was observed (38.0% vs. 34.4%). However, an increase in low personal fulfilment was observed (66.4% vs. 33.6%; p=0.002), a dimension associated with the prevention of psychiatric morbidity, in addition to two others: emotional fatigue and depersonalization, which can negatively affect patient care. Conclusions It is essential to address this syndrome individually and institutionally (AU)

Burnout syndrome increase during COVID-19 pandemic in attending Internal Medicine physicians.

INTRODUCTION: Burnout is a psychosocial syndrome caused by stressful situations in the workplace. It affects 30%-60% of medical professionals. The aim of this study is to carry out a comparative analysis of its frequency before and after the COVID-19 outbreak in Spanish internal medicine attending physicians. METHODS: Surveys that included the Maslach Burnout Inventory were sent via email and associated social networks to physicians who were members of the Spanish Society of Internal Medicine in 2019 and 2020. RESULTS: A non-significant increase in burnout was observed (38.0% vs. 34.4%). However, an increase in low personal fulfilment was observed (66.4% vs. 33.6%; p = 0.002), a dimension associated with the prevention of psychiatric morbidity, in addition to two others: emotional fatigue and depersonalization, which can negatively affect patient care. CONCLUSIONS: It is essential to address this syndrome individually and institutionally.

[Burnout syndrome increase during COVID-19 pandemic in attending Internal Medicine physicians]. / Aumento del síndrome de burnout en los adjuntos de Medicina Interna durante la pandemia de COVID-19.

Introduction: Burnout is a psychosocial syndrome caused by stressful situations in the workplace. It affects 30% to 60% of medical professionals. The aim of this study is to carry out a comparative analysis of its frequency before and after the COVID-19 outbreak in Spanish internal medicine attending physicians. Methods: Surveys that included the Maslach Burnout Inventory were sent via email and associated social networks to physicians who were members of the Spanish Society of Internal Medicine in 2019 and 2020. Results: A non-significant increase in burnout was observed (38.0% vs. 34.4%). However, an increase in low personal fulfilment was observed (66.4% vs. 33.6%; p = 0.002), a dimension associated with the prevention of psychiatric morbidity, in addition to two others: emotional fatigue and depersonalization, which can negatively affect patient care. Conclusions: It is essential to address this syndrome individually and institutionally.

A systematic review on the effects of nanomaterials on gut microbiota.

Some nanomaterials (NMs) have been shown to possess antimicrobial activity and cause GM dysbiosis. Since NMs are being used widely, a systematic assessment of the effects of NMs on GM is warranted. In this systematic review, a total of 46 in vivo and 22 in vitro studies were retrieved from databases and search engines including Science-Direct, Pubmed and Google scholar. Criteria for assessment of studies included use of in vitro or in vivo studies, characterization of NMs, use of single or multiple doses as well as consistency of results. GM dysbiosis has been studied most widely on TiO2, Ag, Zn-based NMs. There was moderate evidence for GM dysbiosis caused by Zn- and Cu-based NMs, Cu-loaded chitosan NPs and Ag NMs, and anatase TiO2 NPs, as well as low evidence for SWCNTs, nanocellulose, SiO2, Se, nanoplastics, CeO2, MoO3 and graphene-based NMs. Most studies indicate adverse effects of NMs towards GM. However, more work is required to elucidate the differences on the reported effects of NM by type and sex of organisms, size, shape and surface properties of NMs as well as effects of exposure to mixtures of NMs. For consistency and better agreement among studies on GM dysbiosis, there is need for internationally agreed protocols on, inter alia, characterization of NMs, dosing (amounts, frequency and duration), use of sonication, test systems (both in vitro and in vivo), including oxygen levels for in vitro models.

Determinants of high residual post-PCV13 pneumococcal vaccine-type carriage in Blantyre, Malawi: a modelling study.

BACKGROUND: In November 2011, Malawi introduced the 13-valent pneumococcal conjugate vaccine (PCV13) into the routine infant schedule. Four to 7 years after introduction (2015-2018), rolling prospective nasopharyngeal carriage surveys were performed in the city of Blantyre. Carriage of Streptococcus pneumoniae vaccine serotypes (VT) remained higher than reported in high-income countries, and impact was asymmetric across age groups. METHODS: A dynamic transmission model was fit to survey data using a Bayesian Markov-chain Monte Carlo approach, to obtain insights into the determinants of post-PCV13 age-specific VT carriage. RESULTS: Accumulation of naturally acquired immunity with age and age-specific transmission potential were both key to reproducing the observed data. VT carriage reduction peaked sequentially over time, earlier in younger and later in older age groups. Estimated vaccine efficacy (protection against carriage) was 66.87% (95% CI 50.49-82.26%), similar to previous estimates. Ten-year projected vaccine impact (VT carriage reduction) among 0-9 years old was lower than observed in other settings, at 76.23% (CI 95% 68.02-81.96%), with sensitivity analyses demonstrating this to be mainly driven by a high local force of infection. CONCLUSIONS: There are both vaccine-related and host-related determinants of post-PCV13 pneumococcal VT transmission in Blantyre with vaccine impact determined by an age-specific, local force of infection. These findings are likely to be generalisable to other Sub-Saharan African countries in which PCV impact on carriage (and therefore herd protection) has been lower than desired, and have implications for the interpretation of post-PCV carriage studies and future vaccination programs.

Potentiometric Determination of Chlorate Impurities in Hypochlorite Solutions.

The method of iodometric determination of chlorates impurities in sodium hypochlorite solutions for medical and veterinary purposes was developed. This method does not require sophisticated equipment and can be implemented directly where the solutions are used. The method is based on the different rates of interaction of ClO- and ClO3 - with iodide ions depending on the acidity of the medium. We have shown that blank titration is advisable to improve the accuracy of the determination of low concentrations of chlorates in the matrix of hypochlorite which is present in excess since in this case possible systematic errors due to the presence of oxidizing impurities in the reagents are prevented. To quantify the low concentrations of chlorates, we proposed to remove 85-95% of hypochlorite ions by means of reducing their excess with sodium sulfite at pH 10.5. The solution of sodium sulfite does not require standardization before each analysis in the proposed procedure. The possibility of quantitative determination of chlorate impurities in the range of 2-50 mg/L in the presence of 50-500-fold excess of sodium hypochlorite with an error of 5% has been proved. The expanded uncertainty of chlorate determination did not exceed 0.6 mg/L.

Kinematic adjustments in the basketball jump shot against an opponent.

The aim of this study was to analyse the adjustments in technique made by a basketball player when shooting against an opponent. The subjects used consisted of 10 professional basketball players of the Spanish First Division League. Three-dimensional motion analysis based on video recordings (50 Hz) was used to obtain the kinematic characteristics of basketball jump shots with and without an opponent. It was found that when performing against an opponent the release angle of the ball increased, the flight time was reduced and postural adjustments as determined by the angles at the knee and shoulder increased, all significantly. There were several other non-significant differences that helped to interpret the changes in technique imposed by the presence of an opponent. It was suggested that when shooting with an opponent, players attempted to release the ball more quickly and from a greater height. This strategy will lessen the chance of the opponent intercepting the ball. It was concluded that the differences noted in the technical execution of the skill had implications for practice. It was suggested that training would benefit from practice with an opponent for at least some of the time to condition players to the demands which they were more likely to meet in the game situation.

Learning volleyball serves: a preliminary study of the effects of knowledge of performance and of results.

Recently, doubts have begun to surface about the emphasis that for years has been given to the variable knowledge of results in motor learning, and a view has been expressed that information on how an action has been made (knowledge of performance) may be of more use. This study compared the two types of information in learning a volleyball serve by eight subjects, who were given the two kinds of feedback at various points in the process. Analysis seems to show that knowledge of performance tends to be more effective for learning and that there may be interference across information if knowledge of results is provided after knowledge of performance.

The mammalian vestibular ganglion cells and the myelin sheath surrounding them.

Morphological findings of the vestibular ganglia of small animals and human temporal bones are reported. For light microscopy, the ganglia were fixed with Levi's solution and stained with iron-hematoxylin and/or azan. The ganglia of bats were studied with electron microscopy. For scanning laser microscopy, human temporal bones were fixed in 10% formalin, decalcified, and embedded in paraffin, then stained with laxol fast blue. The ganglia were found as nodules among the VIIIth cranial nerve. The vestibular ganglion cells were seen in myelinated and unmyelinated nerve fibres, loose collagen fibres, and capillaries, separated from each other. These cells were bipolar and spindle shaped and varied in size, in contrast to spiral ganglion cells. The cell bodies (perikarya) were surrounded by myelin sheaths. Under electron microscopy, the myelin sheath could be seen between a vestibular ganglion cell body and a Schwann cell and consisted of 3-7 major lines in bats, and of about 10 in rabbits. The structure thus depends on species. The myelin sheath of human vestibular ganglion cells was seen in Levi-azan sections with a light microscope and in LFB (and/or HE) mirror slides with a scanning laser microscope.

Morphology of human vestibular ganglion.

Vestibular ganglion cells of mammals have been considered to be myelinated like spiral ganglion cells. Recently, electron microscopic studies reported that the ganglion cells of human vestibular ganglion were mostly unmyelinated unlike in other mammals. The purpose of this study was to find the myelin sheaths of human vestibular ganglion cells by light and laser microscopy.

Effects of different attentional strategies and practice on motor efficiency.

The effect of different attentional strategies on motor efficiency, measured by reaction-response time components, has historically been based on memory-drum construct theory, which implied limited attention and motor-response processing. The present study contrasts these principles by using a recording system and automatic analysis of reaction-response parameters. A within-subject design allowed detailed observation of the frequency of each preparatory set within each parameter and with control of the effects of practice. Analysis indicates (a) practice changes the effects of the attentional strategies on the components of reaction response but not the actual movement; (b) the motor-set strategy produces shorter movement times and, inversely, higher motor reaction times; and (c) the motor-sensory set integrated strategy produces improvements on each component of the reaction response. These findings suggest the memory-drum construct theory needs revision and should be based on other attentional models.