Increase in Trauma Leading to Psychological Injury Among Canadian Homelessness Services Workers During the COVID-19 Pandemic.

OBJECTIVES: This study examined the traumatic psychological impact of the pandemic on frontline workers in homelessness services. METHODS: Staff from homelessness serving organizations completed pre- and mid-COVID pandemic surveys measuring traumatic stress symptoms (PTSS), burnout, and job-related traumatic experiences. The mid-pandemic survey was expanded to seven Canadian cities to determine prevalence of workplace PTSS nationally. RESULTS: In the comparison group, baseline rates of PTSS (41%) rose to 47.3% ( n = 164), while 75% reported low-moderate levels of burnout both times. Nationwide, PYSS was 51% ( n = 574). Case managers working at remotely had greater levels of PTSS. CONCLUSIONS: COVID-19 exacerbated risk of psychological workplace injury from traumatic stress; however, burnout did not increase significantly, indicating the primary dynamic as anxiety and emotional exhaustion associated with ubiquitous trauma induced by COVID-19. Working remotely increased the hazards of psychological workplace injury.

Grit, Gratitude, Grace, and Guidance: Moving Academic Medicine From Crisis to Transformation.

Since the beginning of the COVID-19 crisis within the United States, faculty in academic medicine have experienced serious workplace and personal challenges while also exploring unique solutions and innovations in response to these challenges. Despite the global pandemic, social inequality and unrest, and uncertainty about the future, 3 hopeful themes that bind faculty together have emerged: grit, gratitude, and grace. This commentary describes how these qualities are in fact a culmination of ongoing work within academic medicine. While there is still a long way to go, this work is paving a path forward that is leading faculty to have more control over their professional lives. Indeed, these faculty efforts can be enhanced through shared governance, in which faculty participate more fully in the decision making at their institutions. To create thoughtful and enduring solutions, institutional leadership need to collaborate with faculty and provide guidance focused on improving well-being among faculty. This commentary is a call to action that describes how working together through shared purpose and engagement can harness the power of crisis as a catalyst for change and transformation that leads to the betterment of not just faculty, but academic medicine overall.

Skin marker placement by technologist prior to knee MRI helps identify clinically relevant pathologies.

BACKGROUND: Majority of musculoskeletal cross-sectional imaging requests have a non-revealing and non-specific clinical history of pain. However, the location of pain is very relevant towards arriving at a specific orthopedic diagnosis. The purpose of this research was to study the impact of skin marker placement and training of technologists prior to knee MRI in detection of clinically important findings. METHODS: Total 200 consecutive left knee MRIs were evaluated before and after technologist training with regards to marker placement at the site of clinical symptoms or palpable finding. Marker location in relation to the knee was recorded and important findings were classified as correlated important finding, non-correlated important finding, other compartment important finding in non-correlated cases, and diffuse abnormality, i.e. tri-compartmental cartilage defects in both correlated and non-correlated cases. Differences among scans before and after technologist training were analyzed. RESULTS: The marker placement was observed in higher proportion of patients in post-training scans (78% vs 60%, p = 0.00). The most common location of the marker was in anterior or anterolateral knee (32% and 34% cases, respectively). The marker-important finding correlation was also higher post training, but not statistically significant (53% versus 38%, p = 0.57). Important findings correlated with the marker in more than 50% of the scans in the post-training set. CONCLUSION: Marker placement can aid in detection of clinically important imaging finding and technologist training aids in increased rates of marker placement and improved correlation.

Magnetic Resonance Neurography of the Pelvic Nerves.

Chronic pelvic pain syndrome is commonly caused by nerve injury, inflammation, or entrapment. Owing to the complex anatomy and branching patterns of pelvic nerves, pelvic neuropathies are often difficult to illustrate and diagnose. High-resolution 3-T magnetic resonance neurography is a promising technique for the evaluation of peripheral neuropathy. In this article, the authors discuss the normal anatomy of major pelvic nerves, technical considerations of high-resolution imaging, and normal and abnormal imaging appearances with relevant case examples.