Prognostic Significance of Multifactorial Analysis in Complex Cervical Aero-Digestive Trauma Cases.

Background and Objectives: In the context of complex aerodigestive cervical traumas, the prognosis and outcome heavily depend on risk factors, particularly injuries to the larynx, trachea, major digestive tissues, cervical vertebrae, and vascular structures. With the increasing prevalence of trauma as a public health concern, there is a pressing need for epidemiological research and the implementation of preventative measures. The purpose of this research is to establish the profile of the predictable impact factors that determine the prognosis of patients with complex cervical trauma. Methods and Methods: The study group consisted of 106 patients with complex cervical trauma pathology developed by various mechanisms such as car accidents, home-related accidents, aggression, gunshot wounds, and self-inflicted attempts, resulting in hospitalization in the E.N.T. Clinic at "St. Spiridon" Iași Hospital, from 2012 to 2016; medical records were the source of the collected data. Results: Hemodynamic instability upon admission associated with age, muscle and laryngeal injuries, and anemia were identified as negative prognostic factors. Additionally, the utilization of imaging-based paraclinical investigations for diagnosing traumatic lesions emerged as a positive prognostic factor in managing this pathology. The management of penetrating cervical trauma remains a subject of debate, with some advocating for surgical exploration beyond the platysma layer in all cases, while others argue for a more selective conservative approach due to a high rate of negative explorations. Conclusions: The statistical evaluation of epidemiological, clinical, lesion, paraclinical, and therapeutic parameters is needed to establish predictable risk factors in the prognosis of complex aerodigestive cervical trauma.

Stress and Burnout among Medical Specialists in Romania: A Comparative Study of Clinical and Surgical Physicians.

This study, which focuses on 227 participants (196 females and 31 males) comprising 187 clinical specialists and 40 surgical physicians, examines the prevalence of burnout in medical specialists. We investigate the effects of the emotional exhaustion (EE), Depersonalization (D), and personal accomplishment (PA) dimensions on professional satisfaction and plans to change careers using the modified licensed Maslach Burnout Inventory-Human Services Survey (MBI-HSS (MP)). High emotional exhaustion is reported by 52.63% of men and 71.28% of women in the clinical medicine group (n = 188). In the surgical specialties (n = 39), scores are significantly higher, with 75% of men and 77.77% of women reporting EE. In our sample group, 71.36% express high levels of emotional exhaustion, with similar patterns across specialization and gender. Clinical medicine respondents report high degrees of depersonalization in 33.13% of females and 21.05% of males, while surgical specialty respondents report high levels in 33.33% of females and 50% of males. Across genders and specializations, 33.03% of all respondents show high levels of depersonalization. Clinical medicine participants report high levels of personal accomplishment (42.60% of females and 42.10% of males), whereas surgical specialties report 44.44% of females and 66.66% of male on the PA dimension. Of the total number of respondents, 44.05% report having a high level of personal accomplishment; differences exist depending on specialty and gender. In addition, questions regarding professional fulfilment and intention to change careers were presented to the participants. A total of 53.40% (16 male and 105 female) of the clinical medicine respondents said they intended to change careers, while 33 participants (9 male, 34 female) doubted if they would remain in the same specialization. Furthermore, 86 individuals (9 male and 77 female) in the surgical specialties said they would never choose to work in healthcare again. Regression analysis suggests that being male, higher in age, and working in surgical specialties with lower job satisfaction and a higher intention to change profession are associated with higher levels of EE. Age and work satisfaction are significant predictors of depersonalization, and higher career satisfaction is associated with increased levels of PA.

Burnout and Intention to Change Profession among Romanian Dentists during COVID-19: A Cross Sectional Study Using the Maslach Burnout Inventory.

This study aims to examine the relationship between burnout and dentists' intentions to change careers during the COVID-19 pandemic. The MBI-Human Services Survey for Medical Personnel-MBI-HSS (MP) was used to measure burnout levels and investigate how they relate to dentists' intentions to change their profession. The sample included 69 Romanian dentists, 56 of whom were women and 13 of whom were men. Self-reported questionnaires provided to the participants were used to collect the data. Female participants reported higher levels of emotional Exhaustion and Depersonalisation than males. However, there were no substantial differences in Personal Accomplishment levels between genders. As for the intentions to change careers, 41 expressed a clear intention to change their profession, 15 were still determining if they would choose the same speciality, and 28 indicated they would not choose the medical field. The study's findings provide insight into how dentists' thoughts about perceived burnout during the COVID-19 pandemic significantly influenced their attitudes regarding their career paths. The results suggest concerns regarding burnout in the dental field and emphasise the necessity for burnout interventions and support services, particularly during healthcare crises. Further research and interventions to mitigate burnout and promote well-being among dentists are needed to ensure the sustainability and quality of dental healthcare services in Romania.

Burnout and Online Medical Education: Romanian Students in Lockdown and Their Residency Choices.

The primary aim of the study was to investigate the prevalence of burnout in Romanian medical students during the COVID-19 pandemic using the Maslach Burnout Inventory-General Survey for Students (MBI-GS(S)). The presence of burnout was assessed based on Exhaustion (EX), Cynicism (CY) and Professional Efficacy (PE) subscales. The secondary aim of the study was to identify the presence of intentional shift in medical specialty compared to their initial pursued choice within the population investigated. Data was collected online at the end of 2020 and beginning of 2021 through a licensed, customized MBI-GS(S) questionnaire from a sample of 126 Romanian medical students at the two leading medical schools in the country, Iasi (N = 56) and Cluj Napoca (N = 70). Descriptive statistics and bivariate correlations were also applied to describe the data set (age and gender of participants) and the relationship between variables (EX, CY, PE). Subsequently, the MBI-GS(S) group report revealed that 36.5% of the medical students in the sample (46) experienced burnout, with problematic results both in Exhaustion and Cynicism. Exhaustion and Cynicism, which contribute to burnout, showed high scores compared to the average scale (EX = 3.5/2.4; CY = 2.8/1.8), while the Professional Efficacy score was relatively high (PE = 3.8/4.4), showing a protective effect and burnout reduction. One of the main conclusions is that the consequences of burnout in medical students plays a significant role in shaping the future healthcare practitioners' perception of the medical profession and of patients' wellbeing. Exhaustion and Cynicism are mainly associated with depersonalization and disconnection from the patient. Another conclusion of the study is that about one third of the respondents (30% Cluj students and 37.5% Iasi students) considered changing residency options. The pandemic has also revealed the limitations of and challenges facing current medical education, and that further research is required to assess the trends in prevalence of burnout in medical students.