[Burnout and psychosocial risk factors in the career of flight attendants: Descriptive study of a population of Lebanese flight attendants]. / Le syndrome d'épuisement professionnel et les facteurs de risques psychosociaux spécifiques au métier des personnels navigants commerciaux libanais, en comparaison avec un groupe témoin.

OBJECTIVE: The aim of our study was to investigate the influence of demographic factors (gender and age), work related factors (the position and years of practice) and psychosocial risk factors (cognitive demands, demands to hide emotions, work-family conflict, offensive behaviors…) on the development of burnout among flight attendants, and the nature of psychosocial factors to which they are exposed. METHODS: The sample was divided into two groups: 67 flight attendants and 67 persons in various jobs. Our sampling units were informed and consented to fill in two questionnaires: the Copenhagen burnout inventory (CBI) and the Copenhagen Psychosocial Questionnaire (COPSOQ II). RESULTS: The burnout syndrome affected both groups equally. It affected equally the women as well as men, whatever their age categories and their years of experience. The flight attendants occupying an intermediate position in the hierarchy had the highest score on the burnout syndrome. The psychosocial factors significantly found in flight attendants compared to the control group were: demands for hiding emotions, quantitative demands, emotional demands, temporal demands, lack of influence at work, of rewards, of possibility for development and variation of work, poor quality of leadership, exposure to sexual harassment, lack of social support from supervisors, colleagues, social community at work and work-family conflict. Four of them correlated positively with the development of burnout: quantitative demands, temporal demands, emotional demands and work-family conflict. Their expected work volume is very high (quantitative demands). They have to perform their tasks quickly in a limited time without forgetting the technical constraints (temporal demands). They have to work with an average of three hundred passengers besides colleagues and subordinates, which requires diligent control of the emotions promoted by the airline code of conduct based on repression of emotions (emotional demands). These demands affect the workers once they find themselves in their family environment and can have a negative effect on their private life (work-family conflict). However, the predictability seems to allow them to be aware of decisions and changes and protect them against burnout. CONCLUSION: The profession of flight attendants appears to be characterized by some psychosocial risk factors, some of which are positively correlated with burnout. Improved working conditions can prevent these risks and protect these employees from burnout.

Can dual-headed 18F-FDG SPET imaging reliably supersede PET in clinical oncology? A comparative study in lung and gastrointestinal tract cancer.

In this study, we prospectively compared the sensitivity of PET and planar SPET (collimated gamma camera) 18F-FDG imaging in patients with lung and gastrointestinal tract cancer and analysed their respective impact on patient management. Twenty-eight patients with lung cancer and 14 with gastro-intestinal tract tumours were scanned on the same day with a PET and a collimated planar SPET gamma camera. The planar SPET procedure consisted of whole-body planar views and a tomographic acquisition centred over the torso or the abdomen, with the total imaging time within the same range as the whole-body PET procedure. The staging of lung cancer patients was accurate in 86% with PET and 64% with planar SPET. Planar SPET would have led to inappropriate therapeutic decisions in 8 of 28 patients, mainly due to undetected distant metastases. In patients with suspected gastrointestinal tract cancer, planar SPET identified 7 of 15 (47%) proven tumour sites, whereas PET identified 14 of 15 (93%). Our results suggest that collimated planar SPET cameras are not a substitute for dedicated PET scanners. The sensitivity for the detection of tumours is unacceptably low and can impair patient management. The use of multiple tomographic acquisitions could improve the sensitivity but would require a longer scanning time.

[Can one determine the age at which epiphysiodesis should be performed in the treatment of genu valgum in the adolescent?]. / Peut-on déterminer l'âge de l'épiphysiodèse dans le traitement du genu valgum de l'adolescent?

The authors describe a simplified method for the assessment of the correct time at which tibial epiphyseal arrest may be performed to correct genu valgum in adolescents. The calculation is based on measurements of the length of the tibia, the length of the upper tibial plate and the intermalleolar distance. These measurements make it possible to establish an index of prediction of the amount of growth necessary to bring about correction. This index is then associated with the tables of Green and Anderson in relation to bone age and residual potential for growth. In this way, the age at which epiphyseal arrest must be performed is automatically deduced. Both the risk of hyper-correction and growth rebound after removal of the staples are thus minimised. This method was tested on thirteen patients with satisfactory results. Some uncertainty, however, remains in the exact assessment of bone age.

[Treatment of bimalleolar fractures by centromedullary nailing of the fibula]. / Traitement des fractures bimalléolaires par enclouage centro-médullaire du péroné.

An osteosynthesis technique involving nailing of the fibula was used to treat 106 bimalleolar fractures. Details of the technique used are described and results analyzed with respect to clinical course and radiologic findings. A generally favorable outcome was obtained. Nailing of the fibula provides a solid foundation, particularly in low and comminuted fractures.

Superior vena cava obstruction after extracorporeal membrane oxygenation.

Of 60 neonates who survived extracorporeal membrane oxygenation (ECMO) in our institution between June 1992 and March 1994, seven had either complete or partial superior vena cava (SVC) obstruction. When the patients with SVC obstruction were compared with those who had an echocardiogram after ECMO, no predisposing factors for the development of SVC thrombus could be found. Our data show that SVC thrombus may be a significant complication after ECMO.