Psychosocial and biological predictors of resident physician burnout.

BACKGROUND: A high proportion of health professionals in training suffer from work-related stress and may develop a burnout syndrome. OBJECTIVES: To study the incidence of burnout after the first year of residency in a teaching hospital and to identify baseline psychological, psychosocial work conditions, and biological risk factors. METHODOLOGY: We assessed the following in a prospective cohort of residents at baseline (first month residence) and after 1 year: background factors (socio-demographics, psychiatric history), perceived stress score (Perceived Stress Scale), Maslach Burnout Inventory score, and psychosocial factors (Job Content Questionnaire). Blood samples were obtained to study serum cortisol, IL-6, and TNF-α concentrations. The cumulative incidence was modelled by multivariate log-binomial regression analysis. RESULTS: We included 71 participants with a female majority (64.8%), age 26.4 (2.65) years, psychiatric history in 20%, and burnout in 13%. Among those without burnout initially (N = 59), it had developed by 1 year in 22% of residents. Increased job demand (RR = 1.259, 95%CI = 1.019-1.556, p = 0.033) and decreased cortisol levels (RR = 0.877, 95%CI = 0.778-0.989, p = 0.032) predicted burnout after 1 year of residency among medical trainees. CONCLUSION: Burnout syndrome develops in 22% of residents by 1 year of training and can be predicted by increased work demands and decreased cortisol levels.

Common origin tendon of the biceps femoris and semitendinosus muscles, functional and clinical relevance / Tendón de origen común de los músculos bíceps femoral y semitendinoso, relevancia funcional y clínica

SUMMARY: The injury of Biceps Femoris long head (BFlh) and Semitendinosus (ST) is caused by over-stretch of the muscles at the back of the thigh. This condition encompasses almost one third of sports-related injuries and has severe consequences, such as pain and weakness of the muscles. This injury is related namely to quick and demanding activities, such as short distance sprinting in a limited time period. The Common Origin Tendon (COT) for these two muscles is affected in these injuries. This tendon is formed by the BFlh and ST muscles which together have a common origin in the ischial tuberosity. Given the lack of complete knowledge about the detailed structure of the COT, we dissected cadaveric limbs, describing their morphological characteristics, and discussing its functional and clinical implications.: Thirty-five human cadaveric lower limbs were dissected after fixation to analyze the morphology of the COT, focusing on their volume and muscular/tendinous proportion. We identified two subtypes of COT. The most frequent was the musculotendinous type, in which the origin of the BFlh was mainly tendinous, while the ST muscle was mainly muscular (91.4%). In the tendinous type both muscles had a tendinous origin (8.6%). In the musculotendinous type, the ST muscle ends with a microscopic connective tissue that extend into the ischial tuberosity. We conclude that there is a variability in the anatomical presentations of the COT, and we propose that this will correspond with biomechanical differences in the risks and the response to regional injuries. The connective tissue between the COT and the neighbouring structures could be a risk factor for adhesion tearing.

RESUMEN: Los desgarros de los músculos bíceps femoral cabeza larga (BFcl) y semitendinoso (ST) son causados por una tensión excesiva durante actividades que implican amplios rangos de movimiento en velocidad. Alcanzan casi a un tercio de las lesiones deportivas y tienen graves consecuencias competitivas, además generan dolor y debilidad muscular. El tendón de origen común (TOC) de estos dos músculos se ve afectado en estas lesiones. Este tendón se encuentra formado por el BFcl y el ST, originándose juntos en la tuberosidad isquiática. Debido a la falta de conocimiento completo y detallado de este tendón, se realizó un estudio cadavérico, describiendo sus características morfológicas y discutiendo sobre sus implicaciones funcionales y clínicas. Se practicó la disección anatómica de 35 miembros inferiores, lo que permitió describir la morfología del TOC, focalizando en su volumen y proporciones musculo-tendinosas. La conformación morfológica del TOC fue de 2 tipos: la musculotendinosa, donde el BFcl tenía una estructura tendinosa y el ST tenía una estructura muscular (91,4 %). La conformación tendinosa, donde ambos músculos tenían estructuración tendinosa (8,6 %). Cuando la conformación era musculotendinosa, el ST terminaba con un tejido conjuntivo microscópico, que se extendía hasta la tuberosidad isquiática. La conformación morfológica del TOC del BFcl y ST tuvo una presentación variable, lo cual podría tener implicación en su comportamiento biomecánico, y ser un factor de riesgo de lesiones. Además el tejido conjuntivo situado entre este tendón y las estructuras anatómicas vecinas podría ser un factor de riesgo de lesiones por adherencia.

Multiple rainfall event pollution transport by sustainable drainage systems: the fate of fine sediment pollution.

A key design criterion of sustainable urban drainage systems is to mitigate urban stormwater pollution. Current research defines sustainable urban drainage systems (SuDS) pollutant treatment efficiency through the detention of total suspended solids, urban nutrients and heavy metal pollutants within the system during a design flow event, with research focusing on sand (>2 mm) sediment movement. The impact of multiple rainfall-runoff events on the fine sediment (<2 mm) treatment efficiency of SuDS is not yet well defined, and the temporal movement of detained sediment has not been investigated in detail. The field research presented in this paper addresses this research gap, monitoring ongoing fine sediment transport through a best-practice-designed SuDS network over 12 months through the use of a novel rare earth oxide trace methodology. Through time-stepped monitoring of the fine sediment pollution across three SuDS treatment trains (networks), the following key conclusions have been drawn. (1) That fine sediment becomes re-suspended and re-deposited within SuDS assets and the network as a result of ongoing multiple rainfall-runoff events. (2) That this re-suspension continues for over 52 weeks. (3) That by area, linear wetlands (within the monitored networks) outperform wetland and swale assets in multiple event fine sediment detention. And (4) that multiple event monitoring and analysis of fine sediment within a SuDS network highlights the under-performance of SuDS assets against current design event expectations.

Mixture of Sodium Hypochlorite and Hydrogen Peroxide on Adhered Aeromonas hydrophila to Solid Substrate in Water: Impact of Concentration and Assessment of the Synergistic Effect.

The synergistic effects of the combined treatments of NaOCl and H2O2 on the elimination of A. hydrophila adhered to polythene under static and dynamic conditions were evaluated. The concentrations 0.1, 0.2, and 0.3‰ NaOCl and 0.5, 1, and 1.5‰ H2O2 were used. The contact periods were 180, 360, 540, and 720 minutes. The abundance of cells adhered reached 2.47 and 2.27 units (log (CFU/cm²)), respectively, under static and dynamic conditions after action of the mixture of disinfectants, whereas it reached 2.41 and 3.39 units (log (CFU/cm²)) after action of NaOCl and H2O2 alone, respectively. Increase in the incubation period resulted in a significant decrease in the abundance of cells adhered when the mixture of 0.3‰ NaOCl and 1.5‰ H2O2 was used (P < 0.01). For each cell growth phase, there was a significant difference amongst the mean densities of cells adhered after action of the mixture of disinfectants (P < 0.05). Although the Freundlich isotherm parameters relatively varied from one experimental condition to another, the K f value registered in the exponential growth phase was relatively higher in static state than in dynamic regime; cells adhered under dynamic condition seem more sensitive to the synergistic action than those adhered under static condition.

Involvement of cell shape and flagella in the bacterial retention during percolation of contaminated water through soil columns in tropical region.

Microorganisms' retention in soil contributes to the natural purification of groundwater. Bacteria found in groundwater are generally of various shapes. The aim of this study was to assess the importance of cell shape and flagella in bacterial retention during polluted water percolation through two soil columns CA and CB, in the equatorial region in Central Africa. Percolation tests were carried out using different water loads samples which were contaminated by Escherichia coli (straight rods, peritrichous flagella), Vibrio parahaemolyticus (rods bacteria, polar flagella), and Staphylococcus saprophyticus (spherical, free-flagellum). It has been noted that showed that through soil column CA, the mean values of cells retention ratios (T(R)) varied with bacteria species considered, and from one applied water load sample to another. E. coli T(R) and that of S. saprophyticus were not significantly different (P> 0.05) for the two soil columns. V. parahaemolyticus T(R) significantly differed from that of E. coli and S. saprophyticus through soil column CA (P< 0.01) when the highest water load was applied, and through soil column CB (P< 0.05) for each of water load applied. A relative hierarchical arrangement of retained cells based on the T(R) showed that V. parahaemolyticus was less retained through the 2 soil columns. S. saprophyticus in most cases was more retained than others. The physical properties of the bacterial cell must be taken into consideration when evaluating the transfer of bacteriological pollutants towards groundwater.