Burnout, grit and resilience among Jordanian orthopedic surgeons: a cross-sectional study.

BACKGROUND: Burnout is a serious issue that affects physicians more than the general population; however, those with higher levels of grit and resilience have been shown to experience lower levels of burnout. The primary aim was to determine the prevalence of burnout among Jordanian orthopedic surgeons, explore its risk factors, and investigate the relationship between burnout and grit and resilience. METHODS: We conducted a questionnaire-based cross-sectional study targeting a total of 180 orthopedic surgeons attending the yearly Jordanian National Orthopedic Conference (JNOC). Non-random sampling (i.e., convenience) was utilized to recruit participants. The abbreviated Maslach Burnout Inventory, short grit scale, and Connor-Davidson Resilience Scale were used. Scores were examined using the Mann-Whitney U, Kruskal-Wallis H, and Spearman's rho tests, of which results were corrected using the Bonferroni method. RESULTS: Among 135 respondents, 62.2% were specialists and 37.8% were residents. About 52.0% practiced in public hospitals. Approximately 69.0% worked for more than 50 h weekly. The prevalence of burnout among all participants was 45.2% with more frequency among residents (66.7%). Burnout and the participants' grit and resilience showed an inverse relationship (ρ = -0.441 and ρ = -0.312, respectively). Age (ρ = 0.337), number of children (ρ = 0.245), and years of experience (ρ = 0.331) were positively correlated with grit. The median score for grit was higher in physicians who had or are having their residency outside Jordan (p < 0.001). Age (ρ = 0.233) and years of experience (ρ = 0.269) were positively correlated with resilience. CONCLUSION: Jordanian orthopedic surgeons face significant rates of burnout. Institutional efforts should be taken to detect and prevent burnout in addition to enhancing the grit and resilience among orthopedic professionals.

Long-Term Outcomes of the Knee and Hip Arthroplasties in Patients with Alkaptonuria.

Alkaptonuria is a rare autosomal recessive metabolic disorder. It is characterized by the accumulation of homogentisic acid in the body due to a lack of enzymes that degrade it. Over time, it results in joint degeneration and eventually leads to ochronosis. Ochronosis refers to bluish-black discoloration of connective and other tissues within the body. In this study, we present 5 distinct cases diagnosed with alkaptonuria. They have undergone 8 total joint replacement surgeries (4 hips and 4 knees) within 8 years (2010-2018). All patients had an excellent outcome over several years. The follow-up period ranged from 2 to 10 years. Although none of the presented cases had intraoperative or postoperative adverse sequelae, we must take care when dealing with patients with ochronotic arthropathy. They carry a higher risk of complications than other patients with osteoarthritis disease. These complications include fractures due to fragile bone quality, muscle or tendon rupture, joint instability, and anesthesia-related complications. Total joint arthroplasty is a valid and safe option in the management of hip and knee ochronotic arthropathy.

Mobile care teams improve metabolic control for adults with Type II diabetes in the Southern West Bank, Palestine.

AIM: The purpose of this study is to assess the effectiveness of the Diabetes Comprehensive Care Model (DCCM) intervention on diabetes care outcomes. We hypothesized that participants receiving diabetes care from the mobile diabetes clinic (intervention group) would demonstrate significant improvement in glycemic control compared to those receiving treatment as usual (control group). MATERIALS AND METHODS: We conducted a longitudinal, quasi-experimental study in which two similar clinics were identified. From both, we recruited 100 patients diagnosed with Type II diabetes. At baseline, patients were similar in terms of both socio-demographic and diabetes health variables. The team visited patients at the Bethlehem clinic at the beginning and end of the study (control group). Mobile diabetes care teams implemented the DCCM in Hebron four times over one year (treatment group). RESULTS: Most participants were female (63.5%) with average diabetes duration of 7.9 years. Initial HbA1c was 9.49% on average (SD = 1.93) and 9.20% (SD = 1.92) for the control and intervention groups, respectively. Statistically significant change in HbA1c, cholesterol, creatinine and systolic BP were observed in the intervention group (differences in change between recruitment and follow-up). That is, significant improvement over time was observed for the treatment group whereas little or no change was observed for the control group. CONCLUSION: The DCCM-based intervention leads to improved glycemic control parameters indicative of diabetes control. Clinically significant change was observed in treatment group only. Integrative diabetes care appears especially well suited for fragmented healthcare systems with limited resources.