Burnout among hospital staff during the COVID-19 pandemic: Longitudinal results from the international Cope-Corona survey study.

OBJECTIVE: Long-term changes in burnout and its predictors in hospital staff during the COVID-19 pandemic were investigated in an international study. METHODS: Two online surveys were distributed to hospital staff in seven countries (Germany, Andorra, Ireland, Spain, Italy, Romania, Iran) between May and October 2020 (T1) and between February and April 2021 (T2), using the following variables: Burnout (emotional exhaustion and depersonalization), job function, age, gender, and contact with COVID-19 patients; individual resources (self-compassion, sense of coherence, social support) and work-related resources and demands (support at the workplace, risk perception, health and safety at the workplace, altruistic acceptance of risk). Data were analyzed using linear mixed models repeated measures, controlled for age. RESULTS: A total of 612 respondents were included (76% women). We found an increase in burnout from T1 to T2. Burnout was high among personnel with high contact with COVID-19 patients. Individual factors (self-compassion, sense of coherence) and work-related factors (support at the workplace, risk perception, health and safety at the workplace) showed associations with burnout. Low health and safety at the workplace at T1 was associated with an increase in emotional exhaustion at T2. Men showed an increase in depersonalization if they had much contact with COVID-19 patients. CONCLUSION: Burnout represents a potential problematic consequence of occupational contact with COVID-19 patients. Special attention should be paid to this group in organizational health management. Self-compassion, sense of coherence, support at the workplace, risk perception, and health and safety at the workplace may be important starting points for interventions. REGISTRATION: Müller, M. M. (2020, August 30). Cope-Corona: Identifying and strengthening personal resources of hospital staff to cope with the Corona pandemic. Open Science Foundation.

Supragastric belching: Pathogenesis, diagnostic issues and treatment.

Belching is defined as an audible escape of air from the esophagus or the stomach into the pharynx. It becomes pathologic if it is excessive and becomes bothersome. According to Rome IV diagnostic criteria, there is a belching disorder when one experiences bothersome belching (severe enough to impact on usual activities) more than 3 days a week. Esophageal impedance can differentiate between gastric and supragastric belching. The aim of this review was to provide data on pathogenesis and diagnosis of supragastric belching and study its relationship with gastroesophageal reflux disease and psychological factors. Treatment options for supragastric belching are also presented.

Nursing procedures for advanced dementia: Traditional techniques versus autonomous robotic applications (Review).

The purpose of this study was to perform a comparative analysis of traditional nursing techniques and autonomous robotic applications used for managing patients with advanced stages of dementia. PubMed, Cochrane Library, EMBASE, and WILEY databases were searched for relevant articles concerning nursing techniques applied in the treatment of patients with advanced dementia. The search terms included: (advanced dementia OR severe dementia) AND [artificial intelligence (AI) OR robotic OR robots OR neural networks OR deep learning OR automated procedures OR autonomous application]. This search identified a total of 2,679 articles and 298 articles were selected. Finally, 23 articles were included in this systematic review, out of which 8 studies analyzed traditional nursing techniques and 15 studies analyzed autonomous robotic applications. Significant evidence was revealed, demonstrating that autonomous robotic applications used for patients with advanced stages of dementia are a feasible, cost-efficient solution and represent an excellent benefit for patients and the healthcare system.

Disorders of the brain-gut interaction and eating disorders.

BACKGROUND: Eating disorders (ED) involve both the nervous system and the gastrointestinal tract. A similar double involvement is also found in disorders of the brain-gut interaction (DGBI) and symptoms are sometimes similar. AIM: To find out where there is an association and a cause-effect relationship, we looked for the comorbidity of DGBI and ED. METHODS: A systematic review was undertaken. A literature search was performed. Inclusion criteria for the articles retained for analysis were: Observational cohort population-based or hospital-based and case-control studies, examining the relationship between DGBI and ED. Exclusion criteria were: Studies written in other languages than English, abstracts, conference presentations, letters to the Editor and editorials. Selected papers by two independent investigators were critically evaluated and included in this review. RESULTS: We found 29 articles analyzing the relation between DGBI and ED comprising 13 articles on gastroparesis, 5 articles on functional dyspepsia, 7 articles about functional constipation and 4 articles on irritable bowel syndrome. CONCLUSION: There is no evidence for a cause-effect relationship between DGBI and ED. Their common symptomatology requires correct identification and a tailored therapy of each disorder.

Behavioral outputs of negative symptom domains of schizophrenia.

The present study aimed to validate the hypothesis that negative symptoms of schizophrenia encompass two domains, namely avolition-apathy (AA) and diminished expression (DE), and to investigate the relationship of these domains with behavioral outputs which imply hedonic activities: Cigarette use and weight gain. A total of 106 consecutive schizophrenia outpatients with primary negative symptoms were evaluated using the Positive and Negative Syndrome Scale (PANSS), the Negative Symptoms Assessment Scale (NSA-16), the Calgary Depression Scale for Schizophrenia (CDSS), and the Simpson-Angus Scale (SAS). A semi-structured interview was used to assess demographic features, the number of cigarettes smoked per day, and body mass index. Data were analyzed using descriptive statistics, principal component analysis, analysis of variance, and covariance. A two-factor solution was revealed for the negative symptoms of schizophrenia represented by AA and DE. Analyses of variance and covariance suggested that higher AA scores were associated with normal weight and non-smoking status. No significant differences were revealed regarding DE scores in relationship with the same behavioral hedonic outputs. The present results indicated the AA and DE domains exhibit meaningful differences concerning the outcome, which may imply the need for different approaches regarding rating and treatment.

Coping strategies and irrational beliefs as mediators of the health-related quality of life impairments in irritable bowel syndrome.

BACKGROUND & AIMS: Irritable bowel syndrome (IBS) is a chronic and disabling gastrointestinal disorder. Although considerable research has underlined the influence of coping mechanisms as the determinants of the quality of life (QOL), only limited data are available regarding the specific coping mechanisms used by IBS patients to manage illness in daily life. Irrational cognitions are known to emerge in stressful situations such as chronic diseases, and it has been proposed to have implications in the QOL. The aim of this study was to explore the relationship between coping styles and irrational beliefs in predicting the effects of IBS symptoms on the health-related QOL (HRQOL). METHODS: A cross-sectional study was performed at two tertiary gastroenterology centers. A sample of 70 consecutive IBS patients and 55 healthy controls was studied. All participants completed the Brief Cope Inventory, the Dysfunctional Attitudes Scale, the Short-Form Health Survey and a demographic questionnaire. RESULTS: All the HRQOL scores of the group with IBS were significantly lower than the HRQOL scores of the healthy group [Pillai's trace V = 0.404, F(8, 116) = 9.833, p < 0.001]. Irritable bowel syndrome patients used more problem-focused coping and avoidant-oriented coping than healthy subjects. The impact of IBS symptoms on HRQOL distress is mediated by irrational beliefs and avoidant oriented coping. CONCLUSIONS: Our findings highlight the role of irrational cognition and coping mechanisms in patients with IBS. The results underline the importance of the evaluation of psychological aspects of IBS with the possibility of having more tailored treatments for these patients.

Biopsychosocial Approach of Gastrointestinal Disorders.

Gastrointestinal disorders represent are conditions frequently seen in primary care, usually associated with a poor quality of life, entailing increased direct and indirect costs. Disorders of the digestive tract frequently coexist with psychological impairment. Even in early times scientists were concerned about the influence of the mind over body, and that there are many theories that explain the interaction between psychological factors and the physical status. At the present time the most comprehensive theory is the biopsychosocial model. There are four categories of factors that have to be addressed by the physician (or the integrated team that manages the patient): disease-related, therapeutic-regimen-related, individual factors and psychopathological comorbidities. In the following paper we discuss these factors and their importance in clinical management of gastrointestinal disorders.

Experience of anger in patients with irritable bowel syndrome in Romania.

BACKGROUND AND AIMS: Anger is strongly associated with the coping style, personality, interpersonal conflicts and quality of life. Increased research is being focused on the negative impact of anger on irritable bowel syndrome (IBS). Certain psychological areas such as anger have not been investigated in Romanian patients. The present study aims to determine the basal differences in experiencing anger between IBS patients and controls. METHOD: We examined the State-Trait anger in 60 subjects with IBS and 45 controls. The socio-demographic data and the State-Trait Anger Inventory were administered in individual sessions. RESULTS: evidenced that the IBS group had high mean scores for trait anger. No significant differences between the groups were detected on state anger. CONCLUSION: Higher levels of trait anger characterize IBS patients when compared to controls and this may be associated with symptoms. These findings are discussed within the context of other data suggesting that trait anger contributes to development and evolution of IBS, perhaps through modulation of the colonic motor activity.

ZNF804A rs1344706 variant and schizophrenia in a Romanian population from Cluj Napoca.

The ZNF804A rs1344706 variant was the first risk factor to be identified through genome-wide association studies and follow-up studies with meta-analysis for schizophrenia as well as bipolar disorders; we investigated 231 schizophrenia and 222 controls to see whether this particular variant was associated with schizophrenia in a Romanian population from Cluj Napoca. Clearly, there was no association between the ZNF804A rs1344706 variant and schizophrenia. Our study provides evidence for those that found no association with schizophrenia. A surprising result of our study was that the T allele frequency is the highest, thus far among the ethnic groups studied. We used a PCR-RFLP method that had been recently developed in our laboratory to the genotype ZNF804A rs1344706 variant. In conclusion, the ZNF804A rs1344706 variant was not associated with schizophrenia in the Romanian population from Cluj Napoca (χ(2)=0.734, p=0.693).