Burnout amongst hospital nurses in Kimberley; South Africa

Aim: The aim of this study was to quantify the extent of burnout and identify demographic and employment characteristics associated with burnout in Kimberley hospital nurses. Methods: During staff meetings; 194 of a population of 200 nurses completed a questionnaire; which consisted of socio-demographic details; the Maslach Burnout Inventory and an open-ended question. Results: Most of the respondents were female (94.3) and the median number of years worked was 15 years. More than half (55.2) the nurses suffered from emotional exhaustion; 33.7 from a feeling of depersonalisation and 27.5 from a sense of a lack of personal accomplishment. Only 7.3 suffered from all of the above; i.e. burnout. Nurses in the 31-40 and 41-50 year age groups were more likely to suffer from emotional exhaustion. No significant associations could be found between age; gender or marital status; and a feeling of depersonalisation or a sense of a lack of personal accomplishment. Nurses who had been in the profession longer were more likely to suffer from emotional exhaustion. The significant association between years to stay in the profession and a feeling of depersonalisation was less consistent. Conclusion: This study found that more than half the nurses were emotionally exhausted. Since a mentally and physically sound caregiver is able to render more efficient services than one who is emotionally drained and physically exhausted; the signs of burnout should be detected and addressed as early as possible

Extensor tendons of the fingers: arrangement and variations--II.

One hundred eighty-one dissected hands were examined to study the pattern of extensor tendons on the dorsum of the hand. Extensor digitorum often had multiple tendons for the middle and ring fingers. Its contribution to the little finger was usually by a bifurcating tendon common with that of the ring finger. The index finger always received a single tendon. Intertendinous connections between the various tendons of the extensor digitorum were variable but were most frequent between ring and middle fingers. Extensor indicis had one tendon in most of the specimens and it was always on the ulnar side of the extensor digitorum tendon. This remained true even when there were multiple tendons. Extensor digiti minimi had two tendons in most cases. It was always linked to extensor digitorum either by receiving one or part of its tendon or by an intertendinous connection. Two accessory muscles were seen, one was extensor indicis brevis replacing the proper muscle. The other, the extensor medii brevis, was distributed to the middle finger.

Rabbit and human non-keratinising stratified squamous oesophageal epithelium displays similar microridge structure by scanning electron microscopy.

Since the oesophageal epithelium of common laboratory animals, rats and mice, is keratinized it is unsuitable for comparison with typical non-keratinized stratified squamous human epithelium. It is thus important to find a suitable animal model for the study of human oesophageal tissue changes. This study investigated the microridge structure of immature and adult rabbit specimens, and adult human biopsies by scanning electron microscopy and morphometry. The investigation revealed a similarity between typical squamous human and adult rabbit oesophageal mucosal epithelium. While human epithelium specimens subdivided into two other groups (non-typical squamous and non-squamous); all typical squamous human biopsies were from patients who had normal endoscopy reports and no reflux symptoms. The surface cells of typical squamous human epithelium displayed complex microridge patterns (64% of cell surface) but patterns in non-typical squamous specimens were more variable (38%) (P < 0.001) and cell boundaries less obvious. Rabbit squames displayed clear microridge patterns with an elevation in the percentage of cell surface covered by microridges, with increasing age, from immature to adult specimens (P < 0.001). There was no statistically significant differences between adult rabbit, and 'typical squamous' human biopsies (range 51-65%), results which suggest potential use of a rabbit model to study changes in human oesophageal tissue.

Ligaments associated with lumbar intervertebral foramina. 2. The fifth lumbar level.

The lumbosacral spines of two fetal and twelve adult cadavers have been studied by dissection. Evidence shows that the fifth lumbar intervertebral foramen is crossed on its external aspect by a strong, cord-like corporotransverse ligament passing obliquely downwards, forwards and medially from the inferior aspect of the accessory process of the fifth lumbar vertebra to the lateral surface of the intervertebral disc and the adjacent parts of the bodies of the fifth and first sacral vertebrae. Superficially, the ligament is related to another flat band--the lumbosacral hood. Together these ligaments separate and provide openings for the sympathetic ramus, the ventral ramus and blood vessels related to the intervertebral foramen. On the dorsal aspect, a tripartite ligament, the mamillo-transverso-accessory ligament, bears important relationships to the subdivisions of the dorsal ramus and also the zygapophyseal joint. The significance of these findings is discussed.

Electron microscopic morphometric studies on the resting and secreting nasal (salt) glands of the domestic duck. I. Standardisation of the fixation procedure.

In order to perform morphometric analysis of the nasal (salt) glands of domestic duck it was necessary to standardise the regime of fixation and processing for this tissue. This paper reports the results of these experiments in which the nasal glands of nine groups of ducks were perfused by fixatives containing various concentrations of glutaraldehyde; each group included three secreting ducks and three non-secreting control ducks. Fixative osmolality ranged from 300-825 m-osmol. The resulting effects on the electron microscopical appearances of mitochondria and intercellular spaces were assessed. The fixative finally selected as most satisfactory for both control and secreting tissue contained 3.5% glutaraldehyde and 3% dextran in sodium cacodylate buffer, giving an osmolality range of 580-650 m-osmol.