Background: Work-related stress may lead to mental and physical illnesses. Emergency physicians may be particularly vulnerable to developing such diseases due to their extreme emotional working environment.
Aims: The purpose of the study was to analyse the hormonal stress burden of emergency physicians in the airborne rescue service to create an empirical basis for developing appropriate measures against chronic stress in the rescue service.
Methods: Three salivary cortisol samples were collected after awakening in 15 min intervals-each on a flight rescue day, a clinic day and a free day-to calculate the extent of the hormonal stress load of the emergency physicians. A nested linear mixed-model analysis was used in 40 cases to investigate hormonal stress. Furthermore, professional years and gender were included in the calculations.
Results: The mixed model showed neither a main effect for measurement time nor for day but a significant interaction effect (P = 0.002). The cortisol level rises strongly on the flight rescue and the clinic day, while on the free day it shows a moderate increase. Professional years and gender also proved to be statistically significant for the cortisol level of emergency physicians (P < 0.001).
Conclusions: The results show a significantly higher cortisol increase on working days compared with a free day, which indicates a stronger stress burden on working days of emergency physicians in the airborne rescue service. Future studies should examine the stress level of emergency physicians in more detail to prove whether the working conditions of emergency physicians need to be modified.
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http://dx.doi.org/10.1093/occmed/kqac052 | DOI Listing |
JAMA
January 2025
Division of General Internal Medicine and Geriatrics, Indiana University School of Medicine, Indianapolis.
Importance: Care management benefits community-dwelling patients with dementia, but studies include few patients with moderate to severe dementia or from racial and ethnic minority populations, lack palliative care, and seldom reduce health care utilization.
Objective: To determine whether integrated dementia palliative care reduces dementia symptoms, caregiver depression and distress, and emergency department (ED) visits and hospitalizations compared with usual care in moderate to severe dementia.
Design, Setting, And Participants: A randomized clinical trial of community-dwelling patients with moderate to severe dementia and their caregivers enrolled from March 2019 to December 2020 from 2 sites in central Indiana (2-year follow-up completed on January 7, 2023).
Eur J Nucl Med Mol Imaging
January 2025
Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.
Purpose: The positron range effect can impair PET image quality of Gallium-68 (Ga). A positron range correction (PRC) can be applied to reduce this effect. In this study, the effect of a tissue-independent PRC for Ga was investigated on patient data.
View Article and Find Full Text PDFInfection
January 2025
Division of Infectious Diseases, Department of Medicine II, Medical Centre, Faculty of Medicine, University of Freiburg, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
Objectives: This study aimed to reassess the long-term impact of a Health Action Process Approach (HAPA)-informed intervention on guideline adherence among asplenic patients and their physicians, three years post-intervention.
Methods: This follow-up study was conducted within the framework of the interventional PrePSS (Prevention of Postsplenectomy Sepsis Score) study. Patients aged 18 or older with anatomical asplenia were in enrolled in a prospective controlled, two-armed historical control group design.
J Physician Assist Educ
January 2025
Janice Sabin, PhD, MSW, is a research professor of Department of Biomedical Informatics and Medical Education, School of Medicine at University of Washington, Seattle, Washington.
Introduction: As new equity, diversity, and inclusion programs emerge in physician assistant/associate (PA) education, there is a need to assess baseline levels of implicit and explicit biases among PA preceptors' and trainees. The objectives of this study were (1) to measure implicit and explicit race (Black/White) and weight (fat/thin) biases among PA preceptors and trainees and (2) to identify potential gaps in PA preceptor and trainee education.
Methods: This is a cross-sectional study of PA preceptors and trainees from one program operating in several US states; implicit and explicit race and antifat biases and receipt of prior education were measured.
R I Med J (2013)
February 2025
Professor of Medicine, Clinician Educator, Warren Alpert Medical School, Brown University; Associate Chief, Cardiology, Brown University Health Cardiovascular Institute, Providence, Rhode Island.
Chest pain is one of the most common chief complaints seen in both the emergency department (ED) and primary care settings.1,2 It is estimated that 20-40% of the general population will suffer from chest pain at some point throughout their lives.3 Interestingly although obstructive coronary artery disease (CAD) prevalence has declined, chest pain as a presenting symptom has become increasingly common over the last decade.
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