Assessing Loneliness and Other Types of Emotional Distress among Practicing Physicians

Introduction. Loneliness has been linked to clinician burnout and other types of emotional distress. Research assessing the prevalence of loneliness among physicians is growing. Little is known, however, about how loneliness relates to other types of emotional distress among practicing physicians. The objectives of the study were to determine the prevalence of loneliness, and to explore the relationship between loneliness, burnout, depressive symptoms, and suicidal ideation among active member physicians of the Medical Society of Sedgwick County (MSSC). Methods. The study involved a convenience sample of 197 practicing physicians who were active members of the MSSC. The 3-item University of California, Los Angeles Loneliness Scale, the Abbreviated Maslach Burnout Inventory, and 2-item Primary Care Evaluation of Mental Disorders Patient Health Questionnaire were used to measure prevalence of loneliness, manifestations of burnout, and symptoms of depression, respectively. Results. Using an email survey, 442 practicing physicians received an invitation to participate; 197 (44%) completed the survey. The prevalence of loneliness was 43%. Loneliness prevalence was associated positively with age (p = 0.017) and more likely in those who reported manifestations of burnout (p < 0.01) or screened positive for depression (p < 0.01). Depression (OR = 2.24; 95% CI, 0.97-5.19) and emotional exhaustion (OR = 1.05; 95% CI, 0.39-2.84) were significantly associated with loneliness, including when adjusted for participants’ sex, age, and duty hours. Conclusion. Loneliness is prevalent among active member physicians of the Medical Society of Sedgwick County. Given that loneliness is associated with burnout and other emotional distress, there is an important need to understand its implications better

Patient Perception of Medical Learners and Medical Education during Clinical Consultation at a Family Medicine Residency

Introduction. Experience in treating patients under supervisionof faculty is an important factor in medical education at all levels.However, unpleasant patient experiences with a medical learnerduring clinical consultation can damage the relationship betweenthe medical learner, physician supervisor, and patient. A goal of thisstudy was to examine patient experiences and preferences regardingmedical learners during clinical consultation at a family medicineresidency clinic. Another goal was to determine factors relating topatients’ experiences and preferences regarding medical learners. Methods. This cross-sectional study relied on patients completinga survey designed from extant questionnaires to measure patients’experiences and preferences relating to interactions with medicallearners at a family medicine clinic. Data were collected from 216patients between December 2016 and August 2017. We correlatedpatients’ feelings, overall experiences with medical learners and theimportance of medical education. Results. There was a 93% participation rate. The patients rated theiroverall experiences with medical learners as 3.8 on a 5-point scale,suggesting positive experiences. Eighty-eight percent prefer not morethan three medical learners to be involved in their care during clinicalconsultation. Patients’ overall experiences with medical learnersparticipating in medical care correlated with their preferences regardingmedical learners’ involvement in their treatment (r[209] = .524;p = 0.01). Patients’ perception of medical learners participating inmedical care correlated with the importance of medical education(r[209] = .878; p = 0.01). Conclusions. The results showed that most patients have positiveexperiences with medical learners and are generally in favor ofmedical education.Kans J Med 2018;11(4):102-105

Why Patients Miss Scheduled Outpatient Appointments at Urban Academic Residency Clinics: A Qualitative Evaluation

Introduction Missed outpatient appointments are a common problem for academic residency clinics, and reducing their rate improves office efficiency, income, and resident education. Identifying specific reasons why some patients miss outpatient appointments may provide insight into developing targeted approaches to reducing their rates. This study sought to find reasons associated with patients’ missed appointments at two family medicine residency clinics. Methods The study utilized a qualitative research design involving patients at two urban, university-affiliated family medicine residency outpatient clinics. Twenty-five randomly selected patients who were dismissed from the clinics for missing three or more scheduled appointments during a five-year span (July 2012 to July 2017) were interviewed over the phone about reasons they did not keep their scheduled clinic appointments. The authors, individually and as a group, used an immersion-crystalization approach to analyze the content of the interviews. Results Responses from 25 participants (21 females and four males) are presented. Fifty-two percent of patients were Caucasian, 32% Black, 12% Hispanic, and 4% Asian. Five themes emerged from the data analysis as major reasons the patients missed their scheduled outpatient appointments: forgetfulness, transportation issues, personal health issues, family and employer obligations, and other issues, such as anticipated long clinic wait times, bad weather, and financial problems. Conclusions The findings showed there are several logistical, situational, and clinical reasons for patients’ missed scheduled outpatient appointments

Burnout and Quality of Life among Active Member Physicians of the Medical Society of Sedgwick County

Introduction. The medical literature suggests disturbingly high ratesof burnout among US physicians. The objective of this study was todetermine the rates of burnout, other forms of distress, and overallquality of life among physicians in Sedgwick County.Methods.xThe study involved a convenience sample of 197 physicianswho were active member physicians of the Medical Society of SedgwickCounty (MSSC). Between July and August 2018, we surveyed872 physicians who were active members of the MSSC. The surveyassessed manifestations of burnout, symptoms of depression and suicidalideation, fatigue, and quality of life. The authors used standarddescriptive summary statistics, Mann-Whitney U test/independentsamples t-Test, Fisher’s exact test, and correlations to analyze thedata.Results. The participation rate was 44.6%, with 49.5% of therespondents reporting manifestations of burnout. Although 85% ofthe participants rated their overall quality of life as good/very good,45% screened positive for depression, 5% had thoughts of suicideduring the past year, and 44% reported excessive fatigue during thepast week. Those with manifestations of burnout were 2.13 (100%vs 46.9%, p < 0.01) times more likely to report thoughts of suicidalideation, 2.43 (72.6% vs 30.4%; p < 0.001) times more likely to screenpositive for depression, and 1.89 (67.5% vs 35.8%; p < 0.001) timesmore likely to have high degrees of fatigue. All of the participants whohad suicidal ideation reported manifestations of burnout.Conclusions. Burnout was prevalent among active member physiciansof the MSSC. Burnout among the participants was associatedwith symptoms of depression, fatigue, suicidal ideation, and intentionof leaving the medical profession via early retirement and/or careerchange. Kans J Med 2019;12(2):33-39

Assessing Work-Related Burnout and Job Satisfaction among Obstetrics and Gynecology Residency Program Coordinators

Introduction. This study explored the prevalence of and the relationshipbetween job satisfaction and burnout among obstetrics andgynecology residency program coordinators.Methods.xThis cross-sectional study involved members of theAmerican Program Managers of Obstetrics and Gynecology. TheCopenhagen Burnout Inventory and Spector’s Job SatisfactionSurvey were used to measure the participants’ burnout and job satisfactionrates respectively. Data were collected between August 2017and December 2017. The authors used Fisher’s exact tests, Spearman’sr correlations, and multiple linear regression to analyze thedata.Results. There was an 83% (171/207) response rate. Thirteenpercent of the coordinators reported high, 70% moderate, and 17%low job satisfaction scores. Thirty-nine percent of the coordinatorsreported high, 25% moderate, and 36% slight work-related burnoutrates. Correlation coefficient showed a significantly negative relationshipbetween job satisfaction and work-rated burnout, (rs[169] =-0.402, p < 0.01). Regression analysis showed co-workers (β = -0.47)and supervision (β = -0.16) domains of the job satisfaction scale weresignificant predictors of work-related burnout (R = 0.55; F[5, 195] =11.05; p < .001).Conclusions. The findings highlight the importance of job satisfactionfactors, such as support from coworkers and supervisors, indealing with work-related burnout among residency coordinators.Kans J Med 2019;12(1):11-16

Demand-led approaches to drive post-harvest innovation and nutritious RTB products

Roots, Tubers and Bananas (RTB) Strategy Development Workshop Report

Participatory schemes in co-operatives: a comparative study of management structures of industrial and service co-operatives in the greater Accra region

Recent studies on co-operative organizations in developing countries have indicated that the problems of self-management in co-operatives are due to the failure to implement the principles and ideals of co-operatives in those countries. These studies, coming from sociological and anthropological research, have further pointed out that the principles anti ideals of co-operatives are difficult to implement because they are incompatible with the traditional social structures and norms found in developing countries. Certainly, the principles and ideals of co-operatives are important for ensuring selfmanagement in co-operatives. It is, however, argued that in order to obtain adequate understanding of problems of self-management in co-operatives, it is also necessary to investigate the participatory schemes adopted by them. An empirical description of participatory schemes adopted by industrial producers and service co-operatives in Ghana, is therefore provided. Furthermore, the conditions which give rise to different participatory schemes in the co-operatives are also described

Improving the Quality of Life of a Homeless Person Using Co-Design and Paul Polak\u27s 12 Steps to Practical Problem Solving

Improving the Quality of Life of Homeless Persons using Co-Design and Paul Polack’s 12 Steps for Practical Problem Solving Nana Ofei-Tenkorang Sponsor: Vinka Oyanedel-Craver, Civil and Environmental Engineering The Stewart B. McKinney Act (1994) defines a homeless person as one who lacks a fixed, regular, and adequate night-time residence; and has a primary night time residency that is (A) either a publicly or privately supervised operated shelter designed to provide temporary living accommodations, (B) a public or private place not designed for, or ordinarily used as, a regular sleeping accommodation for human beings and, (C) an institution that provides a temporary residence or service for individuals intended to be institutionalized. This definition includes those people who are on the streets or in shelters and people who face eviction from private dwellings or institutions and who have no residence or resource to obtain housing. There are two major reasons why people become homeless in Rhode Island: (A) lack of affordable housing and, (B) lack of adequate income. A diverse group of people experience homelessness – namely, children, the elderly, individuals and families in both rural communities and in the cities. The number of homeless people has been on the increase over the past few years. For example there were 484 more homeless people in 2011 than in 2007 who visited shelters in the State which accounts for a 12% increase. Considering the increase in numbers of affected people, I have tried to develop some practices that improve the quality of life of a homeless person. In this study I try to answer the following question, Is it possible for a homeless person to have access to a better life? One of the best strategies to obtain an answer to this question is to go out and talk to them. This is where co-design comes in. The term co-design simply means developing or improving a service or device together with the user and customers. To address the root causes of homelessness with the aim to improve the quality of many lives, I utilized Paul Polak’s 12 steps to practical problem solving. He has successfully used this approach to develop alternative solutions to eradicate poverty in developing countries. These steps not only apply to global poverty alleviation, but can also be used to solve problems found in many disciplines. The goal of this study is to develop a prototype that solves a common problem faced by a person who is homeless. To do this I selected a group of 18 Rhode Island residents who are homeless or on the edge of homelessness and asked them to complete a 13-question survey which I developed. Results of the survey showed that resources such as service providers, labor services, and transportation are not easily accessible. Using co-design, a prototype will be developed to solve these common problems faced by the homeless. Keywords: Co-Design, Practical Problem solving, a homeless person, Paul Polak, Povert