Burnout is a major healthcare issue [1] which has intensified with additional stressors arising from the ongoing 2019 Novel Coronavirus (COVID-19) pandemic [2,3]. Emergency Department (ED) healthcare workers (HCWs) have had one of the highest incidences of burnout [4][5][6] even prior to the pandemic. Being at the frontline in direct contact with patients suspected or confirmed to have a COVID-19 infection exacerbates this [7].To evaluate the prevalence of burnout in this population and the preferred methods of coping with the COVID-19 situation, we conducted a cross-sectional study amongst doctors and nurses in our regional health cluster's Emergency Departments (EDs) and Urgent Care Center (UCC). This was performed in end-May, three months into an escalation of hospital workflows in response to the pandemic, at which time Singapore had seen more than 30,000 cases of COVID-19 infections [8]. Approval from the relevant institutional review board was obtained for waiver of consent. Anonymized data was collected via an online questionnaire which covered sociodemographic data, COVID-19 related anxiety and stress as well as coping strategies. These questions were developed based on previous studies and expert opinions on mental health and coping in infectious disease outbreaks [9][10][11]. We evaluated for burnout using the Copenhagen Burnout Inventory (CBI) [12].The primary outcome was the proportion of moderate-to-severe burnout amongst the HCWs, defined by a score of 50 or higher in the personal domain of the CBI. Secondary outcomes assessed included factors associated with moderate-to-severe burnout and preferred methods of coping with the COVID-19 situation.A total of 337 HCWs (210 nurses and 127 doctors) participated in the survey. The overall response rate was 60.2% (69.4% for doctors and 55.7% for nurses). The most common age range was between 21 and 30 years old (46.4%). Majority of respondents were female (67.7%). Most respondents (84.6%) had already been working in the ED or UCC prior to the COVID-19 pandemic while the rest were deployed to augment departmental manpower.Using the CBI, the mean score of personal burnout was 49.2 (SD 18.6). A significant proportion of respondents reported moderate-tosevere personal burnout (49.3%). Nurses had significantly higher CBI scores than doctors, with the mean personal burnout scores for nurses

Purpose. To determine the association between both erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) and osteomyelitis recurrence. Methods. Records of 81 males and 27 females aged 10 to 87 (median, 54) years who underwent antibiotic/ surgical treatment for primary (n=68) or recurrent (n=40) osteomyelitis that was related (n=26) or unrelated (n=82) to a prosthesis were reviewed. Of the 40 cases of osteomyelitis recurrence followed up for a median of 23.4 (range, 0.6-74.0) months, 7 and 33 were related and unrelated to a prosthesis, respectively. The cutoff points of lowest ESR and CRP for osteomyelitis recurrence were calculated. Risk factors for osteomyelitis recurrence were determined. Results. Osteomyelitis recurrence was associated with diabetes mellitus, ischaemic heart disease, nonhealing wound, infection in the lower limb, and infection with methicillin-resistant Staphylococcus Use of erythrocyte sedimentation rate and C-reactive protein to predict osteomyelitis recurrence 2016;24(1):77-83 aureus. The cutoff points of CRP ≥5 mg/l and ESR ≥20 mm/h were used for osteomyelitis recurrence. Risk factors for osteomyelitis recurrence were ESR ≥20 mm/h, infection with methicillin-resistant S aureus, and infection in the lower limb. Conclusion. ESR was more sensitive, specific, and independently associated with osteomyelitis recurrence and should be used to guide the duration of antibiotic treatment.

BackgroundConflicts between doctors and patients occur in People’s Republic of China each year. Serious negative relationships between doctors and patients are a significant social problem. This study aims to evaluate the satisfaction of inpatients in a tertiary hospital through a third party and analyze the relationship between sociodemographic characteristics and overall satisfaction.Patients and methodsA cross-sectional investigation was conducted to obtain the demographic information and results for 20 items in an inpatient satisfaction questionnaire. A total of 872 inpatients were studied. Descriptive analysis was conducted using SPSS version 22.0 software. Independent sample t-tests and one-way ANOVA were used to compare the mean differences between groups. Multiple linear regression analysis was conducted to study the relationship between different demographic characteristics and overall satisfaction. P-values of <0.05 were considered significant. Matrix analysis was used to predict which of the 20 items had a higher priority for patient satisfaction.ResultsAmong the respondents, valid questionnaires were completed by 872 patients, with a response rate of 94.47% (872/923). The hospital inpatient satisfaction score was 84.92±10.34. Among the sociodemographic characteristics, education status, occupation, annual income, residence and frequency of visits were related to inpatient satisfaction and were statistically significant (P<0.05). However, sex, age and marital status were not significantly different in terms of the inpatient satisfaction score (P>0.05). Multiple linear regression analysis results showed that residence, age, occupation and education status were the factors affecting inpatient satisfaction. In further analyses, diet management, medical expenses, complaint management and hospital environment were in urgent need of improvement.ConclusionThe overall level of inpatient satisfaction with this hospital seems to be acceptable, although areas for improvement remain.

The subaqueous delta of the Huanghe (Yellow River) has been StUdied using high-resolution acoustic systems. There are many subtle variations in sea floor morphology and sediment geometries; Smooth, featureless areas are rare, The main components of the SUbaqueous delta include broad, shallow channels; moderately disturbed areas with near-surface cut and fill structures; heavily disturbed areas with sea floor depressions, pits, and gullies; and a Smooth, gently sloping distal delta apron or "rise." These features are not directly related to sediment settling from dilute surface plumes but are due to gravity-driven hyperpycnal underflows, submarine mass movements, and silt flows.