A Road Map to Foster Wellness and Engagement in Our Workplace—A Report of the 2018 Summer Intersociety Meeting

The 2018 radiology Intersociety Committee reviewed the current state of stress and burnout in our workplaces and identified approaches for fostering engagement, wellness, and job satisfaction. In addition to emphasizing the importance of personal wellness (the fourth aim of health care), the major focus of the meeting was to identify strategies and themes to mitigate the frequency, manifestations, and impact of stress. Strategies include reducing the stigma of burnout, minimizing isolation through community building and fostering connectivity, utilizing data and benchmarking to guide effectiveness of improvement efforts, resourcing and training “wellness” committees, acknowledging value contributions of team members, and improving efficiency in the workplace. Four themes were identified to prioritize organizational efforts: (1) collecting, analyzing, and benchmarking data; (2) developing effective leadership; (3) building high-functioning teams; and (4) amplifying our voice to increase our influence.     

Medical Leadership: A Manifesto for Radiologists

Leadership is much discussed but also often misunderstood. For radiologists, leadership may seem irrelevant or, even worse, an onerous addition to their busy careers. It is important that radiologists understand the relevance and importance of good leadership for the success of departments and groups. There are many obstacles to radiologists becoming effective leaders, including personal resistance that is due to myths and misunderstandings, the time and effort (and money) required to learn to lead well, as well as others including the shift in perspective that comes from focusing on organizational success rather than individual career success. This manifesto will explore the what, the why, and the how of becoming a leader in radiology and why it is critical for individuals, their organizations, academic departments, private practice groups, and others, as well as the larger house of radiology.     

烧伤患者疼痛管理的应用分析

目的探讨疼痛管理对烧伤患者焦虑情绪、疼痛、依从性及生活质量的影响。方法选择2017年5月至2018年5月河南理工大学第一附属医院烧伤整形科收治的90例烧伤患者作为研究对象,并按照随机数表法随机分为观察组(45例)与对照组(45例),其中观察组患者采用疼痛管理护理措施予以护理,对照组患者采用常规护理措施予以护理,对比观察两组患者的焦虑评分、疼痛评分、依从性评分及生活质量评分。结果护理4周后,两组患者焦虑评分及疼痛评分均显著降低,且尤以观察组患者降低程度最明显,两组对比,P均0.01,差异具有统计学意义;依从性评分及生活质量评分均显著升高,且尤以观察组患者升高程度最明显,两组对比,P均0.01,差异具有统计学意义。结论疼痛管理可显著改善烧伤患者的疼痛程度及焦虑情绪,提高患者依从性及生活质量,值得临床推广应用。     

Application of forensic anthropology to non-forensic issues: an experimental taphonomic approach to the study of human body decomposition in aerobic conditions

The knowledge of the decomposition process takes a progressively central role in cemetery management. In Europe there is an increase in constructing concrete modules that allow aerobic decomposition, which, theoretically, have advantages. By allowing the circulation of oxygen they will lead to a rapid decomposition, and, consequently, permit burial space rotation. This method also allows the burial of several corpses in small areas. In addition, it solves environmental issues. However, the ways in which the decomposition occurs under these conditions and the time required for skeletonization are still unknown. The aim of this study is to analyse the changes of the cadavers buried in aerobic module systems, realize the time necessary for skeletonization, and study solutions that might enable a faster decomposition. This experimental study utilized three aerobic module systems already used in Portuguese cemeteries and a prototype, with four pig carcasses as animal models. The evolution of the decomposition process was assessed weekly, over 147 days (2184 ADD). This study showed differences in the decomposition process between the four systems. The results allowed us to select the necessary characteristics for the construction of aerobic modules enabling faster decomposition.     

Cliniques urbaines africaines

The team of therapists who gathered around Henry Collomb at the Fann Hospital of Dakar in the sixties has noticed the particularities of the African psychiatry with a noticeable predominance of delirious puffs on the other pathologies. In the eighties, Maurice Dorès drew attention to the evolution of this situation marked by a notable reduction of the delirious puffs in favor of hysterical psychosis and other symptomatologies. This text accounts for the psychotherapeutics of patients who come to consult a psychologist in urban area and currently the most frequent motivations of this approach.     

La psychiatrie dans ses rapports avec l’institutionnel et le familial. Réflexions sur le futur

Psychiatry, like all areas of existence, is made up of the different dimensions of time, the present, the past and the future. We will discuss the reflection on future trajectories in two areas corresponding to our experience : on the one hand, Psychiatry in the dynamics of various medical-educational and therapeutic establishments (rehabilitation, rehabilitation, socio-psychotherapy etc.) for the child, the adolescent the adult (diversified social protection). And on the other hand, the issues concerning the support of families in the light of our studies and our practice of university training of professionals. Of course, the future of our profession is dominated, as we know, by two main general areas : The regulation of problems and conceptions of ethics from the beginning to the end of life on the one hand, and on the other hand the consolidation of structuring Humanism in the midst of currents wanting to deploy transhumanism. In this study, we will start from concrete and conceptual current realities. From an Institutional point of view, we will focus on two important areas for the future. The need for continuity in the function of psychiatry and its practices even within the diversity of personal situations, even within the Institutions and in relation to the different clinical approaches carried out (from the youngest children to adults). And on the other hand, the importance of the coordination of psychiatric practices and conceptions in the face of the current fragmentation and compartmentalisation of practices. Psychotherapies have of course to respond to very specific and well adapted indications and this need for coordination is already well recalled. But it should certainly also correspond to modifications of the training programs of psychiatry developing versatility in future psychiatrists and taking more into account the plurivalence of people as well as the philosophical and anthropological reflection capable of promoting the most complex coordinations. From the point of view of family issues, faced with the constant worsening of disruptions, professionals will have to consider family situations in a different way, taking more into account the modalities of diverse pathological family expressions than is necessary. It will act more to consider systematically in the forms of ordinary models, but as manifestations of dysfunction and suffering for children and for adults, calling for diverse and specialized help. These considerations bring us to the urgent need for measures to prevent family disturbances in the development of modalities for structuring education for young people. All these areas will need to be further supported by general epistemological and anthropological conceptions. It will be a matter of further developing integrative epistemology capable of taking account the different psychological and psychopathological conceptions (development of the child psychologies of consciousness and the unconscious, cognitivism, systemic understanding, etc.) to take more into account the structuring anthropology allowing to consider the child, the teen ager and the adult in a constructive dynamic of all the physical, psychic, noetic and spiritual components of the personalities capable of helping them to regain control and meaning of their existence.     

1H-MR波谱检测腓肠肌细胞内脂质浓度用于早期诊断2型糖尿病模型大鼠周围神经病变

目的 观察¹H-MR波谱(MRS)检测腓肠肌肌细胞内脂质(IMCL)浓度对早期诊断2型糖尿病(T2DM)模型大鼠周围神经病变(DPN)的价值。方法 将30只雄性SD大鼠随机分为糖尿病(DM)组和正常组,每组15只。对DM组以高糖高脂饲养4周联合单次腹腔注射1%链脲佐菌素(STZ)溶液45 mg/kg体质量建立T2DM模型,正常组则以普通饲料饲养4周联合注射1% STZ柠檬酸-柠檬酸钠缓冲液作为对照。于建模成功后第4、8周采集2组大鼠右后肢腓肠肌¹H-MRS,检测其IMCL浓度;于建模成功后第8周处死动物,检测2组右坐骨神经运动神经传导速度(MNCV)和感觉神经传导速度(SNCV),之后行病理学检查,观察坐骨神经组织变化,判断是否发生DPN;评估腓肠肌IMCL浓度对早期诊断DPN的价值。结果 DM组15只均成功建立T2DM大鼠模型,建模成功后每周DM组大鼠空腹血糖及体质量均高于正常组(P均＜0.05)。建模成功后第4、8周,DM组大鼠右后肢腓肠肌IMCL浓度均显著高于正常组(P均＜0.01),且建模成功后第8周DM组及正常组大鼠IMCL浓度均明显高于第4周(P均＜0.01)。建模成功后第8周,DM组大鼠均发生DPN,其右坐骨神经MNCV及SNCV均明显低于正常组(P 均＜0.001);病理结果示神经纤维异常变化。结论 ¹H-MRS检测腓肠肌IMCL对早期诊断T2DM大鼠DPN具有一定价值。     

Therapeutic hypothermia and acute brain injury

Secondary brain injury has devastating effects on morbidity, mortality and good functional outcomes. Neuroprotection is multimodal, with decades of preclinical and small clinical studies showing the benefits of therapeutic hypothermia. The basic scientific principles have merit, yet large randomized controlled trials fail to show a clear benefit. This article will review the basic science – the practical aspects of delivering targeted temperature management and evaluate the evidence behind its use for acute brain injuries. With a lack of high-quality evidence for hypothermia, recent consensus statements are shifting the paradigm away from hypothermia to the maintenance of normothermia and prevention of pyrexia.