Excessive work hours of physicians in training in El Salvador: putting patients at risk.
Ontology highlight
ABSTRACT:
SUBMITTER: Fernandez Taylor KR
PROVIDER: S-EPMC1914065 | biostudies-literature | 2007 Jul
REPOSITORIES: biostudies-literature
Publications
Excessive work hours of physicians in training in El Salvador: putting patients at risk.
PLoS medicine 20070701 7
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Project description:Background: Physicians marry other physicians at a high rate, and theories suggest being married to a physician (MTP) may impact a physician's productivity in different ways. This impact may differ by gender and rurality of work location. This study empirically examines MTP's effects by gender and rurality of physicians' work location. Data and Method: This study uses both the Association of American Medical Colleges (AAMC) 2019 National Sample Survey of Physicians (n = 6,000) and the American Community Survey data 2006-2017 (n = 72,900). We conducted cross-sectional, multivariate analysis with interaction terms between MTP, gender, and rurality, controlling for various work and personal characteristics. Results: A female MTP physician works 2.9 fewer hours (95% confidence interval [CI]: -4.3 to -1.4, p = 0.000) per week than a female non-MTP physician, while a male MTP physician's weekly work hours are not significantly different from a male non-MTP physician's. Compared to non-MTP counterparts, male MTP physicians are more likely to have on-call work, and female MTP physicians are much less likely to have on-call work; male MTP physicians earn $6,635 more (95% CIs: $1,613-$11,657, p = 0.010) per year, while female MTP female physicians earn $5,018 less (95% CIs: -$10,684 to $648, p = 0.083). Furthermore, the MTP-associated gender differential effects are more prominent for physicians in rural areas than in urban areas. Results from both datasets are highly comparable. Conclusions: MTP's effects widen the gender gap in physicians' work hours, on-call probability, and earnings. Understanding and examining the mechanisms for these gender differential effects are essential to promote equity in the physician workforce.
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Project description:We present a map and a data set containing information about intra-plate seismic sources in El Salvador. These are the results of the field campaigns and data analysis carried out by the research group of Planetary Geodinamics, Active Tectonics and Related Risks from Complutense University of Madrid during the last 12 years. We include two maps, the first map contains 1405 fault traces with evidences of Quaternary activity derived form morphometric, paleoseismological and geomorphological analysis together with field data mapping carried in El Salvador. The second map is a synthesis of the 29 intra-plate seismic sources selected from the quaternary faults map. The geometry of these sources was simplified and we also include a table where some available data of the proposed sources are included, such as their name, orientation, length and slip-rate. For further interpretation and discussion of these sources see (Alonso-Henar et al., 2018) [1, doi.org/10.1016/j.enggeo.2018.06.015].
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Project description:We estimate the proportion of patients hospitalized for suspected dengue that tested positive for influenza virus in El Salvador during the 2012 influenza season. We tested specimens from 321 hospitalized patients: 198 patients with SARI and 123 patients with suspected dengue. Among 121 hospitalized suspected dengue (two co-infected excluded) patients, 28% tested positive for dengue and 19% positive for influenza; among 35 with suspected dengue and respiratory symptoms, 14% were positive for dengue and 39% positive for influenza. One percent presented co-infection between influenza and dengue. Clinicians should consider the diagnosis of influenza among patients with suspected dengue during the influenza season.
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Project description:Four Amblyomma sabanerae ticks collected from a turtle (Kinosternon sp.) in San Miguel, El Salvador, were found by molecular analysis to be infected by Rickettsia bellii. We provide the first report of Rickettsia bellii in Central America, and the first report of a Rickettsia species in El Salvador.
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Project description:Fleischmannia profusa is named as new from El Salvador based on material with deltoid leaf blades, numerous axillary fascicles of leaves on the vegetative stems and c. 60 sharply obviously acuminate involucral bracts in 4-5 strongly gradate series.
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Project description:OBJECTIVE:HIV in Central America is concentrated among certain groups such as men who have sex with men (MSM) and female sex workers (FSWs). We compared social recruitment chains and HIV transmission clusters from 699 MSM and 787 FSWs to better understand factors contributing to ongoing HIV transmission in El Salvador. METHODS:Phylogenies were reconstructed using pol sequences from 119 HIV-positive individuals recruited by respondent-driven sampling (RDS) and compared with RDS chains in 3 cities in El Salvador. Transmission clusters with a mean pairwise genetic distance ? 0.015 and Bayesian posterior probabilities =1 were identified. Factors associated with cluster membership were evaluated among MSM. RESULTS:Sequences from 34 (43%) MSM and 4 (10%) FSW grouped in 14 transmission clusters. Clusters were defined by risk group (12 MSM clusters) and geographic residence (only 1 spanned separate cities). In 4 MSM clusters (all n = 2), individuals were also members of the same RDS chain, but only 2 had members directly linked through recruitment. All large clusters (n ? 3) spanned >1 RDS chain. Among MSM, factors independently associated with cluster membership included recent infection by BED assay (P = 0.02), sex with stable male partners (P = 0.02), and sex with ? 3 male partners in the past year (P = 0.04). CONCLUSIONS:We found few HIV transmissions corresponding directly with the social recruitment. However, we identified clustering in nearly one-half of MSM suggesting that RDS recruitment was indirectly but successfully uncovering transmission networks, particularly among recent infections. Interrogating RDS chains with phylogenetic analyses may help refine methods for identifying transmission clusters.
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Project description:ObjectivesLong working hours in Japan is a social concern. This is also true for the working hours of physicians, who often do side work in addition to working at their main hospital. New physician work regulations to be implemented in Japan require work-hour management, including side work. This study examined the association between physicians' overtime and side work hours and their health outcomes.MethodsWe conducted a cross-sectional study using data from a survey of working physicians conducted by the Japan Medical Association from 2021 to 2022. Questionnaires completed by 2906 full-time working physicians aged 24-69, excluding junior resident doctors, were analyzed. Depressive symptoms and the presence of thoughts of death or suicide using the Quick Inventory of Depressive Symptomatology - Japanese version was used to assess health outcomes. Logistic regression analysis was performed using overtime at the main place of employment and side work hours as exposure factors.ResultsBoth depressive symptoms and thoughts of death or suicide increased in the group with longer overtime hours at the main place of work. A similar tendency was observed for side work but adjusting for overtime hours eliminated the association. In other words, total working hours had an impact on health, regardless of whether overtime work at the main place of employment or side work.ConclusionsDespite the existence of multiple hurdles to managing working hours, including side work, the working environment for physicians needs to be improved to protect their health and quality of medical care.
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Project description:As communities worldwide shift from consuming traditional diets to more processed snacks and sugar-sweetened beverages (SSBs), increases in child obesity and tooth decay and persistence of undernutrition are particularly apparent in Latin American countries. Further evidence of shared risk factors between child undernutrition and poor oral health outcomes is needed to structure more effective health interventions for children's nutrition. This study aims to identify dietary, oral health, and sociodemographic risk factors for child undernutrition and severe early childhood caries (sECC) among a convenience sample of 797 caregiver-child pairs from rural Salvadoran communities. Caregiver interviews on child dietary and oral health practices were conducted, and their children's height, weight, and dental exam data were collected. Multivariable regression analyses were performed using RStudio (version 1.0.143). Caregiver use of SSBs in the baby bottle was identified as a common significant risk factor for child undernutrition (p = 0.011) and sECC (p = 0.047). Early childhood caries (p = 0.023) was also a risk factor for developing undernutrition. Future maternal-child health and nutrition programs should coordinate with oral health interventions to discourage feeding children SSBs in the baby bottle and to advocate for policies limiting SSB marketing to young children and their families.
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Project description:Analyses of physician well-being typically rely on small and unrepresentative samples. In April 2011, the UK Office for National Statistics incorporated subjective well-being metrics (SWB) into the Annual Population Survey (APS), a well-established survey. This survey includes variables from the labor market, making APS an ideal source for measuring the association between work hours and SWB metrics and comparing among different professionals. Using APS data from 2011/12 to 2014/15, this study examined the association between SWB levels and work hours using multiple linear models for physicians (primary care physicians and hospital doctors), lawyers, and accountants. Of the 11,810 observations, physicians were more satisfied, happier, and less anxious; females were more stressed (10.7%); and age was negatively associated with happiness and satisfaction. Incorporating information on preferences to work more hours (underemployment) did not affect physicians' but worsened the well-being of other professionals (lawyers and accountants). Surveyed physicians were less anxious, happier, and more satisfied than lawyers or accountants before Covid. Although the total work hours did not alter the SWB metrics, overtime hours for other professionals did. Increasing the working hours of underemployed physicians (with appropriate compensation) could be a relatively inexpensive solution to tackle the shortage of health workers in the short run.
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