Study Finds Surgeon Burnout Associated With Medical Errors

Study Finds Surgeon Burnout Associated With Medical Errors

Depersonalization, emotional exhaustion linked to higher chance of reporting recent errors

FRIDAY, Nov. 27 (HealthDay News) -- Among surgeons, degree of burnout was strongly associated with major medical errors, according to research published online Nov. 19 in theAnnals of Surgery.

Tait D. Shanafelt, M.D., of the Mayo Clinic in Rochester, Minn., and colleagues analyzed data from 7,905 surgeons who responded to a survey asking about career satisfaction, burnout, depression, and major medical errors made in the previous three months.

The researchers found that nearly 9 percent reported recently making a major medical error. Reporting an error was associated with a higher risk of screening positive for depression and a clinically significant decline in mental quality-of-life score. Each one-point increase in depersonalization -- measured with the Maslach Burnout Inventory -- was associated with an 11 percent higher chance of reporting an error. Each additional point on an emotional exhaustion scale was associated with a 5 percent increase.

"Since the present study is cross-sectional, we are unable to determine whether distress causes errors or errors cause distress. The findings are consistent with previous prospective studies in internal medicine and pediatric residents which demonstrate an increased risk of future medical errors among distressed physicians and imply that surgeon distress is a contributing factor to medical errors as well as a consequence," the authors write. Eric Metcalf

The best exercise: Walking the dog- Hindustan Times

The best exercise: Walking the dog- Hindustan Times

Anti–Obesity Day 2009 - Cut Flab and Stay Fit

Anti–Obesity Day 2009 - Cut Flab and Stay Fit

Anti-Obesity Day was observed all over India on November 26th, 2009. The initiative sought to spread the word about the dangers of obesity and the steps to take to cut the flab and stay fit.

This day assumes importance in the wake of the obesity statistics which shows 17 % of the young in the age group of 14-18 in India are overweight or obese. They add to the burden of overall obesity figures in India standing at a mammoth 70 million. What makes it worse is that South Asians are genetically more prone to heart disease and diabetes due obesity. Further, Indians are genetically prone to accumulation of weight around the waist, a sure health risk.

Elaborating on the enormity of the problem Pav Kalsi, care adviser at Diabetes-UK said, “We know that T-2 diabetes, which is linked to being overweight, is up to six times more common in South Asian people than the white population.”

Growing Menace

A person is medically termed obese when the body weight is 20% more than the normal weight. Body Mass Index, the measure of obesity, is calculated using the ratio of weight and height.

Standards used worldwide to measure obesity are based on data from Whites. According to this standard, a BMI of 25 or more is considered overweight and a BMI of 30 or more is considered obese. Though the World Health Organization (WHO) still retains these cut off points for overweight and obese standards, it recognizes the need to develop different cut off points for different ethnic groups throughout the world.

Recently, the BMI limits have been lowered in India for better accuracy and also to avert health risks of obesity by getting more people into the fold– now, a BMI of 23 denotes overweight and a BMI of 25 and above denotes obesity.

Health Risks of Obesity

Obesity has been linked to at least 53 diseases. Not surprising, as overweight and obesity are known to impact blood pressure, cholesterol, triglycerides and insulin resistance of the body, negatively. The health risks of obesity can cost life and hence tackling obesity needs serious attention.

An abnormally high BMI increases the risk of breast cancer, cancer of the colon, prostrate, kidney and gall bladder. Thus, obesity is the leading cause of premature death due to its association with chronic diseases like cancer, cardiovascular diseases, and Type 2 Diabetes.

• Type 2 diabetes and obesity are liked directly. Studies have shown close to 85% of people with Type 2 diabetes are overweight.
• Obesity significantly elevates the risk of heart disease and heart attack if one is 20% overweight. .
• Obese women aged 50 and above carry an elevated risk of hypothyroidism, a disorder of the endocrine system which can trigger further weight gain and a host of other problems.
• Gallstones are another major problem for the obese and for obese women the risk is more pronounced.

The Center for Disease Control (CDC) has outlined some of the health risks of obesity. They are:

High blood cholesterol, dyslipidemia
Insulin resistance, glucose intolerance
Congestive heart failure
Cholescystitis and cholelithiasis
Gout
Osteoarthritis
Some types of cancer (such as endometrial, breast, prostate, and colon)
Complications of pregnancy
Poor female reproductive health (such as menstrual irregularities, infertility, irregular ovulation)
Bladder control problems (such as stress incontinence)
Psychological disorders (such as depression, eating disorders, distorted body image, and low self- esteem)
Bell the Fat

A multi-pronged strategy for effective weight management and prevention of chronic diseases is crucial for those groups at risk. A healthy lifestyle with a proper diet and exercise is the only secret to maintaining optimum weight.

The prevention strategies will include a weight loss programme followed by a weight maintenance programme. The weight loss programme will combine the benefits of rigorous physical activity and a healthy diet regimen designed to knock off the additional weight in a stipulated timeframe.

Obesity which opens the Pandora’s box of chronic diseases can be prevented with just a few healthy steps:

1. Eat a balanced diet rich in proteins, vegetables and fruits. Including more fiber and less fat will do the trick, experts say. Cut down on snacks, bakery products and fast foods laden with trans fat.

2. Stay active. Engage in a 30 minute physical activity with a good pace of exercise preferably 4-5 times a week.

3. Monitor weight regularly.

Notwithstanding personal efforts, it is also imperative that the policymakers in India chip in to regulate the entry of harmful foods. Increasing the taxes of foods saturated with sugar and trans fats while reducing the cost of vegetables and fruits may be the way to go for a leaner, fitter and healthier India.

Source-Medindia
Savitha/S

How to Wake up in the Morning By Kunal Anand

The morning struggle isn’t a lonely one – there are tens of thousands in every city of the world who can’t arouse when arisen. Google is stuffed with search queries on waking up on time - 62,200,000 for ‘How to wake up’! So most of what I’m telling you isn’t something new, but stuff I’ve thought about. Here is what you can do.

Admit you have a sleeping problem. You do. Maybe you associate sleep with ‘escape’. It’s not always going to be escape; sometimes it’s just ‘rest’. And a notion can make a big difference; while rest implies an interval of recovery from tiredness, escape means going the whole way. You have to accept that just because you are under the sheets doesn’t mean your problems are going to go away. Postponing facing what the day will give you with sleep won’t make it better.

Instead, as soon as you wake up, decide to do warfare on any current problem the moment you wake up. As soon as you wake up, start working on the bitch-of-a-PowerPoint-presentation, whip out the calculator & Accounts textbook, the course book you were dreading to read, or any other such horrendous task that you were dodging. By doing this, you are switching on your ‘Let’s get it done’ mode. The morning momentum of getting things done will carry over to other tasks– including staying awake.

You might not be waking up on time because of a bad night of sleep. To get a night of peaceful rested sleep, incorporate the following ‘don’ts’ into your sleep plan.

· Don’t watch TV, or turn on the computer right before sleeping.
· Don’t Eat a heavy meal at night 2 hours before sleeping, especially something with meat. A heavy meal is difficult to digest. Sleep is meant to be restorative, and putting your gut juices into labor isn’t sleep-savvy. Instead, leave room for fresh/dry fruits. You’ll get your fiber and fat without taxing your system. Avoid caffeine, nicotine sugar and alcohol before sleep – while all pack a nice, efficient buzz, you will definitely sleep better without it, thus waking up rested.

Get some exercise. If you incorporate physical activity into your day, you will definitely fall asleep faster, and have a deeper sleep.

Make an efficient ‘sleep plan’. Learn to adjust your evening plan to incorporate a customized chill-out period (music, a quiet read), and similarly make a chilled morning routine. If the idea of a busy, action-packed, ‘energized’ morning intimidates you, work on doing something refreshing and enjoyable that keeps you awake. Why not finish a new level on the PS2? Keep thinking of new ways of making the night sleepy and the morning fun. By creating positive memories of sleeping and waking on time, a good sleep schedule won’t seem like a schedule, but a better way of doing things.

Just because you are awake doesn’t means you are mentally booted up. Like me, you also might think that it’s your rational brain telling you that it’s alright if you sleep a bit more. It’s not. It’s your sleepy head, you sleepyhead! Steve Pavlina, personal development entrepreneur recommends actually visualizing how you will wake up in the morning, until it becomes autopilot. Alternatively, you can also practice your morning drill. He writes:

“…put on your pajamas. Brush your teeth. Set your alarm for a few minutes ahead. Lie down in bed just like you would if you were sleeping, and close your eyes. Get into your favorite sleep position. Imagine it’s early in the morning… a few minutes before your desired wake-up time... “…when your alarm goes off, turn it off as fast as you can. Then take a deep breath to fully inflate your lungs, and stretch your limbs out in all directions for a couple seconds… like you’re stretching during a yawn. Then sit up, plant your feet on the floor, and stand up...Now shake yourself off, restore the pre-waking conditions, return to bed, reset your alarm, and repeat. Do this over and over and over until it becomes so automatic that you run through the whole ritual without thinking about it…When the alarm rings, you have to put yourself through the act you have practiced…”

Wake up on the same time, even on weekends. The weekend morning may make you sore, but you know that it’ll be worth it. Chart your progress – write down what time you fell asleep and what time you woke up. Try this – as soon as you wake up, jot down the exact time – you are literally ‘guilting’ yourself into staying up because you have written it down.

Good night and good morning!