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Background: Objective assessment of grit and its association with burnout in obstetrics and gynaecology (O&G) training is underexplored., Aim: This study utilises the Short Grit Scale and the Oldenburg Burnout Inventory to investigate the association of grit with burnout, thriving and career progression among O&G trainees and Fellows in Australia/New Zealand., Materials and Methods: A cross-sectional survey of the RANZCOG (Royal Australian and New Zealand College of Obstetricians and Gynaecologists) members was conducted. Participants were categorised by seniority level (core trainees, advanced trainees and Fellows). Mean grit and burnout scores were compared with one-way analyses of variance. Correlation between grit and burnout was estimated using Pearson's correlation coefficient. Logistic regression models were used to determine factors associated with high vs low burnout. Grit was categorised as low/medium/high for regression models., Results: A total of 751 (26%) participants completed the survey. Fellows reported higher mean grit than core (P = 0.02) and advanced trainees (P = 0.03), and lower mean burnout than core trainees (P < 0.001). Moderate negative correlation was demonstrated between grit and burnout scores (r = -0.34). In the multivariable model, only seniority (adjusted adds ratio (OR): 0.40 for Fellows vs core trainees, P = 0.008) and grit levels (adjusted OR:4.52 for low versus high, P < 0.001; 2.32 for low vs medium, P = 0.001) were significantly associated with burnout., Conclusion: This study demonstrates the protective role of grit in combating burnout among RANZCOG trainees and Fellows. While further well-designed studies are warranted, findings from our study are expected to help the College in developing targeted interventions and subsequently minimise burnout-related adverse outcomes in high-risk groups., (© 2021 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.)

Severe acute malnutrition (SAM) affects ~4 million infants under 6 months (u6m) worldwide, but evidence underpinning their care is "very low" quality. To inform future research and policy, the objectives of our study were to identify risk factors for infant u6m SAM and describe the clinical and anthropometric outcomes of treatment with current management strategies. We conducted a prospective cohort study in infants u6m in Barisal district, Bangladesh. One group of 77 infants had SAM (weight-for-length Z-score [WLZ] <-3 and/or bipedal oedema); 77 others were "non-SAM" (WLZ ≥-2 to <+2, no oedema, mid-upper-arm circumference ≥125 mm). All were enrolled at 4-8 weeks of age and followed up at 6 months. Maternal education and satisfaction with breastfeeding were among factors associated with SAM. Duration of exclusive breastfeeding was shorter at enrolment (3·9 ± 2.1 vs. 5.7 ± 2.2 weeks, P < 0.0001) and at age 6 months (13.2 ± 8.9 vs. 17.4 ± 7.9 weeks; P = 0.003) among SAM infants. Despite referral, only 13 (17%) reported for inpatient care, and at 6 months, 18 (23%) infants with SAM still had SAM, and 3 (3.9%) died. In the non-SAM group, one child developed SAM, and none died. We conclude that current treatment strategies have limited practical effectiveness: poor uptake of inpatient referral being the main reason. World Health Organization recommendations and other intervention strategies of outpatient-focused care for malnourished but clinically stable infants u6m need to be tested. Breastfeeding support is likely central to future treatment strategies but may be insufficient alone. Better case definitions of nutritionally at-risk infants are also needed., (© 2018 The Authors. Maternal and Child Nutrition Published by John Wiley & Sons, Ltd.)