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There is growing evidence that anaesthetic trainees experience, and may be particularly susceptible to, high levels of work stress, burnout and depression. This is concern for the safety and wellbeing of these doctors and for the patients they treat. To date, there has been no in-depth evaluation of these issues among UK anaesthetic trainees to examine which groups may be most affected, and to identify the professional and personal factors with which they are associated. We conducted an anonymous electronic survey to determine the prevalence of perceived stress, risk of burnout/depression and work satisfaction among anaesthetic trainees within South-West England and Wales, and explored in detail the influence of key baseline characteristics, lifestyle and anaesthetic training variables. We identified a denominator of 619 eligible participants and received 397 responses, a response rate of 64%. We observed a high prevalence of perceived stress; 37% (95%CI 32-42%), burnout risk 25% (21-29%) and depression risk 18% (15-23%), and found that these issues frequently co-exist. Having no children, > 3 days sickness absence in the previous year, ≤ 1 h.week-1 of exercise and > 7.5 h.week-1 of additional non-clinical work were independant predictors of negative psychological outcomes. Although female respondents reported higher stress, burnout risk was more likely in male respondents. This information could help in the identification of at-risk groups as well as informing ways to support these groups and to influence resource and intervention design. Targeted interventions, such as modification of exercise behaviour and methods of reducing stressors relating to non-clinical workloads, warrant further research. [ABSTRACT FROM AUTHOR]

AIM: The aim of this was to evaluate the effectiveness of interventions provided by a Community Mental Health Team (CMHT) in reducing stress in carers of individuals with dementia. BACKGROUND: The CMHT had been created to working specifically with older people with mental health problems and their carers. Following initial multidisciplinary assessment a range of interventions were provided to both clients and carers according to assessed need. There is an established need for mental health services to focus on the need of carers and the study attempts to see if the interventions provided were useful in reducing carer stress. METHOD: The study used a time series design over a 2-year period on all referrals to the CMHT. All carers of individuals with dementia or clearly identified memory problems were invited to participate and a total of 26 carers consented and participated in all stages of data collection. Data were collected on initial assessment, as well as 3 and 6 months following the initial assessment using the Caregiver Strain Index (CSI). A questionnaire was also administered which collected basic demographic information and details of symptoms demonstrated by the carer's relatives. RESULTS: On initial assessment the mean CSI score for the overall sample was 9.23. The mean CSI reading at 3 months (6.63) and 6 months period (4.12) demonstrated statistically highly significant reductions in carer stress (P = 0.000). A linear stepwise regression analysis of the impact of the different interventions on reductions in the CSI scores showed a statistically significant relationship between respite care and reduction in carer stress (B = 1.705, t = 2.586, P = 0.017). CONCLUSION: The results add support to the role of multidisciplinary community based services for individuals with dementia, offering a range of interventions to both clients and their carers, in reducing carer stress. The authors also argue for the routine use of the CSI in such teams as means of monitoring the well-being of carers as well as evaluating the effectiveness of service delivery. [ABSTRACT FROM AUTHOR]

Objectives: Research to develop early screening tools to determine an individual's risk of developing adult-onset disease is a growing field. Expectant parents may find themselves with an option in the future to undergo screening to determine not only genetic abnormalities in their child but also their risk of developing adult-onset non-communicable diseases (NCD) such as hypertension, obesity or hypercholesterolaemia. To ensure acceptability and feasibility of new screening tools researchers must work in partnership with healthcare consumers to discern consumers' current understanding and acceptance of these technologies in research and the potential for clinical applications. We sought to engage with healthcare consumers to develop a consensus, using a modified Delphi study design, for the acceptability of (1) screening tools for use within pregnancy that would indicate a child's risk for developing NCD, and (2) targeted early interventions for those identified at a higher risk of developing NCD using precision medicine approaches. The acceptability of future research design and conduct as well as the implications for implementation into routine healthcare were discussed. In addition, participants were asked to rank the non-communicable diseases they believed were of most importance for precision medicine research focus, in line with recent calls for better involvement of healthcare consumers in setting research questions and defining priority areas., Design: A modified two-stage Delphi study design including an in-person consumer workshop (stage 1) and online follow-up survey (stage 2), was used to evaluate consumer consensus for research to develop precision medicine tools for early detection and potential intervention to reduce onset of NCDs. The acceptability of research design and conduct and future implications for the implementation of newly developed tools into routine healthcare was also addressed., Setting and Participants: We engaged 76 healthcare consumers in 2020, in the Hunter New England Region, New South Wales, Australia. Participants were recruited from existing healthcare consumer organisations, research programmes and healthcare networks through purposeful selection, with a focus on participants having a broad range of experiences and backgrounds to ensure adequate representativeness., Results and Conclusions: Our findings indicate the majority (98%) of participants in our study believe early screening for risk of NCD in their children was acceptable, provided it was equitable and clear pathways for referral and support were available., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Purpose: To describe program characteristics and outcomes of a residential substance use recovery program serving pregnant and parenting women in a rural and urban location., Description: This assessment of administrative records from April 1, 2020 through March 31, 2022, included women in a rural (n = 140) and urban (n = 321) county in Kentucky., Assessment: This retrospective case study used descriptive and non-parametric analyses to assess the population and examine differences between locations, race, and ethnicity for women served. Logistic regression tested predictors of goal achievement by community. Of 461 women served, 65 (14.1%) delivered a baby while in treatment; 62 of which were considered healthy. 13% of the women were Black, 83.1% non-Hispanic (NH) white, and 3.7% were other races/biracial; 1.3% were Hispanic. The mean age was 30.92 years (SD 6.23) and treatment duration was 90.11 days (SD 67.70). Program goals were achieved by 312 (67.7%). There were no differences in rates of goal achievement or treatment duration by race, ethnicity, or age and no difference in the rate of achievement by location in univariate analyses. However, treatment duration was positively associated with program success in both communities. In the urban community, Black women were 8% more likely to successfully complete the program compared to NH white women (OR = 9.77 [95% CI 1.21,79.18; p = 0.033]) after controlling for confounders. Insufficient sample size for non-white women in the rural community prohibited evaluation., Conclusions: Duration of time in the program best predicted successful completion for women in recovery. These findings have policy implications., (© 2024. The Author(s).)