The American journal of medicine
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Meta Analysis
Systematic review and meta-analysis of randomized trials testing interventions to reduce physician burnout.
Physicians deal with intense professional pressures, which may contribute to increasing burnout. We sought to evaluate the efficacy of interventions designed to reduce burnout in physicians, physicians-in-training, and other health care professionals. ⋯ Studies testing interventions to decrease physician burnout led to significant numerical improvements in some domains of burnout, but it is unlikely that these changes result in meaningful changes in clinical burnout. Further, the limited follow-up time, biased assessments, and heterogeneity in intervention efficacy suggest that a more nuanced understanding of the causes of burnout is needed to develop more effective interventions.
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Over the past decade, significant advancements in pharmacological, endoscopic, and radiographic treatments have emerged in the management of patients with cirrhosis and esophagogastric varices or variceal hemorrhage. These advances have been in several areas, including the role of screening and primary prophylaxis (preventing an initial variceal bleed), evaluation and management of acute esophagogastric variceal hemorrhage, and in preventing variceal rebleeding. Therefore, we believe there is a need for an updated, evidence-based "narrative review" on this important clinical topic that will be relevant for internists, hospitalists, intensive care unit physicians, and those in training. We believe the guidance presented in this narrative review will enhance daily medical practice of health care professionals and has the potential to improve quality of care for these complex patients.
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COVID vaccine hesitancy identifies a discrepancy between personal decisions and public guidelines. We tested whether COVID vaccine hesitancy was associated with the long-term risks of a traffic crash. ⋯ COVID vaccine hesitancy is associated with significant increased long-term risks of a traffic crash. A greater awareness of traffic risks might encourage patients to take protective actions for personal safety.