المؤلفون: Lama Obeid, Heather L. Yeo, Teagan E. Marshall, Alyssa G. Blood, Jackly M. Juprasert

المصدر: Journal of Surgical Research. 260:163-168

مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Biomedical Research, Demographics, Attitude of Health Personnel, education, Awards and Prizes, Qualitative property, Surgeon scientist, Grounded theory, Mentorship, Research Support as Topic, Surveys and Questionnaires, Underrepresented Minority, medicine, Humans, Qualitative Research, health care economics and organizations, Retrospective Studies, Surgeons, Career Choice, Mentors, Middle Aged, Achievement, Research Personnel, United States, National Institutes of Health (U.S.), Family medicine, Female, Surgery, Psychology, Qualitative research

الوصف: Background Success in academic surgery is challenging and research cannot survive without funding. NIH K-awards are designed to mentor junior investigators to achieve independence. As a result we aimed to study K awardees in departments of surgery and learn from their experience. Material and methods Utilizing the NIH RePORTer database and filtering by department of surgery, clinically active surgeons receiving a K-award between 2008 and 2018 were asked to complete an online survey. Qualitative data from two open-ended questions were coded independently using standard qualitative methods by three researchers. Using grounded theory, major themes emerged from the codes. Results Of the 144 academic surgeons identified, 89 (62%) completed the survey. The average age was 39 ± 3 when the K-award was granted. Most identified as white (69%). Men (70%) were more likely to be married (P = 0.02) and have children (P = 0.05). To identify intention to pursue R01 funding, surgeons having a K-award for 5 y or more were analyzed (n = 45). Most either intended to (11%) or had already applied (80%) of which 36% were successful. Men were more likely to apply (P = 0.05). Major themes to succeed include protected time, mentorship, and support from leadership. Common barriers to overcome include balancing time, pressures to be clinically productive, and funding. Conclusions The demographics and career trajectory of NIH K-awarded surgeons is described. The lack of underrepresented minorities receiving grants is concerning. Most recipients required more than one application attempt and plan to or have applied for R01 funding. The major themes were very similar; a supportive environment and time available for research are the most crucial factors to succeed as an academic surgeon.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8c0d74caa9534cf06a3c758546973bdcTest
https://doi.org/10.1016/j.jss.2020.11.076Test

المؤلفون: Catherine L. Mavroudis, Elizabeth C. Wick, Sarah Landau, Jennifer F. Waljee, Heather L. Yeo, Zara Cooper, Eun Kyeong Hwang, Elizabeth M. Lancaster, Rachel R. Kelz, Ezra S. Brooks, Blanche Blumenthal, Nicholas L. Berlin, Regan W. Bergmark, Christopher Wirtalla

المصدر: Annals of Surgery

مصطلحات موضوعية: Adult, Male, Coronavirus disease 2019 (COVID-19), Cross-sectional study, Psychological intervention, Surgical workforce, Physicians, Women, 03 medical and health sciences, Sex Factors, 0302 clinical medicine, Risk Factors, Stress (linguistics), Pandemic, Humans, Medicine, Pandemics, Surgeons, Response rate (survey), business.industry, COVID-19, Middle Aged, Health Surveys, United States, Occupational Diseases, Telephone survey, Cross-Sectional Studies, 030220 oncology & carcinogenesis, Linear Models, Female, 030211 gastroenterology & hepatology, Surgery, business, Stress, Psychological, Demography

الوصف: OBJECTIVE: To investigate the relationship between surgeon gender and stress during the Covid-19 pandemic. BACKGROUND: Although female surgeons face difficulties integrating work and home in the best of times, the Covid-19 pandemic has presented new challenges. The implications for the female surgical workforce are unknown. METHODS: This cross-sectional, multi-center telephone survey study of surgeons was conducted across 5 academic institutions (May 15-June 5, 2020). The primary outcome was maximum stress level, measured using the validated Stress Numerical Rating Scale-11. Mixed-effects generalized linear models were used to estimate the relationship between surgeon stress level and gender. RESULTS: Of 529 surgeons contacted, 337 surgeons responded and 335 surveys were complete (response rate 63.7%). The majority of female respondents were housestaff (58.1%), and the majority of male respondents were faculty (56.8%) (P = 0.008). A greater proportion of male surgeons (50.3%) than female surgeons (36.8%) had children ≤18 years (P = 0.015). The mean maximum stress level for female surgeons was 7.51 (SD 1.49) and for male surgeons was 6.71 (SD 2.15) (P < 0.001). After adjusting for the presence of children and training status, female gender was associated with a significantly higher maximum stress level (P < 0.001). CONCLUSIONS: Our findings that women experienced more stress than men during the Covid-19 pandemic, regardless of parental status, suggest that there is more to the gendered differences in the stress experience of the pandemic than the added demands of childcare. Deliberate interventions are needed to promote and support the female surgical workforce during the pandemic.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::067433d2abc7b9f48bb25929e33d4f6dTest
https://doi.org/10.1097/sla.0000000000004762Test

المؤلفون: Catherine L. Mavroudis, Nicholas L. Berlin, Heather L. Yeo, Blanche Blumenthal, Jennifer F. Waljee, Rachel R. Kelz, Elizabeth C. Wick, Zara Cooper, Eun Kyeong Hwang, Sarah Landau, Regan W. Bergmark, Christopher Wirtalla, Elizabeth M. Lancaster, Ezra S. Brooks

المصدر: Annals of Surgery

مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Faculty, Medical, workforce, Cross-sectional study, coronavirus, Staffing, Workforce management, Occupational Stress, stress, 03 medical and health sciences, 0302 clinical medicine, Surveys and Questionnaires, Medical Staff, medicine, Humans, Personal Protective Equipment, Personal protective equipment, Response rate (survey), business.industry, Incidence, Stressor, COVID-19, Internship and Residency, Middle Aged, United States, Cross-Sectional Studies, workplace, General Surgery, 030220 oncology & carcinogenesis, Family medicine, Workforce, surgeon, Female, 030211 gastroenterology & hepatology, Surgery, Occupational stress, business

الوصف: Objective: To explore the impact of the Covid-19 pandemic on the stress levels and experience of academic surgeons by training status (eg, housestaff or faculty). Background: Covid-19 has uniquely challenged and changed the United States healthcare system. A better understanding of the surgeon experience is necessary to inform proactive workforce management and support. Methods: A multi-institutional, cross-sectional telephone survey of surgeons was conducted across 5 academic medical centers from May 15 to June 5, 2020. The exposure of interest was training status. The primary outcome was maximum stress level, measured using the validated Stress Numerical Rating Scale-11 (range 0–10). Results: A total of 335 surveys were completed (49.3% housestaff, 50.7% faculty; response rate 63.7%). The mean maximum stress level of faculty was 7.21 (SD 1.81) and of housestaff was 6.86 (SD 2.06) (P = 0.102). Mean stress levels at the time of the survey trended lower amongst housestaff (4.17, SD 1.89) than faculty (4.56, SD 2.15) (P = 0.076). More housestaff (63.6%) than faculty (40.0%) reported exposure to individuals with Covid-19 (P < 0.001). Subjects reported inadequate personal protective equipment in approximately a third of professional exposures, with no difference by training status (P = 0.557). Conclusions: During the early months of the Covid-19 pandemic, the personal and professional experiences of housestaff and faculty differed, in part due to a difference in exposure as well as non-work-related stressors. Workforce safety, including adequate personal protective equipment, expanded benefits (eg, emergency childcare), and deliberate staffing models may help to alleviate the stress associated with disease resurgence or future disasters.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f109f241e54e6aaf2fd8db1937ebd40dTest
https://doi.org/10.1097/sla.0000000000004690Test

المؤلفون: Julie Ann Sosa, Patrick T. Dolan, Heather L. Yeo, Matthew M. Symer, Jialin Mao

المصدر: The American Journal of Surgery. 220:519-523

مصطلحات موضوعية: Adult, Male, Student Dropouts, media_common.quotation_subject, education, Logistic regression, 03 medical and health sciences, Sex Factors, 0302 clinical medicine, Risk Factors, Debt, Humans, Medicine, Attrition, Prospective Studies, 030212 general & internal medicine, Salary, Prospective cohort study, Categorical variable, media_common, Finance, Career Choice, Salaries and Fringe Benefits, business.industry, Internship and Residency, General Medicine, medicine.disease, Surgical training, United States, Education, Medical, Graduate, Private practice, General Surgery, 030220 oncology & carcinogenesis, Female, Surgery, business

الوصف: Background Attrition from general surgery residency is high with a national rate of 20%. We evaluated potential associations between financial considerations and attrition. Methods National prospective cohort study of categorical general surgery trainees. Results Of the 1048 interns who started training in 2007, 681 (65%) had complete survey and follow-up data. In logistic regression, those with higher starting attending salary expectations (>$300K) were more likely to leave training (OR 2.9, 95% CI 1.2–6.9). Women with a partner who earned more (>$50K/year) were more likely to leave training (OR 4.1, 95% CI 1.6–10.5). In a subgroup of interns undecided about their future practice setting (academic, community, private practice, industry), those with less debt (≤$100K) were more likely to leave training (OR 2.4, 95% CI 1.1–5.2). Conclusions Several financial matters were associated with attrition. Addressing these financial concerns may help decrease attrition in surgical training and improve surgical training.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ea90ab18ce9fd4614a7b2a809c75b51fTest
https://doi.org/10.1016/j.amjsurg.2020.03.010Test

المؤلفون: Heather L. Yeo, Jialin Mao, Art Sedrakyan, Jonathan S. Abelson, Fabrizio Michelassi

المصدر: Annals of Surgery. 268:311-317

مصطلحات موضوعية: Adult, Male, Reoperation, medicine.medical_specialty, Databases, Factual, medicine.medical_treatment, New York, MEDLINE, Disease, 03 medical and health sciences, Ileostomy, Postoperative Complications, 0302 clinical medicine, Gastrointestinal Agents, Risk Factors, medicine, Humans, Colitis, Intraoperative Complications, Colectomy, Aged, Aged, 80 and over, Biological Products, business.industry, Middle Aged, medicine.disease, Ulcerative colitis, Infliximab, Confidence interval, Surgery, Treatment Outcome, 030220 oncology & carcinogenesis, Linear Models, Colitis, Ulcerative, Female, 030211 gastroenterology & hepatology, business, Follow-Up Studies, medicine.drug

الوصف: OBJECTIVE To investigate differences in surgical approach and postoperative outcomes for patients with ulcerative colitis (UC) before and after the introduction of biologic therapy. BACKGROUND Biologic use has dramatically increased since Food and Drug Administration approval of infliximab. Studies conflict as to the effect of these agents on surgical outcomes with some demonstrating worse surgical outcomes whereas others have found no difference. METHODS We used an administrative, all-payer, all-age group database located in New York State. Patients were included if they had a diagnosis of UC and underwent surgery for their disease from 1995 to 2013. Outcomes were compared for the index admission, at 90-day, and 1-year follow up. RESULTS A total of 7070 patients were included for analysis; 54% patients underwent surgery between 1995 and 2005 and the remaining 46% patients underwent surgery between 2005 and 2013. There was a significant increase in the proportion of patients who underwent at least 3 procedures after 2005(14% vs 9%, P < 0.01). On adjusted analysis, patients undergoing surgery after 2005 had higher likelihood of major events (odd s ratio, OR = 1.42; 95% confidence interval, CI = 1.13-1.78), procedural complications (OR = 1.42; 95% CI = 1.20-1.68), and nonroutine discharge (OR = 3.17; 95% CI = 2.79-3.60) during the index admission. Similar trends for worse adjusted outcomes in patients initially undergoing surgery after 2005 were seen at 90-day and 1-year follow up. CONCLUSIONS Since the introduction of biologic agents in 2005, surgery for patients with UC is more likely to require multiple procedures. Despite robust adjustments, patients having surgery recently have worse postoperative morbidity during the index hospitalization, at 90-day and 1-year follow up. More work is necessary to improve outcomes in these higher risk patients that undergo surgery.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9893bab52a6260ed26ddda988140aaf0Test
https://doi.org/10.1097/sla.0000000000002275Test

المؤلفون: Heather L. Yeo, Lama Obeid, Jackly M. Juprasert

المصدر: American journal of surgery. 223(2)

مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, media_common.quotation_subject, Pain medication, 03 medical and health sciences, 0302 clinical medicine, Perception, Medicine, Humans, Pain Management, 030212 general & internal medicine, Practice Patterns, Physicians', media_common, Opioid epidemic, Pain, Postoperative, business.industry, Addiction, General Medicine, Pain management, Middle Aged, Surgery, Analgesics, Opioid, Opioid, Prescription opioid, 030220 oncology & carcinogenesis, Public Opinion, Worry, business, medicine.drug

الوصف: Background In the US, opioids are overprescribed after surgery contributing to the opioid epidemic. Patients’ expectations regarding postoperative opioids remains unclear. Methods A representative survey using random-digit dial telephone sampling of English-speaking adults in US was conducted from August 28 to December 11, 2019. Results Of the 1533 eligible persons contacted, 1000 completed the interviews yielding a cooperation rate of 65%. The mean age was 47 (±18) years, half were men, and most were non-Hispanic white (73%). Forty-eight percent expected an opioid prescription after major surgery, 50% worry about addiction, and 61% believe they contribute to the opioid epidemic. Interestingly, 31% assume that opioid-dependent users were first exposed to opioids following surgery. Conclusion Many Americans surveyed expect to receive an opioid containing pain medication after major surgery, but fear the risk of addiction and believe that they are contributing to the opioid epidemic. They do not think that opioid-dependent users were first exposed to opioids after surgery. This discordance may represent an area of policy action and education.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::41468962f6fd9cf4bdd830f6c93a6efeTest
https://pubmed.ncbi.nlm.nih.gov/33781511Test

المؤلفون: Madison Dennis, Adam F. Steinlauf, Ellen Scherl, Shirley Cohen-Mekelburg, Fabrizio Michelassi, Yecheskel Schneider, Stephanie Gold, Heather L. Yeo, Clara Oromendia

المصدر: Digestive Diseases and Sciences. 64:196-203

مصطلحات موضوعية: Male, Physiology, medicine.medical_treatment, Inflammatory bowel disease, Cohort Studies, 0302 clinical medicine, Crohn Disease, Risk Factors, Intestine, Small, Secondary Prevention, Certolizumab pegol, Cecum, Colectomy, Digestive System Surgical Procedures, Crohn's disease, Gastroenterology, Bowel resection, Middle Aged, 030220 oncology & carcinogenesis, Female, 030211 gastroenterology & hepatology, medicine.drug, Cohort study, Adult, medicine.medical_specialty, Antibodies, Monoclonal, Humanized, Medicare, Time-to-Treatment, 03 medical and health sciences, Ileum, Internal medicine, Preoperative Care, Adalimumab, medicine, Humans, Retrospective Studies, Postoperative Care, Biological Products, Insurance, Health, Medicaid, business.industry, Retrospective cohort study, medicine.disease, Infliximab, United States, Logistic Models, Multivariate Analysis, Certolizumab Pegol, business

الوصف: Studies have shown that prophylactic biologic therapy can reduce post-surgical Crohn’s disease recurrence. We aimed to identify the frequency of delay and risk factors associated with a delay in the initiation of prophylactic post-surgical biologic therapy in high-risk patients. We performed a cohort study of Crohn’s disease patients who underwent a bowel resection. We identified those at risk of recurrence and explored multiple characteristics for those with and without a delay post-operatively. A total of 84 patients were included in our analysis of which 69.0% had a greater than 4-week delay and 56.0% a greater than 8-week delay in post-surgical biologic prophylaxis. Publicly insured patients had a 100% delay in post-surgical prophylaxis initiation (p = 0.039, p = 0.003 at 4 and 8 weeks, respectively). Patients on a biologic pre-surgery were less likely to have a delay (p

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d9510b3130efa438dda426af03fe2f7eTest
https://doi.org/10.1007/s10620-018-5159-4Test

المؤلفون: Jonathan S. Abelson, Mary E. Charlson, Alanna Chait, Heather L. Yeo, Megan Johnson Shen, Anna L. Dickerman

المصدر: Journal of Surgical Research. 226:140-149

مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Colon, Psychological intervention, Anxiety, Cohort Studies, 03 medical and health sciences, Social support, Postoperative Complications, 0302 clinical medicine, Quality of life, medicine, Humans, 030212 general & internal medicine, Perioperative Period, Colectomy, Qualitative Research, Rectal Neoplasms, business.industry, Social Support, Perioperative, Colorectal surgery, Surgery, Distress, 030220 oncology & carcinogenesis, Colonic Neoplasms, Grounded Theory, Quality of Life, Female, Neoplasm Recurrence, Local, medicine.symptom, business, Stress, Psychological, Cohort study

الوصف: Background Distress is common among cancer and surgical patients and can lead to worse outcomes if untreated. The objective of this study was to explore sources of distress among colorectal cancer patients undergoing surgery. Materials and methods This was a qualitative study using in-depth, semistructured, one-on-one interviews in an academic setting. Patients were recruited if they had a pathologically confirmed diagnosis of colon or rectal cancer. Purposive sampling was used to recruit patients who were about to undergo (preoperative), or had recently undergone (postoperative), curative resection for colorectal cancer. Results All participants (n = 24) reported experiencing distress during treatment. Participants identified sources of distress preoperatively (negative emotional reaction to diagnosis, distress from preconception of cancer diagnosis, and distress interacting with healthcare system). Sources of distress during in-hospital recovery included negative emotional reaction to having a surgery and negative emotions experienced in the hospital. Postoperative sources of distress included mismatch of expectations and experience of recovery, dealing with distressing physical symptoms and complications after surgery, and distress worrying about recurrence. Participants identified other sources of distress that were not time-specific (distress related to social support network, from disruption of life, and worrying about death). Conclusions Our results highlight a potential role for a comprehensive screening program to identify which patients require assistance with addressing sources of distress during the surgical experience. Understanding how sources of distress may vary by time will help us tailor interventions at different time points of the surgical experience.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3e8d1ba3c4bce8c3d26026a7a24133f6Test
https://doi.org/10.1016/j.jss.2018.01.017Test

المؤلفون: Jonathan S. Abelson, Matthew M. Symer, M. Zachary Rosenthal, Julie Ann Sosa, Heather L. Yeo

المصدر: Journal of the American College of Surgeons. 226:777-783

مصطلحات موضوعية: Adult, Male, Persistence (psychology), medicine.medical_specialty, media_common.quotation_subject, education, Personnel Turnover, Job Satisfaction, 03 medical and health sciences, 0302 clinical medicine, Drop out, medicine, Humans, Personality, Attrition, 030212 general & internal medicine, Big Five personality traits, media_common, Surgeons, Motivation, Academic Failure, Career Choice, business.industry, Internship and Residency, medicine.disease, Surgical training, United States, Surgery, Education, Medical, Graduate, General Surgery, 030220 oncology & carcinogenesis, Trait, Female, Job satisfaction, business

الوصف: There is limited understanding of the wide variation in attrition rates among general surgery residencies. We used the validated Behavior Inhibitory System/Behavior Approach System (BIS/BAS) instrument to compare motivational traits among residents who did and not complete surgical training.All US general surgery categorical interns in the class of 2007-2008 were surveyed with a validated motivational trait assessment tool. American Board of Surgery records from 2008-2016 were used to determine who completed training. Motivation, an aspect of personality, was assessed with the BIS/BAS, which correlates with an individual's tendency to approach pleasant stimuli (BAS) or avoid negative stimuli (BIS). Subscale mean scores were compared with regard to the primary end point, attrition.Eight hundred and one (76.5%) interns completed the survey and had matching records. Six hundred and forty-five (80.5%) completed training. Men had lower scores than women in the BAS Drive subscale (12.0 vs 12.5; p0.002), BAS Reward Response subscale (17.2 vs 17.7; p0.01), and BIS scale (19.3 vs 20.9; p0.01). The BAS Reward Response scores differed based on program type (academic 17.3 vs community 17.6 vs military 16.6; p0.0027). There were no differences based on program size (BIS average, small program 19.9 vs large program 19.7; p = 0.43). There were also no differences in BIS/BAS subscale scores based on residency completion status (BIS mean: completed 19.9 vs dropped out 20.1; p = 0.51).Surgery residents are characterized by a strong drive and persistence toward their goals. However, residents who drop out do not differ from those who complete training in their motivational personality traits.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ed034ea3acfe6c5f0c1276394d46f612Test
https://doi.org/10.1016/j.jamcollsurg.2018.02.007Test

المؤلفون: Alex Peters, Jonathan S. Abelson, Mary E. Charlson, Matthew M. Symer, Heather L. Yeo

المصدر: The American Journal of Surgery. 214:616-622

مصطلحات موضوعية: Adult, Male, Telemedicine, medicine.medical_specialty, Adolescent, 020205 medical informatics, New York, 02 engineering and technology, Black race, Affect (psychology), Health informatics, 03 medical and health sciences, 0302 clinical medicine, Surveys and Questionnaires, 0202 electrical engineering, electronic engineering, information engineering, Humans, Medicine, Postoperative Period, 030212 general & internal medicine, mHealth, Socioeconomic status, Aged, business.industry, Health technology, General Medicine, Middle Aged, Mobile Applications, Surgery, Self Care, Socioeconomic Factors, Hispanic ethnicity, Female, Patient Participation, business

الوصف: Background Mobile health technologies (mHealth) may improve post-operative care but it is unknown if patients are willing to use this technology. Methods We surveyed 800 NY State residents to determine their willingness to engage in mHealth after surgery and compared socioeconomic factors that may affect willingness to engage. Results A majority of respondents reported willingness to wear a tracker on their wrist (80.6%), fill out a survey (74.3%), send pictures of their wound to their surgeon (66.3%), and share updates with friends/family (59.1%). Older age was associated with lower likelihood of having a smartphone, but not associated with willingness to engage with other features. Hispanic ethnicity was associated with lower likelihood of wearing a tracker while Black race was associated with lower willingness to send pictures. Conclusions Overall, potential users of mHealth are interested and willing to use mHealth. Older respondents are as willing as younger respondents to engage with mHealth. Individuals with Hispanic ethnicity and Black race may be less willing to engage and therefore may require education regarding benefits of this technology.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c222e7ca96a6efd0687b73f0efb60fddTest
https://doi.org/10.1016/j.amjsurg.2017.06.009Test