Risk of burnout, psychological growth, longevity of career and making sense of Covid-19 in senior Australian radiation oncologists

INTRODUCTION

Senior radiation oncologists in hospital/organisational settings, are repetitively and vicariously exposed to others' traumatic distress-perpetuating risk of burnout. Little is known of the additional organisational burdens of the Covid-19 pandemic on their mental well-being for career longevity.

METHODS

Using Interpretative Phenomenological Analysis, semi-structured interviews provided positive and negative subjective interpreted data from five senior Australian radiation oncologists during Covid-19 lockdowns.

RESULTS

One superordinate theme, Vicarious risk, hierarchical invalidation, redefining altruistic authenticity, overarched four subordinate themes: (1) Vicarious contamination of caring, (2) The hierarchical squeeze, (3) The heavy burden of me and (4) Growth of authenticity. For these participants, juxtaposed challenges to career longevity and mental well-being were 'self' as empathic carer to vulnerable patients, and ever-increasing burdens of the organisation. Sensing invalidation, they experienced periods of exhaustion and disengagement. However, with experience and seniority, self-care was prioritised and nurtured through intrapersonal honesty, altruism and relational connectedness with patients and mentoring forward junior colleagues. Focusing on mutual well-being, a sense of life beyond radiation oncology became acceptable.

CONCLUSIONS

For these participants, self-care became a relational joining with their patients separate from the lack of systemic support which heralded an early termination to their career for psychological well-being and authenticity.

Acute osteomyelitis and septic arthritis in children: a systematic review of systematic reviews

OBJECTIVE

Septic arthritis and osteomyelitis are rare in children, but they are difficult to treat and are associated with a high rate of sequelae. This paper addresses the main clinical issues related to septic arthritis and osteomyelitis by means of a systematic review of systematic reviews.

MATERIALS AND METHODS

The major electronic databases were searched for systematic reviews/meta-analyses septic arthritis and osteomyelitis. The papers that fulfilled the inclusion/exclusion criteria were selected.

RESULTS

There were four systematic reviews on septic arthritis and four on osteomyelitis. Independent assessment of their methodological quality by two reviewers using AMSTAR 2 indicated that its criteria were not consistently followed.

CONCLUSIONS

Collectively, these works provide strong evidence regarding a large number of issues including classification, epidemiology and risk factors, causative organisms, clinical presentation, laboratory markers, imaging, diagnostic needle aspiration, antibiotic therapy, surgical therapy, and prognosis. A clinical summary based on the best evidence is supplied.