Are you trapped in an exercise routine that’s good for your body, but isn’t motivating your spirit? It’s time to find your exercise style.
One way is to make a list of the pros and cons of the exercise options that are most convenient for you and that you really like.
For instance, exercise classes offer a lot of variety, but if the commute is too long or you’re uncomfortable in a group, the negatives could outweigh the positives, and you might be better suited to working out at home.
On the other hand, if it takes a trainer to push you beyond your comfort zone and lots of equipment to motivate you to strength train, working out at a gym might be the right style for you.
Here are some other helpful considerations:
If you like to stick to a set schedule, you want a routine that works with your everyday life. That might be early morning fitness classes or a post-dinner workout in a home gym.
If you’re highly motivated to reach fitness goals and maximise your workout time, consider the one-on-one advantages of working with a trainer who can personalise a fitness plan and adjust it as you reach new goals.
If you like the social aspect of fitness, you might like to join a walking group or tennis club to combine an activity you love with the motivational camaraderie. Note: If you like activity-oriented exercise, like playing tennis or hiking, just keep in mind that you need to clock your minutes to be sure you’re meeting daily goals.
If you’re excited by new experiences, look for a gym or fitness facility that offers a very wide range of classes and equipment, especially options you’ve never tried before but always wanted to.
Once you choose the right exercise programme, one that’s custom-tailored to you, at the right venue and at the right speed, you are more likely to stay with it long-term. And that’s the key to wringing out the most benefits.
If your urinary tract infection isn’t responding to antibiotics, you could be headed for a fast relapse, researchers say.
In a new study of 151 adults with antibiotic-resistant UTIs, investigators found that these patients were more likely to have a relapse within a week and were more likely to be prescribed an incorrect antibiotic than a comparison group of patients with non-resistant UTIs.
Relapses are common
“This study adds to the evidence that drug-resistant bacteria are an increasing issue, even in the community and even in patients who have something seemingly uncomplicated, like a urinary tract infection,” said study lead author Dr Judith Anesi. She’s a clinical epidemiologist and infectious disease fellow at Penn Medicine in Philadelphia.
The study was published recently in the journal Infection Control & Hospital Epidemiology.
“These drug-resistant infections are difficult to treat, and our study shows that relapses are common. This is an alarming finding, and interventions to curb antibiotic resistance are urgently needed,” Anesi said in a journal news release.
If patients have antibiotic-resistant UTIs, they should be followed closely for a longer time, and patients at risk for resistant bacteria should have their urine collected and tested, the study authors suggested.
Head-size measurements can help screen for long-term IQ problems in very premature or very low birth weight babies, researchers say.
“Measuring head circumference and thus head growth in early childhood is a proxy measure of brain volume growth in early childhood,” said study senior author Dieter Wolke, of the University of Warwick in England.
Faster growth
It’s “simple and cheap to do and as shown in our research, slow head growth is a specific warning sign for potential neurocognitive problems,” Wolke, a psychology professor, said in a university news release.
The study included about 400 babies born in Germany in 1985–1986 and followed into adulthood. About half were born sooner than 32 weeks’ gestation and/or under 3.3 pounds (1.49kg). The others were born full-term.
The children’s head circumference was checked at birth, five months, 20 months and four years of age. The kids then took intelligence tests at six and eight years, and at 26 years of age.
The very premature/very low birth weight infants had smaller heads at birth, but between birth and 20 months their heads grew relatively faster than that of full-term children because they had to catch up, the researchers said.
Brain volume growth
Study first author Julia Jaekel, of the University of Tennessee, noted that “those who showed faster head growth, whether preterm or term-born, had higher intelligence scores at 26 years”.
In addition, the findings showed that “catch-up head growth was particularly beneficial for intelligence scores in very premature and very low birth weight children. It was a better predictor than how early or at what birth weight infants were born,” said Jaekel.
The results show that head growth reflects brain volume growth and is linked with long-term brain development, according to the researchers.
The study was published in the Journal of the International Neuropsychological Society.
Try not to let it give you a headache, but be aware: People who suffer migraines, especially women, seem to have a higher risk of stroke.
“It’s not like people with migraines should be waiting anxiously about the possibility of having a stroke, but it does occur,” said Dr Mitchell Elkind, a New York City neurologist and professor at the Columbia University College of Physicians and Surgeons.
Migraine with aura
“More work needs to be done, but I think it’s accepted among physicians that among women, migraine with aura is associated with a doubling of risk.”
First, some perspective: According to the federal Office on Women’s Health, about 30 million Americans suffer from migraines, the recurring, throbbing headaches that can be debilitating and accompanied by nausea and weakness.
A particularly alarming variation of the disorder is known as migraine with aura. That’s when the headache is accompanied by sensory disturbances ranging from seeing flashes of light and zigzag lines to tingling sensations and difficulty speaking.
Three-fourths of migraine sufferers are women. Of the roughly 800 000 strokes suffered each year in the United States, the American Migraine Foundation estimates just 2 000 to 3 000 of them are linked to migraines.
But the link is there, and it likely runs through the arteries.
‘Just like a hose’
Dr Karen Furie, chair of the department of neurology at Brown University Medical School in Rhode Island, said migraines involve a spasm in the artery. When that’s combined with oral contraceptives, which can increase the risk of blood clots, problems can develop.
“It’s just like a hose,” she said. “If you constrict the vessel, you reduce flow. If you are on hormones that increase the risk of clotting and the vessel goes into spasm, you may be more likely to form a clot, and that can go on to cause a stroke.”
Furie, who chairs the American Heart Association Stroke Council, stressed that the phenomenon remains relatively rare. Strokes occur much more frequently in older people, she said, while the occurrence of migraines often declines as people get older.
The best response to the uncertainty starts at the doctor.
“If you suffer from migraine with aura you should make sure your health care providers are aware of that,” Furie said. “I’m not sure people always offer up their headache symptoms. And when women do have migraine with aura, you at least try to mitigate what’s already a low risk by reducing the other risk factors for stroke.”
Red flags
That means not smoking, staying active, not abusing alcohol, and controlling weight, blood pressure, blood sugar and cholesterol. Some women with other risk factors may want to think carefully about taking oral contraceptives, Furie said – and if they do, they shouldn’t smoke.
With older patients, Elkind said, doctors watch for the onset of headaches or changes in existing migraine patterns.
“There are certain things we consider red flags,” he said. “If somebody has had infrequent headaches and they’re suddenly occurring more often, or if moderate headaches suddenly become severe, that could be an indication of a new problem.
“We obviously have to be concerned that it’s not a stroke, so they get evaluated pretty thoroughly.”
Elkind said more research needs to focus on the physiological mechanisms of the migraine-stroke link, as well as genetic factors and another less well-known complication of migraine with aura – an increased risk of heart attack.
“That’s really interesting,” he said. “We need to know what it is about migraines that leads to heart disease.”
Thirteen paralysed young adults have regained elbow and hand movement after undergoing complex surgery in Australia, surgeons report.
The patients now brush their hair and teeth, feed themselves and put on makeup – tasks that were impossible before the “nerve transfer” surgery, the doctors report in The Lancet medical journal.
Cost-effective procedure
“For people with tetraplegia [paralysis of upper and lower limbs], improvement in hand function is the single most important goal,” said study leader Dr Natasha van Zyl, of Austin Health in Melbourne.
“Stem cells and neuroprostheses could change the landscape of regenerative medicine in the future,” noted Dr Ida Fox of Washington University in St. Louis.
But, “for now, nerve transfers are a cost-effective way to harness the body’s innate capability to restore movement in a paralysed limb,” said Fox in an editorial accompanying the new study.
The patients underwent extensive physical therapy after the procedure. Two years out, they are using electronic devices and tools, and handling money and credit cards, according to the report.
The restored elbow movement improved their ability to move their wheelchair and to get into bed or a car, the authors said.
Single or multiple transfers
The study included 16 young adults (average age 27) with paralysis of the upper and lower limbs due to spinal cord injuries suffered within the previous 18 months. Most of the injuries occurred in sports or motor vehicle crashes.
The patients underwent single or multiple nerve transfers in one or both arms. Surgeons took nerves from functioning expendable muscles above the spinal injury and attached them to paralysed muscles below the spinal injury.
Altogether, 59 nerve transfers were completed in 13 men and three women and a total of 27 limbs. In 10 patients, nerve transfers were combined with tendon transfers to improve hand function.
The patients were assessed before surgery, and one and two years afterward. Two patients did not complete the follow-up, and one died of causes unrelated to the surgery.
At the two-year assessment, the patients showed major improvements in the ability to pick up and release objects.
The results suggest that nerve transfers can provide improvements similar to traditional tendon transfers, but with smaller incisions and shorter immobilisation times after surgery, according to the researchers.
Excellent results
One hand surgeon who wasn’t involved in the trial said these types of operations have been used for years in other contexts.
“Nerve transfers have been used for the past decade for multiple conditions with excellent results,” explained Dr Steven Beldner. He helps direct the New York Hand and Wrist Center at Lenox Hill Hospital in New York City.
This type of surgery appears to work when spinal cord injuries are involved, as well, Bender said. As he explained, “most muscles have multiple nerve branches controlling the same muscle function. [In these surgeries] some of these muscle branches are transferred to other muscles, which have lost their voluntary control due to nerve injury.”
However, the Australian team stressed that the operation isn’t foolproof. Four nerve transfers failed in three patients, and the researchers said further study is needed to determine which patients are the best candidates for nerve transfer surgery.
“We believe that nerve transfer surgery offers an exciting new option, offering individuals with paralysis the possibility of regaining arm and hand functions to perform everyday tasks, and giving them greater independence and the ability to participate more easily in family and work life,” van Zyl said in a journal news release.
“What’s more, we have shown that nerve transfers can be successfully combined with traditional tendon transfer techniques to maximise benefits,” van Zyl said.
Getting your upper arms in shape is a worthy ambition in any season, and the triceps are the muscles to target for a sleek look.
Toning them can be a challenge, but the “triceps extension” and variations of this key strength training move make up the core of an effective training routine.
Triceps variations
For the basic triceps extension, lie flat on a mat with knees bent and hip-width apart or on a weight bench with feet flat on the floor in front of you. Hold the ends of a dumbbell or the handles of a weighted ball with both hands. Lift arms straight up to the ceiling. From this position, and without moving the upper arms, bend elbows to bring the weight toward your forehead until arms make a 90-degree angle. With control, straighten arms. Repeat.
For the first variation, from the same starting position, hold a dumbbell in each hand. Raise arms straight up to the ceiling, with palms facing away from you. Again, moving only your forearms, bend elbows until upper arms and forearms make a 90-degree angle. With control, straighten arms, but before you lower them again, rotate your wrists so that palms are facing you as you lower your forearms. Straighten arms and continue to reverse the position of your wrists with each rep.
For the second variation, from the same starting position and with a dumbbell in each hand, raise arms straight up to the ceiling. Again, moving only your forearms, bend elbows to lower the weights to the floor on either side of your head. Avoid moving your shoulders. Straighten arms to return to start.
For each exercise, aim for three sets of up to 15 reps each. Start with a weight that allows you to do eight reps per set in good form. Once you can complete 15 reps per set before reaching muscle failure, increase the weight.
If you’re a new or expectant parent, or even just thinking about starting a family, you’ve probably heard at least a little bit about postpartum depression (PPD). But what often gets glossed over in the conversation surrounding maternal mental health is the postpartum anxiety component.
Postpartum anxiety affects an estimated 15 percent of women (though that number varies a bit in the scientific research). This suggests that it’s just as common as PPD, which has been shown to affect anywhere from 10 to 20 percent of new moms.
But postpartum anxiety and postpartum depression are closely related. Historically, medical experts and resources have used “postpartum depression” as an umbrella term for a whole host of mood disorders that can occur in the postpartum period, including obsessive compulsive disorder (OCD), psychosis, and anxiety, explains Dr Shelly Orlowsky, a licensed clinical psychologist who specialises in perinatal mood and anxiety disorders.
The problem with grouping them all together, though, is that it may be confusing to some women who feel off during or after pregnancy but don’t feel like they have symptoms depression. There’s no one-size-fits-all diagnosis, but having a better understanding of what sets postpartum anxiety and depression apart as well as how they overlap is an important step toward getting mamas proper mental health treatment in the perinatal period.
First, a quick refresher on what postpartum depression generally looks like:
Many new moms experience what is casually referred to as the “baby blues” — a period of feeling sad, irritated, angry, annoyed, hopeless, and/or resentful during the first couple of weeks following childbirth. (Hello, you just had a baby, and it’s a LOT.) You may feel like crying for no reason, be unsure about raising your baby, or have trouble sleeping, the American College of Obstetricians and Gynecologists (ACOG) explains. These feelings can come and go in waves, but ultimately they should resolve pretty much on their own within a week or two after welcoming your baby.
So then how is PPD different from the baby blues? PPD may last up to a year after having your baby, and it generally requires more formal treatment (like therapeutic or medical interventions). Fun fact: The latest issue of the Diagnostic and Statistical Manual of Mental Disorders (which is like the medical Bible of mental health disorders), includes a “with postpartum onset” specifier in its section on major depressive disorder (MDD) to more deliberately represent postpartum depression as its own condition. It was kinda lumped in under MDD until fairly recently.
Women with PPD frequently report having an intense feeling of being overwhelmed by motherhood and may even question whether they should’ve become a mom in the first place, Orlowsky describes. Another recurring thread, she says, is just not feeling like yourself, or feeling out of control without knowing why.
She’s also had patients who report feeling nothing, or being emotionally numb; they’re simply going through the motions without any interest in their babies, or life in general. Some moms may harbour thoughts of harming herself or her baby. As you can see, postpartum depression is pretty complex and can look very different from person to person. (Oh, and it can affect new dads, too.)
It’s worth pointing out that with any pregnancy-related mood disorders, the term “postpartum” can be misleading. That’s because symptoms can pop up during your pregnancy or after you give birth. So, you may also hear “perinatal” used, which more generally implies the time before and after childbirth.
Symptoms of postpartum anxiety are a little different.
Postpartum anxiety isn’t listed as its own thing and doesn’t have a specifier in the DSM. But your doctor might still use the term to describe how you’re feeling and to diagnose you — it’s a standard term in the medical world.
Orlowsky describes PPD as a loss of heart, and postpartum anxiety — or perinatal generalized anxiety disorder — as a loss of a normal sense of balance and calm. Women with postpartum anxiety specifically aren’t necessarily dealing with depression.
Rather, women with postpartum anxiety on its own may feel as if they are in a constant state of arousal, agitation, and worry, she explains. They may feel unable to quiet their mind no matter how hard they try, or have trouble sitting still or getting to sleep.
Some moms with postpartum anxiety have disturbing “what if?” thoughts about bad things happening to the baby. They may be afraid to get into the car with their child, or are uncomfortable leaving him or her with anyone else. Moms who suffer from intrusive thoughts like this may not be able to respond to reason, Orlowsky notes. (For instance, even though deep down you *know* your partner is home with the baby while you go out to run errands and everything’s okay, you might be compelled to turn back and go through a safety checklist again.)
Like it’s relative PPD, postpartum anxiety is treatable. That being said, because PPD has been studied and discussed at much greater lengths, many moms with postpartum anxiety don’t recognise they have it, and it often goes undiagnosed. Another reason moms with postpartum anxiety don’t realize they have a problem or delay seeking help is because they don’t know how much anxiety is to be expected or “normal,” versus how much is too much—even for a new mom.
You can have symptoms of postpartum depression or postpartum anxiety, or a mix of the two.
Physical symptoms of PPD are similar to those of perinatal anxiety and typically include changes in sleep and appetite, nausea, headaches, body aches, and dizziness. You can predominantly have symptoms of depression with tell-tale signs of anxiety mixed in, or the opposite.
The relationship between the two disorders isn’t fully understood, per the Massachusetts General Hospital Center for Women’s Mental Health says. It’s unclear whether having postpartum anxiety is more likely to bring on PDD, or vice versa, Orlowsky says. In one scenario, a mom can be depressed and also consumed with worrisome thoughts regarding her baby’s safety. On the flip side, a mom’s anxiety may become so cumbersome that it leads her to have depression symptoms as well.
Women with PPD or anxiety (or a combo) might feel guilty or ashamed about their inability to embrace motherhood. As a result, they might have a hard time being among other moms, friends, and family members. But social isolation can end up deepening the pain of it: “Postpartum depression and anxiety are so draining [that] moms don’t want to be around other people — but that’s precisely what they need,” Orlowsky says.
It may not seem like distinguishing between the two really matters, but it does. Perinatal mood disorders are not black and white for every person, and that’s totally okay. But being able to describe your symptoms to your doctor, whether they take the form of anxiety or depression or seem to be some hybrid, helps your physician tailor a treatment plan to fit your needs.
If you think you have postpartum depression and/or anxiety, these are your next steps.
If you just feel off, and feelings of anxiousness or depression are making you unable to function properly from day to day for longer than two weeks, you likely need to seek out professional help.
But if you’re not ready for that step (hey, no judgment), start by sharing how you’re feeling someone you trust. This can be a friend, family member, doula, or a medical professional. “You don’t have to be able to diagnose yourself, but you know when you have a cold versus the flu,” Orlowsky explains. (In other words, you have the best sense of what feels normal or not for you.)
Ideally, your paediatrician or obstetrician has screening measures in place to assess whether you are exhibiting symptoms of postpartum depression or anxiety, after which they can refer you to a clinician who specializes in perinatal mood and anxiety disorders.
What’s more, if you have dealt with anxiety and/or depression during a previous pregnancy or were diagnosed with both or either one of these conditions prior to having kids — it’s important to address that with your obstetrician. A woman who has had PPD or postpartum anxiety in a previous pregnancy is 50 percent more likely to develop it in a subsequent pregnancy, according to Orlowsky. That said, you may not have had either with your first child (or multiple children) but could still develop it during subsequent pregnancies.
Treatment absolutely exists for both postpartum anxiety and postpartum depression—and you deserve it. Some women may benefit from one-on-one therapy and/or support groups when dealing with PPD and/or anxiety, while others may also require medication. When Orlowsky thinks a patient could benefit from medication, she refers them to a reproductive psychiatrist.
Before you take a pumice stone to your foot calluses just because they’re unsightly, you might want to consider the idea that they are actually nature’s shoes.
That’s one of the messages from a new study suggesting that in certain ways, walking on callused feet can be better for you than the modern luxury of cushioned shoes.
Don’t forego shoes
Researchers found that calluses offer the foot protection while you’re walking around, without compromising tactile sensitivity – or the ability to feel the ground. That’s in contrast to cushioned shoes, which provide a thick layer of protection, but do interfere with the sense of connection to the ground.
Meanwhile, although thick-soled shoes do lessen the impact of each heel strike to the ground, they actually deliver more force into the knee joints.
No one, however, is advising people to forgo shoes – especially if they have medical conditions that make barefoot walking risky.
Study co-author Daniel Lieberman stressed that the study is about understanding a fundamental evolutionary question: How does modern footwear – a recent development in human history – differ from the natural “shoes” that humans wore for thousands of years?
“I’m not anti-shoe,” said Lieberman, who heads human evolutionary biology at Harvard University. “And I’m not telling people to run around barefoot.”
But, he added, you might consider taking a kinder view of the lowly callus.
Poor blood circulation
“Calluses are normal, and they may have some benefits,” Lieberman said.
That comes with some big caveats, though: People with certain medical conditions, such as diabetes, should neither go barefoot nor let calluses build up, said Dr Jane Andersen. She’s a podiatrist and chair of the communications committee for the American Podiatric Medical Association.
People with nerve damage or poor blood circulation to the feet – from diabetes or other medical conditions – should see a foot doctor regularly and, if needed, have calluses trimmed, Andersen said. Calluses can lead to ulcers in those cases.
People with nerve-damaged feet also need to wear shoes, she said. That reduced sensation means they may not notice any cuts or other injuries they’d get while walking barefoot.
Beyond that, Andersen noted, barefoot humans of the past were not running around on hot asphalt and other modern surfaces.
The findings, published in the journal Nature, are based on just over 100 adults from Kenya and the United States. Both groups included people who said they were barefoot more often than not, and people who wore shoes every day.
Controlled studies needed
As expected, the barefoot crowd had thicker, harder calluses. Despite that, they showed no lack of sensitivity in the soles of their feet. In contrast, thick-soled shoes do compromise tactile sensitivity when you’re walking, the researchers said.
It’s not clear what the implication of that might be. But, Lieberman’s team points out, when your perception of a walking surface is dulled, that can affect gait and balance. So it raises the question of whether thick-cushioned shoes can contribute to falls in people at risk.
Lieberman stressed, however, that it’s simply a question. He said controlled studies would be needed to figure out the answer – for example, a trial that compares cushioned shoes to “minimal footwear” in older adults.
Minimal footwear refers to shoes with thinner, harder soles – like moccasins or sandals. According to Lieberman, they more closely approximate thick calluses, compared with cushiony soles.
In other tests, the researchers found that cushioned shoes lessen the impact of the heel striking the ground with each footstep, compared with walking barefoot or in thin-soled shoes. Thick calluses did not have that effect.
Yet cushioned shoes sent more force up into the joints with each step.
“The load is basically delivered to the knees,” Lieberman said.
Minimalist shoes uncomfortable
Again, the consequences of that, if any, are unknown. But one question, Lieberman said, is whether modern footwear could be a contributing factor to knee arthritis.
According to Andersen, it’s an interesting question – but it would be challenging to study the way footwear choices over decades could affect arthritis risk.
“People generally wear all kinds of different shoes,” she said. “There are also many other factors that would affect arthritis risk.”
Plus, Andersen added, many people simply find minimalist shoes uncomfortable. “Even if wearing them for 30 years lowered your risk of knee arthritis, that’s 30 years of being uncomfortable,” she noted.
As for calluses, Andersen said that if they are not causing problems and you’re healthy, they can probably be left alone.
People who drink alcohol don’t only put themselves at risk, they’re also endangering family and friends.
A new study finds the effects of “secondhand” alcohol harms are widespread, with nearly one in five Americans – 53 million people – reporting having been harmed by someone else’s drinking during the past year.
Secondhand harms
Those harms include threats or harassment, damaged property, vandalism, physical aggression, financial problems, relationship issues and issues related to driving.
“Heavy drinkers should be aware of how they might be impacting the lives of people around them,” said study co-author Katherine Karriker-Jaffe, a senior scientist with the Alcohol Research Group at the Public Health Institute in Emeryville, California.
If people know more about the secondhand harms from alcohol, that knowledge “may change the norms about what’s considered acceptable,” she said. And that may affect public policies, such as proposals to allow bars to stay open later or to lower taxes on alcohol.
The study findings were published in the Journal of Studies on Alcohol and Drugs.
In an accompanying editorial, Dr Sven Andreasson of the Karolinska Institute in Sweden noted that “alcohol generates health problems on a massive scale”.
He pointed out that more than 5% of deaths worldwide are attributed to alcohol.
Different kinds of harm
“What is striking about alcohol is its global toxic impact: on virtually all organs of the body as well as on most sectors of society. Health, education, transportation, agriculture, trade and so on – all need to address the impact of alcohol,” Andreasson wrote.
The new study included data from two nationwide US surveys conducted in 2015. They included almost 9 000 adults.
Researchers found that 21% of women and 23% of men were harmed by someone else’s drinking in the past year. Although men and women reported similar levels of harm, the harms they experienced were different.
Women were more likely to have money troubles or family problems due to someone else’s drinking. For men, secondhand alcohol harms often included ruined property, vandalism and physical aggression. They were more likely to report harm due to a stranger’s alcohol use.
People who were heavy drinkers themselves were most likely to report harm from someone else’s drinking, the study found. Almost half of heavy drinkers said they had been harmed by someone else’s alcohol use. (Heavy drinking is five or more drinks at a time for men and four or more for women, the researchers said.)
Younger people were more apt to have experienced secondhand alcohol harms, the study found.
Karriker-Jaffe said screening for risk factors in primary care settings could be a way to help. “We should make sure people are getting help for alcohol harms to others,” she said.
‘One snapshot in time’
Dr Lawrence Brown Jr. is CEO of START Treatment and Recovery Centers in Brooklyn, New York. He said it’s important to alert the public to signs of unhealthy alcohol use, but added that it’s hard to recommend interventions based on one study.
Brown said some groups may be under- or overrepresented in this study.
“From a policy standpoint, it would be difficult to say what would be appropriate,” he said. “The study authors acknowledge that this was one snapshot in time. We don’t know the extent of the harm. Did it occur monthly? Weekly? It helps to know where you should commit money to interventions.”
The author of a second editorial, Dr Timothy Naimi of Boston Medical Center, said population-based strategies are needed. He noted that taxes on alcohol have been effective, yet federal alcohol taxes have recently been cut.
“The freedom to drink alcohol must be counterbalanced by the freedom from being affected by others’ drinking in ways manifested as homicide, alcohol-related sexual assault, car crashes, domestic abuse, lost household wages and child neglect,” Naimi wrote.
He likened policies to protect people from alcohol harms to strategies implemented to safeguard people from secondhand tobacco smoke.
We are often required to put a huge amount of trust in surgeons, because they are responsible for performing procedures which may range from low to high risk.
But a new study warned that the professionalism of surgeons could determine how well a patient will recover after surgery.
The study published in JAMA Surgery, looked at interactions between surgeons and their co-workers and it was found that surgeons who behaved in an unprofessional manner towards their teams had more patient complications after surgery.
This is due to the fact that surgeons who behave this way compromise their team’s performance during surgery.
The post-operative reports were examined to see if the colleagues of surgeons reported any of the following four types of unprofessional behaviour:
Unclear or disrespectful communication
Poor or unsafe care
Lack of integrity
Failure to follow professional responsibilities
Unfortunately, these behaviours do have a big impact on a patient’s post-operative recovery.
The study included cases such as a surgeon shouting at a physician for five minutes after the physician administered medicine to a patient to raise their blood pressure, which in turn made the physician reluctant to raise concerns about the health of the patient in future.
In another instance, a nurse who required a safety-related break was told to “get going without all this time out nonsense” which showed a disregard for her safety.
Complications
The researchers found that surgeons who had one or more reports of unprofessional behaviour had patients who were 12–14% more likely to experience surgical complications 30 days after their surgery. Complications included kidney failure, stroke and pneumonia. It should be noted that the four behaviour subcategories with the highest likelihood for complications were not assessed.
What experts had to say
Jonah Stulberg, a general surgeon at Northwestern Medical Hospital told NPR that “nurses may be more likely to speak up about breaks in sterile technique if the physician is more receptive to them speaking up”. He added that if a surgeon spoke to them in an unprofessional manner or raised their voice, nurses might not say anything.
Dr. William Cooper who was a corresponding author on the study and is a professor of paediatrics and health policy at Vanderbilt University Medical Center said that it is important to note that the vast majority of surgeons are in fact respectful to their co-workers and “a very small proportion account for a disproportionate share of adverse outcomes”.
Cooper also said awareness of the issue could improve the general behaviour of surgeons. In fact, studies have shown that surgeons can improve their behaviour if they are given professional feedback.
