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Background: Burnout, characterised by emotional exhaustion (EE), depersonalisation (DP) and reduced personal accomplishment (PA), is caused by chronic workplace stress. Though widely reported in doctors, variability in definitions and assessment methods render comparisons between studies challenging. Furthermore, traditional methods of reporting burnout can be misleading, focusing more on individuals than on the workplace. Various scores from Maslach Burnout inventory (MBI) have been previously reported as 'burnout', inflating reported prevalence. Recent research suggests using latent profile analysis (LPA), to explore the continuum from engagement to burnout, as distinct patterns of working life may contribute to different profiles., Aims: To examine the prevalence of latent burnout profiles (LBP) amongst Irish hospital doctors., Methods: LBP categorisation of MBI was applied to responses from 1610 hospital doctors from a national survey. Effort-Reward Imbalance (ERI) questionnaire and work ability score were used to measure work stress and work ability., Results: In line with LBP categorisation, the respondents were classified as follow: 23% (N = 364) Engaged; 21% (N = 332) Burnout (High EE and DP), Overextended (N = 476, 30%); 22% (N = 355) Ineffective (low PA score), 5% (N = 83) Disengaged (high DP scores). Consultants were more likely to be classified as Engaged than trainees. Those classified as Burnout were younger. Females were more likely to be classified as Overextended. Work stress was associated with Overextended, Disengaged and Burnout profiles. Insufficient workability was associated with Burnout profile., Conclusions: The use of LPA provides more nuanced exploration of the phenomenon which can be correlated with workplace features, pointing to potential interventions., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Haire et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Food production sites have been a high-risk location for SARS-CoV-2 outbreaks worldwide since early in the COVID-19 pandemic. Ireland has a high population rate of COVID-19 vaccination, but reports from food production sites suggest uptake is lower amongst workers despite prior outbreaks at these workplaces., Aims: To study COVID-19 vaccination rates, intent to undertake future vaccination and hesitancy reasons in food production workers., Methods: Data regarding vaccination status was collected via an online survey from workers at 8 food production sites in Ireland; those who were unvaccinated were asked for reasons for being unvaccinated and likelihood to future vaccination. Respondents were also asked for their usual trusted source of medical information., Results: N = 355 responses were received. The crude vaccination rate is 86% (N = 306). Those employed in the general operative class are more likely to be unvaccinated (N = 30; 18%) when compared to unvaccinated in all other job classes (N = 16; 9%: p < 0.01). The rate of vaccination is lower in those not born in Ireland compared to those born in Ireland (N = 110, 73% vs N = 192; 98%: p < 0.001). N = 35 (76%) of unvaccinated workers report they are very unlikely or unlikely to undertake vaccination in the future., Conclusions: There is an observed lower-than-national vaccination rate in food production workers. Rates are lowest amongst those workers born overseas; targeting these groups with information responding to their concerns may increase uptake and reduce current and future health inequalities., (© 2023. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.)

Introduction: Healthcare organisations have had to make adaptations to reduce the impact of the Coronavirus 2019 (COVID-19) pandemic. This has necessitated urgent reconfiguration within inflammatory bowel disease (IBD) services to ensure safety of patients and staff and seamless continuity of care provision., Aim: To describe the adaptations made by a large inflammatory bowel disease service, caring for over 3,500 IBD patients, in response to the COVID-19 pandemic., Methods: A diary record of responses to the pandemic were logged, and meeting minutes were reviewed. Data were recorded from IBD advice lines, multidisciplinary team (MDT) meeting minutes, infusion unit attendances, and electronic referral systems for the 8-week period from 9 March 2020 until 2 May 2020. Descriptive analysis was performed., Results: The IBD service at Hull University Teaching Hospitals NHS Trust (IBD Hull) instituted rapid structural and functional changes to the service. Outpatient services were suspended and substituted by virtual consultations, and inpatient services were reduced and moved to ambulatory care where possible. The delivery of biologic and immunomodulatory therapies was significantly modified to ensure patient and staff safety. There was a substantial increase in IBD advice line calls., Conclusion: The rapidly evolving COVID-19 pandemic required a prompt response, regular reassessment and planning, and continues to do so. We share our experience in of the successful adaptations made to our IBD service., (© Royal College of Physicians 2020. All rights reserved.)

Objective: ; Early-onset preeclampsia is a rare pregnancy-specific disorder associated with significantly increased maternal and fetal morbidity and mortality. Whilst it is known that even normotensive pregnancies are associated with changes in clot formation and dissolution, the nature of how these changes differ in those with early onset preeclampsia has not been well established. We sought to evaluate parameters of fibrin formation and fibrinolysis in individuals with early onset preeclampsia in comparison to both pregnant and non-pregnant controls. Furthermore, such parameters were correlated with markers of disease severity in this patient cohort, including the presence of multiorgan involvement, the rate of disease progression and the extent of the anti-angiogenic state in this condition., Study Design: ; Patients with early onset preeclampsia (N = 20) and both pregnant (N = 16) and non -pregnant (N = 16) controls were recruited from the cohort at a large urban maternity hospital which saw over 15,000 deliveries during the study period. Platelet poor plasma was prepared from collected whole blood and analysed for parameters of fibrin formation and fibrinolysis (lagtime to and rate of fibrin formation; PAI-1; PAI-2; D-dimer; plasmin-antiplasmin; tPA) in addition to markers of angiogenesis (sFLT-1; Endoglin) using commercially available specific immunoassays., Results: ; The maximum rate of fibrin formation as well as PAI-1, PAI-2 and D-dimer levels were all significantly increased in those with early onset preeclampsia and pregnant controls when compared to non-pregnant controls without significant differences between the 2 former groups. Plasmin-antiplasmin levels were significantly reduced in a similar manner. tPA levels were significantly elevated in EOP compared to both pregnant and non-pregnant controls. EOP was associated with significantly increased anti-angiogenic factors (sFLT-1; Endoglin) when compared to both pregnant and non-pregnant controls., Conclusion: ; Markers of fibrin formation and fibrinolysis are significantly alerted in early onset preeclampsia; furthermore, certain markers correlate with disease severity in this patient cohort., (Copyright © 2019 Elsevier B.V. All rights reserved.)