As the roles of trauma/acute care surgeons continue to evolve, it is imperative that health-care systems adapt to meet workforce needs. Tailoring retention strategies that elicit workforce satisfaction ensure continued coverage that is mutually beneficial to surgeons and health-care systems. We sought to elicit factors related to career characteristics and expectations of the trauma/acute care surgery (ACS) workforce to assist with such future progress. In this study, 1552 Eastern Association for the Surgery of Trauma members were anonymously surveyed. Data collected included demographics, career expectations, and motivators of trauma/ACS. Four hundred eight (26%) Eastern Association for the Surgery of Trauma members responded. Respondents were 78 per cent male and had a median age of 47.3 years. Forty-six per cent of surgeons reported earning $351K–$475K and 23 per cent >$475K. At this point in their career, 49 per cent of surgeons felt quality of life was “most important”, followed by 31 per cent career ambitions and 13 per cent salary. Prominent career satisfiers were patient care and teaching. Greatest detractors were burnout, bureaucracy, and work environment. Eighty per cent would change jobs in the final 10 years of practice, 31 per cent because of family/retirement, 29 per cent because of professional growth, 24 per cent because of workload, and 7 per cent because of salary. This study could be used to help develop trauma/ACS workforce strategies. This workforce remains mobile into late career; personal happiness and patient ownership overshadow financial rewards, and most prefer a total and shared patient care model compared with no patient ownership. Burnout, bureaucracy, and work environment are dominant detractors of job satisfaction among surveyed trauma/ACS surgeons.
We describe a gang violence intervention and define targets for prevention. At-risk youths were identified through courts, public schools, and law enforcement regarding gang-related activities. They participated in “A Second's Chance,” a true-to-life mock emergency department resuscitation and death of a gang member provided over an 18-month period. A questionnaire was completed by each participant. Forty-nine youths identified as at risk for gang involvement participated (37 male and 12 female, P < 0.001). Average age was 14.5 years (range, 10 to 19 years); 32 were black, 9 Hispanic, 6 white, and 2 other ( P < 0.05). Seventeen (35%) had prior arrests ( P = 0.059), 13 (77%) of whom had multiple arrests ( P < 0.05). Forty-one (84%) reported a family member jailed ( P < 0.001). Forty-two (86%) witnessed neighborhood criminal drug activity ( P < 0.001). Household leadership was predominately maternal (24 [49%], ( P < 0.05). Forty-four (90%) participants provided positive meaningful responses to the intervention ( P < 0.001). Gang violence prevention should be channeled through maternal family members. History of incarcerated relatives, acquaintances, and neighborhood exposure to drugs and crime may represent additional risk factors for gang-related involvement. Demonstrations of gang violence scenarios raise awareness to consequences of gang-related activities. Family and neighborhood characteristics should be included in development of intervention scenarios.
In the WHO European Region, 73 000 people were killed by interpersonal violence in 2002, and homicide represents the third leading cause of death after road traffic and suicide. Information on deaths is relatively easy to collect but these are just the tip of the iceberg: psychological, physical, sexual damage and neglect are not captured by routine data. To address this, the general objectives of the PHASE (Public Health Actions for a Safer Europe) project are to enhance injury data exchange in the Member States and to reinforce current health-sector related networks; in particular WP 6 addresses the theme of interpersonal violence. Four focus intervention areas have been identified: child, youth, intimate partners and elderly and four teams of European experts in collaboration with WHO National Focal Points on injury and violence prevention have identified and collected information on: (a) Country profile indicators; (b) Markers of prevalence; (c) Characteristics of violent behaviour; (d) National strategies, prevention programmes and services; (e) Legislation; (f) Reporting Systems; (g) Cost Analysis in the 27 European member states. These domains aimed to describe the magnitude of violence, understand which factors increase the risk for violent victimisation and perpetration, identify which type of programmes are effective and how legislation acts in this respect. The presentation will focus on the methodology adopted; discuss gaps and deficiencies in available information; present epidemiological findings and meta-analysis results. Intervention programmes and strategies that have been implemented and shown effectiveness in preventing violence will also be presented.
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