Search Results (132)

Background/Objectives: The COVID-19 pandemic has had a profound impact on the mental health of the general population, particularly older adults. This study aimed to explore the association between loneliness and mental health disorders in this demographic during the pandemic. Methods: A cross-sectional survey was conducted in Portugal using data from the Survey of Health, Ageing and Retirement in Europe (SHARE) database between June and August 2020, during the COVID-19 pandemic (Wave 8 COVID-19 Survey), using computer-assisted telephone interviews. Results: The final sample included 836 participants, with 387 (46.4%) men and a mean age of 74.5 years (SD = 6.7). Mental health indicators revealed that 441 (52.1%) reported feelings of nervousness, 384 (45.3%) experienced sadness or depression, 349 (41.2%) encountered sleeping difficulties, and 280 (33.1%) reported experiencing loneliness often or some of the time. Increased feelings of loneliness were notably associated with women in poorer health, those with heightened fear of falling, dizziness, fatigue, anxiety, depression, and concurrent health and sleep issues. Age and medication use did not significantly impact feelings of loneliness. Conclusions: The findings highlight a potential association between adverse mental health outcomes among older adults during the initial phase of the pandemic. Future research, employing longitudinal research designs, is warranted to explore these relationships more rigorously, in a post-pandemic context, and to inform effective intervention development and strategies to prevent mental health problems within this vulnerable population. Full article

Background: The present study seeks to examine how social disparities relate to the prevalence of poor glycemic control (HbA1c ≥ 7%), comorbidities such as hypertension and dyslipidemia, and diabetes-related complications (microvascular or macrovascular) among Saudi patients diagnosed with type 2 diabetes. Methods: A cross-sectional study was conducted among 574 patients with type 2 diabetes mellitus (T2DM) attending family medicine clinics at King Saud University Medical City in Riyadh. Participants were selected using a simple random sampling technique and interviewed via phone using a validated questionnaire. Data collected included demographic and clinical variables. Descriptive statistics and multivariate logistic regression analyses were performed to assess the association between socioeconomic status (SES) and cardiovascular complications, including stroke, dyslipidemia, hypertension, and acute coronary syndrome. Result: The analysis revealed that certain socioeconomic factors significantly increased the odds of cardiovascular complications among patients with T2DM. Being female was associated with higher odds of hypertension (OR = 2.29, p = 0.014), dyslipidemia (OR = 2.59, p = 0.012), acute coronary syndrome (ACS) (OR = 2.35, p = 0.001), and stroke (OR = 2.17, p = 0.003). Divorced or widowed participants had significantly increased odds of ACS (OR = 2.91, p = 0.001) and stroke (OR = 2.83, p = 0.002). A lower educational level (secondary school or less) was significantly associated with increased odds of hypertension (OR = 2.64, p = 0.031), dyslipidemia (OR = 2.22, p = 0.005), and stroke (OR = 2.88, p = 0.042). Monthly income between 3001 and 6000 SAR was significantly associated with higher odds of ACS (OR = 2.61, p = 0.003) and stroke (OR = 2.64, p = 0.012). Participants with diabetes duration >15 years had higher odds of dyslipidemia (OR = 2.86, p = 0.004) and stroke (OR = 2.89, p = 0.005). Being retired or not working increased the odds of all four cardiovascular outcomes, with stroke showing the highest risk (OR = 3.18, p < 0.001). Living outside the Riyadh region was also associated with elevated risk across outcomes, notably stroke (OR = 1.52, p = 0.046). Conclusions: The study concluded that notable social disparities exist among diabetic individuals affected by cardiovascular conditions, such as stroke and acute coronary syndrome (ACS), as well as risk factors for cardiovascular disease like dyslipidemia (DLD). These findings can inform targeted cardiovascular risk reduction strategies and address health inequities among diabetic populations in Saudi Arabia. Full article

This observational pilot study investigated neurocardiovascular responses to an active stand test using continuous physiological monitoring and functional data analysis (FDA) in older women. A sample of 25 community-dwelling female adults aged 59–78 years (mean age: 70.3 years) participated. Participants were dichotomized into comparison groups based on five factors: age (<70 vs. ≥70 years); the presence of initial orthostatic hypotension (IOH, yes/no); body mass index (BMI < 25 vs. ≥25 kg/m²); antihypertensive medication use (yes/no); and physical frailty status assessed by the Survey of Health, Ageing and Retirement in Europe—Frailty Instrument (SHARE-FI score < −0.5 vs. ≥−0.5). Each participant completed an active stand test during which six physiological signals were continuously recorded: systolic (sBP) and diastolic (dBP) blood pressure and heart rate (HR) via digital artery photoplethysmography and left frontal oxygenated hemoglobin (O₂Hb), deoxygenated hemoglobin (HHb), and tissue saturation index (TSI) via near-infrared spectroscopy (NIRS). The signal analysis focused on a standardized 200 s window spanning 50 s before to 150 s after the stand, with all signals resampled and synchronized at 5 Hz. FDA was used to statistically compare the full time series between groups for each signal. Group-level differences revealed that younger participants (<70 years) exhibited significantly higher HR in multiple periods following the stand (~10 s, ~30 s, ~90 s, and ~140 s post-stand) compared to their older counterparts. Participants with IOH demonstrated significantly lower sBP at ~10 s, ~80 s, and ~130 s post-stand and lower dBP at ~10 s post-stand. Among participants classified as overweight/obese (BMI ≥ 25 kg/m²), significantly lower levels of HHb were observed at ~10 s, ~30–50 s, and ~60 s post-stand, while O₂Hb levels were reduced at ~50 s, ~60 s, ~70–110 s, ~130 s, and ~140 s post-stand. No statistically significant group-level differences were observed based on antihypertensive medication use or frailty status. These findings demonstrate the utility of FDA in detecting subtle, time-dependent physiological variations during orthostatic challenge and underscore the value of continuous neurocardiovascular monitoring in assessing orthostatic tolerance in aging populations. Full article

Background: Chronic kidney disease (CKD) significantly affects health-related quality of life (HRQoL), impacting physical and mental well-being. This study aimed to identify the key determinants influencing HRQoL among patients with CKD. Methods: A cross-sectional observational study was conducted from July 2022 to March 2023 at the Rajiv Gandhi Cooperative Multi-Specialty Hospital, Palakkad, Kerala, South India, including 154 patients diagnosed with CKD stages 3 to 5. Eligible participants were required to be at least 18 years of age and have a confirmed diagnosis of CKD, specifically stages 3 to 5, with prior treatment. CKD stages were defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) 2012 guidelines, based on estimated glomerular filtration rate (eGFR) thresholds as follows: Stage 3 (eGFR 30–59 mL/min/1.73 m²), Stage 4 (eGFR 15–29 mL/min/1.73 m²), and Stage 5 (eGFR < 15 mL/min/1.73 m²). Participants were classified into stages based on their most recent stable eGFR value at the time of recruitment. HRQoL was assessed using the European Quality of Life-5 Dimensions-3 Levels (EQ-5D-3L) questionnaire. Chi-square, ANOVA, and multivariate regression were used to analyze associations with EQ-5D-3L domains. Results: Out of 154 participants, 68.8% were male, 91.6% were aged over 50 years, and 63.6% were from rural areas. Most had primary education (55.2%) and were unemployed, retired, or housewives (66.2%). As CKD progressed, comorbidities, particularly diabetes mellitus and coronary artery disease (CAD), increased, with Stage 5 showing the highest prevalence. Clinical markers showed significant declines in the glomerular filtration rate (GFR) (Stage 3: 49.16 ± 7.59, Stage 4: 22.37 ± 3.88, Stage 5: 8.79 ± 1.68) and hemoglobin (Stage 3: 10.45 ± 0.84, Stage 4: 8.88 ± 0.60, Stage 5: 7.12 ± 0.53) and an increase in serum creatinine (Stage 3: 1.72 ± 0.40, Stage 4: 3.21 ± 0.44, Stage 5: 7.05 ± 1.46). HRQoL assessments showed significant declines in mobility, self-care, usual activities, pain, and anxiety/depression with advancing CKD. Mobility issues increased from 61.2% in Stage 3 to 62.0% in Stage 5, with greater difficulties in self-care and usual activities at Stage 5. Pain and anxiety/depression worsened across stages. Multivariate analysis identified female gender, older age (≥50 years), lower education, unemployment, multiple comorbidities, smoking, lack of social support, and advanced CKD stages as significant factors linked to impaired HRQoL. CKD stage 5 (GFR < 29 mL/min/1.73 m²) and high serum creatinine (>1.2 mg/dL) were associated with significantly higher odds of impairment in all HRQoL domains. Conclusions: This study highlights that factors such as female gender, older age, lower education, unemployment, multiple comorbidities, smoking, advanced CKD stages, and high serum creatinine levels are associated with reduced quality of life in CKD patients. Conversely, social support acts as a protective factor. The findings emphasize the need for targeted interventions that address both medical care and psychosocial aspects, including lifestyle changes, patient education, mental health support, and community involvement, to improve CKD patients’ well-being. Full article

Background: Rare diseases are defined as clinical conditions that affect only a small number of persons in a population, considered fewer than 1 per 2000 in the European Union or fewer than 1 per 1600 in the United States They are serious, often chronic and progressive conditions, characterized by a pronounced clinical polymorphism that crosses all medical specialties. Multiple areas of life beyond just physical health are affected with significant impact on patients, families, and healthcare systems. Objective: To analyze the socio-demographic, medical, and vocational characteristics that correlate with functional status and work disability as a measure of quality of life in rare diseases. Methods: An observational retrospective study of adults with rare diseases evaluated for eligibility for social insurance rights in the National Institute of Medical Assessment and Work Capacity Rehabilitation Bucharest (INEMRCM, the Romanian abbreviation) over a 5-year period was made. Descriptive analysis was used to present sample characteristics. Means and standard deviations (SD) were calculated to describe numerical variables, frequencies were used to describe categorical variables, and logistic regression analysis was conducted to evaluate potential predictors of work capacity. All statistical analyses were performed by PSPP.3 software. p < 0.05 was the cut-off for statistical significance with a 95% confidence interval. Results: 90 consecutive persons were included in the survey. The mean age of the group was 44.5 years ± SD 10.61 years, with a female/male ratio of 48/42 persons. The mean disease duration was 10.61 years ± SD 9.76 years. Men had more severe disease (73.81%); p = 0.018 and significantly younger retirement age, M/F = 39.10 ± 12.26/43.06 ± 9.32; p = 0.037. Less disabling diseases were predominant autoimmune conditions (85.71% of cases); genetic conditions had a more severe functional impact in 63.75% of cases; p = 0.037. People with multisystem diseases but with specific or targeted treatment can work more frequently (76.19%); those with visual impairment have more severe impairments (73.77%); p < 0.001. All individuals who received specific therapy had a better functional status, unlike only 37.21% of those who received symptomatic treatment or treatment for complications; p = 0.023. Logistic regression analysis indicated that the type of impairment and the availability of specific treatments could serve as predictors of a reduced likelihood of employment in rare disease cases. Education level and occupation were not correlated with functional impairment and work disability (NS). Conclusions: Several factors, including some that are modifiable, were associated with better outcomes, such as reduced disability and an increased potential for work participation. Sex, disease etiology, type of impairment, and treatment were all significantly linked to functional capacity. Among these, the type of impairment and the availability of specific treatments might be predictors of employment. Addressing these parameters requires a multidisciplinary team, involving specialized care and comprehensive support services to improve the overall quality of life of individuals affected by rare diseases. Full article

Polypharmacy, a common condition among the older population, is associated with adverse outcomes, including higher mortality, falls and hospitalization rates, adverse drug reactions, drug–drug interactions, medication nonadherence, and consequently increased healthcare costs. Background/Objectives: This study aims to explore the prevalence of polypharmacy and its associated factors among older adults across 27 European countries and Israel. Methods: In this cross-sectional analysis, we used data from participants aged 65 years or older from Wave 9 of the Survey of Health, Aging, and Retirement in Europe (SHARE) database. The variables studied were classified into the following categories: sociodemographic, behavioral factors, physical functioning, physical health, mental health, and living conditions. Results: Our results showed an overall prevalence of polypharmacy of 36.2%, ranging from 25.0 to 51.8%. Slovenia, Greece, and Switzerland were the countries with the lowest prevalence, whereas Portugal, Israel, and Poland were the countries where the prevalence of polypharmacy was the highest. Polypharmacy was shown to be associated with variables from all categories. Conclusions: Polypharmacy is a highly prevalent condition in the older population. Identification of variables associated with polypharmacy, such as those identified in this study, is important to identify and monitor older groups, which are most vulnerable to polypharmacy. Interventions designed to reduce polypharmacy should consider these associations. Full article

Background/Objectives: The global nursing shortage encompasses issues such as the uneven nurse distribution in low- and middle-income countries, nurse outflow to other countries, and nurse retirement in developed countries, necessitating effective retention strategies. Our objective was to clarify the changes in facility selection reasons among Japanese nurses after changing jobs and the personal attributes influencing facility selection. Methods: In January 2023, an online survey was conducted among licensed practical nurses, registered nurses, midwives, and public health nurses in Japan. The survey items included personal attributes (age and sex), information on ≤five employment facilities, and facility selection reasons. The variations in facility selection reasons by facility number were analyzed using a generalized linear model with a binomial distribution. A logistic regression analysis was conducted with personal attributes and reasons for workplace selection as the independent and dependent variables, respectively. Results: In total, 721 participants were included; 90.8% selected hospitals as their first place of employment. As nurses changed jobs, they increasingly selected non-hospital facilities, including nursing homes, nursery schools, and government agencies. With multiple job changes, the facility selection reasons included “good location for commuting”, “good salary”, and “convenient working style”. Among personal attributes, “age”, “sex”, “age at employment at the facility”, “educational background”, “number of children”, and “living alone” influenced workplace choice reasons. Conclusions: Considering the study results, country-specific demographic trends, medical policy changes, and nursing-shortage-related causes, medical facility managers and policymakers should devise appropriate employment conditions and develop recruitment strategies, especially for situations with severe nursing shortages. Nurses can learn from the career choices of others to manage their own careers. Full article

Introduction/Background: The urology workforce is shifting in terms of the number of physicians per capita, age, gender, and availability. To meet this growing need, physician assistants/associates (PAs) and nurse practitioners (NPs) are part of this workforce backfilling effort. However, limited studies have been conducted on the demographic and employment attributes of PAs practicing in urology. Thus, using a national dataset, this study aims to compare the attributes of PAs in the urology workforce compared with PAs in all other surgical and medical disciplines. Methods: We analyzed the practice of PAs in urology using data from the 2022 National Commission on Certification of PAs (NCCPA). This study drew on responses from 117,748 board-certified PAs who reported their medical and surgical specialty. Our analysis involved descriptive and inferential statistics, comparing the demographic and practice attributes of PAs in urology (n = 1199) with PAs in all other medical disciplines (n = 116,549). Results: In 2022, 1199 (1.0%) PAs were reported to be clinically active in urology. Among PAs in urology, 68.1% self-identified as female, with a median age of 39 [IQR: 32–48]. Compared to PAs in other medical disciplines, PAs in urology resided in urban locations (94.5% vs. 92.5%, p = 0.002). They were also more likely to practice in office-based settings (53.6% vs. 37.0%), work over 40 h weekly (37.9% vs. 29.3%), and partake in telemedicine (52.0% vs. 40.1%; all p < 0.001). No statistical differences were found among PAs in urology versus PAs in all other medical fields related to job satisfaction (p = 0.763), symptoms of burnout (p = 0.124), and retirement plans in the next 5 years (p = 0.442). Conclusions: Given the predicted shortfalls of urologists and their changing demographic composition, this study has important implications for practice in the urology workforce. Our findings can inform workforce planning, recruitment strategies, and organizational policies to support the expansion of PAs in urology and help address shortages in this discipline. Full article

Background: Understanding oncology health human resources across Canada is critical to the delivery of quality cancer care. Little has been published about the medical oncology (MO) workforce and trainees; this study sought to characterize trends in the MO workforce and explore the relationship between medical oncologists and cancer incidence as a surrogate demand marker. Materials and Methods: Publicly available databases from the Canadian Medical Association, the Canadian Institute of Health Information, and the Canadian Post MD Education Registry were utilized to estimate the number, demographics, and regional distribution of practicing MOs and MO trainees between 1994 and 2020. Cancer incidence by province was obtained from Statistics Canada. To estimate changes in demand for, and supply of, medical oncology services over time, annual cancer incidence to MO provider ratios were calculated. Results: Between 1994 and 2020, annual cancer incidence nationally rose from 120,255 to 225,800 cases, while the number of MOs increased by 298%. Incident cancer case to medical oncologist (MO) ratio dropped from 749:1 to 352:1 in the same time. However, the MO workforce is aging; in 2020, 40% of providers were ≥50 years old versus 24% in 1994. Trends in Canadian MO trainees mirror MO trends. Ontario has the largest proportion of the country’s MOs (34% in 2020) and MO trainees (49%). Conclusions: Although the Canadian MO workforce has grown, more MO providers are nearing retirement age, which may influence future workforce trends. Ongoing monitoring of human resources in oncology is essential to ensure future demands for services are met. Full article

Background/Objectives: The prevalence of type 2 diabetes and smoking is increasing in developing countries and is associated with deteriorated health outcomes. Also, addiction to smartphone use is an alarming behavior that can be associated with clinical factors. This study aimed to determine the prevalence and clinical correlates of smartphone addiction in smokers with T2DM in Jordan, with a particular focus on the role of medications. Methods: This cross-sectional study recruited patients from Prince Hamza Hospital, Jordan, according to pre-defined criteria. Besides demographics and clinical information, this study used the validated Arabic version of the Smartphone Addiction Scale to assess addiction to smartphones and a multivariable regression analysis to identify the correlates of smartphone addiction. Results: Data analyzed from 346 patients revealed that 117 (33.8%) of these participants reported addiction to smartphones. Patients who had been diagnosed with T2DM for less than five years (aOR = 3.30; 95% CI = 1.43–7.60), who were “employed” (aOR = 8.85; 95% CI = 2.20–35.64), and who were “retired” (aOR = 11.46; 95% CI = 2.72–48.23) all reported a significantly (p < 0.05) higher odds of smartphone addiction. In contrast, patients on “sulfonylurea” (aOR = 0.18; 95% CI = 0.06–0.53); “metformin” (aOR = 0.19; 95% CI = 0.06–0.66), and “gabapentin” (aOR = 0.16; 95% CI = 0.04–0.67) and those with “comorbid hypertension” (aOR = 0.15; 95% CI = 0.06–0.38) had a significantly (p < 0.05) lower odds of smartphone addiction. Conclusion: These alarming results require adequate action from the health authorities to raise awareness of adopting positive behaviors that could improve the well-being of this high-risk population. Full article

The widespread use of the term “foster fail” in animal rescue suggests that it happens often, but no research has explored the prevalence of volunteers adopting their foster animals or whether the phenomenon is really a “failure”. This survey-based study focused on the following questions: 1. How common are foster fails among volunteers on shelter and rescue lists and why do they occur? 2. What types of volunteers are most likely to adopt their foster animals? 3. Do different attachment styles to pets affect foster adoption? 4. Is the adoption of foster animals a way to deal with the potential grief of letting them go to adoption? 5. What are the impacts of foster fails on animal shelters in terms of longevity of volunteers and satisfaction with the volunteer experience? Data were collected through surveys of foster volunteers. Two nonprofit organizations, the Pedigree Foundation and Shelter Animals Count, distributed information about the survey and shelter directors distributed the survey link to their population of foster volunteers. Nine hundred and forty-seven individuals responded. To address the research questions, frequency, correlation, and regression analyses were employed. A total of 38% of volunteers had not adopted a foster in the past ten years, and another 38% had adopted one or two; 90 (11%) and 103 (13%) had adopted three to four or more than four, respectively. Volunteers that had significantly higher numbers of foster fails were those that were older (r = 0.22, p < 0.001), retired (chi-squared = 9.05, p = 0.029), lower on educational attainment (r = −0.13, p < 0.001), female with their own cats (r = 0.16, p < 0.001), and part of a fostering family (r = 0.08, p = 0.043). Volunteers that expressed higher levels of both people-substituting (r = 0.16, p = 0.003) and general (r = 0.13, p = 0.017) attachment to their fosters were more likely to adopt them, as were those that more frequently fostered animals with special medical or behavioral needs (r = 0.25, p < 0.001). Volunteers that had longer tenures (r = 0.43, p < 0.001), fostered more frequently (r = 0.24, p < 0.001), and reported greater resilience (r = 0.10, p = 0.009) had adopted significantly more animals. Finally, there was a significant and positive relationship between satisfaction with fostering and adopting more foster animals (r = 0.16, p < 0.001). The findings indicated that instead of being a “failure,” foster adoptions can be a positive force for the animal in question, their adopters, and shelters and rescues because they have more resilient, satisfied, and active volunteers. Full article

Chimp Haven is a private, nonprofit organization that serves as the largest chimpanzee sanctuary in the world. The National Institutes of Health supports the federal sanctuary system, which is operated by Chimp Haven, to provide lifetime care for chimpanzees who have retired from biomedical research. Chimp Haven is home to over 300 chimpanzees, with a wide variety of individual health needs including infectious diseases. The chimpanzees live in large, mixed-sex social groups within corrals, multi-dimensional enclosures, and naturally forested habitats, which presents challenges for monitoring and balancing individual versus group needs. Primate veterinarians and animal behavior directors have an obligation to collaborate for the best possible health and welfare outcomes for the species in their care. This manuscript details how veterinarians and behavioral staff at Chimp Haven interface to enhance clinical management and improve chimpanzee welfare using two clinical cases to illustrate this relationship. This is accomplished through the development of individual care plans that include the utilization of welfare assessment metrics and positive reinforcement training programs collaboratively developed between the veterinarians and behaviorists to facilitate voluntary medical procedures without the need for social isolation. Specifically, welfare metrics such as monitoring chimpanzee wounding levels and severity, as well as targeted assessments, involve the input of both the veterinarians and behaviorists. Positive reinforcement training initiatives such as weight loss, heart health, and wound care also require the interface between the two disciplines. The authors aim to demonstrate that working together provides optimal levels of expert care for both the physical and mental health of the chimpanzees in our care. Full article

Background/Objectives: With population aging, disability and chronic conditions are increasingly prevalent among middle-aged and older adults in China. Using panel data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018, this paper explores the effects of Activities of Daily Living limitations, Instrumental Activities of Daily Living limitations, and chronic conditions on Out-of-Pocket Expenditures (OOPEs) among middle-aged and older adults in China. Methods: A first-difference model and a system-generalized method of moment model (GMM) are used. Results: The system-GMM model for the first time addresses unobserved heterogeneity and produces unbiased estimates of the effects of health and OOPEs. Additionally, this paper assesses the heterogeneity of the results across the demographic and socioeconomic groups. Conclusions: These findings can be used to inform policymakers on improving medical resource allocation and ensure better financial protection for those living with a disability and chronic diseases. Full article

Background and Objectives: Health-seeking behavior is a critical determinant of health outcomes, particularly in countries like Indonesia. Given the increasing burden of noncommunicable diseases, understanding the factors that influence health-seeking behavior in this context is essential for developing more accessible and effective public health strategies. This study aimed to identify various factors associated with health-seeking behavior among patients with chronic diseases across Indonesia, especially in formal facilities. Materials and Methods: This study used a cross-sectional research design, utilizing Indonesian Family Life Survey (IFLS)-5 data. The inclusion criteria included respondents aged 20–74 years old with at least one chronic disease based on self-reported data. Respondents who did not receive treatment, practiced self-medication, or provided incomplete data were excluded. We used multivariate logistic regression to identify factors associated with health-seeking behavior in formal facilities. Results: The results revealed that 80.7% (n = 1993) of the 2471 respondents sought treatment in formal facilities, whereas 19.3% (n = 478) opted for informal facilities. Respondents who were Bugis (OR 9.187, 95% CI 2.182–38.683; p = 0.002), retired (OR 2.966, 95% CI 1.233–7.135; p = 0.015), did not smoke (OR 1.604, 95% CI 1.126–2.285; p = 0.009), made less than IDR 1,500,000 a month (OR 1.466, 95% CI 1.174–1.831; p = 0.000), had to travel more than 3 km to reach a treatment facility (OR 1.847, 95% CI 1.41–2.42; p = 0.000), or had more than one comorbidity (OR 1.396, 95% CI; p = 0.01) were more likely to seek treatment at formal facilities. Conclusions: These findings are expected to provide recommendations for policymakers, healthcare providers, and researchers to contribute to the development of targeted interventions that can improve healthcare access and utilization, ultimately enhancing health outcomes and equity in Indonesia. Full article

Background: The work and life of a resident (or “junior”) doctor has changed dramatically over the past 50 years. Descriptions of historic working conditions are usually anecdotal and tinted with nostalgia, but do today’s burns and plastic surgery doctors feel working conditions have improved or declined over the last 50 years, and does this have an impact on recruitment and retention? Methods: An interview was conducted with a retired surgeon who, in 1970, worked as a house surgeon (Year 2 doctor equivalent) in a burns unit for the pioneering burn surgeon Mr. Douglas MacGregor Jackson. This was coupled with a literature review to objectively assess working conditions in that period for doctors. The information generated from this produced a poster summarizing the key differences between these periods. This was presented to the current medical work force, and a survey was conducted to determine their preferences for working conditions. Results: The questionnaire was completed by 68 doctors of mixed grades and backgrounds. The majority of respondents (60%) would choose to work in today’s burns centres. There was a significant difference between the mean age of respondents’ preference of working conditions in 1970 (37 years) and those preferring today (31 years) (p = 0.035). Conclusions: Multiple changes in the working conditions and the management of burns patients were identified. The majority of those who were asked consider today’s working conditions to be better than those of the past. However, more senior clinicians tended to prefer the conditions of 1970 over the present day, suggesting a generational shift in opinion. Full article