Cecilie Markvard Møller

Objective: Limited information exists on burnout among European urologists and urology trainees. This study aimed to explore prevalence of burnout and identify related workplace characteristics among practicing urologists and urology trainees in Denmark. Material and methods: In April 2025, we conducted an anonymous nation-wide online survey of urologists and urology trainees working in a public healthcare department of Urology in Denmark. Burnout and psychosocial work environment factors were evaluated using validated assessment tools. Results: Of the 297 participants invited, 73% (n = 216) completed the survey. Respondents had a mean age of 45.8 years (standard deviation [SD] ± 10.8), 52% (n = 113) were women, and 70% (n = 152) were specialists. Personal burnout was the most prevalent domain, affecting 80.1% (n = 173) of respondents, including 47.7% (n = 103) with mild, 29.6% (n = 64) with moderate, and 2.8% (n = 6) with severe burnout. Personal burnout scores varied significantly by position (p = 0.035) and speciality tenure (p = 0.008). Psychosocial work environment factors differed across groups and departments. Strongest associations with burnout were observed for ‘possibilities for performing work tasks’, ‘emotional demands’, and ‘unnecessary work tasks’, with a notable link between work-related burnout and ‘influence at work’, alongside factors related to job demands and interpersonal relations. Female respondents reported higher personal (p = 0.003) and work-related (p = 0.011) burnout scores. Conclusions: Thirty-two percent of urologists and urology trainees in Denmark experience moderate to severe burnout, linked to psychosocial work conditions. These findings highlight the need to engage in dialogue around work-life expectations, workplace-focused prevention strategies to support career longevity, and ensure a stable workforce capable of delivering safe, high-quality patient care.

Aims: Proliferation of arterial smooth muscle cells (SMCs) and their modulation to alternative mesenchymal phenotypes is central to atherosclerotic lesion growth. It has been studied extensively in mouse models, but a detailed analysis of when and where different mesenchymal cell types accumulate in human atherosclerosis is lacking. This study mapped mesenchymal cell populations during the progression of human coronary atherosclerosis and explored their associations with disease processes in human carotid plaques. Methods and results: Multiplex immunostaining protocols based on single-cell RNA sequencing-validated markers were established to detect SMCs, putatively SMC-derived mesenchymal cell subsets expressing osteoprotegerin or lumican, and macrophages in sections of left anterior descending arteries from forensic autopsies. The material comprised 44 arterial segments from 38 individuals, spanning normal intima, adaptive intimal thickening, pathological intimal thickening, and fibroatheroma. Parallel analysis of carotid endarterectomy samples allowed examination of mesenchymal cell involvement in fibrosis, calcification, and apoptosis. Validated machine learning-assisted cell classification was used to phenotype entire plaques at high microscopic resolution. The combined mesenchymal cell population constituted the majority of plaque cells at all plaque stages. Cells co-expressing contractile and mesenchymal cell markers were present in normal human coronary arteries, but mesenchymal cells lacking contractile protein expression became prominent only at the fibroatheroma stage, where fibroblast-like lumican-expressing cells localized preferentially around the necrotic core. The mesenchymal cell subtypes showed no preferential co-localization with areas of fibrosis or calcification; however, secreted osteoprotegerin was found bound to calcium deposits. Fibroblast-like, lumican-expressing cells accounted for 38–54% of all apoptotic cells for which a cell origin could be determined. Conclusion: Putative SMC-derived mesenchymal cells without contractile protein expression expand at the fibroatheroma stage of coronary atherosclerosis. Fibroblast-like cells localize around the necrotic core region and account for many apoptotic cells in plaques, suggesting a role in necrotic core development.

Background: Specialised palliative care providers face complex challenges when caring for patients with life-limiting diseases. Despite this, a low prevalence of burnout has been observed among physicians in Danish palliative care compared to other Western countries. Given the multidisciplinary nature of palliative care, an expanded investigation was warranted. Aim: To assess burnout and its associations with demographic variables and workplace factors among all professions in Danish palliative care. Design: Cross-sectional survey study using the Copenhagen Burnout Inventory, the Danish Psychosocial Work Environment Questionnaire, and the Warr-Cook-Wall Job Satisfaction Scale. Participants: All 12 palliative care units in the Central Denmark Region participated. Of 288 invited professionals, 151 (52%) completed the survey. Respondents comprised nurses ( n = 88), physicians ( n = 17), other healthcare specialists ( n = 12), and non-healthcare professionals ( n = 34) from six hospices and six palliative care teams. Results: The prevalence of burnout was 23% overall; 28% in hospices and 14% in palliative care teams. Professionals in palliative care teams reported more weekly working hours (38 vs 34, p < 0.001), less shift work (40% vs 73%, p < 0.001), and higher meaningfulness at work (85 vs 76, p < 0.001) compared to hospice professionals. Adjusted analyses showed higher burnout among respondents with young age ( p = 0.01), children living at home ( p = 0.02), and shift work ( p < 0.03). Low burnout was associated with high meaningfulness at work ( p < 0.001), collegial trust ( p < 0.001), and job satisfaction ( p < 0.001). Conclusion: Burnout is a relevant concern in Danish palliative care, especially at hospices. The identified links to organisational and psychosocial factors suggests areas for further research and organisational attention.