Understanding the burnout experience: recent research and its implications for psychiatry

The experience of burnout has been the focus of much research during the past few decades. Measures have been developed, as have various theoretical models, and research studies from many countries have contributed to a better understanding of the causes and consequences of this occupationally‐specific dysphoria. The majority of this work has focused on human service occupations, and particularly health care. Research on the burnout experience for psychiatrists mirrors much of the broader literature, in terms of both sources and outcomes of burnout. But it has also identified some of the unique stressors that mental health professionals face when they are dealing with especially difficult or violent clients. Current issues of particular relevance for psychiatry include the links between burnout and mental illness, the attempts to redefine burnout as simply exhaustion, and the relative dearth of evaluative research on potential interventions to treat and/or prevent burnout. Given that the treatment goal for burnout is usually to enable people to return to their job, and to be successful in their work, psychiatry could make an important contribution by identifying the treatment strategies that would be most effective in achieving that goal.     

Is the fracto‐mechanoluminescence of ZnS:Mn phosphor dominated by charged dislocation mechanism or piezoelectrification mechanism?

Mathematical approaches made for both the charged dislocation model and piezoelectrically induced electron bombardment model of fracto‐mechanoluminescence (FML), the luminescence induced by fracture of solids, in ZnS:Mn phosphor indicate that the piezoelectrically induced electron bombardment model provides a dominating process for the FML of ZnS phosphors. The concentration of 3000 ppm Mn²⁺ is optimal for ML intensity of ZnS:Mn phosphor. The decay time of ML gives the relaxation time of the piston used to deform the sample and the time t_m of maximum of ML is controlled by both the relaxation time of the piston and decay time of charges on the newly created surfaces of crystals. As the product of the velocity of dislocations and pinning time of dislocations gives the mean free path of a moving dislocation. Both factors play an important role in the ML excitation of impurity doped II–VI semiconductors. The linear increase of total ML intensity I_T with the impact velocity indicates that the damage increases linearly with impact velocity of the load. Thus, the ML measurement can be used remotely to monitor the real‐time damage in the structures, and therefore, the ML of ZnS:Mn phosphor has also the potential for a structural health monitoring system. Copyright © 2015 John Wiley & Sons, Ltd.     

The effectiveness of the peer-delivered Thinking Healthy PLUS (THPP+) Program for maternal depression and child socioemotional development in Pakistan: study protocol for a randomized controlled trial

BackgroundThe negative effects of perinatal depression on the mother and child start early and persist throughout the lifecourse (Lancet 369(9556):145–57, 2007; Am J Psychiatry 159(1):43-7, 2002; Arch Dis Child 77(2):99–101, 1997; J Pak Med Assoc 60(4):329; J Psychosoma Res 49(3):207–16, 2000; Clin Child Fam Psychol Rev 14(1):1–27, 2011). Given that 10–35 % of children worldwide are exposed to perinatal depression in their first year of life (Int Rev Psychiatry 8(1):37–54, 1996), mitigating this intergenerational risk is a global public health priority (Perspect Public Health 129(5):221–7, 2009; Trop Med Int Health 13(4):579–83, 2008; Br Med Bull 101(1):57–79, 2012). However, it is not clear whether intervention with depressed women can have long-term benefits for the mother and/or her child. We describe a study of the effectiveness of a peer-delivered depression intervention delivered through 36 postnatal months, the Thinking Healthy Program Peer-delivered PLUS (THPP+) for women and their children in rural Pakistan.Methods/designThe THPP+ study aims are: (1) to evaluate the effects of an extended 36-month perinatal depression intervention on maternal and index child outcomes using a cluster randomized controlled trial (c-RCT) and (2) to determine whether outcomes among index children of perinatally depressed women in the intervention arm converge with those of index children born to perinatally nondepressed women. The trial is designed to recruit 560 pregnant women who screened positive for perinatal depression (PHQ-9 score ≥10) from 40 village clusters, of which 20 receive the THPP+ intervention. An additional reference group consists of 560 perinatally nondepressed women from the same 40 clusters as the THPP+ trial. The women in the nondepressed group are not targeted to receive the THPP+ intervention; but, by recruiting pregnant women from both intervention and control clusters, we are able to evaluate any carryover effects of the THPP+ intervention on the women and their children. Perinatally depressed women in the THPP+ intervention arm receive bimonthly group-based sessions. Primary outcomes are 3-year maternal depression and 3-year child development indicators. Analyses are intention-to-treat and account for the clustered design.DiscussionThis trial, together with the reference group, has the potential to further our understanding of the early developmental lifecourse of children of both perinatally depressed and perinatally nondepressed women in rural Pakistan and to determine whether intervening with women’s depression in the perinatal period can mitigate the negative effects of maternal depression on 36-month child development.

Trial registration

THPP-P ClinicalTrials.gov Identifier: {"type":"clinical-trial","attrs":{"text":"NCT02111915","term_id":"NCT02111915"}}NCT02111915 (registered on 9 April 2014).THPP+ ClinicalTrials.gov Identifier: {"type":"clinical-trial","attrs":{"text":"NCT02658994","term_id":"NCT02658994"}}NCT02658994 (registered on 21 January 2016).Sponsor: Human Development Research Foundation (HDRF).

Electronic supplementary material

The online version of this article (doi:10.1186/s13063-016-1530-y) contains supplementary material, which is available to authorized users.     

肠道噬菌体组与人体健康

噬菌体作为肠道微生物群落的重要组成部分,自生命初期即定植于肠道,在不同生命时期均以较为稳定的状态存在于人体。目前已知的肠道噬菌体主要是DNA噬菌体,且大多以前噬菌体形式存在。肠道噬菌体可通过多种机制优化其宿主微生物群的结构和组成,并以多种方式直接或间接影响人体的生理状态,其结构变化与多种疾病相关。利用测序方法,能够直接获取噬菌体组信息。本文基于噬菌体组的相关研究,综述了肠道噬菌体组与人体健康相关的研究进展,并对该领域的研究方法和发展方向做出展望。     

我国少数民族孕产妇孕期保健及其健康现状综述

孕产妇孕期保健及孕产妇健康对促进安全分娩和优生优育起着十分重要的作用,随着我国孕产妇保健工作的进一步完善及国家二胎政策的实施,现代临床医学所倡导的优生优育的观念已逐渐被社会广泛认可。然而,我国少数民族地区多有经济落后、地理位置偏僻、思想观念陈旧等问题,导致我国少数民族孕产妇孕期保健水平还比较低下,孕产妇健康状况有待改善。为预防少数民族地区出生缺陷,降低出生缺陷率,提高优生率,提高少数民族地区出生人口素质,通过完善医疗制度,改善医疗环境,合理营养干预及加强家庭访视等相关健康教育促进孕期保健,提高孕前检查的依从性,实现优生,孕产期健康教育可以降低整个孕期出现的危险因素,本文对我国少数民族的孕产妇孕期保健及健康做一综述。     

Ethical issues associated with HIV phylogenetics in HIV transmission dynamics research: A review of the literature using the Emanuel Framework

The reduced costs of DNA sequencing and the use of such data for HIV‐1 clinical management and phylogenetic analysis have led to a massive increase of HIV‐1 sequences in the last few years. Phylogenetic analysis has shed light on the origin, spread and characteristics of HIV‐1 epidemics and outbreaks. Phylogenetic analysis is now also being used to advance our knowledge of the drivers of HIV‐1 transmission in order to design effective interventions. However, HIV phylogenetic analysis presents unique ethical challenges, which have not been fully explored. This review presents an analysis of what appear to be key ethical issues in HIV phylogenetics in the hope of stimulating further conceptual and empirical work in this rapidly emerging area. We structure the review using the Emanuel Framework, a systematic, holistic framework, which has been adapted for use in developing countries, which bear the brunt of the HIV‐1 pandemic.     

Effects of probiotic supplementation on performance traits,bone mineralization,cecal microbial composition,cytokines and corticosterone in laying hens

Recent researches have showed that probiotics promote bone health in humans and rodents. The objective of this study was to determine if probiotics have the similar effects in laying hens. Ninety-six 60-week-old White Leghorn hens were assigned to four-hen cages based on their BW. The cages were randomly assigned to 1 of 4 treatments: a layer diet mixed with a commercial probiotic product (containing Enterococcus faecium, Pediococcus acidilactici, Bifidobacterium animalis and Lactobacillus reuteri) at 0, 0.5, 1.0 or 2.0 g/kg feed (Control, 0.5×, 1.0× and 2.0×) for 7 weeks. Cecal Bifidobacterium spp. counts were higher in all probiotic groups (P<0.001) compared with the control group. The percentage of unmarketable eggs (cracked and shell-less eggs) was decreased in both 0.5× and 2.0× groups compared with the control group (P=0.02), mainly due to the reduction of shell-less eggs (P=0.05). The increases in tibial and femoral mineral density and femoral mineral content (P=0.04, 0.03 and 0.02, respectively), with a concomitant trend of increases in humerus mineral density and tibial mineral content (P=0.07 and 0.08, respectively), occurred in the 2.0× group. However, the bone remodeling indicators of circulating osteocalcin and c-terminal telopeptide of type I collagen were similar among all groups (P>0.05). In addition, the plasma concentrations of cytokines (interleukin-1β, interleukin-6, interleukin-10, interferon-γ and tumor necrosis factor-α) and corticosterone as well as the levels of heterophil to lymphocyte ratio were similar between the 2.0× group and the control group (P>0.05). In line with these findings, no differences of cecal tonsil mRNA expressions of interleukin-1β, interleukin-6 and lipopolysaccharide-induced tumor necrosis factor-α factor were detected between these two groups (P>0.05). These results suggest that immune cytokines and corticosterone may not involve in the probiotic-induced improvement of eggshell quality and bone mineralization in laying hens. In conclusion, the dietary probiotic supplementation altered cecal microbiota composition, resulting in reduced shell-less egg production and improved bone mineralization in laying hens; and the dietary dose of the probiotic up to 2.0× did not cause negative stress reactions in laying hens.     

Genetic (co)variances between milk mineral concentration and chemical composition in lactating Holstein-Friesian dairy cows

Milk mineral concentration is important from both the perspective of processing milk into dairy products and its nutritive value for human consumption. Precise estimates of genetic parameters for milk mineral concentration are lacking because of the considerable resources required to collect vast phenotypes quantities. The milk concentration of calcium (Ca), potassium (K), magnesium (Mg), sodium (Na) and phosphorus (P) in the present study was quantified from mid-IR spectroscopy on 12 223 test-day records from 1717 Holstein-Friesian cows. (Co)variance components were estimated using random regressions to model both the additive genetic and within-lactation permanent environmental variances of each trait. The coefficient of genetic variation averaged across days-in-milk (DIM) was 6.93%, 3.46%, 6.55%, 5.20% and 6.68% for Ca, K, Mg, Na and P concentration, respectively; heritability estimates varied across lactation from 0.31±0.05 (5 DIM) to 0.67±0.04 (181 DIM) for Ca, from 0.18±0.03 (60 DIM) to 0.24±0.05 (305 DIM) for K, from 0.08±0.03 (15 DIM) to 0.37±0.03 (223 DIM) for Mg, from 0.16±0.03 (30 DIM) to 0.37±0.04 (305 DIM) for Na and from 0.21±0.04 (12 DIM) to 0.57±0.04 (211 DIM) for P. Genetic correlations within the same trait across different DIM were almost unity between adjacent DIM but weakened as the time interval between pairwise compared DIM lengthened; genetic correlations were weaker than 0.80 only when comparing both peripheries of the lactation. The analysis of the geometry of the additive genetic covariance matrix revealed that almost 90% of the additive genetic variation was accounted by the intercept term of the covariance functions for each trait. Milk protein concentration and mineral concentration were, in general, positively genetically correlated with each other across DIM, whereas milk fat concentration was positively genetically correlated throughout the entire lactation with Ca, K and Mg; the genetic correlation with fat concentration changed from negative to positive with Na and P at 243 DIM and 50 DIM, respectively. Genetic correlations between somatic cell score and Na ranged from 0.38±0.21 (5 DIM) to 0.79±0.18 (305 DIM). Exploitable genetic variation existed for all milk minerals, although many national breeding objectives are probably contributing to an indirect positive response to selection in milk mineral concentration.     

Assessment of welfare indicators in dairy farms offering pasture at differing levels

In terms of animal welfare, farming systems of dairy cows are perceived positively by consumers when compared to pigs or poultry. A main reason is that the majority of consumers associate dairy farming with pasture, which in turn they relate with benefits for animal health and welfare. However, holistic scientific assessments of the effects of pasturing on animal welfare are rare. Hence, it was the aim to study the animal welfare level in 61 German loose housing dairy farms by using the measures of the Welfare Quality® protocol for dairy cattle (WQP). Data were collected twice per farm at the end of the pasture season (July to October) and approximately 6 months later at the end of the barn season (December to April). Farms were classified based on the duration cows had access to pasture per day during the pasture season: group 1 (G1)>10 h; group 2 (G2) 6 to 10 h; group 3 (G3)<6 h and group 4 (G4) without pasture access. The average herd size was 129 Holstein-Friesian or Red-Holstein cows (range 58 to 527). In addition to WQP data, performance data were gathered from routine herd data recordings. The indicators were aggregated to criteria applying the scoring system of the WQP. G4 received lower scores at the first than at the second visit for the criterion absence of hunger, while there were no differences between visits in the other groups (P=0.58 – group×farm visit effect). All pasturing groups were scored better at the end of the pasture season than G4 for the criterion comfort around resting (P<0.01). Compared with G1 for both farm visits and G2 for the end of the barn season, G4 reached inferior scores for the criterion absence of injuries, including indicators such as hairless patches, lesions, and swellings and lameness. At both assessments G2 was scored higher than the other groups for the criterion absence of diseases (P=0.04). In conclusion, pasture access had positive effects only on selected welfare indicators, however, these effects were not maintained throughout the barn season.     

Effect of pesticide exposure on the cholinesterase activity of the occupationally exposed tea garden workers of northern part of West Bengal,India

Context: Pesticide poisoning and related deaths are a global concern, but there is little information about its effect on the occupationally exposed tea garden workers of North Bengal.

Objective: This study investigates the level of acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE) in the blood of the tea garden workers at risk of exposure to a mixture of pesticides.

Materials and methods: The study sample consisted of pesticide exposed workers, non-exposed (control), smokers and alcoholics. AChE and BuChE activity was measured and tested for significance.

Results: Results showed that AChE activity was half in the pesticide exposed individuals than controls (p≤ 0.001). BuChE activity was also significantly decreased in the pesticide exposed individuals than controls (p≤ 0.001), while AChE and BuChE activity in smokers and alcoholics were not different from that of controls. However, significantly decreased AChE and BuChE activities were recorded in pesticide exposed workers compared to smokers and alcoholics.

Conclusions: The results indicated that the decrease in enzyme activities in tea garden workers was due to mixed pesticides (containing organophosphates) exposure. Age was not found to influence the enzyme activities. However, the gender had little effect on the enzyme activities but the effect was not so prominent.