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Articles 1 - 30 of 43
Full-Text Articles in Medicine and Health Sciences
Journal Cover And Front Matter
Create Workshop 2014: Leveraging Mobile Technology And Social Media In Behavioral Research, Andre M. Müller
Create Workshop 2014: Leveraging Mobile Technology And Social Media In Behavioral Research, Andre M. Müller
Andre M Müller
The 2014 CREATE workshop brought together some forty young health behavior researchers from thirteen different countries, all sharing an interest in mobile technology and social media research. The three- day workshop was held in Innsbruck, Austria,...
Developmental And Cultural Perspectives On Children’S Postoperative Pain Management At Home, Brooke N. Jenkins, Michelle A. Fortier
Developmental And Cultural Perspectives On Children’S Postoperative Pain Management At Home, Brooke N. Jenkins, Michelle A. Fortier
Psychology Faculty Articles and Research
Outpatient surgery is extremely common in children, and approximately 4 million children experience significant pain after surgery in the USA each year. Management of children's postoperative pain in the home setting is suboptimal and is impacted by characteristics of children and parents, as well as the larger family and cultural context. In particular, developmental status of the child, parental beliefs regarding pain expression and analgesic use in children, cultural values and language barriers can affect management of children's postoperative pain. Targeting the myriad barriers to children's pain management by capitalizing upon the use of tailored interventions may help bridge the …
An Examination Of Psychological Variables Influencing Perceptions Of The Self Among A Sample Of Female Exercise Initiates, Lisa Cooke
Electronic Thesis and Dissertation Repository
The general purpose of this dissertation was to explore the relationship among and within cognitive variables associated with exercise initiation and maintenance in a sample of female exercise initiates.
Manuscript 1 was structured to explore the changes to exercise identity among a population of female exercise initiates (N = 78) grouped into an imagery or control condition. Previous research has found that a strong exercise identity is associated with more frequent exercise (Strachan et al., 2009) and increases over time as a person continues to exercise (Cardinal & Cardinal, 1997). Participants were assessed multiple times (weeks 0, 5, 9, …
Los Efectos De La Violencia Familiar Y Las Percepciones De Las Mujeres Afectadas: Un Estudio De Las Mujeres Victimas De La Violencia Familiar A Ahmauta / The Effects Of Family Violence And Perceptions Of Women Affected :A Study Of Women Victims Of Domestic Violence To Ahmauta, Catherine Oidtman
Independent Study Project (ISP) Collection
Violence against women is a social problem that demands much attention from society because it is a human rights issue and is damaging to the mental health status of women. The purpose of this investigation is to use an ethnographic approach to analyze the perceptions of women who have suffered from domestic violence to determine how perceptions of domestic violence impact subsequent mental health outcomes. Women (n=6) were recruited from the NGO Amhauta, an educational program that advocates for the rights of women and children in San Jerónimo, a district of Cusco, Peru. This analysis uses an ethnographic approach to …
Dissociation And Sexual Trauma: The Moderating Role Of Somatization, Amineh Abbas
Dissociation And Sexual Trauma: The Moderating Role Of Somatization, Amineh Abbas
Doctoral Dissertations
This study examined various types of trauma, with an emphasis on sexual trauma across the lifespan, in a clinical sample of male and female adult outpatients assessed for trauma, somatization, and dissociation. Two hundred forty-five adult outpatients at the University of Tennessee Psychological Clinic were administered the Dissociative Experiences Scale (DES), the Traumatic Experiences Checklist (TEC), and Symptom Checklist-90-Revised (SCL-90-R), as part of the routine intake procedure. Of those individuals, 200 patients completed the questionnaires correctly and were included in the final study sample. The experience of sexual trauma indeed accounted for additional variance in somatization scores over and above …
Collaborative Models Of Care In The Appalachian Region Of Tennessee: Examining Relationships Between Level Of Collaboration, Clinic Characteristics, And Barriers To Collaboration, Jeffrey Ellison
Electronic Theses and Dissertations
Decades of research have shown that there are significant advantages to maintaining close communicative and collaborative relationships between primary care and behavioral health providers. Fiscal, structural, and systemic barriers, however, often restrict the degree to which such interprofessional collaboration can occur. In the present study the authors examined relationships between primary care clinics in the Appalachian region’s characteristics (i.e., clinic type, rurality, and clinic size), barriers (i.e., fiscal, structural, and systemic) reported to using increased collaboration, and the level of collaboration used at a particular clinic.
For the present study 136 surveys were completed by providers working in primary care …
In-Hospital Depression Predicts Early Hospital Readmission After An Acute Coronary Syndrome: Preliminary Data From Trace-Core, David Mcmanus, Jane Saczynski, Molly Waring, Milena Anatchkova, Richard Mcmanus, Robert Goldberg, Jeroan Allison, David Parish, Hamza Awad, Jerry Gurwitz, Arlene Ash, Catarina Kiefe
In-Hospital Depression Predicts Early Hospital Readmission After An Acute Coronary Syndrome: Preliminary Data From Trace-Core, David Mcmanus, Jane Saczynski, Molly Waring, Milena Anatchkova, Richard Mcmanus, Robert Goldberg, Jeroan Allison, David Parish, Hamza Awad, Jerry Gurwitz, Arlene Ash, Catarina Kiefe
Richard H. McManus
Background: Hospital systems, patients and providers seek to avert rehospitalizations within 30 days for patients admitted with an acute coronary syndrome (ACS). Rehospitalizations within 30 days of discharge are often considered preventable and to reflect poor in-hospital management or discharge practices. However, independent associations of psychosocial factors with early rehospitalization in patients admitted with an ACS have not been examined. Methods: A multi-racial cohort of 1,540 patients admitted with an ACS reported psychosocial factors via standardized questionnaires in an in-hospital interview. One month following discharge, patients were interviewed via phone and reported hospital readmissions. We used logistic regression models to …
“Putting The Occupation Back In Occupational Therapy:” A Survey Of Occupational Therapy Practitioners’ Use Of Gardening As An Intervention, Amy Wagenfeld, Ben Atchison
“Putting The Occupation Back In Occupational Therapy:” A Survey Of Occupational Therapy Practitioners’ Use Of Gardening As An Intervention, Amy Wagenfeld, Ben Atchison
The Open Journal of Occupational Therapy
Background. This study examines how and why occupational therapy practitioners across practice areas use gardening as an intervention. Respondents’ interpretation of the best and least desirable aspects of their facility’s garden and whether they contributed to its design was also examined.
Method. A description and link to a 15-question online survey about gardening as an occupational therapy intervention was emailed to Western Michigan University Occupational Therapy alumni and posted on four OT Connections groups and the AOTA LinkedIn site.
Results. Gardening as an occupational therapy intervention is meaningful and purposeful (93.66%, n = 56), motivating (80%, n = 48), fun …
Concussion Guidelines Step 1: Systematic Review Of Prevalent Indicators, Nancy Carney, Jamshid Ghajar, Andy Jagoda, Steven Bedrick, Cynthia Davis-O'Reilly, Hugo Du Coudray, Dallas Hack, Nora Helfand, Amy Huddleston, Tracie Nettleton, Riggio Silvana
Concussion Guidelines Step 1: Systematic Review Of Prevalent Indicators, Nancy Carney, Jamshid Ghajar, Andy Jagoda, Steven Bedrick, Cynthia Davis-O'Reilly, Hugo Du Coudray, Dallas Hack, Nora Helfand, Amy Huddleston, Tracie Nettleton, Riggio Silvana
Psychology Faculty Publications and Presentations
BACKGROUND: Currently, there is no evidence-based definition for concussion that is being uniformly applied in clinical and research settings.
OBJECTIVE: To conduct a systematic review of the highest-quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion. The goal was to establish an evidence-based foundation from which to derive, in future work, a definition, diagnostic criteria, and prognostic indicators for concussion.
METHODS: Key questions were developed, and an electronic literature search from 1980 to 2012 was conducted to acquire evidence about the prevalence of and associations among signs, symptoms, and neurologic and …
At Risk For Ptsd: The Public Health Implications Of Trauma, Madeline Peyton
At Risk For Ptsd: The Public Health Implications Of Trauma, Madeline Peyton
Master's Projects and Capstones
The fieldwork experience is the summation of six semesters of graduate level public health training. At commencement, students are to be proficient in basic data analysis and epidemiological principles, in how environmental risks impact health, and demonstrate strong program planning, evaluation and leadership skills. Throughout, students are encouraged to focus their academic work on an area of public health that interest them and on a problem that they hope to impact in their professional work. I continued in an area I began as an undergraduate student of medical anthropology and explored the systems that interact to influence mental health of …
Masculinity, Male Empowerment, And Hiv/Aids Risk In Caprivi, Namibia, Mark Perry
Masculinity, Male Empowerment, And Hiv/Aids Risk In Caprivi, Namibia, Mark Perry
Dissertations & Theses (Open Access)
Namibia has a generalized HIV epidemic, with 13% of adults being infected. Its East Caprivi Region has the highest prenatal HIV prevalence in the country, 21%, among girls and women aged 15-24 years. In recent years, researchers have pointed to men who express their masculinity through high-risk sex as driving the epidemic in East Caprivi. This exploratory study examined the role that men and their masculinity concepts played in transmission, how those concepts were evolving over time, what was influencing the change, and in which directions. Employing grounded theory methods and guided by Robert Connell's theoretical framework on masculinities, the …
Basic Psychological Needs, Suicidal Ideation, And Risk For Suicidal Behavior In Young Adults, Peter C. Britton, Kimberly A. Van Orden, Jameson K. Hirsch, Geoffrey C. Williams
Basic Psychological Needs, Suicidal Ideation, And Risk For Suicidal Behavior In Young Adults, Peter C. Britton, Kimberly A. Van Orden, Jameson K. Hirsch, Geoffrey C. Williams
ETSU Faculty Works
Associations between the satisfaction of basic psychological needs of autonomy, competence, and relatedness with current suicidal ideation and risk for suicidal behavior were examined. Two logistic regressions were conducted with a cross-sectional database of 440 university students to examine the association of need satisfaction with suicidal ideation and risk for suicidal behavior, while controlling for demographics and depressive symptoms. Suicidal ideation was reported by 15% of participants and 18% were found to be at risk for suicidal behavior. A one standard deviation increase in need satisfaction reduced the odds of suicidal ideation by 53%, OR (95% CI) = 0.47 (0.33–0.67), …
Development Of A Short Version Of The Modified Yale Preoperative Anxiety Scale, Brooke N. Jenkins, Michelle Fortier, Sherrie H. Kaplan, Linda C. Mayes, Zeev N. Kain
Development Of A Short Version Of The Modified Yale Preoperative Anxiety Scale, Brooke N. Jenkins, Michelle Fortier, Sherrie H. Kaplan, Linda C. Mayes, Zeev N. Kain
Psychology Faculty Articles and Research
BACKGROUND: The modified Yale Preoperative Anxiety Scale (mYPAS) is the current “criterion standard” for assessing child anxiety during induction of anesthesia and has been used in >100 studies. This observational instrument covers 5 items and is typically administered at 4 perioperative time points. Application of this complex instrument in busy operating room (OR) settings, however, presents a challenge. In this investigation, we examined whether the instrument could be modified and made easier to use in OR settings.
METHODS: This study used qualitative methods, principal component analyses, Cronbach αs, and effect sizes to create the mYPAS-Short Form (mYPAS-SF) and reduce time …
Practicing Patienthood Online: Social Media, Chronic Illness, And Lay Expertise, Collette Sosnowy
Practicing Patienthood Online: Social Media, Chronic Illness, And Lay Expertise, Collette Sosnowy
Publications and Research
The use of digital technologies and social media by people with serious illness to find, share, and create health information is much celebrated but rarely critiqued. Proponents laud “Health 2.0” as transforming health care practice and empowering patients. Critics, however, argue that a discourse of developing lay expertise online masks the disciplinary practices of the neoliberal state’s emphasis on individual responsibility. Notably, the perspectives of people who are engaging with social media related to their health and illness are under-represented in this debate. This research examines the experiences and perspectives of women who blog about their lives with Multiple Sclerosis …
Child Life Specialists’ Facilitation Of Family-Centered Care: The Importance Of Sibling Support, Carissa L. Lane
Child Life Specialists’ Facilitation Of Family-Centered Care: The Importance Of Sibling Support, Carissa L. Lane
Psychology and Child Development
Certified Child Life Specialists’ understanding of family-centered care, and their beliefs and practices involving siblings of chronically/critically ill children were examined using an online survey. Participants were Certified Child Life Specialists recruited form the Child Life Council Forum. Relationships between utilization of certain words and support programs offered to siblings, were examined. Findings revealed a relationship in one area of coded language and support program for siblings, but not the other. Findings also revealed that all CCLS believe in the inclusion of siblings during the treatment process, however they are offered less support services than parents. Diverse results regarding multiple …
Family Criticism And Depressive Symptoms In Older Adult Primary Care Patients: Optimism And Pessimism As Moderators, Jameson K. Hirsch, Kristin L. Walker, Ross B. Wilkinson, Jeffrey M. Lyness
Family Criticism And Depressive Symptoms In Older Adult Primary Care Patients: Optimism And Pessimism As Moderators, Jameson K. Hirsch, Kristin L. Walker, Ross B. Wilkinson, Jeffrey M. Lyness
ETSU Faculty Works
Objective: Depression is a significant global public health burden, and older adults may be particularly vulnerable to its effects. Among other risk factors, interpersonal conflicts, such as perceived criticism from family members, can increase risk for depressive symptoms in this population. We examined family criticism as a predictor of depressive symptoms and the potential moderating effect of optimism and pessimism.
Methods: One hundred five older adult, primary care patients completed self-report measures of family criticism, optimism and pessimism, and symptoms of depression. We hypothesized that optimism and pessimism would moderate the relationship between family criticism and depressive symptoms.
Results: In …
To Test Or Not To Test: Barriers And Solutions To Testing African American College Students For Hiv At A Historically Black College/University, Naomi M. Hall-Byers, Jennifer Peterson, Malynnda Johnson
To Test Or Not To Test: Barriers And Solutions To Testing African American College Students For Hiv At A Historically Black College/University, Naomi M. Hall-Byers, Jennifer Peterson, Malynnda Johnson
Journal of Health Disparities Research and Practice
Young African Americans are disproportionately affected by sexually transmitted infections, including HIV. The purpose was to identify reasons that African American college students at a historically Black college/university (HBCU) identified as barriers to HIV testing, and how these barriers can be removed. Fifty-seven heterosexual-identified undergraduate students (ages 18-25) attending an HBCU in the southeastern US participated in the study. Latent content analytic techniques were used to code the transcripts for themes and categories, and representative quotations were used in the findings. Qualitative data indicates three main themes used to avoid testing and three themes to encourage testing. Students were forthcoming …
Pregnant Teens In Foster Care: Concepts, Issues, And Challenges In Conducting Research On Vulnerable Populations, Lisa D. Lieberman, Linda L. Bryant, Kenece Boyce, Patricia Beresford
Pregnant Teens In Foster Care: Concepts, Issues, And Challenges In Conducting Research On Vulnerable Populations, Lisa D. Lieberman, Linda L. Bryant, Kenece Boyce, Patricia Beresford
Department of Public Health Scholarship and Creative Works
Teens in foster care give birth at over twice the rate of other teens. Unique challenges exist for these vulnerable teens and babies, yet research on such populations, particularly within the systems that serve them, is limited. A demonstration project at Inwood House, a residential foster care agency in New York City, from 2000 to 2005, at the same time that the Administration for Children's Services was exploring policy and practice changes for this population, is described. Research design and implementation issues, descriptive data, and experiences provide lessons for improving the evidence base to meet the needs of pregnant teens …
Mixed Methods Pilot Study Of Peri-Diagnostic Exercise Behaviour Change Among Women With Suspected Breast Cancer, Amy L. Deckert
Mixed Methods Pilot Study Of Peri-Diagnostic Exercise Behaviour Change Among Women With Suspected Breast Cancer, Amy L. Deckert
Electronic Thesis and Dissertation Repository
Approximately 1 in 9 Canadian women will develop breast cancer in their lifetime (CCS, 2013). Over the past 30 years, population-based screening programs have contributed to decreased mortality rates (CCS, 2013), however the psychosocial sequelae associated with screening for breast cancer cannot be ignored (Holland et al., 2010). Although the majority of women screened will receive a benign diagnosis, the threat of malignancy can induce elevated levels of distress (Andrykowski et al., 2002).
We conducted a mixed methods pilot study to assess the feasibility and acceptability of a 6-week self-managed exercise behaviour change intervention to attenuate distress in women with …
Improv To Improve Interprofessional Communication, Team Building, Patient Safety, And Patient Satisfaction, Candace A. Campbell
Improv To Improve Interprofessional Communication, Team Building, Patient Safety, And Patient Satisfaction, Candace A. Campbell
Doctor of Nursing Practice (DNP) Projects
The purpose of this process improvement project was to implement a test of change within a healthcare team utilizing applied improvisational exercises (AIEs), and to lay the groundwork for more effective inter- and intra-professional communication.
Literature review: AIEs have been shown to facilitate individual participant communication strengths through a process of un-learning certain common behavioral habits, and learning new habits that assist in creating and expanding closed-loop communication. Such un-learning and learning enriches the participant’s awareness of the environment and encourages participant adaptability through positive group interactions.
Method: An all-day AIE seminar/workshop was conducted with members of two healthcare teams …
Rural Pediatric Primary Care Practice Patterns As A Result Of An On-Site Behavioral Health Consultant: A Retrospective Analysis, Kayla D. Mccarter
Rural Pediatric Primary Care Practice Patterns As A Result Of An On-Site Behavioral Health Consultant: A Retrospective Analysis, Kayla D. Mccarter
Undergraduate Honors Theses
Nationally, it has been estimated that 10 to 21% of children with psychosocial concerns are seen in primary care settings (Jellinek et al., 1999; McInerny, Szilagyi, Childs, Wasserman & Kelleher, 2000; Palermo et al., 2002). Often, however, children go undiagnosed with/treated for psychosocial concerns in pediatric primary care due to lack of physician time and poor referral rates to mental health providers. Evaluations of integrated care models, in which a behavioral health consultant is present in primary care practices, has shown to increase the availability of mental health services (Stancin, Perrin, & Ramirez, 2009). Using extant data from patient records …
Physical Activity And Nutritional Behavior Of Overweight College Students Trying To Lose Weight 2014, Santino Vallejos M.S.
Physical Activity And Nutritional Behavior Of Overweight College Students Trying To Lose Weight 2014, Santino Vallejos M.S.
Master's Theses
Although there are numerous benefits to increased physical activity and proper dietary behaviors, the decreased participation in physical activity and poor dietary behaviors has emerged as a significant problem within the college student population. The focus of this research study was to identify the relationship between physical activity and dietary behavior to weight loss behaviors within an undergraduate student sample of a small, comprehensive northeastern university. College-aged students (age range: 17 to 27 years old) completed the American College Health Association’s (ACHA) National College Health Assessment II (NCHA) during the years 2009 and 2012. According to the results, there were …
Asthma And Adaptive Functioning Among Homeless Kindergarten-Aged Children In Emergency Housing, J. J. Cutuli, Janette E. Herbers, Theresa L. Lafavor, Sandra M. Ahumada, Ann S. Masten, Charles N. Oberg
Asthma And Adaptive Functioning Among Homeless Kindergarten-Aged Children In Emergency Housing, J. J. Cutuli, Janette E. Herbers, Theresa L. Lafavor, Sandra M. Ahumada, Ann S. Masten, Charles N. Oberg
J. J. Cutuli
Background. Children who experience homelessness have elevated rates of asthma, a risk factor for other problems. Purpose. Examine rates of asthma and its relation to health care use and adaptive functioning among young children staying in family emergency shelters. Methods. Children and caregivers (N = 138) completed assessments in shelters, including measurement of child cognitive functioning, parent report of child health care service utilization and asthma diagnosis, and teacher report of child school functioning. Results. Asthma diagnosis was reported for 21% of 4‑to‑6‑year‑ old children, about twice the national and state prevalences. Children with asthma used more health care services …
Openness, Neuroticism, Conscientiousness, And Family Health And Aging Concerns Interact In The Prediction Of Health-Related Internet Searches In A Representative U.S. Sample, Tim Bogg, Phuong T. Vo
Openness, Neuroticism, Conscientiousness, And Family Health And Aging Concerns Interact In The Prediction Of Health-Related Internet Searches In A Representative U.S. Sample, Tim Bogg, Phuong T. Vo
Psychology Faculty Research Publications
Recent estimates suggest 60 % of the U.S. adult population uses the Internet to find health-related information. The goal of the present study was to model health-related Internet searches as a function of an interdependent system of personality adaptation in the context of recent health and aging-related concerns. Assessments of background factors, Big Five personality traits, past-month health and aging-related concerns, and the frequency of past-month health-related Internet searches (via Google, Yahoo, AOL, Bing, or some other search engine) were obtained from a representative U.S. sample (N = 1,015). Controlling for background factors, regression analyses showed more frequent health-related …
Possible Psychosocial Benefits Of Having A Sibling With A Disability, Jenna M. Talbott
Possible Psychosocial Benefits Of Having A Sibling With A Disability, Jenna M. Talbott
Senior Honors Theses
Possible psychosocial benefits resulting from exposure to siblings with disabilities are investigated in the current study. Previous literature has generally overlooked the possibility of psychosocial benefits by exclusively focusing on the negative effects of having a sibling with disabilities. Contact theory suggests that the increased exposure to individuals with disabilities should increase positive attitude toward those who are struggling with disadvantages. This investigation hypothesized that this tendency would be manifested as elevated empathy and compassion in individuals who have siblings with disabilities, and that these traits would be influenced by certain demographic variables. A survey was distributed, and the responses …
Depression Is More Prevalent Throughout Pregnancy And The First Six Months Postpartum In Women Low In Religious Commitment And Social Support, Andrea D. Clements, Tifani A. Fletcher, Beth A. Bailey
Depression Is More Prevalent Throughout Pregnancy And The First Six Months Postpartum In Women Low In Religious Commitment And Social Support, Andrea D. Clements, Tifani A. Fletcher, Beth A. Bailey
ETSU Faculty Works
Abstract available through the Annals of Behavioral Medicine.
Latinos' Health Perceptions: A Cross-Cultural Analyisis, Elizabeth Pappenfus
Latinos' Health Perceptions: A Cross-Cultural Analyisis, Elizabeth Pappenfus
Undergraduate Research Symposium 2014
The purpose of my study is to examine how Latinos’ cultural health beliefs impact their illness behaviors in a rural setting in comparison to White individuals. Illness behavior is defined as the manner in which a person monitors their body, interprets their symptoms, and their reactions to those symptoms. Although Latino immigrants suffer from higher rates of treatable diseases, they are largely underutilizing the healthcare system in the U.S. The Andersen model of healthcare utilization is the most commonly used model for predicting utilization based on the person's environment (i.e. healthcare system) and personal characteristics (i.e. personal need, available resources, …
A Pilot Study On The Effects Of Exercise On Depression Symptoms Using Levels Of Neurotransmitters And Eeg As Markers, Timothy H. Barclay, Scott Richards, James Schoffstall, Chad Magnuson, Christine Mcphee, Josh Price, Stephen Aita, Audrey Anderson, Dan Johnson, Jerry Price
A Pilot Study On The Effects Of Exercise On Depression Symptoms Using Levels Of Neurotransmitters And Eeg As Markers, Timothy H. Barclay, Scott Richards, James Schoffstall, Chad Magnuson, Christine Mcphee, Josh Price, Stephen Aita, Audrey Anderson, Dan Johnson, Jerry Price
Faculty Publications and Presentations
Context: The prescribing of exercise by physicians has become a popular practice, yet the effectiveness of exercise on symptoms of depression is difficult to determine due to a lack of randomized controlled trials with clinical populations. Reports also indicate that only a small percentage of physicians advise their patients regarding exercise and confusion still exists as to how much and what types are best. Aims: To understand the mechanisms that make exercise a viable treatment in depression. Settings and Design: This study employed a six‑week, two group, single‑level trial, pre‑ and posttest design using self‑report of symptoms, blood …
Is Burnout A Depressive Disorder? A Reexamination With Special Focus On Atypical Depression, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent
Is Burnout A Depressive Disorder? A Reexamination With Special Focus On Atypical Depression, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent
Publications and Research
Whether burnout and depression cover the same psychopathology remains to be elucidated. To date, subtypes of depression have been overlooked in research on the burnout–depression overlap. Our aim was to estimate the prevalence of depressive disorders in workers with burnout while examining the overlap of burnout with the atypical subtype of depression. The present study included 5,575 schoolteachers (mean age = 41 years; 78% female). Burnout was assessed with the Maslach Burnout Inventory. Depression was measured with the 9-item depression scale of the Patient Health Questionnaire (PHQ-9). Atypical features of depression were examined using a dedicated module, referenced to …