Medicine and Health Sciences Commons^™

On The Depressive Nature Of The “Burnout Syndrome”: A Clarification, Renzo Bianchi, Irvin Sam Schonfeld, Pierre Vandel, Eric Laurent

Publications and Research

Key theoretical arguments and empirical findings converge to suggest that the burnout construct captures a depressive phenomenon. The reluctance to consider burnout a depressive condition may be due to (a) a neglect of the stress–depression relationship and (b) a difficulty coordinating dimensional and categorical approaches to psychopathology in burnout research. The dimensions and categories constitute two ways of describing (psychopathological) phenomena. Thus, dimensions and categories should be heuristically combined rather than opposed: burnout and depression can be studied both as ‘‘processes’’ or ‘‘end-states’’. Clarifying what burnout actually is matters in terms of conceptual parsimony, theoretical integration, nosological consistency, interventional effectiveness, …

Physician Burnout Is Better Conceptualised As Depression, Bianchi Renzo, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Ronald Epstein and Michael Privitera reported that burnout affects more than half of practising physicians. The authors additionally warned against confusing burnout with depression. For two reasons we are concerned with the validity of these conclusions. First, there is now robust evidence that burnout is a depressive condition. Second, the published estimates of burnout’s prevalence rely on clinically groundless criteria, cobbled together without any rationale.

On The Overlap Of Vital Exhaustion And Depression, Bianchi Renzo, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Our reexamination of the symptoms and main measure of vital exhasution (VE) suggests that the overlap of VE with depression has been problematically underestimated due to inconsistent comparisons and blindness to definitional similarities. In our view, the case of VE is emblematic of a trend toward construct proliferation. Many ‘‘new’’ constructs are introduced in the literature precipitously, with insufficient examination of their added value, and based on ‘‘linguistic contortions’’ and anecdotal evidence rather than robust empirical findings and sound theorizing. Such constructs are often ‘‘distinguished’’ from existing ones on the basis of specious arguments and missing-the-point conclusions. This is for …

Can We Trust Burnout Research?, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Banerjee et al. recently attempted to estimate the ‘prevalence’ of burnout among European oncologists.Studies of burnout’s ‘prevalence’ are flourishing in the medical literature, with their cortege of arbitrary estimates. We think that it is high time to reconsider the way burnout is conceived and assessed, in order to avoid a trivialization of the job stress phenomenon and allow for a more rational allocation of our (limited) interventional resources. Recasting burnout as a work-related depressive condition may be a critical step in this process.

Do Burnout Researchers Go Around In Circles?, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

The incessant reports on the burnout syndrome contrasts sharply with the validity of burnout research. Major problems in the definition and discriminant validity of burnout prevent investigators from getting a clear view of how job stress affects physicians’ health. The inability to distinguish a case of burnout from a non-case is only one of many signs that burnout research is problematic. Burnout researchers should face this reality rather than ignore it.

Defining Physician Burnout, And Differentiating Between Burnout And Depression—I, Bianchi Renzo, Irvin Sam Schonfeld

Publications and Research

A redefinition of burnout as a depressive condition is called for so that the harmful effects of unresolvable job stress can be more accurately and comprehensively assessed. As research compellingly suggests, reducing the harmful effects of unresolvable job stress to the experience of burnout's dimensions of emotional exhaustion, depersonalization, and reduced personal accomplishment is mistaken in that it denies the depressive core of the syndrome referred to as “burnout.” Replacing the notion of burnout by the concept of job-induced depression would help us be more effective in the management of occupational adversity.

Burnout Symptoms: Depressive Manifestations Under Psychosocial Labels?, Bianchi Renzo, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

It can be concluded that burnout symptoms represent depressive symptoms under nonmedical labels. Our analysis supports the view that burnout is synonymous with depression and constitutes a roadblock to transdisciplinary communication.

Burnout And The Hypothalamic-Pituitary-Thyroid Axis: A Methodological Comment, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Because (a) burnout overlaps with depression and (b) depression has been associated with altered functioning of the hypothalamic-pituitary-thyroid axis changes in the activity of the HPT axis can be expected in burnout. Most probably, Guo et al.’s (2017) results are flawed by a severe form of the “healthy worker effect.”

Consequences Of Job Stress For The Psychological Well-Being Of Teachers, Irvin Sam Schonfeld, Renzo Bianchi, Peter Luehring-Jones

Publications and Research

This chapter examines research on the relationship between job stressors and mental health (depressive symptoms, burnout, and mental disorders such as depression) in teachers. Teachers are exposed daily to job stressors (e.g., student disruptiveness) that have been linked to adverse mental health effects. Epidemiologic research indicates that when compared to members of other groups, teachers experience higher rates of mental disorder, although some studies question that conclusion. Large-scale studies indicate when compared to members of other occupational groups, teachers are at higher risk for exposure to workplace violence, with its adverse mental health consequences. Longitudinal research has linked teaching-related stressors …

Training Pharmacists In The Stage-Of-Change Model Of Smoking Cessation And Motivational Interviewing: A Randomized Controlled Trial, Pasquale Caponnetto, Jennifer Dipiazza, Maria Rosaria Aiello, Riccardo Polosa

Publications and Research

This study evaluated the effect of training pharmacists in the stage-of-change model for smoking cessation and motivational interviewing on smoking cessation outcomes. A training based on the stage-of-change model for smoking cessation and motivational interviewing was introduced to pharmacists. Pharmacists were randomly assigned to the intervention or control group. The control group attended a 3-hour training session, whereas the intervention group also attended a further 6-hour training session. At week 24, 12.2 percent of the smokers quit smoking in the intervention group, whereas 1.6 percent of the smokers quit smoking in the control group. The findings of this study showed …

Borneol, A Novel Agent That Improves Central Nervous System Drug Delivery By Enhancing Blood–Brain Barrier Permeability, Qun-Lin Zhang, Bingmei M. Fu, Zhang-Jin Zhang

Publications and Research

The clinical application of central nervous system (CNS) drugs is limited by their poor bioavailability due to the blood–brain barrier (BBB). Borneol is a naturally occurring compound in a class of ‘orificeopening’ agents often used for resuscitative purposes in traditional Chinese medicine. A growing body of evidence confirms that the ‘orifice-opening’ effect of borneol is principally derived from opening the BBB. Borneol is therefore believed to be an effective adjuvant that can improve drug delivery to the brain. The purpose of this paper is to provide a comprehensive review of information accumulated over the past two decades on borneol’s chemical …

Dynamical Systems Modeling To Identify A Cohort Of Problem Drinkers With Similar Mechanisms Of Behavior Change, Kidist Maxwell, Rebecca Everett, Sijing Shao, Alexis Kuerbis, Lyric Stephenson, H. T. Banks, Jon Morgenstern

Publications and Research

One challenge to understanding mechanisms of behavior change (MOBC) completely among individuals with alcohol use disorder is that processes of change are theorized to be complex, dynamic (time varying), and at times non-linear, and they interact with each other to influence alcohol consumption. We used dynamical systems modeling to better understand MOBC within a cohort of problem drinkers undergoing treatment. We fit a mathematical model to ecological momentary assessment data from individual patients who successfully reduced their drinking by the end of the treatment. The model solutions agreed with the trend of the data reasonably well, suggesting the cohort patients …

The Determinants Of Health: Neighborhood Characteristics, Obesity And The Mental Health Of African-American Adolescent Girls, Roseanne L. Flores

Publications and Research

The present study examined the relationship among neighborhood characteristics, obesity, and the mental health outcomes of a nationally representative sample of African-American adolescent girls between the ages of 12 - 17. Using data from the 2011/2012 National Survey of Children’s Health, four questions were extracted to measure neighborhood amenities, neighborhood detractors, body mass index, and experience of depression. Ordinal regressions were calculated to estimate the relationships between all variables. The results indicated that over 25% of African- American girls, ages 12 - 14 were overweight and obese with fewer 15 - 17-year-old girls falling within these categories. African-American girls had …

Minority College Women’S Views On Condom Negotiation, Tywanda Mclaurin-Jones, Maudry-Beverly Lashley, Vanessa Marshall

Publications and Research

This study utilized quantitative and qualitative methods to (1) investigate the relationship between frequency of condom use and negotiation strategies and (2) evaluate experiences with condom negotiations among sexually active, heterosexual, African American college women. One hundred female students from a Historically Black Colleges and Universities (HBCU) completed a questionnaire that included the Condom Influence Strategies Scale (CIS) and participated in a focus group. An ANOVA was conducted to compare differences between never, inconsistent, and consistent condom users. Consistent condom users scored higher than never users on the “withholding sex” subscale of the CIS (4.88 vs. 3.55; p < 0.001) as well as endorsed items more strongly on the “direct request” subscale of the CIS (4.63 vs. 3.82, p < 0.05) than never users. A thematic analysis of open discussions identified overarching themes. Similarly, refusing sex and/or having direct communications with partner emerged as primary strategies. Threats to negotiation included deciding the “right timing” of discussion and having a previous history of sexual intercourse without a condom with their partner. Other key concepts that contribute to condom negotiation are the views that condoms are a male’s responsibility and stigma of women who carry condoms.

Liver Enzymes And Risk Of Ischemic Heart Disease And Type 2 Diabetes Mellitus: A Mendelian Randomization Study, Junxi Liu, Shiu Lun Au Yeung, Gabriel M. Leung, C. Mary Schooling

Publications and Research

We used Mendelian randomization to estimate the causal effects of the liver enzymes, alanine aminotransferase (ALT), alkaline phosphatase (ALP) and gamma glutamyltransferase (GGT), on diabetes and cardiovascular disease, using genetic variants predicting these liver enzymes at genome wide significance applied to extensively genotyped case-control studies of diabetes (DIAGRAM) and coronary artery disease (CAD)/myocardial infarction (MI) (CARDIoGRAMplusC4D 1000 Genomes). Genetically higher ALT was associated with higher risk of diabetes, odds ratio (OR) 2.99 per 100% change in concentration (95% confidence interval (CI) 1.62 to 5.52) but ALP OR 0.92 (95% CI 0.71 to 1.19) and GGT OR 0.88 (95% CI 0.75 …

Characteristics Of Medication Advertisements Found In Us Women’S Fashion Magazines, Jennifer Mongiovi, Grace Clarke Hillyer, Corey H. Basch, Danna Ethan, Rodney Hammond

Publications and Research

Background: Although prescriptions are dispensed at discretion of medical professionals, many pharmaceutical companies use direct-to-consumer (DTC) advertising to increase sales. Over-the- counter (OTC) medications are similarly marketed.

Methods: We examined the content of advertisements in 38 issues of 9 popular US women’s fashion magazines. We evaluated target audience, health condition, product availability, message appeal, target to females, and mention of potential side effects and benefits.

Results: Sixty total medication advertisements were identified, 58.3% (95% CI: 45.8, 70.8) for prescription products. In magazines targeted to non-Hispanic Whites, >65% of advertisements were for OTC medications whereas 80% (95% CI: 66.7, 94.5) of …

Burden Of Disease Associated With Lower Levels Of Income Among Us Adults Aged 65 And Older, Erica I. Lubetkin, Haomia Jia

Publications and Research

Background: Persons aged 65 years and older represent a heterogeneous group whose prevalence in the USA is expected to markedly increase. Few investigations have examined the total burden of disease attributable to lower levels of income in a single number that accounts for morbidity and mortality.

Methods: We ascertained respondents’ health-related quality of life (HRQOL) scores and mortality status from the 2003 to 2004, 2005 to 2006, 2007 to 2008 and 2009 to 2010 cohorts of the National Health and Nutrition Examination Survey (NHANES) with mortality follow-up through 31 December 2011. A mapping algorithm based on respondents’ age and answers …

Improved Genome-Scale Multitarget Virtual Screening Via A Novel Collaborative Filtering Approach To Cold-Start Problem, Hansaim Lim, Paul Gray, Lei Xie, Aleksandar Poleksic

Publications and Research

Conventional one-drug-one-gene approach has been of limited success in modern drug discovery. Polypharmacology, which focuses on searching for multi-targeted drugs to perturb disease-causing networks instead of designing selective ligands to target individual proteins, has emerged as a new drug discovery paradigm. Although many methods for single-target virtual screening have been developed to improve the efficiency of drug discovery, few of these algorithms are designed for polypharmacology. Here, we present a novel theoretical framework and a corresponding algorithm for genome-scale multitarget virtual screening based on the one-class collaborative filtering technique. Our method overcomes the sparseness of the protein-chemical interaction data by …

Birth Weight And Risk Of Ischemic Heart Disease: A Mendelian Randomization Study, Shiu Lun Au Yeung, Shi Lin Lin, Albert Martin Li, C. Mary Schooling

Publications and Research

Low birth weight is a risk factor for cardiovascular disease. However, the association could be confounded by many factors. We used Mendelian randomization to clarify the role of birth weight in ischemic heart disease (IHD) and lipids. We used all 7 single nucleotide polymorphisms (SNPs) independently contributing to birth weight at genome wide significance (p < 5 × 10−8) in separate sample instrumental variable analysis to estimate the effect of birth weight on IHD using the CARDIoGRAMplusC4D 1000 Genomes based GWAS case (n = 60,801)-control (n = 123,504) study and on lipids using GLGC (n = 188,577). Higher genetically predicted birth weight was associated with lower risk of IHD (odds ratio (OR) 0.96 per 100 grams, 95% confidence interval (CI) 0.93 to 0.99), but the association was not robust to sensitivity analyses excluding SNPs related to height or use of weighted median methods. Genetically predicted birth weight was not associated with low density lipoprotein cholesterol or triglycerides, but was associated with lower high density lipoprotein cholesterol (−0.014 standard deviation, 95% CI −0.027 to −0.0005) and the association was more robust to the sensitivity analyses. Our study does not show strong evidence for an effect of birth weight on IHD and lipids.

Striatal Dopaminergic Innervation Regulates Subthalamic Beta-Oscillations And Cortical-Subcortical Coupling During Movements: Preliminary Evidence In Subjects With Parkinson’S Disease, Andrea Canessa, Nicolo G. Pozzi, Gabriele Arnulfo, Joachim Brumberg, Martin M. Reich, Gianni Pezzoli, Maria F. Ghilardi, Cordula Matthies, Frank Steigerwald, Jens Volkman, Ioannis U. Isais

Publications and Research

Activation of the basal ganglia has been shown during the preparation and execution of movement. However, the functional interaction of cortical and subcortical brain areas during movement and the relative contribution of dopaminergic striatal innervation remains unclear. We recorded local field potential (LFP) activity from the subthalamic nucleus (STN) and high-density electroencephalography (EEG) signals in four patients with Parkinson’s disease (PD) off dopaminergic medication during a multi-joint motor task performed with their dominant and non-dominant hand. Recordings were performed by means of a fully-implantable deep brain stimulation (DBS) device at 4 months after surgery. Three patients also performed a single-photon …

Efficient Method For Transfer Of Microinjected Eggs To Mouse Ampulla For Generating Transgenic Mice, Guang Wen, Jin Di, Qian Li, Jianling Chen, Ling Jin, Cheng Wang, Sanqing Xu

Publications and Research

Background: The new method described here is highly efficient in transferring microinjected mouse eggs (MEs) through the bursa membrane of a surrogate mother mouse to the ampulla of the oviduct without damaging the blood vessels on the bursa membrane.

Results: This method causes no loss of blood, and it produces newborn pups/founders from approximately 70% of the transferred MEs, because only a small hole is made on the blood vessel–free area of the bursa membrane and ampulla of the surrogate mother mouse. The infundibulum remains intact. The small hole on the bursa membrane/ ampulla may already heal up before the …

Narrative Review Of Vitamin D And Its Specific Impact On Balance Capacity In Older Adults, Ray Marks

Publications and Research

Introduction and Aims: Falls injuries among older adults, a widespread well-established contributor to high disability levels, excess morbidity and mortality rates, have many causes. This review examines the association between vitamin D levels and postural stability or balance control—a fairly consistent predictor of falls among older adults.

Materials and Method: All relevant English language peer reviewed research publications detailing the relationship between vitamin D levels and balance control among the elderly were sought. Key words included “Vitamin D and Balance or Postural Control.” Databases used were Academic Search Complete, PubMed, Scopus, and Web of Science.

Results: Analysis showed no consistent …

Stimulus Threat And Exposure Context Modulate The Effect Of Mere Exposure On Approach Behaviors, Steven G. Young, Isaiah F. Jones, Heather M. Claypool

Publications and Research

Mere-exposure (ME) research has found that initially neutral objects made familiar are preferred relative to novel objects. Recent work extends these preference judgments into the behavioral domain by illustrating that mere exposure prompts approachoriented behavior toward familiar stimuli. However, no investigations have examined the effect of mere exposure on approach-oriented behavior toward threatening stimuli. The current work examines this issue and also explores how exposure context interacts with stimulus threat to influence behavioral tendencies. In two experiments participants were presented with both mere-exposed and novel stimuli and approach speed was assessed. In the first experiment, when stimulus threat was presented …

Temporary Nerve Block At Selected Digits Revealed Hand Motor Deficits In Grasping Tasks, Aude Cateron, Kerry Mcpartlan, Christina Gioeli, Emily Reid, Matt Turturro, Barry Hahn, Cynthia Benson, Wei Zhang

Publications and Research

Peripheral sensory feedback plays a crucial role in ensuring correct motor execution throughout hand grasp control. Previous studies utilized local anesthesia to deprive somatosensory feedback in the digits or hand, observations included sensorimotor deficits at both corticospinal and peripheral levels. However, the questions of how the disturbed and intact sensory input integrate and interact with each other to assist the motor program execution, and whether the motor coordination based on motor output variability between affected and non-affected elements (e.g., digits) becomes interfered by the local sensory deficiency, have not been answered. The current study aims to investigate the effect of …

Regional Variation In Ascaris Lumbricoides And Trichuris Trichiura Infections By Age Cohort And Sex: Effects Of Market Integration Among The Indigenous Shuar Of Amazonian Ecuador, Theresa E. Gildner, Tara J. Cepon-Robins, Melissa A. Liebert, Samuel S. Urlacher, Felicia C. Madimenos, J. Josh Snodgross, Lawrence S. Sugiyama

Publications and Research

Background: Soil-transmitted helminth (STH) infection peaks during childhood and varies by sex. The impact of market integration (MI) (increasing production for and consumption from a market-based economy) on these infection patterns, however, is unclear. In this study, STH infection is examined by sex and age among indigenous Shuar inhabiting two regions of Amazonian Ecuador: (1) the modestly market-integrated Upano Valley (UV) and (2) the more traditional Cross-Cutucú (CC) region.

Methods: Kato-Katz fecal smears were examined for parasite presence and infection intensity. Factorial ANOVAs and post hoc simple effects analyses were performed by sex to compare infection intensity between regions and …

Illegitimate Tasks As An Impediment To Job Satisfaction And Intrinsic Motivation: Moderated Mediation Effects Of Gender And Effort-Reward Imbalance, Rachel Omansky, Erin M. Eatough, Marcus J. Fila

Publications and Research

The current work examines a contemporary workplace stressor that has only recently been introduced into the literature: illegitimate tasks. Illegitimate tasks are work tasks that violate identity role norms about what can reasonably be expected from an employee in a given position. Although illegitimate tasks have been linked to employee well-being in past work, we know little about the potential explanatory mechanisms linking illegitimate tasks to work-relevant negative psychological states. Using a sample of 213 US-based employees of mixed occupations and a cross-sectional design, the present study examines job satisfaction and intrinsic motivation as outcomes of illegitimate tasks. Additionally, we …

Hiv Glycoprotein Gp120 Impairs Fast Axonal Transport By Activating Tak1 Signaling Pathways, Sarah H. Berth, Nichole Mesnard-Hoaglin, Bin Wang, Hajwa Kim, Yuyu Song, Maria Sapar, Gerardo Morfini, Scott T. Brady

Publications and Research

Sensory neuropathies are the most common neurological complication of HIV. Of these, distal sensory polyneuropathy (DSP) is directly caused by HIV infection and characterized by length-dependent axonal degeneration of dorsal root ganglion (DRG) neurons. Mechanisms for axonal degeneration in DSP remain unclear, but recent experiments revealed that the HIV glycoprotein gp120 is internalized and localized within axons of DRG neurons. Based on these findings, we investigated whether intra-axonal gp120 might impair fast axonal transport (FAT), a cellular process critical for appropriate maintenance of the axonal compartment. Significantly, we found that gp120 severely impaired both anterograde and retrograde FAT. Providing a …

Towards An Integrated Primary And Secondary Hiv Prevention Continuum For The United States: A Cyclical Process Model, Tim Horn, Jennifer Sherwood, Robert H. Remien, Denis Nash, Judith D. Auerbach

Publications and Research

Introduction: Every new HIV infection is preventable and every HIV-related death is avoidable. As many jurisdictions around the world endeavour to end HIV as an epidemic, missed HIV prevention and treatment opportunities must be regarded as public health emergencies, and efforts to quickly fill gaps in service provision for all people living with and vulnerable to HIV infection must be prioritized.

Discussion: We present a novel, comprehensive, primary and secondary HIV prevention continuum model for the United States as a conceptual framework to identify key steps in reducing HIV incidence and improving health outcomes among those vulnerable to, as well …

Habitual Coffee Consumption And Risk Of Type 2 Diabetes, Ischemic Heart Disease, Depression And Alzheimer’S Disease: A Mendelian Randomization Study, Man Ki Kwok, Gabriel M. Leung, C. Mary Schooling

Publications and Research

Observationally, coffee is inversely associated with type 2 diabetes mellitus (T2DM), depression and Alzheimer’s disease, but not ischemic heart disease (IHD). Coffee features as possibly protective in the 2015 Dietary Guidelines for Americans. Short-term trials suggest coffee has neutral effect on most glycemic traits, but raises lipids and adiponectin. To clarify we compared T2DM, depression, Alzheimer’s disease, and IHD and its risk factors by genetically predicted coffee consumption using two-sample Mendelian randomization applied to large extensively genotyped case-control and cross-sectional studies. Childhood cognition was used as a negative control outcome. Genetically predicted coffee consumption was not associated with T2DM (odds …

Glucose-6-Phosphate Dehydrogenase Deficiency And Physical And Mental Health Until Adolescence, Man Ki Kwok, Gabriel M. Leung, C. Mary Schooling

Publications and Research

Background: To examine the association of glucose-6-phosphate dehydrogenase (G6PD) deficiency with adolescent physical and mental health, as effects of G6PD deficiency on health are rarely reported.

Methods: In a population-representative Chinese birth cohort: ªChildren of 1997º (n = 8,327), we estimated the adjusted associations of G6PD deficiency with growth using generalized estimating equations, with pubertal onset using interval censored regression, with hospitalization using Cox proportional hazards regression and with size, blood pressure, pubertal maturation and mental health using linear regression with multiple imputation and inverse probability weighting.

Results: Among 5,520 screened adolescents (66% follow-up), 4.8% boys and 0.5% girls had …