Burnout among Military Personnel: A systematic Review.

Objective: Burnout is a psychological symptom characterized by emotional exhaustion, depersonalization, and lack of personal accomplishment. Several systematic reviews have examined the prevalence of burnout in some communities, including the communities of physicians, nurses, students, and teachers. Risk factors, consequences of burnout, and related interventions have also been evaluated in several systematic review studies. The purpose of this systematic review was to investigate the prevalence, risk factors, consequences, and interventions associated with burnout among military personnel in all types of studies. Method : Studies that quantitatively examined burnout in military personnel after 2000 were identified through systematic searches in PubMed, Scopus, Web of Knowledge, Embase, PsychInfo, and PsycArticles databases. Results: A total of 43 studies met the criteria for inclusion in this systematic review. Of these, 34 were cross-sectional, 7 were longitudinal, 1 was case-control and 1 was experimental. Half of the studies had more than 350 samples. The studies were from 17 different countries, among which the United States had the largest number with 17 studies. 33 studies were measured with one version of Maslach Burnout Inventory (MBI). Totally, only 10 studies reported a prevalence of burnout and/or its subscales. The prevalence of high emotional exhaustion ranged from 0% to 49.7% (median 19%), the prevalence of high depersonalization ranged from 0% to 59.6% (median 14%) and the prevalence of low personal accomplishment ranged from 0% to 60% (median 6.4%). In this systematic review, work environment factors (such as workload, shift work), psychological factors (anxiety, depression, stress), and duration and quality of sleep were shown as risk factors of burnout or its subscales. Also, psychological distress was observed as the consequence of burnout in more than one study. Conclusion: The studies investigated in this systematic review showed a relatively moderate prevalence of burnout. In fact, burnout was associated with work environment factors and psychological variables.

Relationship Between Visceral Adipose Tissue and Bone Mineral Density in Older People: Results from AHAP Study.

INTRODUCTION: Due to discrepancy of the relationship between visceral adipose tissue (VAT) and bone mineral density (BMD), this study was performed to determine the relationship between BMD and VAT in the elderly. METHODOLOGY: This cross-sectional study is part of the second wave of Amirkola Health and Ageing Project (AHAP), including 1,200 people aged 60 years and older. BMD and VAT were measured by dual-energy X-ray absorptiometry (DXA) in Hologic equipment. Based on the amount of VAT, individuals were divided into four quartiles. Then, the data were statistically analyzed by SPSS22 software using chi-square, ANOVA, Pearson correlation coefficient and logistic regression. RESULTS: The mean age of the participants was 69.6 ± 6.9 year and the mean VAT was 862.6 ± 337.8 gram. In this study, people with osteoporosis had less VAT (p<0.0001). Furthermore, with the increase in the amount of VAT, BMD increased in the femoral region and lumbar spine (p<0.0001). There was a positive and significant correlation between VAT and BMD in the femoral region (r = 0.267) and lumbar spine (r = 0.197) (p<0.0001). After performing multiple logistic regression analysis in the presence of factors such as age, gender, body mass index and especially lean mass, the protective role of VAT against osteoporosis was maintained (OR=0.510, CI95% (0.290-0.895)) (P = 0.019). CONCLUSIONS: This study has shown that VAT can independently have a positive association with BMD in the elderly.

Relationship of Hardiness Components to General Health, Spiritual Health, and Burnout: The Path Analysis.

Objective: Acknowledging the key role of hardiness, importance of health and its various dimensions, the present study aimed to investigate the simultaneous relationship between hardiness components and spiritual health, burnout, and general health, among Baqiyatallah University of Medical Sciences staff. Method : 307 Baqiyatallah University of Medical Sciences' staff in Tehran with at least five years work experience participated in this cross-sectional study using simple random sampling. Four questionnaires were used to evaluate the participants: the 28-item General Health Questionnaire (GHQ) to assess general mental problems with four subscales, 22-item Maslach Burnout Inventory (MBI) with two aspects (frequency and intensity) and three subscales of emotional exhaustion, depersonalization and personal accomplishment, the 20-item Spiritual Well Being Scale (SWBS) Questionnaire with two subscales of religious well-being and existential well-being and the 50-item Kobasa Hardiness Questionnaire to measure psychological hardiness with three subscales of control, commitment and challenge. At the end, two conceptual models which have shown effect of hardiness and its subscales on general health, Spiritual health and burnout were evaluated by path analysis. Results: According to the path analysis results, it was found that hardiness and its subscales, which were approved by univariable and multivariable analyses, had significant relationship with general health (direct effect: -0.525, P < 0.001), spiritual health (direct effect: 0.555, P < 0.001) and burnout (direct effect of frequency aspect: -0.523, P < 0.001). Thus, by increasing hardiness and its subscales, spiritual health increases while symptoms of illness and burnout decrease. Conclusion: Spiritual health increases as hardiness and its subscales increase as well; therefore, symptoms of illness and burnout decrease as hardiness and its subscales increase.

Regulation of Nrf2 and Nrf2-related proteins by ganoderma lucidum in hepatocellular carcinoma.

BACKGROUND: HCC is among the most common cancer. Ganoderma lucidum (G.lucidum) has been essential in preventing and treating cancer. The Nrf2 signaling cascade is a cell protective mechanism against further damage, such as cancer development. This signaling pathway upregulates the cytoprotective genes and is vital in eliminating xenobiotics and reactive oxygen. This study aimed to show the potential cytotoxic activity of G. lucidum aqueous extract in HCC. METHODS AND RESULTS: MTT assay was used to detect cell viability. Nrf2-related proteins were measured by western blotting, and the flow cytometry method assayed cell population in different cycle phases. Cell viability was 49% and 47% following G. lucidum extract at 100 µg/ml at 24 and 48 h treatments, respectively. G. lucidum extract (aqueous, 100 or 50 µg/ml) treatments for 24, 48, or 72 h were able to significantly change the cytoplasmic/nuclear amount of Nrf2 and HO-1, NQO1 protein levels. Moreover, at both concentrations, arrest of the G0/G1 cell cycle was stimulated in HCC. CONCLUSIONS: The activation of the Nrf2 signaling pathways seems to be among the mechanisms underlining the protective and therapeutic action of G. lucidum against HCC.

Comparison of the efficacy and safety of 308-nm excimer laser with intralesional corticosteroids for the treatment of alopecia areata: A randomized controlled study.

BACKGROUND: Corticosteroids have been the mainstay of treatment for alopecia areata (AA). Recently, the 308-nm excimer laser has been proposed for treating AA. OBJECTIVES: To compare the efficacy and safety of excimer laser with intralesional corticosteroid (ILCS) in AA. METHODS: Patients with at least two alopecic patches were randomly assigned to receive weekly excimer laser treatments or monthly injections of ILCS. Photographs and trichoscopy images were examined at baseline, the last treatment session, and after one month of follow-up. The hair regrowth score was evaluated on a 6-point scale. RESULTS: Sixteen patients with 99 alopecic patches completed the study. At the last treatment session, the mean score of hair regrowth for the laser was significantly lower than the ILCS (p = 0.003). However, after a month of follow-up, the difference was not statistically significant (p = 0.148). Positive response in hair regrowth (≥50%) was achieved in 47% of laser-treated patches and 66% in ILCS-treated ones. Four (25%) and 8 (50%) patients experienced severe adverse events of laser and ILCS, respectively. CONCLUSIONS: The excimer laser was safe and effective in AA. The effect of laser on hair regrowth might be delayed as compared with ILCS.

Association between body fat and bone mineral density in non-obese post-menopausal women over 60 years old.

BACKGROUND: Loss of bone mineral density is one of the most important complications of menopause. The results of studies about the relation between body fat and bone mineral density are controversial. The aim of this study was to determine the association between fat mass and bone mineral density on non-obese post-menopausal elderly women. METHODS: This cross-sectional study is a part of the second phase of the Amirkola Health and Ageing Project (AHAP) that has been done on 356 elderly women with BMI of 18.5-30. Bone mineral density (BMD) and total body fat were measured using the Hologic Horizon-WI densitometer. Statistical tests were ANOVA, Pearson's correlation coefficient and multiple linear regression and a p- value less than 0.05 was considered significant. RESULTS: The mean age of the participants was 70.22±7.34 and the mean age of menopause was 47.68±5.05. Women with highest fat mass had a greater spine, femur and whole-body BMD (p<0.0001). In this study, we observed a direct and positive significant correlation between body fat mass and BMD at spine (r=0.308), femur (r=0.420) and whole body (r=0.312) (p<0.0001). Adjusted linear regression showed positive effect of fat mass on BMD on all three anatomical sites especially in total femur (ß=0.254, p<0.0001). CONCLUSION: This study showed a positive correlation between fat mass and bone mineral density at all sites in post-menopausal women.