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There is little or no information comparing working experience, including burnout, amongst psychiatry residents internationally. We present preliminary findings from six of the first countries to complete data collection.
Objectives and aims
To obtain data from psychiatric residents in over twenty countries regarding rates of burnout, depression and suicidality and their associations with working conditions and personality traits.
An online survey incorporating the Maslach Burnout Inventory General Survey (MBI-GS), Areas of Work Life Survey (AWLS), Patient Health Questionnaire-9 (PHQ-9), Suicide Ideation and Behaviour Questionnaire (SIBQ), Big Five Inventory - 10 (BFI-10) and questions on demographics and working circumstances was designed, and checked by national co-ordinators for suitability in each participating country, prior to agreeing the final version. This was then translated and back-translated before being sent to participants. A stratified hierarchy sample methodology was developed and used to obtain the best possible study population in each country. This allowed us to maximise participation despite major differences in ease of access to residents across the study countries. The aim of studying the whole resident population was achieved in a large number of countries. Data was then analysed by the study statistician using SPSS. No funding was received for the study.
Results and conclusions
Data from Croatia (n=106), France (n=374), Hungary (n=81), Italy (n=180), Romania (n=52) and United Kingdom (n>2000) revealed marked differences between countries in the factors studied including in working circumstances, rates of burnout and suicidality. The associations discovered may help further improve psychiatric training experience internationally.
Postgraduate medical trainees experience high rates of burnout, but evidence regarding psychiatric trainees is missing. We aim to determine burnout rates among psychiatric trainees, and identify individual, educational and work-related factors associated with severe burnout.
In an online survey psychiatric trainees from 22 countries were asked to complete the Maslach Burnout Inventory (MBI-GS) and provide information on individual, educational and work-related parameters. Linear mixed models were used to predict the MBI-GS scores, and a generalized linear mixed model to predict severe burnout.
This is the largest study on burnout and training conditions among psychiatric trainees to date. Complete data were obtained from 1980 out of 7625 approached trainees (26%; range 17.8–65.6%). Participants were 31.9 (SD 5.3) years old with 2.8 (SD 1.9) years of training. Severe burnout was found in 726 (36.7%) trainees. The risk was higher for trainees who were younger (P < 0.001), without children (P = 0.010), and had not opted for psychiatry as a first career choice (P = 0.043). After adjustment for socio-demographic characteristics, years in training and country differences in burnout, severe burnout remained associated with long working hours (P < 0.001), lack of supervision (P < 0.001), and not having regular time to rest (P = 0.001). Main findings were replicated in a sensitivity analysis with countries with response rate above 50%.
Besides previously described risk factors such as working hours and younger age, this is the first evidence of negative influence of lack of supervision and not opting for psychiatry as a first career choice on trainees’ burnout.
To investigate dietary sources of Ca and vitamin D (VitD) intakes, and the associated sociodemographic and lifestyle factors, among European adolescents.
Linear regression mixed models were used to examine sex-specific associations of Ca and VitD intakes with parental education, family affluence (FAS), physical activity and television (TV) watching while controlling for age, Tanner stage, energy intake and diet quality.
The Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA)Cross-Sectional Study.
Adolescents aged 12·5–17·5 years (n 1804).
Milk and cheese were the main sources of Ca (23 and 19 % contribution to overall Ca intake, respectively). Fish products were the main VitD source (30 % contribution to overall VitD intake). Ca intake was positively associated with maternal education (β=56·41; 95 % CI 1·98, 110·82) and negatively associated with TV viewing in boys (β=–0·43; 95 % CI −0·79, −0·07); however, the significance of these associations disappeared when adjusting for diet quality. In girls, Ca intake was positively associated with mother’s (β=73·08; 95 % CI 34·41, 111·74) and father’s education (β=43·29; 95 % CI 5·44, 81·14) and FAS (β=37·45; 95 % CI 2·25, 72·65). This association between Ca intake and mother’s education remained significant after further adjustment for diet quality (β=41·66; 95 % CI 0·94, 82·38). Girls with high-educated mothers had higher Ca intake.
Low-educated families with poor diet quality may be targeted when strategizing health promotion programmes to enhance dietary Ca.
The Evolutionary Map of the Universe (EMU) is a proposed radio continuum survey
of the Southern Hemisphere up to declination + 30°, with the Australian
Square Kilometre Array Pathfinder (ASKAP). EMU will use an automated source
identification and measurement approach that is demonstrably optimal, to
maximise the reliability and robustness of the resulting radio source
catalogues. As a step toward this goal we conducted a “Data
Challenge” to test a variety of source finders on simulated images. The
aim is to quantify the accuracy and limitations of existing automated source
finding and measurement approaches. The Challenge initiators also tested the
current ASKAPsoft source-finding tool to establish how it could benefit from
incorporating successful features of the other tools. As expected, most finders
show completeness around 100% at ≈ 10σ dropping to about 10% by
≈ 5σ. Reliability is typically close to 100% at ≈
10σ, with performance to lower sensitivities varying between finders. All
finders show the expected trade-off, where a high completeness at low
signal-to-noise gives a corresponding reduction in reliability, and vice versa.
We conclude with a series of recommendations for improving the performance of
the ASKAPsoft source-finding tool.
Trochotomidae is a small but distinctive extinct family of pleurotomarioidean gastropods characterized by trochiform shells with an elliptical trema. Two new species of trochotomids are described from Pliensbachian deposits in the Neuquén Basin, Argentina. The new genus-group name Placotoma is proposed to replace the pre-occupied name Discotoma Haber non Mulsant. The record of Trochotoma (Trochotoma) protonotialis new species and Trochotoma (Placotoma) neuquensis new species in the early Jurassic of Argentina extends the paleobiogeographical distribution of the genus (and the family) to the Southern Hemisphere. The new taxa reported here represent a component of the pleurotomarioidean adaptive radiation that took place in the Tethyan region during the earliest Jurassic. They are related to local patch coral reefs of shallow, open-marine paleoenvironments, agreeing with the known habitat of most species of this family. The group was well represented in the Tethyan region during the Mesozoic, especially during the Jurassic, and the new species represent its southernmost occurrence.
Lead-containing (Pb-B-X)-2H apatites encompass a number of [AF]4[AT]6[(BO4)6]X2 compounds used for waste stabilization, environmental catalysis and ion conduction, but the influence of the stereochemically active lone-pair electrons of Pb2+ on crystal chemistry and functionality is poorly understood. This article presents a compilation of existing structural data for Pb apatites that demonstrate paired electrons of Pb2+ at both the AF and AT results in substantial adjustments to the PbFO6 metaprism twist angle, φ. New structure refinements are presented for several natural varieties as a function of temperature by single-crystal X-ray diffraction (XRD) of vanadinite-2H (ideally Pb10(VO4)6Cl2), pyromorphite-2H (Pb10(PO4)6Cl2), mimetite-2H/M (Pb10(As5+O4)6Cl2) and finnemanite-2H (Pb10(As3+O3)6Cl2). A supercell for mimetite is confirmed using synchrotron single-crystal XRD. It is suggested the superstructure is necessary to accommodate displacement of the stereochemically active 6s2 lone-pair electrons on the Pb2+ that occupy a volume similar to an O2− anion. We propose that depending on the temperature and concentration of minor substitutional ions, the mimetite superstructure is a structural adaptation common to all Pb-containing apatites and by extension apatite electrolytes, where oxide ion interstitials are found at similar positions to the lonepair electrons. It is also shown that plumbous apatite framework flexes substantially through adjustments of the PbFO6 metaprism twist-angles (φ) as the temperature changes. Finally, crystalchemical  zoning observed at submicron scales will probably impact on the treatment of diffraction data and may account for certain inconsistencies in reported structures.
The factors underlying the temporal dynamics of rubella outside of Europe and North America are not well known. Here we used 20 years of incidence reports from Mexico to identify variation in seasonal forcing and magnitude of transmission across the country and to explore determinants of inter-annual variability in epidemic magnitude in rubella. We found considerable regional variation in both magnitude of transmission and amplitude of seasonal variation in transmission. Several lines of evidence pointed to stochastic dynamics as an important driver of multi-annual cycles. Since average age of infection increased with the relative importance of stochastic dynamics, this conclusion has implications for the burden of congenital rubella syndrome. We discuss factors underlying regional variation, and implications of the importance of stochasticity for vaccination implementation.
Though largely controlled in developed countries, measles remains a major global public health issue. Regional and local transmission patterns are rooted in human mixing behaviour across spatial scales. Identifying spatial interactions that contribute to recurring epidemics helps define and predict outbreak patterns. Using spatially explicit reported cases from measles outbreaks in Niger, we explored how regional variations in movement and contact patterns relate to patterns of measles incidence. Because we expected to see lower rates of re-introductions in small, compared to large, populations, we measured the population-size corrected proportion of weeks with zero cases across districts to understand relative rates of measles re-introductions. We found that critical elements of spatial disease dynamics in Niger are agricultural seasonality, transnational contact clusters, and roads networks that facilitate host movement and connectivity. These results highlight the need to understand local patterns of seasonality, demographic characteristics, and spatial heterogeneities to inform vaccination policy.
In 2006 an outbreak of avian influenza A(H5N1) in Turkey caused 12 human infections, including four deaths. We conducted a serological survey to determine the extent of subclinical infection caused by the outbreak. Single serum samples were collected from five individuals with avian influenza whose nasopharyngeal swabs tested positive for H5 RNA by polymerase chain reaction, 28 family contacts of the cases, 95 poultry cullers, 75 individuals known to have had contact with diseased chickens and 81 individuals living in the region with no known contact with infected chickens and/or patients. Paired serum samples were collected from 97 healthcare workers. All sera were tested for the presence of neutralizing antibodies by enzyme-linked immunoassay, haemagglutination inhibition and microneutralization assays. Only one serum sample, from a parent of an avian influenza patient, tested positive for H5N1 by microneutralization assay. This survey shows that there was minimal subclinical H5N1 infection among contacts of human cases and infected poultry in Turkey in 2006. Further, the low rate of subclinical infection following contact with diseased poultry gave further support to the reported low infectivity of the virus.
In recent years, Salmonella enteritidis has become an increasingly important public health problem in Italy. In some parts of the country, the fraction of total human salmonella isolates accounted for by S. enteritidis has risen from 3–4% in the mid-1980s to more than 30% in 1990. Between 1090 and 1991. the number of reported S. enteritidis outbreaks increased more than sixfold. The 33 outbreaks reported in 1991 occurred in seven contiguous regions in northern and central Italy and were clustered in time between June and October: in the majority, products containing raw or undercooked shell eggs were implicated. Five of the egg-related outbreaks that occurred within a 30 kilometre radius over a 7-week period were investigated in detail. A phage type 1 strain containing a 38·9 MDa plasmid appeared responsible for three of the outbreaks, while in the remaining two a phage type 4 strain, also with a 38·9 MDa plasmid was isolated. Efforts are being made to enhance epidemiological surveillance and laboratory evaluation, and the use of pasteurized eggs has been recommended for high-risk populations.
Studies were carried out in South America to assess the effect of maternally derived antibody (MDA) on the responsiveness of calves to FMD vaccination. It was found that calves with MDA did not merely fail to respond to vaccination, but that their serum titres were depressed. This depression was proportional to the level of pre-existing MDA at the time of vaccination and following primary vaccination it persisted for a least 60 days. High MDA titres interfered with both primary and secondary responses. Animals with relatively low MDA titres were able to respond to vaccination, or at least to be sensitized so that on revaccination they showed a satisfactory response. The half-life of MDA was shown to be approximately 22 days, suggesting that under field conditions significant MDA titres are likely to persist for 4–5 months. A trial carried out in Brazil in which the primary course of two inoculations, 4 weeks apart, was initiated when the calves were 5–6 months of age, resulted in the reduction of FMD in the calf population from 11% to 0·9% over a 12-month period. The use of vaccination programmes of this type to lessen the incidence of FMD in young bovines is discussed.
Understanding age-specific differences in infection rates can be important in predicting the magnitude of and mortality in outbreaks and targeting age groups for vaccination programmes. Standard methods to estimate age-specific rates assume that the age-specific force of infection is constant in time. However, this assumption may easily be violated in the face of a highly variable outbreak history, as recently observed for acute immunizing infections like measles, in strongly seasonal settings. Here we investigate the biases that result from ignoring such fluctuations in incidence and present a correction based on the epidemic history. We apply the method to data from a measles outbreak in Niamey, Niger and show that, despite a bimodal age distribution of cases, the estimated age-specific force of infection is unimodal and concentrated in young children (<5 years) consistent with previous analyses of age-specific rates in the region.
AMBER is the near I.R. focal instrument of the VLTI. It recombines 3
beams simultaneously and has spectral resolution capability allowing
simultaneous spectrum, visibilities, differential visibilities,
closure phase and differential phases measurements on the observed
sources. We present here the general formalism used on AMBER in
order to compute differential phases and differential visibilities,
in complement to the article of Tatulli et al. (2006). We show that
these differential observables have precisions close to the
fundamental noises and we present an illustration of
model-fitting using them on the binary star γ2 Velorum where we
made a precise measurment of the astrometry of the 2 components
This paper exposes a method for evaluating the performances of a system
dedicated to exoplanet direct imaging. It is based on the use of a statistical
description of a somewhat ideal star/planet couple in terms of contrast and
Among many already available techniques, the Phase Induced Amplitude Apodization
Coronagraph (PIAAC) seems to gather all the necessary qualities to perform
direct imaging of hypothetical Earth-like exoplanets in the close Solar
neighbourhood (30 pc).
After a quick description of its concept, the proposed evaluation method is
used and provides an original set of criteria to classify concepts.
The technique of pupil densification bridges the gap existing between
conventionnal optical astronomy observing techniques and optical
interferometry: it indeed leads to the concept of hypertelescope: an
instrument that can provide direct images at the focus of an interferometer.
The hypertelescope is the open sesame for high dynamic imaging with an
interferometer: indeed, the elementary remapping of the pupil operated by a
densifier not only maximizes the dynamic range and the signal to noise ratio
of images but also makes the interferometer compatible with most existing
Moreover, a careful discussion about field of view show that for a diluted
array, the pupil densification preserves all the relevant high angular
resolution information collected by the interferometer and therefore induces
no field loss.
IRAN is a method of beam-combination in the
hypertelescope imaging technique recently introduced by
Labeyrie in optical interferometry. We propose to observe the interferometric image in the pupil plane, performing multi-axial pupil plane interferometry. Imaging is performed in a combined pupil-plane where the point-source intensity distribution (PSID) tends towards a
pseudo Airy disc for a sufficiently large number of telescopes. The image is concentrated into the limited support of the output pupil of the individual telescopes, in which the object-image convolution relation is conserved. Specific deconvolution algorithms have been developped for IRAN hypertelescope imagery, based upon Lucy-like iterative techniques. We show that the classical (image plane) and IRAN (pupil plane) hypertelescope imaging techniques are equivalent if one uses optical fibers for beam transportation. An application to the VLT/VIDA concept is presented.
In this paper, some basics concepts in statistical approaches
for detection of signals embedded in noise are briefly
reviewed. Though most material presented in the first part of
the paper is well documented in the litterature (see
references), some effort is made to provide a self-contained
and concise introduction to the subject. The importance and
relevance of the likelihood ratio is highlighted from a
Bayesian formulation of the problem; the optimal (in the sense
of maximized detection probability for given false alarm rates)
Neyman Pearson test and likelihood ratio test are discussed in
the general framework of test performance studies. Therefore,
the usefullness of the ROCs (Receiver Operating
Characteristics) is illustrated on simple examples. When some
unknown parameters must be taken into account, extension of the
previous approaches are mentionned, with some emphasis put on
the GLRT (generalized likelihood ratio test). Most results
introduced in this tutorial are then applied and discussed in
the framework of the extra-solar planet detection problem. A
observation model involving Poisson random variables is
studied. A thorough study in performed, and the Gaussian
asymptotics are discussed in the case where all parameters of
the model are assumed. In a more realistic situation where some
parameters must be estimated, the GLRT is derived and its
performances are evaluated by Monte Carlo simulation.
The addition of silicon to hydrogenated amorphous carbon can have the advantageous effect of lowering the compressive stress, improving the thermal stability of its hydrogen and maintaining a low friction coefficient up to high humidity. Most experiments to date have been on a-C1-xSix:H alloys deposited by RF plasma enhanced chemical vapour deposition (PECVD). This method gives alloys with considerable hydrogen content and only moderate hardness. Here, we use a high plasma density source, the electron cyclotron wave resonance (ECWR) source, to prepare films with a high deposition rate. The composition and bonding in the alloys is determined by XPS, visible and UV Raman and FTIR spectroscopy. We find that it is possible to produce hard, low stress, low friction, almost humidity insensitive a-Cl. xSix:H alloys with a good optical transparency and a band gap over 2 eV.