Two sides of the same coin? On the history and phenomenology of chronic fatigue and burnout

Background: Burnout and chronic fatigue syndrome (CFS) are two fatigue syndromes which have developed largely independently from each other, yet whose similarities in symptoms can be a source of confusion. We aim to explore the phenomenology of burnout and CFS in a historical context as this may provide some insight into the links and relationship between these conditions. Method: A narrative review based on literature in the fields of history, social science and medicine. Results: The origins of CFS lie within medicine, whereas burnout developed in a psychological setting. As well as symptoms, burnout and CFS also share similar themes such as an overload process triggering illness onset, the need for restoration of depleted energy, external causal attributions and the characteristics of people suffering from these illnesses. However, these themes are expressed in either psychological or medical terms according to the historical background. Conclusion: Despite their similarities, there have been few direct comparisons of the two concepts. Culture, illness perceptions and accountability are important issues in both conditions and could contribute to their differences. Comparing burnout and CFS within one sample frame, thus looking beyond the psychology/medicine divide, could be a useful first step towards understanding their relationship.     

Lifestyle effects of group health education for patients with coronary heart disease

Abstract

In the present study, effects of a health education (INFO) and a PsychoEducational Prevention (INFO + PEP) Programme were Investigated in three hospitals. These programmes were offered to groups of coronary heart disease (CHD) patients and their partners alter discharge from hospital. The INFO was offered to 127 CHD patients in addition to FIT (i.e. standard medical care and physical training). The PEP was offered to 90 Patients in, addition to the INFO and FIT. A control group of 122 patients received only FIT. The INFO and the PEP consisted of four weekly two-hour group sessions each. In addition, the PEP was followed by seven telephone follow-up contacts.

On average, patients improved their lifestyles during the first three months. Between three and twelve months an extra improvement was found for eating habits, whereas there was a relapse for smoking and a sedentary lifestyle. In the short term, angina pectoris and a longer period of heart complaints were parallelled with a decrease in the risk of maintaining unhealthy eating habits, whereas in the long term a longer period of heart complaints a younger age and unemployment predicted a lower risk of maintaining unhealthy eating habits In the short term living with a partner and in the long term female gender were predictive of continued smoking behaviour In the short term, older age, a first CABG and a specific hospital setting decreased the risk of a continued sedentary lifestyle.

The FIT + INFO + PEP had a favourable short-term effect on eating habits. For smoking and a sedentary lifestyle, however, there were negative effects. In the short term patients in the FIT +INFO and those in the FIT +INFO+PEP had significantly more problems in quitting a sedentary lifestyle than those in the FIT intervention in the long term, patients in the FIT + INFO had significantly more problems in stopping smoking compared to these in the FIT.     

A longitudinal study of psychosocial distress in breast cancer: Prevalence and risk factors

This longitudinal study was conducted among 102 women with non-metastasic breast cancer to identify the time evolution and prevalence of distress at specific times through diagnosis and treatment of disease: preliminary diagnosis, surgery, definitive diagnosis and chemotherapy. Additionally, the study aimed to examine the role of demographic, medical and psychosocial factors on distress. The results indicated that prevalence of distress was higher at initial diagnosis (25%) than the following time points (approximately 17%). The differences inter-individuals in the levels of distress were observed over the four assessments. No relation between distress and demographic and medical factors was found. However, psychosocial aspects were significant risk factors. Patterns of emotional suppression and specific coping responses like helplessness/hopelessness, anxious preoccupation, cognitive avoidance and fatalism were positively related to distress, whereas fighting spirit and perceived social support showed a protective role. Moreover, helplessness/hopelessness and anxious preoccupation jointly predicted 75% of cases and 98% non-cases of distress. Finally, a mediational model between emotional suppression and distress through helplessness/hopelessness was tested. Results support the necessity of routine distress screening all through the illness. Implications of data for psychosocial interventions with breast cancer patients are highlighted.     

Family relations,mental health and adherence to nutritional guidelines in patients facing dialysis initiation

This study investigated the effect of family relations on patients’ adjustment to dialysis. The two main aims were to develop a family typology, and to explore the influence of family profile on the patient's anxiety, depression and adherence to nutritional guidelines. The sample consisted of 120 patients (mean age 63 years; 67.5% of men). They completed several measures 1, 6 and 12 months after dialysis initiation. The scales used were the Family Relationship Index and the Hospital Anxiety and Depression Scale. Perceived adherence to nutritional guidelines was assessed using two visual analogical scales. Results showed that family relations remained stable over time. Cluster analysis yielded three family profiles, which were named conflict, communicative and supportive families. Patients belonging to conflict families perceived themselves as less adhering to nutritional guidelines. For these patients, anxiety and depressive moods increased significantly over time, whereas mental health remained stable over time for communicative and supportive families. This research underlines that family relations are essential in global consideration of the care of patients treated by dialysis. Conflict families seem especially at risk. They should be identified early to help them adapt to this stressful treatment.     

Developmental changes of win-stay and loss-shift strategies in decision making

This study aims to clarify the developmental changes in real-life decision making when strategy is adjusted using both positive and negative feedback, that is, whether strategic adjustment evolves with age. A total of 84 participants divided into three age groups (children, adolescents, and adults) performed the standard version of the Iowa Gambling Task (IGT). Children and adolescents showed a strong bias in favor of disadvantageous choices whereas adults learned to decide advantageously during the course of the task. Interestingly, the results clearly demonstrate that children did not switch differently following gains and losses whereas adolescents and adults switched more often after a loss than after a gain, corresponding to the “loss-shift” and the “win-stay” strategies, respectively. The results also revealed that adults switched less often after losses compared to children and adolescents and, thus, used the loss-stay strategy more often than the 2 youngest groups. These new findings suggest that successful completion of the IGT by adults requires fine feedback monitoring and more frequent use of the win-stay and loss-stay strategic adjustments.     

Environmental sound recognition by timbre in children with Williams syndrome

Anecdotal reports have described children with Williams syndrome (WS) as presenting outstanding skills for recognizing environmental sounds by their timbre. This has led to suggest that the skills for environmental sound recognition by timbre are highly developed in WS. Furthermore, the term hypertimbria has been proposed to refer to this feature. However, no academic research has assessed these skills in WS. This study therefore aimed to contrast the reports on the highly developed skills for environmental sound recognition by timbre in children with WS. An environmental sound recognition task was administered to children with WS, children with Down syndrome of the same chronological age and cognitive level, and chronological age-matched typically developing children. Participants with WS performed significantly lower than their typically developing peers and no significant differences were found between the WS and Down syndrome groups. Unlike previous reports, this study points out that in WS environmental sound recognition by timbre does not constitute a phenotypic strength either in absolute or relative terms. Results suggest that children with WS do not present hypertimbria or preserved skills for timbre recognition. We discuss the implications of these results for theories of cognitive modularity.     

A constitutive model for quasicrystal plasticity

High-pressure X-ray diffraction studies on gadolinium sesquioxide (Gd₂O₃) have been carried out up to a pressure of ～25 GPa in a diamond-anvil cell at room temperature. Gadolinium oxide, which has a cubic or bixbyite structure under ambient conditions, undergoes an irreversible structural phase at around 12 GPa. The high-pressure phase has been identified as a hexagonal La₂O₃-type structure. The bulk modulus and its pressure derivative of this phase have been calculated.     

Nanoscale inclusions in the phonon glass thermoelectric material Zn4Sb3

We have investigated the thermoelectric material Zn₄Sb₃ using transmission electron microscopy (TEM). Nanoscale inclusions with a diameter of about 10 nm were observed, constituting on the order of 1% by volume of the material. Studies using energy filtered imaging, electron diffraction, and high-angle annular dark-field STEM indicate that the inclusions consist of Zn. These inclusions are expected to scatter the medium and long-wavelength phonons effectively, thus contributing to phonon glass behavior which results in the exceptionally low thermal conductivity for this thermoelectric material.     

Electron irradiation damage in SnO

In a study of radiation effects in SnO we have found that electron-beam damage is observable from changes in a high-resolution electron microscopy image or electron diffraction pattern. The early stage of the damage is not accompanied by a change in composition or a loss of crystallinity. The dose required for this damage (about 600 C cm^?2) is approximately independent of electron energy (between 100 and 400 keV) and specimen temperature (between 100 and 300 K). The damage is believed to start with displacement of oxygen atoms from their lattice position through a radiolytic mechanism with an efficiency of approximately 10^?4.     

Linear-parabolic shift of initially sharp interface in AB diffusion couple above the ordering temperature

It is shown that initially sharp interface in AB diffusion couple, above the ordering temperature, can shift with anomalous kinetics, i.e. deviations from the parabolic growth kinetics are possible. The initial slopes of the shift versus time functions can be even unity for large diffusion asymmetry (the ratio of diffusion coefficients of the parent materials in orders of magnitude) and gradually decrease to 0.5 at larger distances (longer times). This is in accordance with earlier results obtained in phase separating systems. It is shown that from the results of simulations the crossover thickness, X*, between the linear and parabolic regimes can also be calculated, and the applicability of the linear–parabolic law is confirmed. Furthermore, it is illustrated that the crossover thickness depends exponentially on the diffusion asymmetry parameter, with the exponent close to the value obtained from analytical estimations.