Personality\u27s Influence on Burnout: An Unfinished Puzzle

This study examines the relationship between emotional exhaustion-the main component of burnout-and several facets of the Big Five Factors of personality. Previous research has found small relationships between the Big Five Factors and emotional exhaustion. I hypothesized that the facets of trust, cooperation, orderliness, and self-discipline will have curvilinear relationships with emotional exhaustion. The facets of vulnerability and depression were also hypothesized to moderate the curvilinear relationships between orderliness and self-discipline and emotional exhaustion. Regression analyses only found a curvilinear relationship between order and personal burnout when vulnerability was controlled for. A significant quadratic-by-linear interaction was found between order and vulnerability with personal burnout. Alternative explanations for results are given, implications are discussed, and future research is suggested

Nevirapine and Efavirenz Elicit Different Changes in Lipid Profiles in Antiretroviral- Therapy-Naive Patients Infected with HIV-1

BACKGROUND: Patients infected with HIV-1 initiating antiretroviral therapy (ART) containing a non-nucleoside reverse transcriptase inhibitor (NNRTI) show presumably fewer atherogenic lipid changes than those initiating most ARTs containing a protease inhibitor. We analysed whether lipid changes differed between the two most commonly used NNRTIs, nevirapine (NVP) and efavirenz (EFV). METHODS AND FINDINGS: Prospective analysis of lipids and lipoproteins was performed in patients enrolled in the NVP and EFV treatment groups of the 2NN study who remained on allocated treatment during 48 wk of follow-up. Patients were allocated to NVP (n = 417), or EFV (n = 289) in combination with stavudine and lamivudine. The primary endpoint was percentage change over 48 wk in high-density lipoprotein cholesterol (HDL-c), total cholesterol (TC), TC:HDL-c ratio, non-HDL-c, low-density lipoprotein cholesterol, and triglycerides. The increase of HDL-c was significantly larger for patients receiving NVP (42.5%) than for patients receiving EFV (33.7%; p = 0.036), while the increase in TC was lower (26.9% and 31.1%, respectively; p = 0.073), resulting in a decrease of the TC:HDL-c ratio for patients receiving NVP (−4.1%) and an increase for patients receiving EFV (+5.9%; p < 0.001). The increase of non-HDL-c was smaller for patients receiving NVP (24.7%) than for patients receiving EFV (33.6%; p = 0.007), as were the increases of triglycerides (20.1% and 49.0%, respectively; p < 0.001) and low-density lipoprotein cholesterol (35.0% and 40.0%, respectively; p = 0.378). These differences remained, or even increased, after adjusting for changes in HIV-1 RNA and CD4+ cell levels, indicating an effect of the drugs on lipids over and above that which may be explained by suppression of HIV-1 infection. The increases in HDL-c were of the same order of magnitude as those seen with the use of the investigational HDL-c-increasing drugs. CONCLUSION: NVP-containing ART shows larger increases in HDL-c and decreases in TC:HDL-c ratio than an EFV-containing regimen. Based on these findings, protease-inhibitor-sparing regimens based on non-nucleoside reverse transcriptase inhibitor, particularly those containing NVP, may be expected to result in a reduced risk of coronary heart disease

A Bifactor Model of Burnout? An Item Response Theory Analysis of the Maslach Burnout Inventory – Human Services Survey.

Burnout is a syndrome-composed of emotional exhaustion, depersonalization, and personal accomplishment-resulting from chronic stress. The Maslach Burnout Inventory - Human Services Survey (MBI-HSS; Maslach, Jackson, & Leiter, 1996) is the most popular measure of burnout. Unfortunately, the MBI-HSS has flaws including highly correlated traits and low subscale reliabilities. I tested a bifactor model for the MBI-HSS based on the work by Meszaros, Adam, Svabo, Szigeti, and Urban (2014) using item response theory. Bifactor models specify a general factor that underlies all the items within a scale and specific factors that underlie the subscale items; also, all factors are orthogonal. I found that the bifactor model had superior fit to the traditional correlated traits. A method for decomposing item and test information in multidimensional item response theory is also introduced along with a new method of displaying the test information. Finally, I provide the scoring recommendation that only the general burnout dimension for the MBI-HSS should be reported as the subscales are unreliable

Ketoconazole is inferior to ritonavir as an alternative booster for saquinavir in a once daily regimen in Thai HIV-1 infected patients.

Contains fulltext : 52575.pdf (publisher's version ) (Closed access)OBJECTIVE: To improve the pharmacokinetics of protease inhibitors, boosting with low-dose ritonavir is performed. However, toxicity, storage conditions and high costs of antiretroviral treatment may necessitate interruption of ritonavir. Ketoconazole was investigated as a potential booster of once-daily (o.d.) saquinavir. METHODS: In a single-group, two-period design, 25 virologically and immunologically stable patients on saquinavir/ritonavir 2000/100 mg o.d. were switched to saquinavir/ketoconazole 2000/400 mg o.d. for 2 weeks. Two steady-state pharmacokinetic curves were recorded at both periods. RESULTS: Fourteen females and 11 male patients were included. Median age was 34 years [interquartile range (IQR), 32-42 years], body weight 54 kg (IQR, 47-59 kg) and body mass index 21 kg/m (19-23 kg/m). The mean saquinavir area under the curve (AUC) during boosting with ritonavir was 57.93 +/- 27.96 mg/h/l, maximum observed concentration (Cmax) was 7.50 +/- 3.45 mg/l and concentration at 24 h (Cmin) was 0.35 +/- 0.30 mg/l. When ketoconazole was used, the saquinavir AUC, Cmax, and Cmin were 12.00 +/- 6.97 mg/h/l, 2.43 +/- 1.35 mg/l and 0.03 +/- 0.04 mg/l, respectively. CONCLUSION: Boosting with ketoconazole resulted in 80% lower exposure to saquinavir. Although saquinavir AUC might still be adequate for treatment, concentrations at 24 h reached levels below the recommended trough concentrations of 0.1 mg/l, which may result in selection of resistant HIV-1 viral strains. Therefore, boosting of saquinavir by ketoconazole is not recommended