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      Physical, psychological and occupational consequences of job burnout: A systematic review of prospective studies

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          Abstract

          Burnout is a syndrome that results from chronic stress at work, with several consequences to workers’ well-being and health. This systematic review aimed to summarize the evidence of the physical, psychological and occupational consequences of job burnout in prospective studies. The PubMed, Science Direct, PsycInfo, SciELO, LILACS and Web of Science databases were searched without language or date restrictions. The Transparent Reporting of Systematic Reviews and Meta-Analyses guidelines were followed. Prospective studies that analyzed burnout as the exposure condition were included. Among the 993 articles initially identified, 61 fulfilled the inclusion criteria, and 36 were analyzed because they met three criteria that must be followed in prospective studies. Burnout was a significant predictor of the following physical consequences: hypercholesterolemia, type 2 diabetes, coronary heart disease, hospitalization due to cardiovascular disorder, musculoskeletal pain, changes in pain experiences, prolonged fatigue, headaches, gastrointestinal issues, respiratory problems, severe injuries and mortality below the age of 45 years. The psychological effects were insomnia, depressive symptoms, use of psychotropic and antidepressant medications, hospitalization for mental disorders and psychological ill-health symptoms. Job dissatisfaction, absenteeism, new disability pension, job demands, job resources and presenteeism were identified as professional outcomes. Conflicting findings were observed. In conclusion, several prospective and high-quality studies showed physical, psychological and occupational consequences of job burnout. The individual and social impacts of burnout highlight the need for preventive interventions and early identification of this health condition in the work environment.

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          Newcastle-Ottawa Scale: comparing reviewers’ to authors’ assessments

          Background Lack of appropriate reporting of methodological details has previously been shown to distort risk of bias assessments in randomized controlled trials. The same might be true for observational studies. The goal of this study was to compare the Newcastle-Ottawa Scale (NOS) assessment for risk of bias between reviewers and authors of cohort studies included in a published systematic review on risk factors for severe outcomes in patients infected with influenza. Methods Cohort studies included in the systematic review and published between 2008–2011 were included. The corresponding or first authors completed a survey covering all NOS items. Results were compared with the NOS assessment applied by reviewers of the systematic review. Inter-rater reliability was calculated using kappa (K) statistics. Results Authors of 65/182 (36%) studies completed the survey. The overall NOS score was significantly higher (p < 0.001) in the reviewers’ assessment (median = 6; interquartile range [IQR] 6–6) compared with those by authors (median = 5, IQR 4–6). Inter-rater reliability by item ranged from slight (K = 0.15, 95% confidence interval [CI] = −0.19, 0.48) to poor (K = −0.06, 95% CI = −0.22, 0.10). Reliability for the overall score was poor (K = −0.004, 95% CI = −0.11, 0.11). Conclusions Differences in assessment and low agreement between reviewers and authors suggest the need to contact authors for information not published in studies when applying the NOS in systematic reviews.
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            Burnout and risk of cardiovascular disease: evidence, possible causal paths, and promising research directions.

            Burnout is characterized by emotional exhaustion, physical fatigue, and cognitive weariness, resulting from prolonged exposure to work-related stress. The authors review the accumulated evidence suggesting that burnout and the related concept of vital exhaustion are associated with increased risk of cardiovascular disease and cardiovascular-related events. The authors present evidence supporting several potential mechanisms linking burnout with ill health, including the metabolic syndrome, dysregulation of the hypothalamic-pituitary-adrenal axis along with sympathetic nervous system activation, sleep disturbances, systemic inflammation, impaired immunity functions, blood coagulation and fibrinolysis, and poor health behaviors. The association of burnout and vital exhaustion with these disease mediators suggests that their impact on health may be more extensive than currently indicated. Copyright 2006 APA, all rights reserved.
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              A systematic literature review of attrition between waves in longitudinal studies in the elderly shows a consistent pattern of dropout between differing studies.

              Longitudinal studies of the elderly are complicated by the loss of individuals between waves due to death or other dropout mechanisms. Factors that affect dropout may well be similar from one study to another. This article systematically reviews all large population-based studies of the elderly (published 1966-2002) that report on differences in individual characteristics between people who remain and people who dropout at follow-up. A systematic review of articles that investigate attrition after baseline interview. Twelve studies were found that investigated dropout other than death using unadjusted, multivariable methods or both. The unadjusted analyses showed many significant factors related to attrition. Multivariable analyses showed two main independent factors were related to increased attrition: increasing age and cognitive impairment. People who were very ill or frail had higher dropout rates, and people in worse health were less likely to be recontactable. Multivariable methods of analyzing attrition in longitudinal studies show consistent patterns of dropout between differing studies, with a small number of key relationships. These findings will assist researchers when planning studies of older people, and provide insight into the possible biases in longitudinal studies introduced by differential dropout.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: ValidationRole: VisualizationRole: Writing – review & editing
                Role: ConceptualizationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: VisualizationRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: InvestigationRole: Project administrationRole: VisualizationRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                4 October 2017
                2017
                : 12
                : 10
                : e0185781
                Affiliations
                [1 ] Department of Nursing, Instituto Federal do Paraná, Londrina, Paraná, Brazil
                [2 ] Department of Pathological Sciences, Universidade Estadual de Londrina, Paraná, Brazil
                [3 ] Department of Public Health, Universidade Estadual de Londrina, Paraná, Brazil
                [4 ] Department of Nursing, Universidade Estadual de Londrina, Paraná, Brazil
                TNO, NETHERLANDS
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                [¤]

                Current address: Department of Public Health, Universidade Estadual de Londrina, Londrina, Paraná, Brazil

                Author information
                http://orcid.org/0000-0002-3765-1929
                http://orcid.org/0000-0001-6843-8330
                Article
                PONE-D-17-19647
                10.1371/journal.pone.0185781
                5627926
                28977041
                c7ad7560-3623-469f-b8ec-df2655da1f46
                © 2017 Salvagioni et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 16 June 2017
                : 19 September 2017
                Page count
                Figures: 3, Tables: 4, Pages: 29
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/501100003593, Conselho Nacional de Desenvolvimento Científico e Tecnológico;
                Award ID: 310259/2015-0
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/501100003593, Conselho Nacional de Desenvolvimento Científico e Tecnológico;
                Award ID: 303141/2014-0
                Award Recipient :
                This work was supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
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                Medicine and Health Sciences
                Mental Health and Psychiatry
                Psychological Stress
                Biology and Life Sciences
                Psychology
                Psychological Stress
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                Psychology
                Psychological Stress
                Social Sciences
                Economics
                Labor Economics
                Employment
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                Mood Disorders
                Depression
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                Economics
                Labor Economics
                Employment
                Jobs
                Biology and Life Sciences
                Psychology
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                Pain
                Myalgia
                Medicine and Health Sciences
                Pathology and Laboratory Medicine
                Signs and Symptoms
                Pain
                Myalgia
                Medicine and Health Sciences
                Neurology
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                Dyssomnias
                Insomnia
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