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PurposeOur objective was to assess burnout prevalence rates among physicians practicing in Europe (regardless of their specialty) taking into account the main approaches used to define burnout with the Maslach Burnout Inventory (MBI) tool.MethodsA systematic review was carried out from 2006 to 2018. A keyword request was obtained using the PubMed/Medline, Web of Science and Banque de Données en Santé Publique search engine. Studies written in English measuring burnout with the MBI tool among a population of practicing European physicians were selected. Data were extracted and classified according to burnout’s definition provided by the authors. Three definitions using the MBI dimensions were considered: tri-, bi- and unidimensional definition. A meta-analysis was then performed on burnout prevalence rates according to the dimensional definition of burnout.ResultsFrom 2378 search results, we selected 56 studies including from up to 41 European countries. Depending upon the study, physicians’ burnout prevalence rates ranged from 2.5% to 72.0%. The pooled prevalence rate of burnout was estimated at 7.7% [5.3–10.4%] with the tridimensional definition, 19.7% [13.5–26.3%] with the bidimensional definition and 43.2% [29.0–57.6%] with the unidimensional definition.ConclusionBurnout pooled prevalence among physicians varies from single to fivefold depending on the method employed to assess burnout with the MBI tool. Medical community should determine a standardized method to assess burnout prevalence rates to best evaluate this phenomenon.

This study measures the association between hospital staff's job strain (JS), mental quality of life (MQL) and how they are influenced by the organization models within emergency and critical care units. This study describes workers employed in emergency departments and intensive care units of a French public hospital. A selfadministered questionnaire was used to survey the demographic and organizational characteristics of their work, as well as work-related mental stress, psychosocial and organizational constraints, and their MQL. Among 145 workers participating in the study, 59.3% of them report job strain and 54.5% of them have low MQL scores. The majority of staff with job strain has reported working more than 2 weekends per month, were regularly on-call, worked in dysfunctional environments and did not participate in regular meetings. The staff with low MQL worked more frequently in dysfunctional environments, had significant complaints regarding employer's efforts to promote communications or provide adequate staffing levels than the workers with a high MQL score. If stress reduction and improved MQL in emergency and intensive care units is to be achieved, hospital management needs to design work schedules that provide a better balance between working and non-working hours. Additionally, ergonomic design, functional environments and improved communications needs to be implemented.

Periodic monitoring over 52 years have revealed temporal changes in the vegetation and floristic patterns associated with what has been acclaimed to be the world's oldest known experimental snow fence, which is located on an exposed high-alpine cushionfield on the Old Man Range in south-central New Zealand. The induced pattern of intermittent snow-lie has been increased by the fence from the normal ∼140 days to more than 200 days (and up to 140 cm deep), estimated from subsurface soil temperatures, together with periodic observations and measurements of snow depth. Some but not all species associated with natural snowbanks on the range have established in areas of induced snow accumulation. The timing of species establishment was not obviously related to relevant features of the local snowbank species or their distribution on the range, but the abundance of various plant species and their functional traits across zones of snowmelt point to competition and plant productivity being associated with the deepest snow in the lee of the fence. In addition, three of the several measured physical and chemical soil factors (Mg, available PO43-, and C:N) have differentiated significantly in relation to the vegetation and snow-lie pattern at year 52, although these seem not to be relevant on the basis of the pattern of the same factors in two nearby natural snowbanks on the range.

IntroductionSARS-CoV-2, which causes COVID-19, is a virus that has caused a global pandemic. Health workers (HWs) are major players in the fight against this infection and are occupationally exposed to the virus in the course of their work. In this context, this study presents surveillance data on 1714 workers in a hospital center in the south of France for the period from March 17 to April 20, 2020.Materials and methodsSymptomatic HWs, contact cases and those with high anxiety were tested. Diagnosis of COVID-19 was performed by RT-PCR after nasopharyngeal sampling.ResultsDuring this period, 30.4% of hospital staff received 3028 nasal swabs. Of these, 8.0% were infected with SARS-CoV-2. Among the SARS-CoV-2 positive HWs, 24.3% were asymptomatic. Among COVID unit and non COVID unit, the positive HWs for SARS-CoV-2 were, respectively, 5.8% and 8.2% (p = 0.2). HWs over 50 years of age were less likely to be positive for SARS-CoV-2 (3.8%) than other younger HWs (9.1%) (p < 0.001). No serious cases of COVID-19 were reported in our population during this period.DiscussionOur study suggests that HWs who tested positive for COVID-19 are often asymptomatic. Therefore, PPE is pivotal to prevent HWs to patients and HWs to HWs transmission during workshifts. Contact tracing and screening is essential to limit the spread of the virus within the hospital. On the other hand, HWs working in COVID-19 units are not more often infected probably because they have a higher risk awareness than other HWs.

OBJECTIVES:Solvent exposure is among the most common occupational exposures to chemical toxicants; data about the impact of such exposure on semen parameters are contradictory. We conducted the first meta-analysis to evaluate the risk of alteration in semen parameters related to occupational exposure to solvents. METHODS:From the PubMed database, we selected studies analyzing the semen of subjects occupationally exposed to solvents, compared with unexposed controls. The meta-analysis was performed on the various semen parameters analyzed in both populations. RESULTS:Seven studies were included in the study. The meta-analysis revealed a significant decrease in ejaculate volume [standardized mean difference (SMD) = −0.35 (−0.63 to −0.07)] and sperm concentration [SMD = −0.36 (−0.64 to −0.08)] in workers exposed to solvents compared with unexposed controls. CONCLUSION:Our results highlight the importance of preventing reprotoxic risks to male fertility in the workplace.

Questions: Is there a shift from positive to negative biotic interaction effects on seedling recruitment along two different stress gradients, temperature and precipitation (the stress-gradient hypothesis); do such interaction effects differ between species with different bioclimatic affinities? Location: Boreal, sub-alpine and alpine grassland in southern Norway. Methods: We tested the stress-gradient hypothesis by comparing seedling recruitment in bare-ground gaps where vegetation has been removed vs in extant grassland vegetation in 12 boreal, sub-alpine and alpine grassland sites along a precipitation gradient. This was tested in (1) a seed-sowing experiment and (2) in naturally occurring recruitment of alpine, generalist and boreal species. Results: Emergence of the sown alpine species was higher in the cold alpine than in the warmer sub-alpine sites, with no effects of precipitation or vegetation removal. The sown generalists also decreased in emergence towards warmer sites, whereas there was no effect of temperature on the sown boreal species. Vegetation removal, interacting with precipitation, increased the emergence of the generalist and boreal species sown at intermediate precipitation levels. In contrast, interactions between temperature and vegetation removal regulated the emergence of all groups of naturally occurring seedlings. Alpine and generalist species emerged at the highest rate in alpine sites, whereas boreal species had highest emergence in the lowlands. Conclusion: For all species groups, strong effects of vegetation removal show that competition from the extant vegetation dominates in controlling seedling emergence across all study sites and species. In generalist and boreal species, positive interactions between vegetation removal and temperature show that competitive interactions affect seedling emergence more strongly towards warmer climates, in line with the stress-gradient hypothesis. In contrast, alpine species show no such interactions. This suggests that species' adaptations to climate, in combination with environmental forcing, control seedling emergence along the bioclimatic gradients. Our results have implications for nature conservation, as we propose that disturbance from grazing animals can be useful to release competition and thereby increase seedling recruitment and biodiversity in boreal and alpine grasslands in a warmer future.

Numerous studies have increasingly suggested that medical history and lifestyle factors could be involved in the increase of cancer risk in adults. The issue whether psychological factors can influence the development of cancer has been discussed for many years. In the field of brain cancer, psychological stress has not so far been investigated. We conducted a French case–control pilot study with 122 adult incident cases and 122 controls free of any cancer diagnosis, matched for age and gender, to investigate links between malignant primitive brain tumours (MPBT) and medical history, private habits and psychological stress. Data were collected through self-administered questionnaires, and person-to-person interviews. To complete the psychological stress assessment, 100-mm visual analog scales were used. After adjustment for confounders, we found no significant effect of head trauma, aspartame, tobacco or alcohol consumption, place (rural or urban) of residence, sociodemographic data, and experience of psychological stress at work/home. Our results showed a significant association between MPBT risk and major life events over the past 5 years before diagnosis (OR = 1.90, 95% CI 1.13–3.20), family histories of cancer (OR = 1.90, 95% CI 1.12–3.22), fresh vegetable and fruit intake (OR = 0.29, 95% CI 0.09–0.95), and skipped meals several times per week (OR = 0.35, 95% CI 0.16–0.77). The present study suggests the role of genetic factors in glioma risk, and also suggests that an acute and sudden psychological stress might influence MPBT appearance. Additional large clinical studies are needed to confirm these findings.

Purpose Our principal aim was to assess the occupational outcomes of French survivors of childhood leukemia, compared to national population. The secondary objective was to identify determinants linked with employment stability after childhood leukemia. Methods All survivors aged 15 and over enrolled in the French LEA Cohort (Childhood and Adolescent Leukemia) were included. Occupational data were self-reported. The occupational distributions expected in the cohort for each age range were established based on the distribution in France as reference, and comparisons between observed and expected distributions were performed. Logistic regression model was used to explore determinants of stability of survivors’ employment. Results The questionnaire was completed by 845 eligible survivors (response rate 87.8 %), with a mean age of 22.3 ± 5.4 years and a mean follow-up duration of 14.3 ± 6.3 years. Among the 361 survivors currently in the labor market, 36 (10.0 %) were seeking a job, which is significantly lower than expected (19.3 %) compared to French population. Conversely, among those currently employed, the number of survivors in unstable employment (43.9 %) was significantly higher than expected (33.5 %). Younger age and higher number of late effects were risk factors for unstable employment. Conclusions While the employment rate of the young French adult population of childhood leukemia survivors seems rather positive, access to a steady job appears to be compromised for some survivors. Implications for Cancer Survivors A strategy to better identify particular subgroups of survivors at greatest risk for difficulties in their professional achievement will help ensure the development of specific intervention strategies and support procedures.

OBJECTIVE:This survey compares certain quality of work-life factors between a relocated work group and a control group. METHODS:A self-administered, cross-sectional survey was conducted 12 months after five departments (304 workers) had been relocated between two public health sites. The survey explored the workers’ psychosocial job characteristics, their perceived health, and psycho-organizational constraints. The results compared both the relocated and control groups by using univariate and then multivariate statistical analyzes. RESULTS:When compared with the control group (n = 272), the relocated group (n = 180) showed a higher prevalence of psychosocial job characteristic “isostrain.” The relocated group showed greater psycho-organizational constraints regarding the organizations favoring communication and team relationships. CONCLUSIONS:It seems that staff relocation can provoke a sense of uncertainty and isolation. Perhaps better communication might have reduced this and deter possible negative health outcomes.

Bryophytes are widespread in terrestrial ecosystems but little is known about their influence on vascular species. Water-soluble leachates (0%, 1%, 5%, 10% concentration) derived from 18 species of bryophytes (mosses 11 species; liverworts 7 species) were tested on the germination and seedling growth of Lactuca sativa and two common trees Melicytus ramiflorus (Violaceae) and Fuchsia excorticata (Onagraceae) in southern New Zealand forests. Bryophyte water soluble extracts (BWSE) have minor impact on seed germination of Lactuca, stimulatory effects on radical growth at low (1%) concentrations and inhibitory effects at higher concentrations (5—10%). For Melicytus the BWSE had variable effects, with evidence of strong stimulatory (Dendrohypopterygium filiculiforme) and inhibitory (Lepidozia concinna) effects on germination, but generally inhibited radical growth. BWSE at all test concentrations consistently inhibit both germination and seedling radicle growth in Fuchsia. The toxicity effect of water-soluble leachates varies significantly between bryophyte species but not consistently between mosses and liverworts. Bryophyte species exhibiting strongest inhibition effects under control conditions were associated with significantly reduced densities of broadleaved tree seedlings in forest ecosystems. Our results demonstrate that some bryophyte species via allelopathic interactions can inhibit seedling establishment and growth of forest trees. This mechanism provides an additional factor constraining the spatial distribution of the regeneration niche in forest communities.