Physical activity, burnout and quality of life in medical students: A systematic review.

BACKGROUND: Medical students are at risk of burnout and reduced quality of life (QoL). The risk of burnout doubles from third to sixth year of medical school, and medical students have an 8%-11% lower QoL than nonmedical students. It is imperative to prevent this, as burnout and reduced QoL is independently associated with errors in practice. This systematic review aims to examine whether physical activity/exercise is associated with burnout and/or QoL in medical students. METHODS: Articles were identified through database searches of Embase, Medline, PsycINFO, Scopus and Web of Science. Studies were included if both physical activity/exercise and burnout or QoL were measured and limited to those focussing on medical students. Risk of bias was assessed using accredited cohort and cross-sectional checklists. A narrative synthesis was conducted due to heterogeneity in the dataset. FINDINGS: Eighteen studies were included, comprising 11,500 medical students across 13 countries. Physical activity was negatively associated with burnout and positively associated with QoL. Furthermore, the findings were suggestive of a dose-response effect of physical activity on both burnout and QoL; higher intensities and frequencies precipitated greater improvements in outcomes. CONCLUSIONS: This multinational review demonstrates that physical activity is associated with reduced burnout and improved QoL in medical students. It also identifies a paucity of research into the optimal intensity, frequency, volume and mode of physical activity. Further research, building on this review, is likely to inform the long overdue development of evidence-based, well-being curricula. This could involve incorporating physical activity into medical education which may improve well-being and better prepare students for the demands of medical practice.

Housing shortages in urban regions: aggressive interactions at tree hollows in forest remnants.

Urbanisation typically results in a reduction of hollow-bearing trees and an increase in the density of particularly species, potentially resulting in an increased level of competition as cavity-nesting species compete for a limited resource. To improve understanding of hollow usage between urban cavity-nesting species in Australia, particularly parrots, we investigated how the hollow-using assemblage, visitation rate, diversity and number of interactions varied between hollows within urban remnant forest and continuous forest. Motion-activated video cameras were installed, via roped access to the canopy, and hollow usage was monitored at 61 hollows over a two-year period. Tree hollows within urban remnants had a significantly different assemblage of visitors to those in continuous forest as well as a higher rate of visitation than hollows within continuous forest, with the rainbow lorikeet making significantly more visitations than any other taxa. Hollows within urban remnants were characterised by significantly higher usage rates and significantly more aggressive interactions than hollows within continuous forest, with parrots responsible for almost all interactions. Within urban remnants, high rates of hollow visitation and both interspecific and intraspecific interactions observed at tree hollows suggest the number of available optimal hollows may be limiting. Understanding the usage of urban remnant hollows by wildlife, as well as the role of parrots as a potential flagship for the conservation of tree-hollows, is vital to prevent a decrease in the diversity of urban fauna, particularly as other less competitive species risk being outcompeted by abundant native species.