The Effectiveness of Transcranial Direct Current Stimulation (tDCS) and Omega-3 on Food Craving, Executive Functions, Weight, and Depressive Symptoms in Patients with Depression and Overweight: A Randomized Controlled Trial.

Objective: The most important hypothesis of this research was based on the fact that the mechanism of the effect of omega-3 on depression and obesity is formed through its accumulation in the dorsolateral prefrontal cortex (DLPFC), especially in women. Accordingly, we investigated the omega-3 intake and the concurrent stimulation of the DLPFC by tDCS and hypothesized that the synergy of these two treatments can increase the obtained effect size in patients with depression and overweight. Method : This research was a double-blind randomized controlled trial (RCT) with a factorial design consisting of four treatment and control groups. The participants were females with depression and overweight on an outpatient basis. They received 5 ml/day omega-3 syrup (545 mg DHA, 620 mg EPA) or placebo adjunct with 12 sessions sham/tDCS stimulation administered for 3 weeks with anode-left/cathode-right protocol in the prefrontal cortex (1.5 mA, 15 minutes' stimulation / 15-20 minutes' rest intervals/one visit per week, 4 stimulations per visit). Results: tDCS or omega-3 alone did not significantly improve the executive functions, depression, food cravings, and weight in the experimental groups compared to the control group (P > 0.05). However, tDCS adjunct with the omega-3 had a significant and positive effect on improving weight change (P = 0.011; df = 1; F = 1.27; Eta = 0.108) with a power of 0.73 compared to the control group. Furthermore, their interaction led to an improving trend in executive functions and a decreasing trend in food cravings which are clinically important. Conclusion: tDCS could strengthen the omega-3 mechanisms of effect through stimulating its accumulation site in the brain (i.e., the DLPFC) and the synergistic effects of these two treatments result in weight control as well as an improvement trend in the executive functions and food craving in women.

Interventions for Physician Burnout: A Systematic Review of Systematic Reviews.

Occupational burnout is a common syndrome among physicians, and several individual-directed and organization-directed interventions have been implemented to reduce it. Until now, several review studies have tried to identify and introduce the most appropriate interventions. The aim of this article was to systematically review systematic review studies of interventions for physician burnout to evaluate and summarize their results, and ultimately guide researchers to select appropriate interventions. A search was conducted to find review studies and systematic reviews in Cochrane Database of Systematic Reviews, Medline, Google Scholar, PubMed, and PsycINFO. Two reviewers independently selected and evaluated the studies based on inclusion criteria. Four of seven obtained review studies and systematic reviews met the inclusion criteria. These studies have reviewed individual-directed and organization-directed interventions intended to reduce burnout among medical students, interns, physicians, residents, and fellows. Various studies of the effectiveness of individual- and organization-directed interventions have obtained different results. This research has shown that reaching conclusions about effective interventions (individual- or organization-directed) for physician burnout is not easy and that a number of mediating or moderating variables probably influence the effectiveness of these interventions. Therefore, it is necessary to understand approaches and interventions for the prevention or reduction of physician burnout to fill the gaps in research. In addition, review studies are required to be more precise in choosing their criteria to find more accurate results.

Exploring the Strengths of Patients With Psychiatric Disorders: A Qualitative Study.

BACKGROUND: Professional nurses typically pay significantly more attention to the weaknesses rather than strengths of their psychiatric patients. Thus, new approaches to care are needed to discover the strengths of these patients and to provide effective encouragement during the caring process. However, little is currently known regarding the strengths that psychiatric patients possess during their illness and healing. PURPOSE: The current study aimed to explore the self-perceptions and experiences of psychiatric patients regarding their strengths. METHODS: Psychiatric patients were recruited through purposive sampling in Isfahan, Iran, from July to December 2012. Variables such as age, gender, and diagnosis were used to vet potential participants to ensure adequate sample diversity. All of the qualified individuals were informed verbally and in writing regarding the information that they would be asked to provide during the interview process, and the researchers obtained written and oral informed consent from each before enrolment. Twenty-one semistructured, qualitative interviews were conducted, and content analysis was performed to identify the themes. RESULTS: Four major themes emerged from the interviews, including (a) life with spiritual factors, (b) responsibility, (c) love of learning, and (d) sources of support. CONCLUSIONS: A repertoire of strengths was identified among the participants. Furthermore, all of the participants voiced the opinion that healthcare providers rarely focused on their strengths. Therefore, mental health professionals, particularly nurses, should pay closer attention to the strengths of their psychiatric patients to use these strengths in advancing their care.

The effect of participating in the labor preparation classes on maternal vitality and positive affect during the pregnancy and after the labor.

BACKGROUND: Pregnant women predispose to physical and emotional diseases. Vitality and positive affect are against the depression and low energetic mood Exercise and physical activities in pregnancy have short and long term consequences for mothers and their growing fetus and affected in mood regulation. Respiratory and relaxation skills could decrease stress, pain and use of analgesics during labor. METHODS: In this study, 117 primigravida and multigravida women (59 women in case and 58 in control groups) were enrolled. Women in case group participated in delivery preparation classes since 20 weeks of pregnancy for 8 sessions. The control group was just received routine pregnancy care. The education was about pregnancy and delivery, physical exercises and relaxation skills. Questionnaires of vitality and positive affect toward the labor were completed three times: before intervention, after the 8(th) session and after delivery to 2 weeks later by an interview. Data analyzed using SPSS16 software and repeated measurement. RESULTS: There was a significant difference in vitality and positive affect regarding type of delivery before and after intervention and after delivery in case group(p < 0.0001).There was no significant difference in vitality and positive affect scores after delivery and after intervention (p < 0.083, p < 0.545). There was significant difference in vitality and positive affect scores regarding between case and control groups after the intervention and after the delivery (p < 0.001, p < 0.0001). CONCLUSIONS: Considering the results of this study, it could be recommended that all pregnant women should contribute in delivery preparation classes to improve their mood, confidence, vitality toward labor.