Background: Researchers have become increasingly aware that ambulance personnel may be at risk of developing work-related health problems. This article systematically explores the literature on health problems and work-related and individual health predictors in the ambulance services.

BackgroundThis study examined the relationship between life satisfaction among medical students and a basic model of personality, stress and coping. Previous studies have shown relatively high levels of distress, such as symptoms of depression and suicidal thoughts in medical undergraduates. However despite the increased focus on positive psychological health and well-being during the past decades, only a few studies have focused on life satisfaction and coping in medical students. This is the first longitudinal study which has identified predictors of sustained high levels of life satisfaction among medical students.MethodsThis longitudinal, nationwide questionnaire study examined the course of life satisfaction during medical school, compared the level of satisfaction of medical students with that of other university students, and identified resilience factors. T-tests were used to compare means of life satisfaction between and within the population groups. K-means cluster analyses were applied to identify subgroups among the medical students. Analysis of Variance (ANOVA) and logistic regression analyses were used to compare the subgroups.ResultsLife satisfaction decreased during medical school. Medical students were as satisfied as other students in the first year of study, but reported less satisfaction in their graduation year. Medical students who sustained high levels of life satisfaction perceived medical school as interfering less with their social and personal life, and were less likely to use emotion focused coping, such as wishful thinking, than their peers.ConclusionMedical schools should encourage students to spend adequate time on their social and personal lives and emphasise the importance of health-promoting coping strategies.

Cancer may be a risk factor for suicide, particularly shortly after diagnosis. However, the relative risk gradually decreased during the period 1960 to 1999.

This is the first study to show that a specific combination of personality traits can predict medical school stress. The combination of high neuroticism and high conscientiousness is considered to be particularly high risk.

BackgroundReliable suicide statistics are a prerequisite for suicide monitoring and prevention. The aim of this study was to assess the reliability of suicide statistics through a systematic review of the international literature.MethodsWe searched for relevant publications in EMBASE, Ovid Medline, PubMed, PsycINFO and the Cochrane Library up to October 2010. In addition, we screened related studies and reference lists of identified studies. We included studies published in English, German, French, Spanish, Norwegian, Swedish and Danish that assessed the reliability of suicide statistics. We excluded case reports, editorials, letters, comments, abstracts and statistical analyses. All three authors independently screened the abstracts, and then the relevant full-text articles. Disagreements were resolved through consensus.ResultsThe primary search yielded 127 potential studies, of which 31 studies met the inclusion criteria and were included in the final review. The included studies were published between 1963 and 2009. Twenty were from Europe, seven from North America, two from Asia and two from Oceania. The manner of death had been re-evaluated in 23 studies (40-3,993 cases), and there were six registry studies (195-17,412 cases) and two combined registry and re-evaluation studies. The study conclusions varied, from findings of fairly reliable to poor suicide statistics. Thirteen studies reported fairly reliable suicide statistics or under-reporting of 0-10%. Of the 31 studies during the 46-year period, 52% found more than 10% under-reporting, and 39% found more than 30% under-reporting or poor suicide statistics. Eleven studies reassessed a nationwide representative sample, although these samples were limited to suicide within subgroups. Only two studies compared data from two countries.ConclusionsThe main finding was that there is a lack of systematic assessment of the reliability of suicide statistics. Few studies have been done, and few countries have been covered. The findings support the general under-reporting of suicide. In particular, nationwide studies and comparisons between countries are lacking.

The high suicide rates among physicians and elderly graduates are of concern. The reasons why graduates are more vulnerable than others when getting older and the low rate among theologians warrant further study.

Although physicians are known to experience more stress than other workers, knowledge is lacking on the course of stress from a longitudinal perspective. This study explored the course of and contributors to, different dimensions of early career job-stress among physicians by means of a nationwide mail survey, with a particular emphasis on stress relating to the work-home interference. All physicians graduating from all four Norwegian universities in 1993 / 94 (N=631), responded during their final year of medical school (N=522), during their internship (N=402), in their 4th postgraduate year (N=422), and in their 10th postgraduate year (N=390). The mean observation period was 9.2 yr (SD=0.5). The main outcomes were job stress dimensions derived from an established job stress questionnaire (Cooper / Tyssen), with emphasis placed on dimensions of the work-home interference. Stress relating to the work-home interference increased during the observation period for both genders (repeated measures: β β β β β=0.06, p<0.05), whereas stress relating to emotional pressure, time pressure, and fear of complaints and criticism, decreased. Stress relating to the work-home interference increased during their early career, mainly due to a lack of adaptive reduction in work hours and an increased number of children. Neuroticism, conscientiousness, and lack of support from one's partner and colleagues, appeared to be predictive of this stress.

Physicians have a higher suicide rate than the general population or other academics. Little is known about the reasons for this. Analysing risk factors may be a valuable way of identifying reasons for the high suicide rate among physicians, thereby leading to preventive efforts. The present study is one of the first papers on suicidal thoughts and attempts among physicians. A questionnaire about suicidal thoughts (developed by E.S. Paykel) was completed by 1,063 of 1,476 active Norwegian physicians (72%). Lifetime prevalence ranged from 51.1% for feelings that life was not worth living to 1.6% for a suicide attempt. Risk factors were being female, living alone, and depression. Suicidal thoughts, however, were hardly attributed to working conditions. A high rate of suicide and a low rate of suicidal attempts support the hypothesis that physicians do not 'cry for help,' but are inclined to act out their suicidal impulses.