BackgroundWhether burnout is a distinct phenomenon rather than a type of depression and whether it is a syndrome, limited to three “core” components (emotional exhaustion, depersonalization and low personal accomplishment) are subjects of current debate. We investigated the depression-burnout overlap, and the pertinence of these three components in a large, representative sample of physicians.MethodsIn a cross-sectional study, all Austrian physicians were invited to answer a questionnaire that included the Major Depression Inventory (MDI), the Hamburg Burnout Inventory (HBI), as well as demographic and job-related parameters. Of the 40093 physicians who received an invitation, a total of 6351 (15.8%) participated. The data of 5897 participants were suitable for analysis.ResultsOf the participants, 10.3% were affected by major depression. Our study results suggest that potentially 50.7% of the participants were affected by symptoms of burnout. Compared to physicians unaffected by burnout, the odds ratio of suffering from major depression was 2.99 (95% CI 2.21–4.06) for physicians with mild, 10.14 (95% CI 7.58–13.59) for physicians with moderate, 46.84 (95% CI 35.25–62.24) for physicians with severe burnout and 92.78 (95% CI 62.96–136.74) for the 3% of participants with the highest HBI_sum (sum score of all ten HBI components). The HBI components Emotional Exhaustion, Personal Accomplishment and Detachment (representing depersonalization) tend to correlate more highly with the main symptoms of major depression (sadness, lack of interest and lack of energy) than with each other. A combination of the HBI components Emotional Exhaustion, Helplessness, Inner Void and Tedium (adj.R2 = 0.92) explained more HBI_sum variance than the three “core” components (adj.R2 = 0.85) of burnout combined. Cronbach’s alpha for Emotional Exhaustion, Helplessness, Inner Void and Tedium combined was 0.90 compared to α = 0.54 for the combination of the three “core” components.ConclusionsThis study demonstrates the overlap of burnout and major depression in terms of symptoms and the deficiency of the three-dimensional concept of burnout. In our opinion, it might be preferable to use multidimensional burnout inventories in combination with valid depression scales than to rely exclusively on MBI when clinically assessing burnout.

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Central muscle relaxants like tizanidine might have an impact on the development of delirium. Tizanidine withdrawal should be considered in patients who manifest signs and symptoms of withdrawal from medications. The drug should be gradually reduced in dosage under observation by a psychiatrist. When prescribing tizanidine, the possible pharmacological side effects and interactions should be taken into careful account.

The article proposes a model for the computational core of the decision support system (DSS) in assessing the risks of investment loss during the dynamic planning (DP) of Smart City development. In contrast to the existing solutions, the proposed model provides specific recommendations when assessing the risks of loss. In case of an unsatisfactory risk forecast, it is possible to flexibly adjust the parameters of the investment process in order for the parties to achieve an acceptable financial result. The scientific novelty of the results is that for the first time it is proposed to apply a new class of bilinear multistep games. This class allowed us to adequately describe the process of assessing the risks of investment loss, using the example of dynamic planning for the placement of financial resources of players in Smart City projects. A distinctive feature of the considered approach is the use of tools based on the solution of a bilinear multistep game of both quality with several terminal surfaces, and a game of degree solved in the class of mixed strategies. Computational experiments were carried out in the Maple mathematical modeling package, and a DSS was developed in which a risk assessment model was implemented. The developed DSS allows to reduce the discrepancies between the data for predicting the risks of investment loss during the Smart City DP and the real return on investment.

This article discusses problems based on group methods of decision-making based on a multimodal approach to solving the problems of dynamic planning of Smart City development. In particular, the main tool for decision-making in the process of dynamic planning is a system of models and methods, which are the basis for creating the structure of the dynamic plan, optimizing the plan and finding the desired solution. Collective decision-making methods are used in the collective development of planning decisions, including in the context of solving the problems of dynamic planning of Smart City development and group decision-making, which requires the agreed decisions of several specialists.