Since the onset of the COVID-19 pandemic, burnout symptoms have been prevalent among healthcare workers. Living with spouses can be complex and was associated with an increased burnout risk during the COVID-19 pandemic. This study investigated the relationship between living with spouses and burnout among healthcare workers during the COVID-19 pandemic. We distributed questionnaires to participants working in a hospital affiliated with a medical university in Taiwan. The questionnaires were the Copenhagen Burnout Inventory, which comprises personal burnout (PB), work-related burnout (WB), and client burnout subscales; the Nordic Musculoskeletal Questionnaire; and information on basic demographic variables, family factors, living habits, work-related factors, and physical health factors. Multiple linear regression and mediation analysis were used. We obtained 1615 (63.81%) valid questionnaires. After analysis revealed that marriage was an independent risk factor for PB; however, the effect of marriage on WB was nonsignificant after controlling for risk factors. Parenthood, less alcohol use, reported sleep duration less than six hours, less overtime, less shift work, and participation in leisure activities with family and friends were found to be mediators between marriage and a lower WB level. In addition, chronic diseases, frequent neck pain, and shoulder pain were suppression factors. In summary, marriage was associated with an increased risk of PB. Married individuals sustain a high WB level because of changes in family roles, living conditions, and work conditions. Overall, helping healthcare workers to maintain well-being in marriage or family living may be effective in decreasing burnout during the COVID-19 pandemic.

In addition to increasing the mortality among older adults, spousal death (SD) increases their risk of depression. This study explored the factors affecting depression among widowed older adults to provide health care strategies for successful aging. A total of 710 adults older than 60 years completed a questionnaire before and after their spouses’ deaths. The survey data included age, sex, ethnic group, education level, financial station socioeconomic status, SD (including time point), smoking status, alcohol consumption, self-rated health status, Center for Epidemiologic Studies Depression Scale score, mobility, and degree of support from relatives and friends. The proportion of participants with depression after SD was 1.7 times that of before SD (p < 0.0001). Worsened mobility (odds ratio [OR] = 1.3, p < 0.01), low self-rated health status (OR = 0.5, p < 0.01), and a high degree of support from relatives and friends (OR = 1.5, p < 0.01) had a significant positive correlation with depression after SD. The proportion of depression that occurred within 6 months after SD was 6.0 times higher than that of depression before SD. Participants who lived alone after losing their spouses who were healthy before their deaths exhibited a significantly increased proportion of depression after their spouses’ deaths. Male sex, spouse’s health, and the period of 6 months after SD are risk factors for depression in older adults. The maintenance of mobility, positive self-rated health status, and a shorter period of depression after a spouse’s death result in more favorable adaptability among women. Social workers or family members should focus on older adults whose spouses died unexpectedly or within the last 6 months. Living with family members after SD can alleviate depression in older adults.

Background and Objectives: Burnout affects approximately half of all nurses, physicians, and other clinicians. Alcohol use may impair performance in work-related tasks, leading to decreased productivity and morale. The present study’s aim was to determine whether a causal relationship existed between alcohol use, work-related burnout (WB), and musculoskeletal pain. Materials and Methods: A total of 1633 members from a hospital affiliated with a medical university in Taichung, Taiwan, completed questionnaires in 2021, where 1615 questionnaires were declared valid. Questionnaires were used to obtain information on basic demographic variables, and the Nordic Musculoskeletal Questionnaire and Copenhagen Burnout Inventory were used. Statistical analyses were performed using SAS Enterprise Guide 6.1 software, and significance was set at p < 0.05. Results: Work experience, being married, parenthood, leisure activities with family and friends, and regular weekly exercise were negatively associated with WB. In addition, overtime work, irregular and regular shift work, the physician and nurse medical profession, chronic disease (heart disease, diabetes, etc.), neck and both shoulders pain (NBSP), both ankles pain (BAP), and alcohol use frequency (AUF) were positively associated with WB. NBSP could explain the residual effect of AUF on WB. AUF was determined to mediate the relationship between NBSP and WB. In addition, NBSP was found to mediate the relationship between AUF and WB. Conclusions: The individuals who used alcohol to cope with NBSP or those with NBSP who often consumed alcohol had worsened WB due to a vicious circle of musculoskeletal pain and alcohol use. Therefore, medical staff should not consider alcohol use as an option to reduce burnout.

The coexistence of diabetes mellitus (DM) and heart failure (HF) is frequent and is associated with a higher risk of hospitalization for HF and all-cause and cardiovascular mortality. It has been estimated that millions of people are affected by HF and DM, and the prevalence of both conditions has increased over time. Concomitant HF and diabetes confer a worse prognosis than each alone; therefore, managing DM care is critical for preventing HF. This article reviews the prevalence of HF and diabetes and the correlated prognosis as well as provides a basic understanding of diabetic cardiomyopathy, including its pathophysiology, focusing on the relationship between DM and HF with a preserved ejection fraction and summarizes the potential aldosterone and the mineralocorticoid receptor antagonists approaches for managing heart failure and DM. Sodium–glucose cotransporter 2 inhibitors (SGLT2Is) are an emerging class of glucose-lowering drugs, and the role of SGLT2Is in DM patients with HF was reviewed to establish updated and comprehensive concepts for improving optimal medical care in clinical practice.

Objectives: This study explores the relationship among commuting, musculoskeletal (MS) pain, and burnout.Methods: An observational and cross-sectional study was conducted at a medical university-affiliated hospital in Taichung, Taiwan in 2021. The two questionnaire was used and they included the Copenhagen Burnout Inventory (CBI) and the Nordic Musculoskeletal Questionnaire (NMQ). All participants were invited to complete the cross-sectional survey. A multiple linear regression was assessed correlations between commuting, MS pain, and burnout.Results: After excluding those with missing data, 1,615 healthcare workers were deemed valid as research participants. In multiple linear regression, commuting time longer than 50 min was associated with personal burnout (PB) in the presence of adjusted confounders; however, long commuting time was not associated with work-related burnout (WB). Furthermore, the choice of commuting method did not affect PB or WB. Notably, both neck and shoulder pain (NBSP) and ankle pain (BAP) increase the risk of PB and WB. The mediation analysis demonstrated that NBSP is a mediating factor, increasing the level of PB and WB for commuting times longer than 50 min.Conclusions: Healthcare workers who commute for more than 50 min should be considered part of a high-risk group for burnout and musculoskeletal pain. They should also be provided with resources and programs focused on burnout prevention and MS pain relief.

Background: Epidemiological evidence suggests the association of diabetes with an increased risk of stroke. Clinical studies have investigated the effects of sodium-glucose co-transporter-2 (SGLT2) inhibitors on new-onset stroke (NOS), but the results are inconsistent.Objectives: To determine the association between the use of SGLT2 inhibitors and NOS in patients with type 2 diabetes mellitus (DM).Methods: We conducted a retrospective longitudinal cohort study based on the Taiwan Health Insurance Review and Assessment Service database (2016–2019). The primary outcome of the assessment was the risk of incident stroke by estimating hazard ratios (HRs) and 95% confidence intervals (CIs). Multiple Cox regression was applied to estimate the adjusted HR of NOS. Subgroup analysis was also conducted.Results: Among the 232,101 eligible patients with type 2 DM aged ≥ 20 years, SGLT2-inhibitor users were compared with non-SGLT2-inhibitor users based on age, sex, and the duration of type 2 DM matching at a ratio of 1:2. The event rate per 10 000 person-months was 9.20 (95% CI 8.95 to 9.45) for SGLT2-inhibitor users and 10.5(10.3–10.6) for non-SGLT2-inhibitor users. There was a decreased risk of NOS for SGLT2-inhibitor users (adjusted HR 0.85, 95% CI 0.82–0.88) compared with non-SGLT2-inhibitor users. Results for the propensity score-matched analyses showed similar results (adjusted HR 0.87, 95% CI 0.84–0.91 for both SGLT2-inhibitor users and non-SGLT2-inhibitor users).Conclusion: The risk of developing NOS was lower in patients with SGLT2-inhibitor users than in non-SGLT2-inhibitor users. The decreased risk of NOS in patients with type 2 DM was greater among patients with concurrent use of statins, biguanides, thiazolidinediones, and glucagon-like peptide-1 receptor agonists. We, therefore, suggest that the long-term use of SGLT2 inhibitors may help reduce the incidence of NOS in patients with type 2 DM.