Clinical Trainees\u27 Experience of Burnout and its Relationship to Supervision

Burnout is a phenomenon that has recently gotten a lot of attention in research and media, but there is still a need to understand burnout among clinical trainees. Burnout is characterized by emotional exhaustion, a sense of cynicism, and a reduced sense of personal accomplishment. This qualitative study attempted to understand clinical trainees’ experience of burnout, the factors they believed were contributing factors to their burnout, and how supervision impacted this experience. The participants included six trainees who were enrolled in a clinical or counseling doctorate program, have experienced or are currently experiencing burnout, and had at least six months of practica experience. The results of this study were fairly consistent with the literature, though there were characteristics of both how the burnout was experienced and the factors that contributed to burnout that were unique to this study. I also provide ways academic and training programs can ameliorate burnout among trainees, directions for future research, and the limits of this study

Effects of very low calorie diet intervention on body composition and physical activity

Access to thesis permanently restricted to Ball State community only.Background: The Very-Low-Calorie Diet (VLCD) is becoming an increasingly popular treatment option for obesity. The diet consists of 400-800 kcal/day in the form of meal replacements, and has been shown to be effective at producing rapid and significant weight loss. However, research is limited pertaining to the influence of the diet on parameters of health other than weight – such as body composition, physical activity, cardiovascular risk factors, arterial health, and psychological health. Additionally, many VLCD studies have noted limitations, such as the use of less reliable body composition measures than what are available and subjective physical activity assessments. Studies have also used calorie intakes closer to 400 kcal/day, whereas an increasing number of programs are beginning to prescribe higher consumptions. Purpose: This study aimed to assess the effects of participation in a VLCD program for the initial three months of treatment. Specifically, changes in abdominal obesity, lean mass (LM), physical activity (PA), sedentary behavior (SB), cardiovascular (CV) risk factors, arterial stiffness, fatigue level, and health-related quality of life (HRQOL) were studied. A reliable measure of body composition and objective measure of PA were used to expand on previous research. Findings from this study provide information to health care professionals regarding use of a VLCD as a weight loss treatment for overall health. Methods: Eighteen subjects (1 male) completed four visits for this study. The first visit consisted of completion of questionnaires including health-history, fatigue, and HRQOL. Subjects were asked to complete one week of objective PA monitor wear-time. The second visit followed the first by approximately one week. Measurements of body composition and arterial stiffness were obtained. The third and fourth visits were separated from the first and second by approximately three months and included a complete assessment of the same measures as the initial visits. Changes in initial to follow-up measures were assessed via paired-samples t-tests. Results: Significant improvements were found in initial to three-month follow up measures in weight (115.7 ± 31.2 kg to 101.0 ± 26.7 kg), abdominal fat (5.7 ± 2.4 kg to 4.3 ± 2.0 kg), systolic blood pressure (BP; 127 ± 16 mmHg to 112 ± 20 mmHg), diastolic BP (83 ± 9 mmHg to 69 ± 9 mmHg), fatigue severity (score 32 ± 11 to score 26 ± 10), and HRQOL (score 99 ± 11 to score 109 ± 9). Additionally, a significant decrease was detected in LM (51.8 ± 9.7 kg to 50.4 ± 9.1 kg). No significant changes were found in objective PA, objective SB, or arterial stiffness. Conclusions: The results of this study indicated weight loss via a VLCD consisting of 760 kcal/day was effective at producing positive changes in several measures of body composition and psychological health, and cardiovascular risk; and also resulted in a significant decrease in LM. Findings expanded on previous research to include a reliable measure of body composition that showed similar directional changes. Conversely, objective measurement of PA in the current study found no significant changes, whereas previous research using subjective measures has found increased PA engagement. Due to the relationship between PA and long-term weight loss maintenance, health care professionals should consider implementation of a specific exercise prescription as an integral component of a VLCD program.School of Physical Education, Sport, and Exercise ScienceThesis (M.S.

Investigations of a Surrogate Fuel Based on Fischer-Tropsch GTL and CTL in CVCC, IDI and DI Compression Ignition Engines

With the increase in availability, feedstocks, and properties of alternative fuels, compatibility issues emerge between current engine platforms often requiring a limit on the blend percentage of alternative fuel in conventional fuel or alteration to the engine platform. Two key metrics were identified, autoignition quality and lubrication characteristics, as vital for the proper function of a compression ignition engine, and if the blend of alternative fuels matches these two criteria for the diesel standard, then the resulting blend percentage can be considered as a viable alternative for complete replacement of conventional petroleum ULSD. Autoignition quality was matched using blends S-8, DCN 62, and IPK, DCN 26, with three blends labeled as B1, B2, and B3. A modified DCN equation was then derived for the F-T fuels based on measured ID, CD, and DCN. The results of which determined that a 60% S-8 and 40% IPK blend percentage match the DCN set point of 50 and denoted in the text as S1. The lubricity investigation found that a 3% of a biodiesel compound, methyl oleate, improved average friction force and wear scar depth to within 1% of ULSD. This final surrogate blend is denoted as S2 for the duration of this study. All researched neat fuels and blends were investigated in the CVCC for LTHR, NTC, HTHR, peak pressure ringing, and energy released and duration of each combustion region. The analysis of peak pressure ringing indicated an increase in combustion stability for S2 when compared to ULSD. The LTHR analysis revealed that S2 has a much longer NTC region when compared to ULSD despite its increase in DCN. Three representative fuels were chosen for further investigation in both dual combustion chamber indirect injection and common rail direct injection engine platforms: ULSD (baseline), S2, and IPK. In both engines, the combustion of S2 resulted in a reduction in ringing intensity, BSFC, NOx emissions, CO2 emissions. No significant differences were found in peak pressure, peak pressure rise rate, or combustion phasing between the combustion of S2 and the combustion of ULSD indicating its high viability as a functional drop-in fuel replacement

Fresh Squeezed: The Dilemma of Local Food Production Along Colorado\u27s Front Range Urban Corridor

Today, the Front Range Urban Corridor of Colorado is one example from the urban/agricultural battlefield. The history of food production and urbanization in this area is similar to many regions throughout the western United States. Originally an extraction based economy, Colorado later became agriculturally/pastorally based, and more recently became a service-based, urban economy. On the Front Range Urban Corridor specifically, the urban core of Denver and Boulder developed with rich agricultural lands toward the northeast to Weld County along the northern border of the state. Though a semi-arid region, this agricultural zone produces a volume and variety of food-based crops due to a vast irrigation network on the rich piedmont soils of the Platte River valley (Whitney 1983, Acevedo and Taylor 2006). Urban development, however, is overtaking agricultural areas as cities grow towards each other and spread out along transportation networks (Acevedo and Taylor 2006). Unfortunately, the same rich, flat, irrigated soil used to grow food is also favored by land developers and home owners. As development and food production are starting to challenge the finite limits of the land, there are choices to make regarding land, development, and local food production. By combining data from the U.S. Agricultural Census with results of an author-driven survey of local producers in Colorado, this project will consider these choices and illuminate the complex web of their interdependence. The principal results display that Colorado faces increasing competition for food production and urban development space potentially pressuring local food prices upward and forcing producers to peripheral land or out of food production

Monitoring Sarcomere Structure Changes in Whole Muscle Using Diffuse Light Reflectance

doi:10.1117/1.2234278Normal biomechanical and physiological functions of striated muscles are facilitated by the repeating sarcomere units. Light scattering technique has been used in studying single extracted muscle fibers. However, few studies, if any, have been conducted to investigate the possibility of using optical detection to examine sarcomere structure changes in whole muscles. We conducted a series of experiments to demonstrate that optical scattering properties measured in whole muscle are related to changes in sarcomere structure. These results suggest that photon migration technique has a potential for characterizing in vivo tissue ultrastructure changes in whole muscle

Histamine-Induced Conjunctivitis and Breakdown of Blood–Tear Barrier in Dogs: A Model for Ocular Pharmacology and Therapeutics

Conjunctival inflammation disturbs the blood–tear barrier and thus affects the tear film stability and composition. We aimed to develop a non-invasive and reliable method to induce conjunctivitis in dogs, a large animal model for translational work on ocular surface disease in humans. Six beagle dogs underwent a randomized, vehicle-controlled, balanced crossover trial—on six separate days, one eye received topical artificial tears (vehicle), while the other eye received one of six concentrations of histamine solution (0.005–500 mg/ml). At sequential times after eyedrop administration, a conjunctivitis score was given to each eye based on the degree of palpebral and bulbar conjunctival hyperemia and chemosis, ocular pruritus, and discharge. Total protein content (TPC) and serum albumin were quantified in tear fluid at baseline and 20 min. Additionally, 13 dogs presenting for various ophthalmic diseases with associated conjunctivitis were examined. Experimentally induced conjunctivitis developed rapidly (\u3c1 min) following topical histamine administration and lasted for 1–3 h (four lowest doses) to 6–8 h (two highest doses). The severity of conjunctivitis was dose-dependent. Histamine was overall well tolerated, although transient blepharitis, aqueous flare, and ocular hypertension occurred in a few dogs receiving histamine ≥375 mg/ml. TPC and serum albumin levels increased in tears of eyes receiving histamine ≥1.0 mg/ml, being significantly higher than vehicle and baseline in eyes receiving histamine ≥375 mg/ml. Lacrimal albumin levels were also increased in 13 dogs with naturally acquired conjunctivitis, up 2.7–14.9 fold compared to contralateral healthy eyes. Histamine-induced conjunctivitis represents a robust model for translational work on the ocular surface given the low cost, non-invasiveness, self-resolving nature, ability to adjust the duration and severity of the disease, and shared features with naturally occurring ocular diseases. Histamine solutions of 1, 10, and 375 mg/ml induce mild, moderate, and severe conjunctivitis in dogs, respectively. Leakage of serum albumin in tear fluid of eyes with conjunctivitis suggests a breakdown of the blood–tear barrier

Onsite Wastewater Treatment Systems: Liquid Chlorination

4 pp., 2 figuresThis publication explains the process, components, legal requirements, factors affecting performance, and maintenance needs of liquid chlorination systems for onsite wastewater treatment