Experience of Burnout Among Educational Leadership Doctoral Candidates

In this era of high accountability, standardized based instructions, and public debates over teacher quality, performance, and evaluation, education administrators across the country have come under intense pressures (Boccio, Weisz, & Lefkowitz, 2016; Carey, 2011; Ravitch, 2010). Due to the high incentives and intense pressures on school leaders, and the wide-ranging impact these positions have on communities, it is crucial to understand those who are seeking greater leadership roles in education. The purpose of this study was to determine if candidates pursing doctorate degrees in educational leadership are experiencing burnout. The dissertation addresses the phenomenon of job burnout, which is a response to prolonged chronic emotional and interpersonal stressors at the work environment (Maslach, 2003). Doctoral candidates are prime candidates for experiencing life stressors and burnout. The dissertation addresses the questions: (1) What levels of burnout do educational leadership doctoral candidates experience? (2) How do levels of emotional exhaustion, depersonalization, and personal accomplishments vary among doctoral candidates experience? And (3) Does educational work role impact self-perceptions of burnout by educational leadership doctoral candidates? Participants for this study were comprised of educational leadership doctoral program candidates and those who graduated from the program within a 24 month time period prior to the administration of the survey. The program takes place at a university in eastern Nebraska. The findings indicated that a majority of participants in this study had a low to moderate degree of burnout across two components of burnout through emotional exhaustion and depersonalization. Participants self-reported moderate to high degree of personal accomplishment, indicating low degrees of burnout. This study was intended to provide information for post-secondary institutions, local and state education agencies and policy makers. Educational leadership doctoral program faculty may follow up and choose to review and modify professional preparation course content and engage aspiring educational leaders in meaningful dialogue about burnout and its impact on individuals and organizations. These findings are discussed along with limitations, directions for future research, and implications of these findings

Aural stealth for night vision portable imagers

Modern tactics for carrying out military and antiterrorist operations calls for the development of a new generation of enhanced portable infrared imagers. The high performance of these imagers relies on the focal plane arrays, which are maintained at cryogenic temperatures using rotary Stirling cryogenic engines. These engines are known as powerful sources of wideband vibration export. For the sake of weight and compactness, the enclosure of the above imager is usually designed in the form of a light metal thin-walled shell, accommodating a directly mounted Infrared Detector Dewar Cooler Assembly. The operation of the device typically leads to an excitation of the inherently lightly damped structural resonances and therefore, to a radiation of the specific acoustic signature capable of compromising the aural stealth of the IR imager. Such a noisy IR imager may be detected from quite a long distance using enhanced sniper detection equipment or even aurally spotted when used in a close proximity to the target. Numerous efforts were taken towards achieving the desired inaudibility level, apparently becoming one of a crucial figure of merit characterizing the portable IR imager. However, even the best examples of modern should-be silent imagers are quite audible from as far as 50 meters. The presented research intends to improve the aural stealth of the portable IR imager by using three different approaches: First, by compliantly mounting the Infrared Detector Dewar Cooler Assembly where the stiffness and damping of the vibration protective pad are optimized for the best acoustical performance without developing excessive line of sight jitter. Secondly, by using the concept of the weak radiator to reshape the enclosure mode shapes, and finally developing a multi-modal distributed dynamic absorber (MMDA) to enhance the absorption of the vibrating structure. The multi-modal characteristic of such a dynamic absorber makes it highly dynamically reactive through a wide frequency range (20 kHz) of excitation. It will be shown that incorporating a MMDA into the vibrating structure will result in ultra range vibration attenuation, making the IR aurally silent

Characteristics and outcome of patients with newly diagnosed advanced or metastatic lung cancer admitted to intensive care units (ICUs)

BACKGROUND: Although patients with advanced or metastatic lung cancer have poor prognosis, admission to the ICU for management of life-threatening complications has increased over the years. Patients with newly diagnosed lung cancer appear as good candidates for ICU admission, but more robust information to assist decisions is lacking. The aim of our study was to evaluate the prognosis of newly diagnosed unresectable lung cancer patients. METHODS: A retrospective multicentric study analyzed the outcome of patients admitted to the ICU with a newly diagnosed lung cancer (diagnosis within the month) between 2010 and 2013. RESULTS: Out of the 100 patients, 30 had small cell lung cancer (SCLC) and 70 had non-small cell lung cancer. (Thirty patients had already been treated with oncologic treatments.) Mechanical ventilation (MV) was performed for 81 patients. Seventeen patients received emergency chemotherapy during their ICU stay. ICU, hospital, 3- and 6-month mortality were, respectively, 47, 60, 67 and 71%. Hospital mortality was 60% when invasive MV was used alone, 71% when MV and vasopressors were needed and 83% when MV, vasopressors and hemodialysis were required. In multivariate analysis, hospital mortality was associated with metastatic disease (OR 4.22 [1.4-12.4]; p = 0.008), need for invasive MV (OR 4.20 [1.11-16.2]; p = 0.030), while chemotherapy in ICU was associated with survival (OR 0.23, [0.07-0.81]; p = 0.020). CONCLUSION: This study shows that ICU management can be appropriate for selected newly diagnosed patients with advanced lung cancer, and chemotherapy might improve outcome for patients with SCLC admitted for cancer-related complications. Nevertheless, tumors' characteristics, numbers and types of organ dysfunction should be taken into account in the decisional process before admitting these patients in ICU.Peer reviewe

Intensive care of the cancer patient: recent achievements and remaining challenges

A few decades have passed since intensive care unit (ICU) beds have been available for critically ill patients with cancer. Although the initial reports showed dismal prognosis, recent data suggest that an increased number of patients with solid and hematological malignancies benefit from intensive care support, with dramatically decreased mortality rates. Advances in the management of the underlying malignancies and support of organ dysfunctions have led to survival gains in patients with life-threatening complications from the malignancy itself, as well as infectious and toxic adverse effects related to the oncological treatments. In this review, we will appraise the prognostic factors and discuss the overall perspective related to the management of critically ill patients with cancer. The prognostic significance of certain factors has changed over time. For example, neutropenia or autologous bone marrow transplantation (BMT) have less adverse prognostic implications than two decades ago. Similarly, because hematologists and oncologists select patients for ICU admission based on the characteristics of the malignancy, the underlying malignancy rarely influences short-term survival after ICU admission. Since the recent data do not clearly support the benefit of ICU support to unselected critically ill allogeneic BMT recipients, more outcome research is needed in this subgroup. Because of the overall increased survival that has been reported in critically ill patients with cancer, we outline an easy-to-use and evidence-based ICU admission triage criteria that may help avoid depriving life support to patients with cancer who can benefit. Lastly, we propose a research agenda to address unanswered questions

Admission of advanced lung cancer patients to intensive care unit: A retrospective study of 76 patients

<p>Abstract</p> <p>Background</p> <p>Criteria for admitting patients with incurable diseases to the medical intensive care unit (MICU) remain unclear and have ethical implications.</p> <p>Methods</p> <p>We retrospectively evaluated MICU outcomes and identified risk factors for MICU mortality in consecutive patients with advanced lung cancer admitted to two university-hospital MICUs in France between 1996 and 2006.</p> <p>Results</p> <p>Of 76 included patients, 49 had non-small cell lung cancer (stage IIIB n = 20; stage IV n = 29). In 60 patients, MICU admission was directly related to the lung cancer (complication of cancer management, n = 30; cancer progression, n = 14; and lung-cancer-induced diseases, n = 17). Mechanical ventilation was required during the MICU stay in 57 patients. Thirty-six (47.4%) patients died in the MICU. Three factors were independently associated with MICU mortality: use of vasoactive agents (odds ratio [OR] 6.81 95% confidence interval [95%CI] [1.77-26.26], p = 0.005), mechanical ventilation (OR 6.61 95%CI [1.44-30.5], p = 0.015) and thrombocytopenia (OR 5.13; 95%CI [1.17-22.5], p = 0.030). In contrast, mortality was lower in patients admitted for a complication of cancer management (OR 0.206; 95%CI [0.058-0.738], p = 0.015). Of the 27 patients who returned home, four received specific lung cancer treatment after the MICU stay.</p> <p>Conclusions</p> <p>Patients with acute complications of treatment for advanced lung cancer may benefit from MCIU admission. Further studies are necessary to assess outcomes such as quality of life after MICU discharge.</p