Physician burnout among West Virginia primary care providers

TITLE: Physician burnout among West Virginia primary care providers INTRODUCTION: Work related burnout is highly prevalent in US physicians and linked to adverse effects on patients, providers and organizations. This study measures burnout in West Virginia (WV) primary care providers, allowing for comparison of results to a similar, recent study of US physicians. METHODS: Anonymous survey through email that included Maslach Burnout Inventory, demographic, workload, and practice characteristics. Responses were analyzed using JMP Pro 13. Analysis used JMP Pro 13 for descriptive statistics, chi-square and regression modeling. RESULTS: Subjects = 110, female/male ratio 1.4, all primary care physicians (PCP), or advanced practice registered nurses or physician assistants (APRN/PA). PCP and APRN/PA differed on sex ratio (p /= 65 vs under 0.178 (p 0.032). Severe burnout in WV PCP was 57.6% and in all US physicians 43.9% (p 0.015). The OR for severe burnout in PCP versus APRN/PA was 2.89 (p 0.039). Burnout in PCP \u3e APRN in rural (p 0.046) but not urban. Private practice 17.6% in our population, 48% US physicians (p 0.0003). Burnout increased linearly with work hours (p 0.003). Self-estimate of burnout correlated with MBI results (p \u3c0.0001). DISCUSSION/CONCLUSION: Severe burnout was highly prevalent in this high risk specialty serving a patient population at risk in regards to poverty, age and medical complexity. This community had a low rate of private practice, fewer providers over age 65, a higher rate of burnout in physicians compared to APRN/PA, and a linear association of burnout to work hours. There was also validation of a single question burnout screening tool. High risk community systems could be a reservoir for burnout research and improvement there could reduce costs and improve outcomes

X-ray Tomographic System Behavior Prediction Based on a Mathematical Model

There appear certain challenges in defining the dependence of the X-ray radiation intensity change in passing through the material (as fixed by the detector) conditioned by various parameters of an X-ray optical system while designing new modifications of X-ray tomographs. At present, this problem is experimentally solved by selection of voltage corresponding parameter values on an X-ray tube with thickness and type of the studied material considered. To reduce the design time and complexity, a mathematical model of parameter behavior is required to characterize the X-ray optical system in the major working range of values. The present paper investigates the X-ray optical system behavior using methods of mathematical statistics. A regression model has been obtained which matches the change of the X-ray intensity value to the intensity in the X-ray tube. The research has defined the further study direction of X -ray optical system parameters

Overview of Kyoto Fusioneering’s SCYLLA© (“Self-Cooled Yuryo Lithium-Lead Advanced”) Blanket for Commercial Fusion Reactors

This article outlines Kyoto Fusioneering’s (KF’s) initial engineering and development activities for its self-cooled lithium lead-type blanket: Self-Cooled Yuryo Lithium-Lead Advanced (SCYLLA©). We provide details on overall design, including an initial tritium breeding ratio (TBR) assessment via neutronics analysis, as well as the status of SCYLLA©-relevant R&D. This includes silicon carbide composite (SiCf/SiC) manufacturing techniques, tritium extraction, materials compatibility, and heat transfer, which are being explored via collaboration with Kyoto University. Results of previous work in relation to this R&D are presented. Permeability coefficients indicate a promising property of SiCf/SiC tritium hermeticity at high temperatures. Tritium extraction technology via vacuum sieve tray (VST) is shown to be demonstrated at engineering scale. A local TBR of up to 1.4 can be achieved with the SCYLLA© configuration. Fabrication methods for various SiCf/SiC components including the blanket module, heat exchanger, and flow path components are provided. A tritium compatible high-temperature SiCf/SiC heat exchanger is discussed. Commercial viability and reactor adaptability are considered as a theme throughout. Finally, KF’s plans to build a facility for demonstration reactor relevant testing of a SCYLLA© prototype in the mid-2020s, which will provide a significant step toward commercial fusion energy, are presented

Transport Coefficients of the Yukawa One Component Plasma

We present equilibrium molecular-dynamics computations of the thermal conductivity and the two viscosities of the Yukawa one-component plasma. The simulations were performed within periodic boundary conditions and Ewald sums were implemented for the potentials, the forces, and for all the currents which enter the Kubo formulas. For large values of the screening parameter, our estimates of the shear viscosity and the thermal conductivity are in good agreement with the predictions of the Chapman-Enskog theory.Comment: 11 pages, 2 figure

Heterogeneities in Supercooled liquids: A Density Functional Study

A metastable state, characterized by a low degree of mass localization is identified using Density Functional Theory. This free energy minimum, located through the proper evaluation of the competing terms in the free energy functional, is independent of the specific form of the DFT used. Computer simulation results on particle motion indicate that this heterogeneous state corresponds to the supercooled state.Comment: 10 pages, 6 figure

Density functional theory of phase coexistence in weakly polydisperse fluids

The recently proposed universal relations between the moments of the polydispersity distributions of a phase-separated weakly polydisperse system are analyzed in detail using the numerical results obtained by solving a simple density functional theory of a polydisperse fluid. It is shown that universal properties are the exception rather than the rule.Comment: 10 pages, 2 figures, to appear in PR

Dislocation-Mediated Melting: The One-Component Plasma Limit

The melting parameter $\Gamma_m$ of a classical one-component plasma is estimated using a relation between melting temperature, density, shear modulus, and crystal coordination number that follows from our model of dislocation-mediated melting. We obtain $\Gamma_m=172\pm 35,$ in good agreement with the results of numerous Monte-Carlo calculations.Comment: 8 pages, LaTe

Mean Field Fluid Behavior of the Gaussian Core Model

We show that the Gaussian core model of particles interacting via a penetrable repulsive Gaussian potential, first considered by Stillinger (J. Chem. Phys. 65, 3968 (1976)), behaves like a weakly correlated ``mean field fluid'' over a surprisingly wide density and temperature range. In the bulk the structure of the fluid phase is accurately described by the random phase approximation for the direct correlation function, and by the more sophisticated HNC integral equation. The resulting pressure deviates very little from a simple, mean-field like, quadratic form in the density, while the low density virial expansion turns out to have an extremely small radius of convergence. Density profiles near a hard wall are also very accurately described by the corresponding mean-field free-energy functional. The binary version of the model exhibits a spinodal instability against de-mixing at high densities. Possible implications for semi-dilute polymer solutions are discussed.Comment: 13 pages, 2 columns, ReVTeX epsfig,multicol,amssym, 15 figures; submitted to Phys. Rev. E (change: important reference added

Equation of state of fully ionized electron-ion plasmas

Thermodynamic quantities of Coulomb plasmas consisting of point-like ions immersed in a compressible, polarizable electron background are calculated for ion charges Z=1 to 26 and for a wide domain of plasma parameters ranging from the Debye-Hueckel limit to the crystallization point and from the region of nondegenerate to fully degenerate nonrelativistic or relativistic electrons. The calculations are based on the linear-response theory for the electron-ion interaction, including the local-field corrections in the electronic dielectric function. The thermodynamic quantities are calculated in the framework of the N-body hypernetted-chain equations and fitted by analytic expressions. We present also accurate analytic approximations for the free energy of the ideal electron gas at arbitrary degeneracy and relativity and for the excess free energy of the one-component plasma of ions (OCP) derived from Monte Carlo simulations. The extension to multi-ionic mixtures is discussed within the framework of the linear mixing rule. These formulae provide a completely analytic, accurate description of the thermodynamic quantities of fully ionized electron-ion Coulomb plasmas, a useful tool for various applications from liquid state theory to dense stellar matter.Comment: 13 pages, 2 tables, 7 figures, REVTeX using epsf.sty. To be published in Phys. Rev. E, vol. 58 (1998

Lattice density-functional theory of surface melting: the effect of a square-gradient correction

I use the method of classical density-functional theory in the weighted-density approximation of Tarazona to investigate the phase diagram and the interface structure of a two-dimensional lattice-gas model with three phases -- vapour, liquid, and triangular solid. While a straightforward mean-field treatment of the interparticle attraction is unable to give a stable liquid phase, the correct phase diagram is obtained when including a suitably chosen square-gradient term in the system grand potential. Taken this theory for granted, I further examine the structure of the solid-vapour interface as the triple point is approached from low temperature. Surprisingly, a novel phase (rather than the liquid) is found to grow at the interface, exhibiting an unusually long modulation along the interface normal. The conventional surface-melting behaviour is recovered only by artificially restricting the symmetries being available to the density field.Comment: 16 pages, 6 figure