Job burnout in mental health providers: A meta-analysis of 35 years of intervention research.

Burnout is prevalent among mental health providers and is associated with significant employee, consumer, and organizational costs. Over the past 35 years, numerous intervention studies have been conducted but have yet to be reviewed and synthesized using a quantitative approach. To fill this gap, we performed a meta-analysis on the effectiveness of burnout interventions for mental health workers. We completed a systematic literature search of burnout intervention studies that spanned more than 3 decades (1980 to 2015). Each eligible study was independently coded by 2 researchers, and data were analyzed using a random-effects model with effect sizes based on the Hedges’ g statistic. We computed an overall intervention effect size and performed moderator analyses. Twenty-seven unique samples were included in the meta-analysis, representing 1,894 mental health workers. Interventions had a small but positive effect on provider burnout (Hedges’ g = .13, p = .006). Moderator analyses suggested that person-directed interventions were more effective than organization-directed interventions at reducing emotional exhaustion (Qbetween = 6.70, p = .010) and that job training/education was the most effective organizational intervention subtype (Qbetween = 12.50, p < .001). Lower baseline burnout levels were associated with smaller intervention effects and accounted for a significant proportion of effect size variability. The field has made limited progress in ameliorating mental health provider burnout. Based on our findings, we suggest that researchers implement a wider breadth of interventions that are tailored to address unique organizational and staff needs and that incorporate longer follow-up periods

Mitochondrial Diagnostics: A Multiplexed Assay Platform for Comprehensive Assessment of Mitochondrial Energy Fluxes

Chronic metabolic diseases have been linked to molecular signatures of mitochondrial dysfunction. Nonetheless, molecular remodeling of the transcriptome, proteome, and/or metabolome does not necessarily translate to functional consequences that confer physiologic phenotypes. The work here aims to bridge the gap between molecular and functional phenomics by developing and validating a multiplexed assay platform for comprehensive assessment of mitochondrial energy transduction. The diagnostic power of the platform stems from a modified version of the creatine kinase energetic clamp technique, performed in parallel with multiplexed analyses of dehydrogenase activities and ATP synthesis rates. Together, these assays provide diagnostic coverage of the mitochondrial network at a level approaching that gained by molecular “-omics� technologies. Application of the platform to a comparison of skeletal muscle versus heart mitochondria reveals mechanistic insights into tissue-specific distinctions in energy transfer efficiency. This platform opens exciting opportunities to unravel the connection between mitochondrial bioenergetics and human disease

The Very Young Type Ia Supernova 2012cg: Discovery and Early-Time Follow-Up Observations

On 2012 May 17.2 UT, only 1.5 +/- 0.2 d after explosion, we discovered SN 2012cg, a Type Ia supernova (SN Ia) in NGC 4424 (d ~ 15 Mpc). As a result of the newly modified strategy employed by the Lick Observatory SN Search, a sequence of filtered images was obtained starting 161 s after discovery. Utilizing recent models describing the interaction of SN ejecta with a companion star, we rule out a ~1 M_Sun companion for half of all viewing angles and a red-giant companion for nearly all orientations. SN 2012cg reached a B-band maximum of 12.09 +/- 0.02 mag on 2012 June 2.0 and took ~17.3 d from explosion to reach this, typical for SNe Ia. Our pre-maximum brightness photometry shows a narrower-than-average B-band light curve for SN 2012cg, though slightly overluminous at maximum brightness and with normal color evolution (including some of the earliest SN Ia filtered photometry ever obtained). Spectral fits to SN 2012cg reveal ions typically found in SNe Ia at early times, with expansion velocities >14,000 km/s at 2.5 d past explosion. Absorption from C II is detected early, as well as high-velocity components of both Si II 6355 Ang. and Ca II. Our last spectrum (13.5 d past explosion) resembles that of the somewhat peculiar SN Ia 1999aa. This suggests that SN 2012cg will have a slower-than-average declining light curve, which may be surprising given the faster-than-average rising light curve.Comment: re-submitted to ApJL, 4 figures, 1 tabl

Integration of an Earth-Based Science Team During Human Exploration of Mars

NASA Extreme Environment Mission Operations (NEEMO) is an underwater spaceflight analog that allows a true mission-like operational environment and uses buoyancy effects and added weight to simulate different gravity levels. A mission was undertaken in 2016, NEEMO 21, at the Aquarius undersea research habitat. During the mission, the effects of varied oper-ations concepts with representative communication latencies as-sociated with Mars missions were studied. Six subjects were weighed out to simulate partial gravity and evaluated different operations concepts for integration and management of a simulated Earth-based science team (ST) who provided input and direction during exploration activities. Exploration traverses were planned in advance based on precursor data collected. Subjects completed science-related tasks including presampling surveys and marine-science-based sampling during saturation dives up to 4 hours in duration that simulated extravehicular activity (EVA) on Mars. A communication latency of 15 minutes in each direction between space and ground was simulated throughout the EVAs. Objective data included task completion times, total EVA time, crew idle time, translation time, ST assimilation time (defined as time available for the science team to discuss, to review and act upon data/imagery after they have been collected and transmitted to the ground). Subjective data included acceptability, simulation quality, capability assessment ratings, and comments. In addition, comments from both the crew and the ST were captured during the post-mission debrief. Here, we focus on the acceptability of the operations concepts studied and the capabilities most enhancing or enabling in the operations concept. The importance and challenges of designing EVA time-lines to account for the length of the task, level of interaction with the ground that is required/desired, and communication latency, are discussed

The role of dietary fatty acids in predicting myocardial structure in fat-fed rats

<p>Abstract</p> <p><it>Background</it></p> <p>Obesity increases the risk for development of cardiomyopathy in the absence of hypertension, diabetes or myocardial ischemia. Not all obese individuals, however, progress to heart failure. Indeed, obesity may provide protection from cardiovascular mortality in some populations. The fatty acid milieu, modulated by diet, may modify obesity-induced myocardial structure and function, lending partial explanation for the array of cardiomyopathic phenotypy in obese individuals.</p> <p><it>Methods</it></p> <p>Adult male Sprague-Dawley rats were fed 1 of the following 4 diets for 32 weeks: control (CON); 50% saturated fat (SAT); 40% saturated fat + 10% linoleic acid (SAT+LA); 40% saturated fat + 10% α-linolenic acid (SAT+ALA). Serum leptin, insulin, glucose, free fatty acids and triglycerides were quantitated. <it>In vivo </it>cardiovascular outcomes included blood pressure, heart rate and echocardiographic measurements of structure and function. The rats were sacrificed and myocardium was processed for fatty acid analysis (TLC-GC), and evaluation of potential modifiers of myocardial structure including collagen (Masson's trichrome, hydroxyproline quantitation), lipid (Oil Red O, triglyceride quantitation) and myocyte cross sectional area.</p> <p><it>Results</it></p> <p>Rats fed SAT+LA and SAT+ALA diets had greater cranial LV wall thickness compared to rats fed CON and SAT diets, in the absence of hypertension or apparent insulin resistance. Treatment was not associated with changes in myocardial function. Myocardial collagen and triglycerides were similar among treatment groups; however, rats fed the high-fat diets, regardless of composition, demonstrated increased myocyte cross sectional area.</p> <p><it>Conclusions</it></p> <p>Under conditions of high-fat feeding, replacement of 10% saturated fat with either LA or ALA is associated with thickening of the cranial LV wall, but without concomitant functional changes. Increased myocyte size appears to be a more likely contributor to early LV thickening in response to high-fat feeding. These findings suggest that myocyte hypertrophy may be an early change leading to gross LV hypertrophy in the hearts of "healthy" obese rats, in the absence of hypertension, diabetes and myocardial ischemia.</p

Reverberation Mapping of the Kepler-Field AGN KA1858+4850

KA1858+4850 is a narrow-line Seyfert 1 galaxy at redshift 0.078 and is among the brightest active galaxies monitored by the Kepler mission. We have carried out a reverberation mapping campaign designed to measure the broad-line region size and estimate the mass of the black hole in this galaxy. We obtained 74 epochs of spectroscopic data using the Kast Spectrograph at the Lick 3-m telescope from February to November of 2012, and obtained complementary V-band images from five other ground-based telescopes. We measured the H-beta light curve lag with respect to the V-band continuum light curve using both cross-correlation techniques (CCF) and continuum light curve variability modeling with the JAVELIN method, and found rest-frame lags of lag_CCF = 13.53 (+2.03, -2.32) days and lag_JAVELIN = 13.15 (+1.08, -1.00) days. The H-beta root-mean-square line profile has a width of sigma_line = 770 +/- 49 km/s. Combining these two results and assuming a virial scale factor of f = 5.13, we obtained a virial estimate of M_BH = 8.06 (+1.59, -1.72) x 10^6 M_sun for the mass of the central black hole and an Eddington ratio of L/L_Edd ~ 0.2. We also obtained consistent but slightly shorter emission-line lags with respect to the Kepler light curve. Thanks to the Kepler mission, the light curve of KA1858+4850 has among the highest cadences and signal-to-noise ratios ever measured for an active galactic nucleus; thus, our black hole mass measurement will serve as a reference point for relations between black hole mass and continuum variability characteristics in active galactic nuclei

Resume

Ready-to-use therapeutic foods (RUTFs) are solid foods that were developed by changing the formulation of the existing liquid diet, F-100, recommended by the World Health Organization (WHO) for the rapid catch-up phase of the treatment of children suffering from severe acute malnutrition (SAM). The resulting products proved highly effective in promoting weight gain in both severely and moderately wasted children and adults, including those infected with HIV. The formulation of the existing RUTFs, however, has never been optimized to maximize linear growth, vitamin and mineral status, and functional outcomes. The high milk content of RUTFs makes it an expensive product, and using lower quantities of milk seems desirable. However, the formulation of alternative, less expensive but more effective versions of RUTF faces difficult challenges, as there are uncertainties regarding the effect in terms of protein quality, antinutrient content, and flatulence factors that will result from the replacement of current dairy ingredients by less expensive protein-rich ingredients. The formulation of alternative RUTFs will require further research on these aspects, followed by efficacy studies comparing the future RUTFs to the existing formulations

Characteristics of outdoor falls among older people: A qualitative study

Background Falls are a major threat to older people’s health and wellbeing. Approximately half of falls occur in outdoor environments but little is known about the circumstances in which they occur. We conducted a qualitative study to explore older people’s experiences of outdoor falls to develop understanding of how they may be prevented. Methods We conducted nine focus groups across the UK (England, Wales, and Scotland). Our sample was from urban and rural settings and different environmental landscapes. Participants were aged 65+ and had at least one outdoor fall in the past year. We analysed the data using framework and content analyses. Results Forty-four adults aged 65 – 92 took part and reported their experience of 88 outdoor falls. Outdoor falls occurred in a variety of contexts, though reports suggested the following scenarios may have been more frequent: when crossing a road, in a familiar area, when bystanders were around, and with an unreported or unknown attribution. Most frequently, falls resulted in either minor or moderate injury, feeling embarrassed at the time of the fall, and anxiety about falling again. Ten falls resulted in fracture, but no strong pattern emerged in regard to the contexts of these falls. Anxiety about falling again appeared more prevalent among those that fell in urban settings and who made more visits into their neighbourhood in a typical week. Conclusions This exploratory study has highlighted several aspects of the outdoor environment that may represent risk factors for outdoor falls and associated fear of falling. Health professionals are recommended to consider outdoor environments as well as the home setting when working to prevent falls and increase mobility among older people