Finishing Well: Investigating Despair In Retired Leaders

Due to conflicting information in the literature, the purpose of this research is to determine whether retired leaders experience despair or a loss of hope. This study interviewed eight male retired leaders, ranging in age from 60 to 82 and retired 1. 5 to 12 years, using a semi-structured interview guide. By analyzing question summaries, this research provided retirement insights from both organizational and individual perspectives. From an organizational perspective, this research builds upon the four exit strategies for organizational leaders, defined by Sonnenfeld 1988 as monarchs, generals, ambassadors, and governors. This research indicates the existence of a fifth exit strategy. While yet unnamed, this exit strategy is generally known as “forced retirement. ” Despite the desires of some of the retired leaders, organizations do not have frameworks to utilize this talent after traditional work roles have terminated. The retired leaders, all but one characterized as ambassadors or governors, did not experience despair. However, moments of frustration or sadness appeared related to existential despair, defined as the ability to transcend present circumstances to alter the status quo. These moments of frustration were caused by the realization of character defects, physical ailments, difficulty in dealing with family members and the inability to mentally separate from the organization itself. Most of the leaders spent little time preparing for retirement. From this research, there appears to be an opportunity to develop frameworks from both organizational and individual perspectives for working and living in the latter half of one’s life. Elements of these frameworks should include expanding the exit strategies for organizational leaders and methods for facilitating the progression of life predefined by the epigenetic principle Erickson, 1959

Observed Limits on Charge Exchange Contributions to the Diffuse X-ray Background

We present a high resolution spectrum of the diffuse X-ray background from 0.1 to 1 keV for a ~1 region of the sky centered at l=90, b=+60 using a 36-pixel array of microcalorimeters flown on a sounding rocket. With an energy resolution of 11 eV FWHM below 1 keV, the spectrum's observed line ratios help separate charge exchange contributions originating within the heliosphere from thermal emission of hot gas in the interstellar medium. The X-ray sensitivity below 1 keV was reduced by about a factor of four from contamination that occurred early in the flight, limiting the significance of the results. The observed centroid of helium-like O VII is 568+2-3 eV at 90% confidence. Since the centroid expected for thermal emission is 568.4 eV while for charge exchange is 564.2 eV, thermal emission appears to dominate for this line complex, consistent with much of the high-latitude O VII emission originating in 2-3 x 10^6 K gas in the Galactic halo. On the other hand, the observed ratio of C VI Ly gamma to Ly alpha is 0.3+-0.2. The expected ratios are 0.04 for thermal emission and 0.24 for charge exchange, indicating that charge exchange must contribute strongly to this line and therefore potentially to the rest of the ROSAT R12 band usually associated with 10^6 K emission from the Local Hot Bubble. The limited statistics of this experiment and systematic uncertainties due to the contamination require only >32% thermal emission for O VII and >20% from charge exchange for C VI at the 90% confidence level. An experimental gold coating on the silicon substrate of the array greatly reduced extraneous signals induced on nearby pixels from cosmic rays passing through the substrate, reducing the triggered event rate by a factor of 15 from a previous flight of the instrument.Comment: 14 pages, 7 figures, to be published in Ap

Searching for keV Sterile Neutrino Dark Matter with X-ray Microcalorimeter Sounding Rockets

High-resolution X-ray spectrometers onboard suborbital sounding rockets can search for dark matter candidates that produce X-ray lines, such as decaying keV-scale sterile neutrinos. Even with exposure times and effective areas far smaller than XMM-Newton and Chandra observations, high-resolution, wide field-of-view observations with sounding rockets have competitive sensitivity to decaying sterile neutrinos. We analyze a subset of the 2011 observation by the X-ray Quantum Calorimeter instrument centered on Galactic coordinates l = 165, b = -5 with an effective exposure of 106 seconds, obtaining a limit on the sterile neutrino mixing angle of sin^2(2 theta) < 7.2e-10 at 95% CL for a 7 keV neutrino. Better sensitivity at the level of sin^2(2 theta) ~ 2.1e-11 at 95\% CL for a 7 keV neutrino is achievable with future 300-second observations of the galactic center by the Micro-X instrument, providing a definitive test of the sterile neutrino interpretation of the reported 3.56 keV excess from galaxy clusters.Comment: 13 pages, 13 figures, submitted to Ap

Thermal Transport Model for Heat Sink Design

A document discusses the development of a finite element model for describing thermal transport through microcalorimeter arrays in order to assist in heat-sinking design. A fabricated multi-absorber transition edge sensor (PoST) was designed in order to reduce device wiring density by a factor of four. The finite element model consists of breaking the microcalorimeter array into separate elements, including the transition edge sensor (TES) and the silicon substrate on which the sensor is deposited. Each element is then broken up into subelements, whose surface area subtends 10 10 microns. The heat capacity per unit temperature, thermal conductance, and thermal diffusivity of each subelement are the model inputs, as are the temperatures of each subelement. Numerical integration using the Finite in Time Centered in Space algorithm of the thermal diffusion equation is then performed in order to obtain a temporal evolution of the subelement temperature. Thermal transport across interfaces is modeled using a thermal boundary resistance obtained using the acoustic mismatch model. The document concludes with a discussion of the PoST fabrication. PoSTs are novel because they enable incident x-ray position sensitivity with good energy resolution and low wiring density

Monte-Carlo Simulations of the Suzaku-XRS Residual Background Spectrum

Cryogenic micro-calorimeters are suitable to detect small amounts of energy deposited by electromagnetic and nuclear interactions, which makes them attractive in a variety of applications on ground and in space. The only X-ray microcalorimeter that operated in orbit to date is the X-Ray Spectrometer on-board of the Japanese Suzaku satellite. We discuss the analysis of the components of its residual background spectrum with the support of Monte-Carlo simulations

Antipsychotic Prescribing Pathways, Polypharmacy, and Clozapine Use in Treatment of Schizophrenia

Objective To ensure optimal care for patients with schizophrenia, antipsychotic medications must be appropriately prescribed and used. Therefore, the primary objectives of this study were to identify and describe pathways for antipsychotic prescribing, assess the consistency of observed pathways with treatment guidelines, and describe variability across facilities. Methods Data from Veterans Affairs administrative data sets from fiscal year (FY) 2003 to FY 2007 were gathered for analysis in this retrospective cohort study of antipsychotic prescribing pathways among 13 facilities across two regional networks. Patients with a new episode of care for schizophrenia or schizoaffective disorder in FY 2005 were identified, and antipsychotic prescribing history was obtained for two years before and after the index diagnosis. Demographic characteristics and distribution of comorbidities were assessed. Median medical center rates of polypharmacy were calculated and compared with Fisher’s exact test. Results Of 1,923 patients with a new episode of schizophrenia care, 1,003 (52%) had complete data on prescribing pathways. A majority (74%) of patients were prescribed antipsychotic monotherapy, and 19% received antipsychotic polypharmacy. Of patients receiving antipsychotic polypharmacy, 65% began polypharmacy within 90 days of starting any antipsychotic treatment. There was a fourfold difference in polypharmacy across facilities. Antipsychotic polypharmacy was not associated with geographic location or medical center patient volume. Clozapine utilization was low (0%–2%). Conclusions Retrospective examination of longitudinal prescribing patterns identified multiple antipsychotic prescribing pathways. Although most patients received guideline-concordant care, antipsychotic polypharmacy was commonly used as initial treatment, and there was substantial variability among facilities. Study findings suggest the utility of secondary data to assess treatment adaptation or switching for practical clinical trials

Organizational factors and depression management in community-based primary care settings

Abstract Background Evidence-based quality improvement models for depression have not been fully implemented in routine primary care settings. To date, few studies have examined the organizational factors associated with depression management in real-world primary care practice. To successfully implement quality improvement models for depression, there must be a better understanding of the relevant organizational structure and processes of the primary care setting. The objective of this study is to describe these organizational features of routine primary care practice, and the organization of depression care, using survey questions derived from an evidence-based framework. Methods We used this framework to implement a survey of 27 practices comprised of 49 unique offices within a large primary care practice network in western Pennsylvania. Survey questions addressed practice structure (e.g., human resources, leadership, information technology (IT) infrastructure, and external incentives) and process features (e.g., staff performance, degree of integrated depression care, and IT performance). Results The results of our survey demonstrated substantial variation across the practice network of organizational factors pertinent to implementation of evidence-based depression management. Notably, quality improvement capability and IT infrastructure were widespread, but specific application to depression care differed between practices, as did coordination and communication tasks surrounding depression treatment. Conclusions The primary care practices in the network that we surveyed are at differing stages in their organization and implementation of evidence-based depression management. Practical surveys such as this may serve to better direct implementation of these quality improvement strategies for depression by improving understanding of the organizational barriers and facilitators that exist within both practices and practice networks. In addition, survey information can inform efforts of individual primary care practices in customizing intervention strategies to improve depression management.http://deepblue.lib.umich.edu/bitstream/2027.42/78269/1/1748-5908-4-84.xmlhttp://deepblue.lib.umich.edu/bitstream/2027.42/78269/2/1748-5908-4-84-S1.PDFhttp://deepblue.lib.umich.edu/bitstream/2027.42/78269/3/1748-5908-4-84.pdfPeer Reviewe