Counselor Burnout and Self-Care Within an Outpatient Mental Health Agency

The purpose of this study was to investigate the experience of burnout and counselor self care in the lives of practicing counselors within an outpatient mental health agency in the northeast. Qualitative methods involving semi-structured interviews were utilized and involved seven participants. The findings of the study identified the following themes as imperative information to be considered: structure of the work day, reactions (including: thoughts, feelings, affect and physical), prevention, and barriers. Included is a discussion depicting the connections surrounding the affect of the identified themes and how this impacts the counselor in regards to burnout and self-care

Time outdoors and the prevention of myopia

Recent epidemiological evidence suggests that children who spend more time outdoors are less likely to be, or to become myopic, irrespective of how much near work they do, or whether their parents are myopic. It is currently uncertain if time outdoors also blocks progression of myopia. It has been suggested that the mechanism of the protective effect of time outdoors involves light-stimulated release of dopamine from the retina, since increased dopamine release appears to inhibit increased axial elongation, which is the structural basis of myopia. This hypothesis has been supported by animal experiments which have replicated the protective effects of bright light against the development of myopia under laboratory conditions, and have shown that the effect is, at least in part, mediated by dopamine, since the D2-dopamine antagonist spiperone reduces the protective effect. There are some inconsistencies in the evidence, most notably the limited inhibition by bright light under laboratory conditions of lens-induced myopia in monkeys, but other proposed mechanisms possibly associated with time outdoors such as relaxed accommodation, more uniform dioptric space, increased pupil constriction, exposure to UV light, changes in the spectral composition of visible light, or increased physical activity have little epidemiological or experimental support. Irrespective of the mechanisms involved, clinical trials are now underway to reduce the development of myopia in children by increasing the amount of time they spend outdoors. These trials would benefit from more precise definition of thresholds for protection in terms of intensity and duration of light exposures. These can be investigated in animal experiments in appropriate models, and can also be determined in epidemiological studies, although more precise measurement of exposures than those currently provided by questionnaires is desirable

Assessing the Role of Smaller Format Retailers on the Food Desert Landscape in Dallas, Texas

Many policy and business decisions regarding food deserts in the U.S. are based on the United States Department of Agriculture (USDA) definition of a food desert. This definition only includes large/national chain grocery retailers, based on the assumption that these major retailers are the only affordable sources of food contributing to balanced diets. As alternative distribution channels, including smaller stores, start to include groceries in their product offering, the need to consider the role of other businesses in the food retailing environment should be addressed. This thesis assesses the role of smaller format grocery retailers (small local grocers, convenience stores, gas stations, dollar stores, and drug stores) in shaping the food desert landscape in Dallas, Texas. The analysis evaluates the products offered in these stores, and then identifies the difference these stores make when included in the USDA analysis. This was done by collecting in-store data to determine the variety of products offered, the affordability of those products, and the overall healthfulness of the store. In addition, the gaps in supply and demand were identified in the USDA-defined food deserts in order to identify the impact any smaller format retailer may have. The findings suggest that, overall, smaller format retailers do offer a variety of products needed for a balanced diet. However, the products in these stores are mostly not affordable, and most stores offer more unhealthy foods, than unhealthy. Overall, results suggest dollar stores may play a role in alleviating the impact of food deserts

Planning ahead for better neighborhoods: long run evidence from Tanzania

What are the long run consequences of planning and providing basic infrastructure in neighborhoods, where people build their own homes? We study "Sites and Services" projects implemented in seven Tanzanian cities during the 1970s and 1980s, half of which provided infrastructure in previously unpopulated areas (de novo neighborhoods), while the other half upgraded squatter settlements. Using satellite images and surveys from the 2010s, we find that de novo neighborhoods developed better housing than adjacent residential areas (control areas) that were also initially unpopulated. Specifically, de novo neighborhood are more orderly and their buildings have larger footprint areas and are more likely to have multiple stories, as well as connections to electricity and water, basic sanitation and access to roads. And though de novo neighborhoods generally attracted better educated residents than control areas, the educational difference is too small to account for the large difference in residential quality that we find. While we have no natural counterfactual for the upgrading areas, descriptive evidence suggests that they are if anything worse than the control area

Planning ahead for better neighborhoods: long-run evidence from Tanzania

Africa’s demand for urban housing is soaring, even as it faces a proliferation of slums. In this setting, can modest infrastructure investments in greenfield areas where people subsequently build their own houses facilitate long-run neighborhood development? We study Sites and Services projects implemented in seven Tanzanian cities during the 1970s and 1980s, and we use a spatial regression discontinuity design to compare greenfield areas that were treated (de novo) with nearby greenfield areas that were not. We find that by the 2010s, de novo areas developed into neighborhoods with larger, more regularly laid-out buildings and better-quality housing

Planning ahead for better neighborhoods: long-run evidence from Tanzania

Africa’s demand for urban housing is soaring, even as it faces a proliferation of slums. In this setting, can modest infrastructure investments in greenfield areas where people subsequently build their own houses facilitate long-run neighborhood development? We study Sites and Services projects implemented in seven Tanzanian cities during the 1970s and 1980s, and we use a spatial regression discontinuity design to compare greenfield areas that were treated (de novo) with nearby greenfield areas that were not. We find that by the 2010s, de novo areas developed into neighborhoods with larger, more regularly laid-out buildings and better-quality housing

Overview of ESA’s Earth Observation upcoming small satellites missions

The “New Space” paradigm, has enabled the creation of many new opportunities in the space sector like the development of a large number of missions based on small and nano-satellites. The European Space Agency (ESA) is supporting these new development approaches and technology advancements, including use of Commercial-Off-The-Shelf (COTS) components to enable missions based on small and nano satellites. ESA’s Earth Observation Programmes Directorate (ESA-EOP) is already involved not only in the implementation of technologies exploiting the capabilities offered by small and nano-satellites as a complement to the EOP scientific and application-driven flagship satellites, but also in the quick validation of new approaches like A.I, super resolution or more in general in orbit data processing. ESA-EOP developments in the area of small and nano satellites are spread in three different programmatic lines, each with its own objectives: Scout and F-sat Missions and the InCubed Programme. This paper presents the overall ESA-EOP small missions strategy providing a brief insight on the genesis of each programmatic line and their selection processes including an update of the status of the first initiatives and missions under development or study

The epidemics of myopia: Aetiology and prevention

There is an epidemic of myopia in East and Southeast Asia, with the prevalence of myopia in young adults around 80-90%, and an accompanying high prevalence of high myopia in young adults (10-20%). This may foreshadow an increase in low vision and blindness due to pathological myopia. These two epidemics are linked, since the increasingly early onset of myopia, combined with high progression rates, naturally generates an epidemic of high myopia, with high prevalences of "acquired" high myopia appearing around the age of 11-13. The major risk factors identified are intensive education, and limited time outdoors. The localization of the epidemic appears to be due to the high educational pressures and limited time outdoors in the region, rather than to genetically elevated sensitivity to these factors. Causality has been demonstrated in the case of time outdoors through randomized clinical trials in which increased time outdoors in schools has prevented the onset of myopia. In the case of educational pressures, evidence of causality comes from the high prevalence of myopia and high myopia in Jewish boys attending Orthodox schools in Israel compared to their sisters attending religious schools, and boys and girls attending secular schools. Combining increased time outdoors in schools, to slow the onset of myopia, with clinical methods for slowing myopic progression, should lead to the control of this epidemic, which would otherwise pose a major health challenge. Reforms to the organization of school systems to reduce intense early competition for accelerated learning pathways may also be important

Why Wait?: Early Enteral Feeding After Pediatric Gastrostomy Tube Placement

Purpose Early initiation of feedings after gastrostomy tube (GT) placement may reduce associated hospital costs, but many surgeons fear complications could result from earlier feeds. We hypothesized that, irrespective of placement method, starting feedings within the first 6 h following GT placement would not result in a greater number of post-operative complications. Methods An IRB-approved retrospective review of all GTs placed between January 2012 and December 2014 at three academic institutions was undertaken. Data was stratified by placement method and whether the patient was initiated on feeds at less than 6 h or after. Baseline demographics, operative variables, post-operative management and complications were analyzed. Descriptive statistics were used and P-values < 0.05 were considered significant. Results One thousand and forty-eight patients met inclusion criteria. GTs were inserted endoscopically (48.9%), laparoscopically (44.9%), or via an open approach (6.2%). Demographics were similar in early and late fed groups. When controlling for method of placement, those patients who were fed within the first 6 h after gastrostomy placement had shorter lengths of stay compared to those fed greater than 6 h after placement (P < 0.05). Total post-operative outcomes were equivalent between feeding groups for all methods of placement (laparoscopic (P = 0.87), PEG (P = 0.94), open (P = 0.81)). Conclusions Early initiation of feedings following GT placement was not associated with an increase in complications. Feeds initiated earlier may shorten hospital stays and decrease overall hospital costs

MRCK-1 Drives Apical Constriction in C. elegans by Linking Developmental Patterning to Force Generation

Apical constriction is a change in cell shape that drives key morphogenetic events including gastrulation and neural tube formation. Apical force-producing actomyosin networks drive apical constriction by contracting while connected to cell-cell junctions. The mechanisms by which developmental patterning regulates these actomyosin networks and associated junctions with spatial precision are not fully understood. Here, we identify a myosin light chain kinase MRCK-1 as a key regulator of C. elegans gastrulation that integrates spatial and developmental patterning information. We show that MRCK-1 is required for activation of contractile actomyosin dynamics and elevated cortical tension in the apical cell cortex of endodermal precursor cells. MRCK-1 is apically localized by active Cdc42 at the external, cell-cell contact-free surfaces of apically constricting cells, downstream of cell fate determination mechanisms. We establish that the junctional components α-catenin, β-catenin, and cadherin become highly enriched at the apical junctions of apically-constricting cells, and that MRCK-1 and myosin activity are required in vivo for this enrichment. Taken together, our results define mechanisms that position a myosin activator to a specific cell surface where it both locally increases cortical tension and locally enriches junctional components to facilitate apical constriction. These results reveal crucial links that can tie spatial information to local force generation to drive morphogenesis