The experiences of support staff in a traumatic brain injury rehabilitation center.

PURPOSE: Employee turnover is a major issue for health care organizations. Burnout is a leading contributor to such turnover. Extensive research on burnout has been conducted in health care settings; however, it has primarily been focused on health care professionals ignoring other critical staff. In particular, traumatic brain injury rehabilitation is an area of health care that includes unique challenges and stressors that may contribute to burnout. Brain injury professionals report experiencing high levels of burnout that further increase as they spend more time with patients; however, little is known about the experiences of brain injury paraprofessionals. This study explores the unique experiences of support staff in traumatic brain injury rehabilitation centers. METHOD: The present study used a grounded theory method to explore the phenomena of burnout, turnover, and job satisfaction from the perspective of paraprofessional support staff in 1 posthospital brain injury rehabilitation center. Support staff participated in the research via small group interviews (N = 4) and survey (N = 11). RESULTS: The analysis resulted in a grounded theory model, entitled "The Balance model of Rehabilitation Support Work." This model is a framework of risk and protective factors that appeared to influence whether these frontline rehabilitation staff experienced negative outcomes from this often challenging/stressful work environment. The model includes 4 axial-level themes: doing the work, protective factors, risk factors, and imbalance of factors. Within the 4 axial categories are twenty open-coding level categories. IMPLICATIONS: Implications for traumatic brain injury rehabilitation organizations and areas for future research are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Life cycle environmental and economic implications of small drinking water system upgrades to reduce disinfection byproducts.

Many of the small drinking water systems in the US that utilize simple filtration and chlorine disinfection or chlorine disinfection alone are facing disinfection byproduct (DBP) noncompliance issues, which need immediate upgrades. In this study, four potential upgrade scenarios, namely the GAC, ozone, UV30, and UV186 scenarios, were designed for a typical small drinking water systems and compared in terms of embodied energy, carbon footprint, and life cycle cost. These scenarios are designed to either reduce the amount of DBP precursors using granular activated carbon filtration (the GAC scenario) or ozonation (the ozone scenario), or replace the chlorine disinfection with the UV disinfection at different intensities followed by chloramination (the UV30 and UV186 scenarios). The UV30 scenario was found to have the lowest embodied energy (417 GJ/year) and life cycle cost ($0.25 million US dollars), while the GAC scenario has the lowest carbon footprint (21 Mg CO2e/year). The UV186 scenario consistently presents the highest environmental and economic impacts. The major contributors of the economic and environmental impacts of individual scenarios also differ. Energy and/or material consumptions during the operation phase dominate the environmental impacts of the four scenarios, while the infrastructure investments have a noticeable contribution to the economic costs. The results are sensitive to changes in water quality. An increase of raw water quality, i.e., an increase in organic precursor content, could potentially result in the ozone scenario being the least energy intensive scenario, while a decrease of water quality could greatly reduce the overall competitiveness of the GAC scenario.

Estimating mercury emissions resulting from wildfire in forests of the Western United States.

Understanding the emissions of mercury (Hg) from wildfires is important for quantifying the global atmospheric Hg sources. Emissions of Hg from soils resulting from wildfires in the Western United States was estimated for the 2000 to 2013 period, and the potential emission of Hg from forest soils was assessed as a function of forest type and soil-heating. Wildfire released an annual average of 3100±1900kg-Hgy(-1) for the years spanning 2000-2013 in the 11 states within the study area. This estimate is nearly 5-fold lower than previous estimates for the study region. Lower emission estimates are attributed to an inclusion of fire severity within burn perimeters. Within reported wildfire perimeters, the average distribution of low, moderate, and high severity burns was 52, 29, and 19% of the total area, respectively. Review of literature data suggests that that low severity burning does not result in soil heating, moderate severity fire results in shallow soil heating, and high severity fire results in relatively deep soil heating (<5cm). Using this approach, emission factors for high severity burns ranged from 58 to 640µg-Hgkg-fuel(-1). In contrast, low severity burns have emission factors that are estimated to be only 18-34µg-Hgkg-fuel(-1). In this estimate, wildfire is predicted to release 1-30gHgha(-1) from Western United States forest soils while above ground fuels are projected to contribute an additional 0.9 to 7.8gHgha(-1). Land cover types with low biomass (desert scrub) are projected to release less than 1gHgha(-1). Following soil sources, fuel source contributions to total Hg emissions generally followed the order of duff>wood>foliage>litter>branches.

A synthesis of terrestrial mercury in the western United States: Spatial distribution defined by land cover and plant productivity.

A synthesis of published vegetation mercury (Hg) data across 11 contiguous states in the western United States showed that aboveground biomass concentrations followed the order: leaves (26µgkg(-1))~branches (26µgkg(-1))>bark (16µgkg(-1))>bole wood (1µgkg(-1)). No spatial trends of Hg in aboveground biomass distribution were detected, which likely is due to very sparse data coverage and different sampling protocols. Vegetation data are largely lacking for important functional vegetation types such as shrubs, herbaceous species, and grasses. Soil concentrations collected from the published literature were high in the western United States, with 12% of observations exceeding 100µgkg(-1), reflecting a bias toward investigations in Hg-enriched sites. In contrast, soil Hg concentrations from a randomly distributed data set (1911 sampling points; Smith et al., 2013a) averaged 24µgkg(-1) (A-horizon) and 22µgkg(-1) (C-horizon), and only 2.6% of data exceeded 100µgkg(-1). Soil Hg concentrations significantly differed among land covers, following the order: forested upland>planted/cultivated>herbaceous upland/shrubland>barren soils. Concentrations in forests were on average 2.5 times higher than in barren locations. Principal component analyses showed that soil Hg concentrations were not or weakly related to modeled dry and wet Hg deposition and proximity to mining, geothermal areas, and coal-fired power plants. Soil Hg distribution also was not closely related to other trace metals, but strongly associated with organic carbon, precipitation, canopy greenness, and foliar Hg pools of overlying vegetation. These patterns indicate that soil Hg concentrations are related to atmospheric deposition and reflect an overwhelming influence of plant productivity - driven by water availability - with productive landscapes showing high soil Hg accumulation and unproductive barren soils and shrublands showing low soil Hg values. Large expanses of low-productivity, arid ecosystems across the western U.S. result in some of the lowest soil Hg concentrations observed worldwide.