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Burnout is a growing concern in many areas of life. This manuscript first outlines the history occupational burnout. Research as it pertains to burnout in sport is then discussed, with an emphasis on broad conceptual models of burnout. The rationale for the current study is then given. First, previous research as shown that the longer one has been on the job the greater the likelihood of burnout (Pines & Maslach, 1978; Mor & Lalibaerte, 1984; Turnipseed, 1994). Therefore, Hypothesis I was that seniors were more likely to experience burnout than freshmen. Second, Smith (1986) and Coakley (1992) have maintained that athletes participating in coacting sports are more likely to experience burnout than those in interacting sports. Hypothesis 2 tested this assertion. Third, the role of emotional affect and burnout was examined. Hypothesis 3 stated that athletes with high positive affect are more likely to have lower burnout scores, while those with high negative affect are more likely to have higher burnout scores. The present study examined burnout in college athletes (N=216). The Eades Athlete Burnout Inventory was used to measure burnout. The Positive and Negative Affect Schedule was used to measure affect. Contrary to predictions, seniors reported lower burnout scores than any other year in school F (18, 580) = 1.67, p= .04. Also, there was no difference in burnout rates between coacting and interacting sports F (1, 213) = 1.96, p = .16. Finally, high positive affect scores were associated with low burnout scores E (1, 104) = 57.27, p <.001. Conversely, high negative affect scores were associated with high burnout scores F (1, 110) = 72.83, p < .001. The implications of these findings are also discussed. / Department of Counseling Psychology and Guidance Services

A murine model was utilized to test the influence of heavy metal protoporphyrins on burn conversion, heme oxygenase – 1 (HO-1) expression, and inflammation. Heavy metal protoporphyrins, such as cobalt protoporphyrin (Co PP) and tin protoporphyrin (Sn PP), were used to influence the heme oxygenase activity. The effects of these heavy metal protoporphyrins on burn wound conversion were examined using a burn comb model in rats. In addition to assessing the extent of conversion, HO-1 expression and parameters of inflammation were also examined in the area of injury (interspace region) subject to conversion. These studies demonstrate proof in principal that pharmacologic agents known to modify HO activity can also modulate burn wound conversion. Improved outcome correlated with HO-1 expression/activity and reduced inflammation. This suggests that one of the mechanisms utilized by HO-1 to improve burn wound outcome involves modulation of one or more components of the inflammatory response.

Os objetivos deste estudo foram adaptar a "Burns Specific Pain Anxiety Scale"(BSPAS), incluindo a “Impact Event Scale" (IES), para a língua portuguesa; avaliar a consistência interna das versões em português da BSPAS e da IES, por meio de sua aplicação em um grupo de pacientes brasileiros que sofreram queimaduras; comparar as medidas de ansiedade obtidas com o instrumento traduzido e as medidas do IDATE; comparar as medidas de dor obtidas com o instrumento traduzido e as medidas obtidas com a aplicação da Escala Visual Analógica para dor (EVA). A BSPAS é um instrumento específico para avaliar a ansiedade antecipatória e a dor em pacientes vítimas de queimaduras, proposta em holandês em duas versões (nove e cinco itens). A versão de nove itens foi selecionada para ser submetida a um processo de adaptação transcultural. A IES avalia o impacto psicológico que um evento traumático tem sobre a pessoa, e neste estudo diz respeito ao impacto provocado pela queimadura. O processo de adaptação seguiu os seguintes passos: tradução da BSPAS e da IES para a língua portuguesa por dois tradutores brasileiros com domínio da língua holandesa; obtenção do consenso das versões das duas escalas em português; avaliação das versões em português por um Comitê de Juízes (enfermeiros, fisioterapeuta, terapeuta ocupacional, psicólogo e pesquisadores na área e na metodologia); “back-translation" das escalas para o holandês por dois tradutores fluentes na língua holandesa com conhecimento da língua portuguesa; obtenção do consenso das versões em holandês; comparação das versões original em holandês e do consenso em holandês; análise semântica dos itens e pré-teste das versões finais em português. As versões adaptadas para o português (BSPAS – VP e IES – VP) foram aplicadas em conjunto em um grupo de 21 pacientes brasileiros, maiores de 15 anos, internados na Unidade de Queimados do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto. Os resultados mostraram, entre os participantes, média de escores altos de manifestações de dor, imediatamente após a realização de procedimentos de banho e curativo, e manifestações de baixa (29%) e de média ansiedade-estado (71%), no final da primeira semana de internação. Obteve-se pontuação média de escore com a aplicação da BSPAS – VP de 46,60 (DP: 22,53) e da IES – VP de 62,80 (DP: 28,60). A aplicação de testes de avaliação da consistência interna representada pelo Alfa de Cronbach para a BSPAS – VP foi de 0,905 e para a IES – VP foi de 0,841. Esses valores indicam alta consistência interna entre os itens dos instrumentos por estarem próximos de 1,00. Não foi encontrada correlação entre a BSPAS – VP e o IDATE e entre a IES – VP e o IDATE. Os dados mostraram correlação entre a IES – VP e a BSPAS – VP (0,594; p<0,01) e entre a SCQ e a BSPAS – VP (0,536; p<0,05). Concluímos, assim, que a BSPAS – VP e a IES – VP para seu primeiro estágio de aplicação para população brasileira encontram-se adequadas. / This study aimed to adapt the Burns Specific Pain Anxiety Scale (BSPAS), including the Impact Event Scale (IES), to Portuguese; to evaluate the internal consistency of the Portuguese versions of the BSPAS and the IES, by applying them to a sample of Brazilian patients who were victims of burns; to compare the anxiety measures obtained through the translated instrument with the measures from Spielberger’s State Anxiety Inventory (STAI-S); to compare the pain measures obtained through the translated instrument with those obtained by applying the Visual Analogue Scale (VAS) for pain. The BSPAS is a specific instrument to evaluate anticipatory anxiety and pain in burn victims, which was proposed in Dutch in two versions (nine and five items). The nine-item version was selected to be submitted to a cross-cultural adaptation process. The IES evaluates the psychological impact of a traumatic event on the person and, in this study, refers to the impact provoked by the burn. The adaptation process involved the following steps: translation of the BSPAS and the IES to Portuguese by two Brazilian translators who master Dutch; reaching a consensus on the Portuguese translations of the two scales; evaluation of the Portuguese translations by an expert committee (nurses, physiotherapist, occupational therapist, psychologist, as well as researchers in this field and in methodology); back-translation of the scales to Dutch by two translators who are fluent in Dutch and have knowledge of Portuguese; reaching a consensus on the Dutch translations; comparison between the original and consensus versions in Dutch; semantic analysis of the items and pretest of the final Portuguese versions. The versions adapted to Portuguese (BSPAS – VP and IES - VP) were jointly applied to a sample of 21 Brazilian patients over 15, who were hospitalized at the Burns Unity of the Ribeirão Preto Medical School Hospital das Clínicas. On the average, the results demonstrated high scores among the participants for pain manifestations immediately after washing and wound dressing procedures, and low (29%) and average (71%) state anxiety measures at the end of the first hospitalization week. Patients’ average score on the BSPAS – VP was 46.60 (SD: 22,53) and on the IES – VP 62.80 (SD: 28.60). Internal consistency tests by means of Cronbach’s Alpha revealed 0.905 for the BSPAS - VP and 0.841 for the IES – VP. Being close to 1.00, these values indicated high internal consistency between the instrument items. No correlation was found between the BSPAS – VP and the STAI - S, nor between the IES – VP and the STAI – S. Data revealed a correlation between the IES – VP (0.594; p<0.01) and the BSPAS – VP, and between the Burned Body Surface and the BSPAS – VP (0.536; p<0.05). Thus, we concluded that the BSPAS – VP and the IES – VP are adequate for their first stage of application to a Brazilian population.

Controlled hydrogel dissolution allows for: 1) atraumatic material removal after it served its function, 2) site-specific delivery of encapsulated therapeutics (e.g., proteins, small molecules), and 3) a tailored administration of an agent with high efficiency. Dissolution of covalently crosslinked hydrogels has been accomplished by incorporating cleavable moieties that undergo ester hydrolysis or enzymatic degradation. Recently, thiol-disulfide exchange, retro Michal-type reactions, retro Diels-Alder reactions, and thiol-thioester exchange chemistries have gained attention, as they provide a responsive synthetic handle for engineering hydrogel dissolution rates. We synthesized, characterized and tested in vivo two on-demand dissolvable dendritic thioester hydrogel dressings for second-degree burn care and hemorrhage control. The hydrogels are composed of lysine-based dendrons and PEG-based crosslinkers, which were prepared in high yields. In context of hemorrhage, there is an unmet clinical need for an on-demand dissolvable sealant for non-compressible hemorrhage or areas of body not amenable to treatment with a torniquet. In a model of in vivo hemorrhage control of intra-abdominal wounds, our hydrogel reduced blood loss by 33% in severe hepatic hemorrhage and by 22% in aortic injury, as compared to untreated controls. There is an unmet clinical need for a second-degree burn dressing that can be removed atraumatically and serve as a barrier to bacterial infection. When our hydrogel was used as a dressing, local and systemic bacterial proliferation after wound contamination was significantly lower than in the untreated group. The total bacterial burden of the burn wound in the positive controls was significantly higher than in the hydrogel group and the negative controls (1.39x10E8 ± 8.30x10E7 CFU/g v. 4.04x10E3 ± 3.99x10E3 CFU/g v. 6.88x10E2 ± 6.38x10E2 respectively; P = 0.009). Also, the total systemic bacterial burden in the positive controls was significantly higher than the hydrogel group and the negative controls (9x10E2 ± 7.76x10E7 CFU/g v. 5x10E1 ± 0 CFU/g v. 5x10E1 ± 0 CFU/g, respectively; P = 0.031). A unique feature of both hydrogel systems is their capability to be dissolved on-demand via thiol-thioester exchange reaction with a biocompatible solution following its initial application – thus the wound area can be re-exposed to allow for definitive surgical care.

Burn injuries are one of the most painful and potentially debilitating traumatic injuries that a person can suffer. Every reader is likely to have, at some point in their life, suffered a burn injury, no matter how minor and therefore can have some comprehension of the pain and suffering associated with significant burn injury. Traumatic injury is the leading cause of death and disability in children and young adults. Although much has been done to optimise pre-hospital care and emergent treatment of injuries in recent times, the mainstay of managing death and disability from traumatic injury must lie in preventing these injuries where at all possible. To enable effective preventative strategies to be put in place it is important to define the demographics of those injured and the mechanisms of injury for any given population. Only then can we ensure that strategies are targeted in the areas where they are most needed at the mechanisms that are occurring most commonly. This study has combined a number of data sources namely burns service, fire service, coroners' service and accident and emergency department in an attempt to define the epidemiology and aetiology of burn injury in Greater Manchester. Data from the different sources was pooled and underwent a process of data-linkage to remove duplicate records. Rates have been calculated and compared according to age group, sex group and deprivation status. Poisson regression modelling was used to calculate the rate ratios amongst the different groups. Postcode data was used to allow geographical mapping of injuries across the county to allow rates to be calculated for different areas of the city. Where rates have been calculated for small area geographies Bayesian modelling was used to predict injury rates for those areas. Maps have been produced that show the areas with the highest rates of injury. The results show that in children it is the under five age group that have the highest rates of injury, particularly the under 2's. In adults, those over 75 years of age have the highest rates of injury. For all age groups males were more likely to be injured than females. In both children and adults higher rates of injury were seen in those areas where there were increased levels of deprivation. Key mechanisms of injury for individual age groups have been highlighted. The maps of Greater Manchester and its constituent local authorities show those areas with the highest rates of injury. The definition of target demographic groups and geographical areas within Greater Manchester will be used to allow development of targeted prevention strategies in those areas.

Os objetivos deste estudo foram adaptar a "Burns Specific Pain Anxiety Scale"(BSPAS), incluindo a “Impact Event Scale” (IES), para a língua portuguesa; avaliar a consistência interna das versões em português da BSPAS e da IES, por meio de sua aplicação em um grupo de pacientes brasileiros que sofreram queimaduras; comparar as medidas de ansiedade obtidas com o instrumento traduzido e as medidas do IDATE; comparar as medidas de dor obtidas com o instrumento traduzido e as medidas obtidas com a aplicação da Escala Visual Analógica para dor (EVA). A BSPAS é um instrumento específico para avaliar a ansiedade antecipatória e a dor em pacientes vítimas de queimaduras, proposta em holandês em duas versões (nove e cinco itens). A versão de nove itens foi selecionada para ser submetida a um processo de adaptação transcultural. A IES avalia o impacto psicológico que um evento traumático tem sobre a pessoa, e neste estudo diz respeito ao impacto provocado pela queimadura. O processo de adaptação seguiu os seguintes passos: tradução da BSPAS e da IES para a língua portuguesa por dois tradutores brasileiros com domínio da língua holandesa; obtenção do consenso das versões das duas escalas em português; avaliação das versões em português por um Comitê de Juízes (enfermeiros, fisioterapeuta, terapeuta ocupacional, psicólogo e pesquisadores na área e na metodologia); “back-translation” das escalas para o holandês por dois tradutores fluentes na língua holandesa com conhecimento da língua portuguesa; obtenção do consenso das versões em holandês; comparação das versões original em holandês e do consenso em holandês; análise semântica dos itens e pré-teste das versões finais em português. As versões adaptadas para o português (BSPAS – VP e IES – VP) foram aplicadas em conjunto em um grupo de 21 pacientes brasileiros, maiores de 15 anos, internados na Unidade de Queimados do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto. Os resultados mostraram, entre os participantes, média de escores altos de manifestações de dor, imediatamente após a realização de procedimentos de banho e curativo, e manifestações de baixa (29%) e de média ansiedade-estado (71%), no final da primeira semana de internação. Obteve-se pontuação média de escore com a aplicação da BSPAS – VP de 46,60 (DP: 22,53) e da IES – VP de 62,80 (DP: 28,60). A aplicação de testes de avaliação da consistência interna representada pelo Alfa de Cronbach para a BSPAS – VP foi de 0,905 e para a IES – VP foi de 0,841. Esses valores indicam alta consistência interna entre os itens dos instrumentos por estarem próximos de 1,00. Não foi encontrada correlação entre a BSPAS – VP e o IDATE e entre a IES – VP e o IDATE. Os dados mostraram correlação entre a IES – VP e a BSPAS – VP (0,594; p<0,01) e entre a SCQ e a BSPAS – VP (0,536; p<0,05). Concluímos, assim, que a BSPAS – VP e a IES – VP para seu primeiro estágio de aplicação para população brasileira encontram-se adequadas. / This study aimed to adapt the Burns Specific Pain Anxiety Scale (BSPAS), including the Impact Event Scale (IES), to Portuguese; to evaluate the internal consistency of the Portuguese versions of the BSPAS and the IES, by applying them to a sample of Brazilian patients who were victims of burns; to compare the anxiety measures obtained through the translated instrument with the measures from Spielberger’s State Anxiety Inventory (STAI-S); to compare the pain measures obtained through the translated instrument with those obtained by applying the Visual Analogue Scale (VAS) for pain. The BSPAS is a specific instrument to evaluate anticipatory anxiety and pain in burn victims, which was proposed in Dutch in two versions (nine and five items). The nine-item version was selected to be submitted to a cross-cultural adaptation process. The IES evaluates the psychological impact of a traumatic event on the person and, in this study, refers to the impact provoked by the burn. The adaptation process involved the following steps: translation of the BSPAS and the IES to Portuguese by two Brazilian translators who master Dutch; reaching a consensus on the Portuguese translations of the two scales; evaluation of the Portuguese translations by an expert committee (nurses, physiotherapist, occupational therapist, psychologist, as well as researchers in this field and in methodology); back-translation of the scales to Dutch by two translators who are fluent in Dutch and have knowledge of Portuguese; reaching a consensus on the Dutch translations; comparison between the original and consensus versions in Dutch; semantic analysis of the items and pretest of the final Portuguese versions. The versions adapted to Portuguese (BSPAS – VP and IES - VP) were jointly applied to a sample of 21 Brazilian patients over 15, who were hospitalized at the Burns Unity of the Ribeirão Preto Medical School Hospital das Clínicas. On the average, the results demonstrated high scores among the participants for pain manifestations immediately after washing and wound dressing procedures, and low (29%) and average (71%) state anxiety measures at the end of the first hospitalization week. Patients’ average score on the BSPAS – VP was 46.60 (SD: 22,53) and on the IES – VP 62.80 (SD: 28.60). Internal consistency tests by means of Cronbach’s Alpha revealed 0.905 for the BSPAS - VP and 0.841 for the IES – VP. Being close to 1.00, these values indicated high internal consistency between the instrument items. No correlation was found between the BSPAS – VP and the STAI - S, nor between the IES – VP and the STAI – S. Data revealed a correlation between the IES – VP (0.594; p<0.01) and the BSPAS – VP, and between the Burned Body Surface and the BSPAS – VP (0.536; p<0.05). Thus, we concluded that the BSPAS – VP and the IES – VP are adequate for their first stage of application to a Brazilian population.

Thesis (MA)--University of Stellenbosch, 2007. / Bibliography. Also available via the Internet.