Search results for: burnout management

Authors: Robert E. Kenney, Efrain Antunez, Samuel Nodal, Ameer Malik, Richard B. Aguilar

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Physician burnout has gained much attention during the COVID pandemic. After-hours workload, HCC coding, HEDIS metrics, and clinical documentation negatively impact career satisfaction. These and other influences have increased the rate of physicians leaving the workforce. In addition, roughly 1% of the entire physician workforce will be retiring earlier than expected based on pre-pandemic trends. The two Medical Specialties with the highest rates of burnout are Family Medicine and Primary Care. With a predicted shortage of primary care physicians looming, the need to address physician burnout is crucial. Commonly reported issues leading to clinician burnout are clerical documentation requirements, increased time working on Electronic Health Records (EHR) after hours, and a decrease in work-life balance. Clinicians experiencing burnout with physical and emotional exhaustion are at an increased likelihood of providing lower quality and less efficient patient care. This may include a lack of suitable clinical documentation, medication reconciliation, clinical assessment, and treatment plans. While the annual baseline turnover rates of physicians hover around 6-7%, the COVID pandemic profoundly disrupted the delivery of healthcare. A report found that 43% of physicians switched jobs during the initial two years of the COVID pandemic (2020 and 2021), tripling the expected average annual rate to 21.5 %/yr. During this same time, an average of 4% and 1.5% of physicians retired or left the workforce for a non-clinical career, respectively. The report notes that 35.2% made career changes for a better work-life balance and another 35% reported the reason as being unhappy with their administration’s response to the pandemic. A physician-led primary care-focused health organization, Cano Health (CH), based out of Florida, sought to preemptively address this problem by implementing several supportive measures. Working with >120 clinics and >280 PCPs from Miami to Tampa and Orlando, managing nearly 120,000 Medicare Advantage lives, CH implemented a number of changes to assist with the clinician’s workload. Supportive services such as after hour and home visits by APRNs, in-clinic care managers, and patient educators were implemented. In 2021, assistive Artificial Intelligence Software (AIS) was integrated into the EHR platform. This AIS converts free text within PDF files into a usable (copy-paste) format facilitating documentation. The software also systematically and chronologically organizes clinical data, including labs, medical records, consultations, diagnostic images, medications, etc., into an easy-to-use organ system or chronic disease state format. This reduced the excess time and documentation burden required to meet payor and CMS guidelines. A clinician Documentation Support team was employed to improve the billing/coding performance. The effects of these newly designed workflow interventions were measured via analysis of clinician turnover from CH’s hiring and termination reporting software. CH’s annualized average clinician turnover rate in 2020 and 2021 were 17.7% and 12.6%, respectively. This represents a 30% relative reduction in turnover rate compared to the reported national average of 21.5%. Retirement rates during both years were 0.1%, demonstrating a relative reduction of >95% compared to the national average (4%). This model successfully promoted the retention of clinicians in a Value-Based Care setting.

Keywords: clinician burnout, COVID-19, value-based care, burnout, clinician retirement

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Authors: Huan Zhang, Darius K. S Chan

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Despite a large number of studies linking emotional labor and its detrimental impact for laborer, research on how emotional labor would influence the receiver is still in its infancy. Especially under the call for “people management”, supervisors inside the organization are more inclined to display happy mood to support their employees, thus endorsing emotional labor. The present study focuses on the employees in the service industry as emotional labor recipients and investigates how they respond to their supervisors’ emotional display, given their sensitivity to emotional cues. Targeted at a sample of 250 survey data from a wide range of customer service professions, this ongoing study examines how perceived supervisory emotional labor would moderate the relationship between employees surface acting and their well-being. Our major hypotheses are that employees’ surface acting predicts well-being level, and that perceived supervisory emotional labor to moderate the surface acting—outcome links. Preliminary findings have provided some support to the hypothesized model. Specifically, supervisors who are perceived to be high in surface acting are also regarded as fake and pseudo, hence the enhancing the detrimental effect of employees’ surface acting is attenuated, resulting in lower job satisfaction, higher physical stress and burnout; whereas perceived high supervisor’s deep acting, as associated with genuine and authenticity, buffers the negative impact and leads to higher job satisfaction, lower physical stress and burnout. This study first confirms the negative impacts of the surface acting on well-being for service industry employees as laborer and then extends the emotional labor studies by considering them as recipients of supervisory emotional labor. The findings provide insights for leaders by pointing out the importance of authentic emotional expression in workplace.

Keywords: perceived supervisory emotional labor, surface acting, well-being

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Authors: Amy Atkinson

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Teacher burnout and dissatisfaction is a concerning challenge for visual art (VA) programs within the western (Canadian) educational context, however VA programs who offer the International Baccalaureate (IB) curriculum within international schools are thriving. The purpose of this research was to investigate the experiences of Canadian-educated seasoned VA teachers within a range of curriculums, administrative systems and locations focusing on issues related to the VA teaching experience such as viability of the artist-teacher relationship, teaching satisfaction and teacher burnout. Research was conducted using an auto-ethnography approach coupled with a comparative case study method using in-depth interviews. Insights were uncovered into VA teacher’s lived experience, values and decisions, occupational ideology, cultural knowledge, and perspectives. Research for creation methods were explored to develop a creative narrative to amplify teacher voice; endeavouring to make the obscure vivid, empathy possible, direct attention to individuality and locate the universal. Case study results sustain ethnographic observations revealing that VA teachers are experiencing more efficacy, satisfaction and success, with less burn out within the international school/IB context.

Keywords: international baccalaureate, autoethnography, teacher voice, visual arts

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Authors: Sylvia Acquah

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The assumption that social enterprises are empowering has strong theoretical support, but empirical verification is anecdotal at best. Social enterprises blend social goal with an enterprising idea and therefore in theory these enterprises should provide meaningful jobs that are empowering. Whether jobs created are meaningful, or whether these organizations are practicing social entrepreneurship remains unexplored key questions. This paper addresses these key questions through a comprehensive literature review and an ethnographical study of a Domiciliary Home Care Social Enterprise in the UK. The social entrepreneurs, management and 9 staff members were observed, interviewed and achieves were reviewed and analyzed. In this study, the social entrepreneur’s vision was lost in transition during management change and the organization was only identified as a social enterprise by name. The organization that was set up to tackle lack of continuity in care and create a family of independent carers, was eventually closed down overnight and subjected to investigation by social services and the local council. Also, the ineffectiveness of the organization led to staff being stressed and without the support of the management to help rectify the issues; staff started displaying symptoms of burnout. Social enterprise managers should not only focus on profit maximization or generation, but should equally live up to the core tenets of the enterprise and effectively communicate and gain buy-in of all employees for any changes. Further, there ought to be an independent organization that regulates social enterprises to ensure that they are adhering to their social goals.

Keywords: ethnography, carer, social, enterprise

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Authors: Junhai Liao, Yansong Shen, Aibing Yu

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A 3D numerical model is developed to simulate the complicated in-furnace combustion phenomena in the lower part of an ironmaking blast furnace (BF) while using pulverized coal injection (PCI) technology to reduce the consumption of relatively expensive coke. The computational domain covers blowpipe-tuyere-raceway-coke bed in the BF. The model is validated against experimental data in terms of gaseous compositions and coal burnout. Parameters, such as coal properties and some key operational variables, play an important role on the performance of coal combustion. Their diverse effects on different combustion characteristics are examined in the domain, in terms of gas compositions, temperature, and burnout. The heat generated by the combustion of upgraded Victorian brown coal is able to meet the heating requirement of a BF, hence making upgraded brown coal injected into BF possible. It is evidenced that the model is suitable to investigate the mechanism of the PCI operation in a BF. Prediction results provide scientific insights to optimize and control of the PCI operation. This model cuts the cost to investigate and understand the comprehensive combustion phenomena of upgraded Victorian brown coal in a full-scale BF.

Keywords: blast furnace, numerical study, pulverized coal injection, Victorian brown coal

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Authors: John Faucett, Hao Wu, Bruce Moore, Sean Nadji

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The demands of the ministry often conflict with responsibilities at home, and clergy often experience domain ambiguity between the domains of work and family. However, the unique level of family involvement in the pastor’s profession might enrich the pastor’s ministry as well as the functioning of the family unit. Life in the church family might offer clergy family members a sense of meaning and purpose, social support, and a feeling of belonging. Church activities can offer enhanced opportunities for family interaction. The purpose of this study was to investigate the relationships of work/family enrichment to clergy job satisfaction, burnout, engagement, and withdrawal. Method: Participants were clergy serving within a state conference of the United Methodist Church. A survey was administered electronically, with e-mails and the United Methodist Church (UMC) Facebook page used as access points to the survey. Usable responses for this portion of the survey were obtained from 132 clergy. Participants completed The Work-Family Enrichment Scales, The Utrecht Work Engagement Scale, The Scale of Emotional Exhaustion in Ministry, The Satisfaction in Ministry Scale, and a scale of withdrawal developed for the present study. They also answered questions relating to how involved their spouses are in their ministry and the degree to which spouse involvement in church ministry strengthens church ministry. Findings: Higher scores for work to family enrichment correlated positively with job satisfaction (r = - .69, p < .01) and engagement (r = .50, p < .01), and negatively with burnout (r = -.48, p < .01) and withdrawal (r = -.46, p < .01). Higher scores for family to work enrichment correlated positively with job satisfaction (r = .29, p = .01) and engagement (.24, p < .05), and negatively with burnout (r = -.48, p < .01), and withdrawal (r = -.46, p < .01). Hierarchical regression analysis suggested that clergy perceptions concerning the degree to which spouse involvement in church ministry strengthens church ministry moderates the relationship between degree of spouse involvement in church activities and clergy withdrawal. To the degree that spouse involvement is believed to strengthen ministry, high spouse involvement is related to less clergy withdrawal (Multiple R-Squared = .068, Adj. R-Squared = .043, F = 2.69 on 3 & 110 DF, p = .05). Concluding Statement: Clergy job attitudes are related to work/family enrichment. Spouse involvement in parish ministry is associated with less clergy withdrawal, as long as clergy believe spouse involvement strengthens their ministry.

Keywords: clergy, emotional exhaustion, job engagement, job satisfaction, work/family enrichment

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Authors: Ali H. Muhammad

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The present study examines some antecedents and consequences of employee job involvement in Kuwaiti business organization. The model presented in the current study suggests that job satisfaction and organizational commitments are determinates of job involvements. Employees who are satisfied with their jobs tend to be more attached to their jobs and view their jobs as an essential part of their existence. Similarly, employees who are committed to organizational goals, and identify with organizational values, tend to have high level of involvement. Furthermore, our model suggests that job involvement is positively related to work performance and organizational citizenship behavior. The negative consequences of job involvement include burnout and work family conflict. To test the hypotheses, a sample of 204 Kuwaiti employees representing 8 Kuwaiti work organizations is used. The sample covers a variety of business sectors in Kuwait, including manufacturing, services, and transportation. The data were analyzed using non-parametric tests, Pearson correlations, and structural equation modeling. Results indicate that job satisfaction and organizational commitment have significant positive effects on job involvement. Furthermore, findings reveal that job involvement is positively associated with performance, organization citizenship behavior, and work family conflict. Findings are discussed, and future areas of research are identified.

Keywords: job involvement, organizational citizenship behavior, work family conflict, burnout

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Authors: Jeongil Kim

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The present study examined the effects of arts-mediated mother-child dyads mindfulness-based intervention for Korean children with attention deficit hyperactivity disorder (ADHD) and their mothers, on behaviors in children and subjective psychological states in mothers. Four elementary school boys with ADHD and their mothers participated in the study. Using a multiple baseline design across four mother-child dyads, data were collected on the target behaviors (disruptive behavior, on-task behavior, and compliance in class) in children using a 10-second partial interval recording system and on the subjective psychological states in mothers using four questionnaires (on perceived stress, burnout, mindfulness, and satisfaction with life). The intervention consisted of a) mindfulness training, b) mindfulness practice, and c) mindful management of body and feeling. The arts activities, making a coiled clay pot and Korean traditional music performance, were utilized to facilitate the environment to help each participant to understand the content and progress of the intervention program. The results showed that all four dyads showed improvement in adaptive behaviors in the children (increase in on-task behavior; decrease in disruptive behavior) and positive change in subjective psychological states in the mothers (increase in scores of mindfulness and satisfaction with life; decrease in scores of perceived stress and burnout). The changes in the children’s behaviors and in the mothers’ subjective psychological states were maintained when the intervention was drawn and generalized in novel settings. The results suggest that arts-mediated mother-child dyads mindfulness-based intervention would be a mutual benefiting strategy to support both children with ADHD and their mothers who experience diverse challenges in behavioral and psychological aspects.

Keywords: mindfulness, attention deficit hyperactivity disorder (ADHD), arts-mediated, behavior, psychological well-being, child-mother

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Authors: Jui Chen Wu, Ming Yi Hsu

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Background and Purpose: Shift work of nursing staff is inevitable in hospital to provide continuing medical care. However, shift work is considered as a health hazard that may cause physical and psychological problems. Serious workplace fatigue of nursing shift work might impact on family, social and work life, moreover, causes serious reduction of quality of medical care, or even malpractice. This study aims to explore relationships among nursing staff’s shift, workplace fatigue and quality of working life. Method: Structured questionnaires were used in this study to explore relationships among shift work, workplace fatigue and quality of working life in nursing staffs. We recruited 590 nursing staffs in different Community Teaching hospitals in Taiwan. Data analysed by descriptive statistics, single sample t-test, single factor analysis, Pearson correlation coefficient and hierarchical regression, etc. Results: The overall workplace fatigue score is 50.59 points. In further analysis, the score of personal burnout, work-related burnout, over-commitment and client-related burnout are 57.86, 53.83, 45.95 and 44.71. The basic attributes of nursing staff are significantly different from those of workplace fatigue with different ages, licenses, sleeping quality, self-conscious health status, number of care patients of chronic diseases and number of care people in the obstetric ward. The shift variables revealed no significant influence on workplace fatigue during the hierarchical regression analysis. About the analysis on nursing staff’s basic attributes and shift on the quality of working life, descriptive results show that the overall quality of working life of nursing staff is 3.23 points. Comparing the average score of the six aspects, the ranked average score are 3.47 (SD= .43) in interrelationship, 3.40 (SD= .46) in self-actualisation, 3.30 (SD= .40) in self-efficacy, 3.15 (SD= .38) in vocational concept, 3.07 (SD= .37) in work aspects, and 3.02 (SD= .56) in organization aspects. The basic attributes of nursing staff are significantly different from quality of working life in different marriage situations, education level, years of nursing work, occupation area, sleep quality, self-conscious health status and number of care in medical ward. There are significant differences between shift mode and shift rate with the quality of working life. The results of the hierarchical regression analysis reveal that one of the shifts variables 'shift mode' which does affect staff’s quality of working life. The workplace fatigue is negatively correlated with the quality of working life, and the over-commitment in the workplace fatigue is positively related to the vocational concept of the quality of working life. According to the regression analysis of nursing staff’s basic attributes, shift mode, workplace fatigue and quality of working life related shift, the results show that the workplace fatigue has a significant impact on nursing staff’s quality of working life. Conclusion: According to our study, shift work is correlated with workplace fatigue in nursing staffs. This results work as important reference for human resources management in hospitals to establishing a more positive and healthy work arrangement policy.

Keywords: nursing staff, shift, workplace fatigue, quality of working life

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Authors: Meirav Eshkol, Miri Blaufeld, Rinat Basal

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Aim: The working environment in rural clinics is often isolated and distant from major health centers. In these circumstances, rural health care faces numerous challenges. The hope is that, in the immediate future and in the medium and long range, the rural nursing staff will realize their full professional and personal potential to their own satisfaction and to the health and welfare of their patients. Background: Rural nurses work mostly alone or with very few colleagues, and have the authority to make professional decisions, a fact which often requires them to make critical decisions in pressure situations. In addition, the expectations set for these nurses are extremely high, a fact which requires them to be extremely skilled and to fulfill their professional potential. They are required to provide high-quality and comprehensive care to the individual, the family, and the community and to maintain close interaction with the community. Work in a rural setting requires the flexibility to perform multiple tasks in an isolated setting, often far removed from major health centers. In order to maintain professional satisfaction for the rural nurse, expanded direction and training are required in professional know-how, and in the development of new and existing skills, toward the goal of treating a diverse population and to obtain a comprehensive view of the components of a diagnosis for treatment and to develop an understanding appropriate to the presented reality. Objective: To provide knowledge and to expand and develop professional skills in the prevention and advancement of health in the care of a diverse patient population. The development of strategies and skills for work under pressure alone instills expertise in performing multiple tasks in diverse disciplines. To reduce feelings of stress and burnout. Methodology: This course is the first and one of a kind in Clalit - the biggest health organisation in Israel. Observing and identifying the needs of the nurses in the field relating to the development of professional and personal skills defining goals and objectives, and determining the content of a course designed for rural nurses and kibbutz nurses who are not Clalit employees. Results: 43 nurses participated and 30 answered the feedback questionnaire. The rating of their experience was 4.33 (on a scale of 1-5, with 5 being the highest ranking). 92% indicated the importance of meeting with additional nurses to teach their colleagues. 83% of the nurses indicated an increased sense of organizational belonging. 60% indicated that the course helped to reduce feelings of stress and burnout in becoming a better rural nurse. 80% indicated that the course helped them establish intra-organizational professional cooperation and initiating processes. Conclusion: The course is an instrument which aids in increasing the feeling of organizational belonging, reducing feelings of stress and burnout, creation of relationships and cooperation both within and outside of the organization, increased the realization of the potential of the village nurse.

Keywords: rural nurse, alone, burnout, multiple tasks

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Authors: Paul Lawrence Filomeno, John Robert Medina, Anna Lisa Ong-Lim, Leonila Dans

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Introduction: In most hospitals, pediatric residents are part of the frontline team who interacts with medically underserved patients. Despite of these daily encounters, little is known regarding their attitudes and behaviors towards caring for these underserved patients. Objectives: This study measured the pediatric resident physicians’ attitudes and behaviors towards underserved patients and determine its association. Methodology: The study utilized a cross-sectional mixed methodology, combining the use of a self-administered questionnaire survey using the Learner’s Needs Assessment tool, measuring both attitudes and behaviors towards the underserved. This is followed by a focus group discussion (FGD) involving a sample of residents at the Philippine General Hospital. Results: The response rate was 100% among 62 residents. Overall, 78% of pediatric residents acknowledged the issues of medically underserved to be very important. Volunteerism (behaviors) was only 27% during residency, and was projected to be 90% in future practice. No significant association was noted between their attitudes and behaviors. The FGD revealed that factors (i.e. burnout) causes strains in residents towards the underserved. Frustration from genuine concern for the underserved children was apparent. Conclusion: Among PGH pediatric residents, their attitudes and behaviors are noted to be positive towards the underserved. There was no significant correlation noted between having positive attitudes and volunteerism (behaviors) of the residents towards the underserved. Despite this, residents pointed out certain factors (i.e. burnout) that affect their attitudes and behaviors. The study results may serve as the basis for curriculum enhancements tailored to promote resident well-being, molding them to become the ‘5-star pediatricians’ who will genuinely be ready to serve the underserved.

Keywords: pediatric residents, attitudes, behaviors, underserved children

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Authors: Alice Schittek, Isabelle Roskam, Moira Mikolajczak

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Background: Perfectionistic strivings (PS) and perfectionistic concerns (PC) are associated with an increase in parental burnout (PB), and PB causally increases violence towards the offspring. Objective: To our best knowledge, no study has ever investigated whether perfectionism (PS and PC) predicts violence towards the offspring and whether PB could explain this link. We hypothesized that an increase in PS and PC would lead to an increase in violence via an increase in PB. Method: 228 participants responded to an online survey, with three measurement occasions spaced two months apart. Results: Contrary to expectations, cross-lagged path models revealed that violence towards the offspring prospectively predicts an increase in PS and PC. Mediation models showed that PB is not a significant mediator. The results of all models did not change when controlling for social desirability. Conclusion: The present study shows that violence towards the offspring increases the risk of PS and PC in parents, which highlights the importance of understanding the effect of child maltreatment on the whole family system and not just on children. Results are discussed in light of the feeling of guilt experienced by parents. Considering the insignificant mediation effect, PB research should slowly shift towards more (quasi) causal designs, allowing to identify which significant correlations translate into causal effects. Implications: Clinicians should focus on preventing child maltreatment as well as treating parental perfectionism. Researchers should unravel the effects of child maltreatment on the family system.

Keywords: maltreatment, parental burnout, perfectionistic strivings, perfectionistic concerns, perfectionism, violence

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Authors: Kinneret Segal

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Background: The work of a midwife is emotionally challenging, both positively and negatively. Midwives share moments of joy when a baby is welcomed into the world and also attend difficult events of loss and trauma. The relationship that develops with the maternity is the essence of the midwife's care, and it is a fundamental source of motivation and professional satisfaction. This close relationship with the maternity may be used as a double-edged sword in cases of exposure to traumatic events at birth. Birth problems, exposure to emergencies and traumatic events, and loss can affect the professional quality of life and the Compassion satisfaction of the midwife. It seems that the issue of traumatic experiences in the work of midwives has not been sufficiently explored. Aim: The present study examined the associations between exposure to traumatic events, personal resilience and post-traumatic symptoms, professional quality of life, and organizational commitment among midwifery nurses in Israeli hospitals. Methods: 131 midwives from three hospitals in the country's center in Israel participated in this study. The data were collected during 2021 using a self-report questionnaire that examined sociodemographic characteristics, the degree of exposure to traumatic events in the delivery room, personal resilience, post-traumatic symptoms, professional quality of life, and organizational commitment. Results: The three most difficult traumatic events for the midwives were death or fear of death of a newborn, death or fear of the death of a mother, and a quiet birth. The higher the frequency of exposure to traumatic events, the more numerous and intense the onset of post-trauma symptoms. The more numerous and powerful the post-trauma symptoms, the higher the level of professional burnout and/or compassion fatigue, and the lower the level of compassion satisfaction. High levels of compassion satisfaction and/or low professional burnout were expressed in a heightened sense of organizational commitment. Personal resilience, country of birth, traumatic symptoms, and organizational commitment predicted satisfaction from compassion. Conclusions: Midwives are exposed to traumatic events associated with dissatisfaction and impairment of the professional quality of life that accompanies burnout and compassion fatigue. Exposure to traumatic events leads to the appearance of traumatic symptoms, a decrease in organizational commitment, and psychological and mental well-being. The issue needs to be addressed by implementing training programs, organizational support, and policies to improving well-being and quality of care among midwives.

Keywords: organizational commitment, traumatic experiences, personal resilience, quality of life

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Authors: Frank Fan

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PharmD (Doctor of Pharmacy) education has confronted an increasing challenge — curricular overload, a phenomenon resulting from the expansion of curricular requirements, as PharmD education strives to produce graduates who are practice-ready. The aftermath of the global pandemic has amplified the need for healthcare professionals, leading to a growing trend of assigning more responsibilities to them to address the global healthcare shortage. For instance, the pharmacist’s role has expanded to include not only compounding and distributing medication but also providing clinical services, including minor ailments management, patient counselling and vaccination. Consequently, PharmD programs have responded by continually expanding their curricula adding more requirements. While these changes aim to enhance the education and training of future professionals, they have also led to unintended consequences, including curricular overload, student burnout, and a potential decrease in program quality. To address the issue and ensure program quality, there is a growing need for evidence-based curriculum reforms. My research seeks to integrate Cognitive Load Theory, emerging machine learning algorithms within artificial intelligence (AI), and statistical approaches to develop a quantitative framework for optimizing curriculum design within the PharmD program at the University of Toronto, the largest PharmD program within Canada, to provide quantification and measurement of issues that currently are only discussed in terms of anecdote rather than data. This research will serve as a guide for curriculum planners, administrators, and educators, aiding in the comprehension of how the pharmacy degree program compares to others within and beyond the field of pharmacy. It will also shed light on opportunities to reduce the curricular load while maintaining its quality and rigor. Given that pharmacists constitute the third-largest healthcare workforce, their education shares similarities and challenges with other health education programs. Therefore, my evidence-based, data-driven curriculum analysis framework holds significant potential for training programs in other healthcare professions, including medicine, nursing, and physiotherapy.

Keywords: curriculum, curriculum analysis, health professions education, reflective writing, machine learning

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Authors: Merkouche Wassila, Marchand Alain, Renaud Stéphane

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Organizations are facing competitive pressures constraining them to modify their practices and change initial work conditions of employees, however, these modifications have to sustain initial quality of work and engagements toward the workforce. We focus on the importance of promises in the perspective of psychological contract. According to this perspective, employees perceiving a breach of the expected obligations from the employer may become unsatisfied at work and develop organizational withdrawal behaviors. These are negative counterproductive behaviours aiming to damage the organisation according to the principle of reciprocity and social exchange. We present an integrative model of the determinants and manifestations of organizational withdrawal (OW), a set of behaviors allowing the employee to leave his job or avoid his assigned work. OW contains two main components often studied in silos: work withdrawal (delays, absenteeism and other adverse behaviors) and job withdrawal (turnover). We use the systemic micro, meso and macro sociological approach designing the individual at the heart of a system containing individual, organizational, and environmental determinants. Under the influence of these different factors, the individual assesses the type of behavior to adopt. We provide better lighting for understanding OW using both psychological contract approach through the perception of its respect by the organization and job embeddedness approach which explains why the employee does not leave the organization and then remains in his post while practicing negative and counterproductive behaviors such as OW. We study specifically cynicism as a type of OW as it is a dimension of burnout. We focus on the antecedents of cynicism to try to prevent it in the workplace.

Keywords: burnout, cynicism, job embeddedness, organizational withdrawal, psychological contract

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Authors: Ágnes Győri, Éva Perpék, Zsófia Bauer, Zsuzsanna Elek

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The aim of the research (funded by Hungarian national grant, NFKI- FK 138315) is to examine the professional mobility, mental health and work environment of social workers with a complex approach. Previous international and Hungarian research has pointed out that those working in the helping professions are strongly exposed to the risk of emotional-mental-physical exhaustion due to stress. Mental and physical strain, as well as lack of coping (can) cause health problems, but its role in career change and high labor turnover has also been proven. Even though satisfaction with working conditions of those employed in the human service sector in the context of the stress burden has been researched extensively, there is a lack of large-sample international and Hungarian domestic studies exploring the effects of profession-specific conditions. Nor has it been examined how the specific features of the social profession and mental health affect the career mobility of the professionals concerned. In our research, these factors and their correlations are analyzed by means of mixed methodology, utilizing the benefits of netnographic big data analysis and a sector-specific quantitative survey. The netnographic analysis of open web content generated inside and outside the social profession offers a holistic overview of the influencing factors related to mental health and the work environment of social workers. On the one hand, the topics and topoi emerging in the external discourse concerning the sector are examined, and on the other hand, focus on mentions and streams of comments regarding the profession, burnout, stress, coping, as well as labor turnover and career changes among social professionals. The analysis focuses on new trends and changes in discourse that have emerged during and after the pandemic. In addition to the online conversation analysis, a survey of social professionals with a specific focus has been conducted. The questionnaire is based on input from the first two research phases. The applied approach underlines that the mobility paths of social professionals can only be understood if, apart from the general working conditions, the specific features of social work and the effects of certain aspects of mental health (emotional-mental-physical strain, resilience) are taken into account as well. In this paper, the preliminary results from this innovative methodological mix are presented, with the aim of highlighting new opportunities and dimensions in the research on social work. A gap in existing research is aimed to be filled both on a methodological and empirical level, and the Hungarian domestic findings can create a feasible and relevant framework for a further international investigation and cross-cultural comparative analysis. Said results can contribute to the foundation of organizational and policy-level interventions, targeted programs whereby the risk of burnout and the rate of career abandonment can be reduced. Exploring different aspects of resilience and mapping personality strengths can be a starting point for stress-management, motivation-building, and personality-development training for social professionals.

Keywords: burnout, mixed methods, netnography, professional mobility, social work

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Authors: Ashleigh Cicconi

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Teachers may not have access to necessary and effective strategies for managing stress, trauma, and emotional exhaustion, which can lead to burnout. This practice-based research focused on the exploration of teacher well-being through participation in a wellness program in order to mitigate high stress levels and feelings of burnout. The purpose of this qualitative research was to explore how a multimodal, trauma-informed yoga and arts-based mindfulness program impacted stress levels and overall well-being for teachers in a school setting. The case study approach was used to investigate participant perceptions of interactions between multimodal accessibility, a trauma-informed wellness program, and teacher well-being. A sample size of 10 teachers employed full-time at a public high school in the Mid-Atlantic region were recruited via email correspondence to participate in the eight-week wellness program. Data were triangulated across semi-structured interviews, journal entries, and focus group guided questions, and transcripts were uploaded into the NVivo software application for thematic analysis. Data showed perceptions of improvements in overall well-being from participation in the wellness program and that utilizing trauma-informed practices may be an effective coping skill for stress. The multimodal design of the program was perceived to positively impact participation and accessibility to wellness strategies. Findings from this study suggest that the inclusion of trauma-informed practices within a wellness program may be effective for managing stress and trauma experienced by teachers, thereby aiding in improvement in overall well-being. Findings also suggest that multimodality may be effective for increasing participation in and accessibility to wellness strategies.

Keywords: trauma informed practices, wellness program, teacher wellbeing, accessible program, multimodal

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Authors: Aysen Caliskan, Hanzade Haykiri-Acma, Serdar Yaman

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Co-firing of coal and biomass blends is an effective method to reduce carbon dioxide emissions released by burning coals, thanks to the carbon-neutral nature of biomass. Besides, usage of biomass that is renewable and sustainable energy resource mitigates the dependency on fossil fuels for power generation. However, most of the biomass species has negative aspects such as low calorific value, high moisture and volatile matter contents compared to coal. Torrefaction is a promising technique in order to upgrade the fuel properties of biomass through thermal treatment. That is, this technique improves the calorific value of biomass along with serious reductions in the moisture and volatile matter contents. In this context, several woody biomass materials including Rhododendron, hybrid poplar, and ash-tree were subjected to torrefaction process in a horizontal tube furnace at 200°C under nitrogen flow. In this way, the solid residue obtained from torrefaction that is also called as 'biochar' was obtained and analyzed to monitor the variations taking place in biomass properties. On the other hand, some Turkish lignites from Elbistan, Adıyaman-Gölbaşı and Çorum-Dodurga deposits were chosen as coal samples since these lignites are of great importance in lignite-fired power stations in Turkey. These lignites were blended with the obtained biochars for which the blending ratio of biochars was kept at 10 wt% and the lignites were the dominant constituents in the fuel blends. Burning tests of the lignites, biomasses, biochars, and blends were performed using a thermogravimetric analyzer up to 900°C with a heating rate of 40°C/min under dry air atmosphere. Based on these burning tests, properties relevant to burning characteristics such as the burning reactivity and burnout yields etc. could be compared to justify the effects of torrefaction and blending. Besides, some characterization techniques including X-Ray Diffraction (XRD), Fourier Transform Infrared (FTIR) spectroscopy and Scanning Electron Microscopy (SEM) were also conducted for the untreated biomass and torrefied biomass (biochar) samples, lignites and their blends to examine the co-combustion characteristics elaborately. Results of this study revealed the fact that blending of lignite with 10 wt% biochar created synergistic behaviors during co-combustion in comparison to the individual burning of the ingredient fuels in the blends. Burnout and ignition performances of each blend were compared by taking into account the lignite and biomass structures and characteristics. The blend that has the best co-combustion profile and ignition properties was selected. Even though final burnouts of the lignites were decreased due to the addition of biomass, co-combustion process acts as a reasonable and sustainable solution due to its environmentally friendly benefits such as reductions in net carbon dioxide (CO2), SOx and hazardous organic chemicals derived from volatiles.

Keywords: burnout performance, co-combustion, thermal analysis, torrefaction pretreatment

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Authors: Mohamed Abdalla Elamein Boshara, Peter Charles Woods, Nour Eldin Mohamed Elshaiekh

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Knowledge Management has become very important for Disaster Management response and planning. This paper proposes the implementation of a Knowledge Management System with a sustainable data collection mechanism for reliable and timely information management to support decision makers in making the right decisions in the timely manner.

Keywords: knowledge management, disaster management, incident tracking, web application

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Authors: Aline Woine, Moïra Mikolajczak, Virginie Dardier, Isabelle Roskam

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Background information: Becoming a parent is said to be the happiest event one can ever experience in one’s life. This popular (and almost absolute) truth–which no reasonable and decent human being would ever dare question on pain of being singled out as a bad parent–contrasts with the nuances that reality offers. Indeed, while many parents do thrive in their parenting role, some others falter and become progressively overwhelmed by their parenting role, ineluctably caught in a spiral of exhaustion. Parental burnout (henceforth PB) sets in when parental demands (stressors) exceed parental resources. While it is now generally acknowledged that PB affects the parent’s behavior in terms of neglect and violence toward their offspring, little is known about the impact that the syndrome might have on the children’s internalized (anxious and depressive symptoms, somatic complaints, etc.) and/or externalized (irritability, violence, aggressiveness, conduct disorder, oppositional disorder, etc.) behaviors. Furthermore, at the time of writing, to our best knowledge, no research has yet tested the reverse effect, namely, that of the child's internalized and/or externalized behaviors on the onset and/or maintenance of parental burnout symptoms. Goals and hypotheses: The present pioneering research proposes to fill an important gap in the existing literature related to PB by investigating the bidirectional effect between PB and the child’s internalized and/or externalized behaviors. Relying on a cross-lagged longitudinal study with three waves of data collection (4 months apart), our study tests a transactional model with bidirectional and recursive relations between observed variables and at the three waves, as well as autoregressive paths and cross-sectional correlations. Methods: As we write this, wave-two data are being collected via Qualtrics, and we expect a final sample of about 600 participants composed of French-speaking (snowball sample) and English-speaking (Prolific sample) parents. Structural equation modeling is employed using Stata version 17. In order to retain as much statistical power as possible, we use all available data and therefore apply the maximum likelihood with a missing value (mlmv) as the method of estimation to compute the parameter estimates. To limit (in so far is possible) the shared method variance bias in the evaluation of the child’s behavior, the study relies on a multi-informant evaluation approach. Expected results: We expect our three-wave longitudinal study to show that PB symptoms (measured at T1) raise the occurrence/intensity of the child’s externalized and/or internalized behaviors (measured at T2 and T3). We further expect the child’s occurrence/intensity of externalized and/or internalized behaviors (measured at T1) to augment the risk for PB (measured at T2 and T3). Conclusion: Should our hypotheses be confirmed, our results will make an important contribution to the understanding of both PB and children’s behavioral issues, thereby opening interesting theoretical and clinical avenues.

Keywords: exhaustion, structural equation modeling, cross-lagged longitudinal study, violence and neglect, child-parent relationship

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Authors: James Boag

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The needs of people with a diagnosis of dementia and their carers and families are physical, psychosocial, and psychological and begin at the time of diagnosis. There is frequently a lack of emotional support and counselling. Care- giving support is required from the presentation of the first symptoms of dementia until death. Alzheimer's disease begins decades before the clinical symptoms begin to appear, and in many cases, it remains undiagnosed, or diagnosed too late for any possible interventions to have any effect. However, if an incorrect diagnosis is given, it may result in a person being treated, without effect, for a type of dementia they do not have and delaying the interventions they should have received. Being diagnosed with dementia can cause emotional distress to the person, and physical and emotional support is needed, which will become more important as the disease progresses. The severity of the patient's dementia and their symptoms has a bearing of the impact on the carer and the support needed. A lack of insight and /or a denial of the diagnosis, grief, reacting to anticipated future losses, and coping methods to maximise the disease outcome, are things that should be addressed. Because of the stigma, it is important for carers not to lose contact with family and others because social isolation leads to depression and burnout. The impact on a carer's well- being and quality of life can be influenced by the severity of the illness, its type of dementia, its symptoms, healthcare support, financial and social status, career, age, health, residential setting, and relationship to the patient. Carer burnout due to lack of support leads to people diagnosed with dementia being put into residential care prematurely. Often dementia is not recognised as a terminal illness, limiting the ability of the person diagnosed with dementia and their carers to work on advance care planning and getting access to palliative and other support. Many carers have been satisfied with the physical support they were given in their everyday life, however, it was agreed that there was an immense unmet need for psychosocial support, especially after diagnosis and approaching end of life. Providing continuity and coordination of care is important. Training is necessary for providers to understand that every case is different, and they should understand the complexities. Grief, the emotional response to loss, is suffered during the progression of the disease and long afterwards, and carers should continue to be supported after the death of the person they were caring for.

Keywords: dementia, caring, challenges, needs

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Authors: Miriam Schiff, Hadas Rosenne, Ran Nir-Paz, Shiri Shinan Altman

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To examine (1) the level, predictors, and subjective perception of professional quality of life (PRoQL), posttraumatic growth, roles, task changes during the pandemic, and perceived preparedness for the next pandemic. These variables were added as part of an international study on social workers in healthcare stress, resilience, and perceived preparedness we took part in, along with Australia, Canada, China, Hong Kong, Singapore, and Taiwan. (2) The extent to which background variables, rate of exposure to the virus, working in COVID wards, profession, personal resilience, and resistance to organizational change predict posttraumatic growth, perceived preparedness, and PRoQL (the latter was examined among social workers only). (3) The teams' perceptions of how the pandemic impacted them at the personal, professional, and organizational levels and what assisted them. Methodologies: Mixed quantitative and qualitative methods were used. 1039 hospital healthcare workers from various professions participated in the quantitative study while 32 participated in in-depth interviews. The same methods were used in six other countries. Findings: The level of PRoQL was moderate, with higher burnout and secondary traumatization level than during routine times. Differences between countries in the level of PRoQL were found as well. Perceived preparedness for the next pandemic at the personal level was moderate and similar among the different health professions. Higher exposure to the virus was associated with lower perceived preparedness of the hospitals. Compared to other professions, doctors and nurses perceived hospitals as significantly less prepared for the next pandemic. The preparedness of the State of Israel for the next pandemic is perceived as low by all healthcare professionals. A moderate level of posttraumatic growth was found. Staff who worked at the COVID ward reported a greater level of growth. Doctors reported the lowest level of growth. The staff's resilience was high, with no differences among professions or levels of exposure. Working in the COVID ward and resilience predicted better preparedness, while resistance to organizational change predicted worse preparedness. Findings from the qualitative part of the study revealed that healthcare workers reported challenges at the personal, professional and organizational level during the different waves of the pandemic. They also report on internal and external resources they either owned or obtained during that period. Conclusion: Exposure to the COVID-19 virus is associated with secondary traumatization on one hand and personal posttraumatic growth on the other hand. Personal and professional discoveries and a sense of mission helped cope with the pandemic that was perceived as a historical event, war, or mass casualty event. Personal resilience, along with the support of colleagues, family, and direct management, were seen as significant components of coping. Hospitals should plan ahead and improve their preparedness to the next pandemic.

Keywords: covid-19, health-care, social workers, burnout, preparedness, international perspective

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Authors: Belakhdar Salah Brahim

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The Urban management is a major element of social control of public space and thus the functioning of society. As such, it is a key element of a social conception of sustainable development. Also, it is a cross-cutting sector that relies on land management, infrastructure management, habitat management, management of social services, the management of economic development, etc. This study aims to study how urban management focusing on the study of problems related to urban waste management in developing countries. It appears from the study that the city management is to improve infrastructure and urban services in order to increase the city's development and improve living conditions in cities. It covers various aspects including management of urban space, economic management, administrative management, asset management or infrastructure and finally waste management. Environmental management is important because it solves the pollution problems of life and preserve resources for future generations. Changing perceptions of waste has led to the definition of new policies for integrated waste management requirements appropriate to the urban site.

Keywords: urbanization, urban management, environmental management, waste management

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Authors: Chukwuka Justus Iwegbu

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Background: A major concern facing the world is providing senior citizens, individuals with disabilities, and other vulnerable groups with high-quality care. This issue is more serious in Nigeria's North Eastern area, where the burden of disease and disability is heavy, and access to care is constrained. This study aims to fill this gap by exploring the roles, challenges and support needs of caregivers, care home management, funding and administration in challenged communities in North Eastern Nigeria. The study will also provide a comprehensive understanding of the current situation and identify opportunities for improving the quality of care and support for caregivers and care recipients in these communities. Methods: A mixed-methods design, including both quantitative and qualitative data collection methods, will be used, and it will be guided by the stress process model of caregiving. The qualitative stage approach will comprise a survey, In-depth interviews, observations, and focus group discussion and the quantitative analysis will be used in order to comprehend the variations between caregiver's roles and care home management. A review of relevant documents, such as care home policies and funding reports, would be used to gather quantitative data on the administrative and financial aspects of care. The data collected will be analyzed using both descriptive statistics and thematic analysis. A sample size of around 200-300 participants, including caregivers, care recipients, care home managers and administrators, policymakers and health care providers, would be recruited. Findings: The study revealed that caregivers in challenged communities in North Eastern Nigeria face significant challenges, including lack of training and support, limited access to funding and resources, and high levels of burnout. Care home management and administration were also found to be inadequate, with a lack of clear policies and procedures and limited oversight and accountability. Conclusion: There is a need for increased investment in training and support for caregivers, as well as a need for improved care home management and administration in challenged communities in North Eastern Nigeria. It also highlights the importance of involving community members in decision-making and planning processes related to care homes and services. The study would contribute to the existing body of knowledge by providing a detailed understanding of the challenges faced by caregivers, care home managers and administrators.

Keywords: caregivers, care home management, funding, administration, challenge communities, North Eastern Nigeria

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Authors: Mehrnoosh Askarizadeh

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The customer’s value has become obvious for the leading companies in today’s competitive environment. Therefore they are constantly trying to improve their relationship with customers. Customer Knowledge has been recognized as a strategic resource and a key to the success of any company. Talking about the Customer Knowledge Management is closely associated with Knowledge Management and Customer Relationship Management (CRM). Recent studies conducted in the fields of Knowledge Management (KM) and Customer Relationship Management (CRM) has explained that the two approaches can have great synergies. In this paper, our aim is to provide an understanding of Customer Knowledge Management (CKM) as an integrated management approach and competence it requires. We describe CKM as an ongoing process of generating, disseminating and using customer knowledge within an organization and between an organization and its customers. In addition, we propose a comprehensive framework of CKM, the ability to integrate customer knowledge into customer relationship management processes.

Keywords: e-commerce, knowledge management (KM), customer relationship management (CRM), customer knowledge management (CKM)

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Authors: Mehrnoosh Askarizadeh

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To meet the challenges of the new global environment, companies have started paying great attention towards quality management as an integral part of their strategic business plans. The purpose of this article is to investigate the relationship between total quality management (TQM) and knowledge management (KM). Successful total quality management implementation throughout the organizations requires major changes in the main four aspects of knowledge management, namely: Creating, storage, sharing and application. Skill, knowledge and productivity are important factors in organization’s success and have important role. Therefore, TQM management system pays special attention to it. However, knowledge as the source is essential for organization’s survival. Our study points out how the quality management and knowledge management have been incorporated into each other for the development of the quality culture within the organization.

Keywords: knowledge management (KM), total quality management (TQM), organizational performance (OP), deming cycle

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Authors: Anita D. Adamu, Winston M. W. Shakantu

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Maintenance management is no longer a stand-alone activity. It has now assumed a strategic position in many organisations that have recognised its importance in achieving primary goals and a key aspect of effective management of facilities. This paper aims at providing an understanding of the role and function of strategic management in creating and sustaining an effective maintenance management system in an organisation. The background provides an articulated concept and principles of strategic management. The theoretical concepts paved way for a conceptual framework for which strategic management can be integrated into the maintenance management system of an organisation to improve effectiveness in the maintenance of facilities.

Keywords: facilities, maintenance management, organisations, strategic management

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Authors: Tanya Anand, Arun Kandasamy, L. N. Suman

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Family based therapy for adolescent substance abuse has been studied to be effective in the West. Whereas, based on literature review, family therapy and interventions for adolescent substance abuse is still in its nascent stages in India. A multidimensional perspective to treatment has been indicated consistently in the Indian literature, but standardized therapy which addresses early substance abuse, from a social-ecological perspective has not been developed and studied for Indian population. While numerous researches have been conducted in India on the need of engaging the family in therapy for the purpose of symptom reduction, long-term maintenance of gains, and reducing family burnout, distress and dysfunction; a family based model in the Indian context has not been developed and tried, to the best of our knowledge. Hence, from the aim of building a model to treat adolescent substance abuse within the family context, experts in the area of mental health and deaddiction were interviewed to inform upon the clinical difficulties, challenges, uniqueness that Indian families present with. The integration of indigenous techniques that would be helpful in engaging families of young individuals with difficulties were also explored. Eight experts' who were interviewed, have 10-30 years of experience in working with families and substance users. An open-ended interview was conducted with the experts individually and audio-recorded. The interviews were then transcribed and subjected to qualitative analysis for building a framework and treatment guideline. Additionally, interviews with patients and their parents were conducted to elicit ‘felt needs’. The results of the analysis revealed culture-specific issues widely experienced within Indian families by adolescents and young adults, centering around the theme of Individuation versus collective identity and living. Substance abuse, in this framework, was found to be perceived as one of the maladaptive ways of the youth to disengage from the family and attempt at individuation and the responsibilities that are considered entitlements in the culture. On the other hand, interviews with family members revealed them to be engaging in inconsistent patterns of care and parenting. This was experienced and observed in terms of fostering interdependence within the family, sometimes within adverse socio-economic and societal conditions, where enacted and perceived stigma kept the individual and family members in a vicious loop of maladaptive coping patterns, dysfunctional family arrangements, and often leading to burnout with poor help seeking. The paper inform upon a framework that lays down the foundation for assessments, planning, case management and therapist competencies, required to address alcohol and drug issues in an Indian family context with such etiological factors at its heart. This paper will cover qualitative results of the interviews and present a model that may guide mental health professionals for treatment of adolescent substance use and family therapy.

Keywords: Indian families, family therapy, de-addiction, adolescent, youth, substance abuse, behavioral issues, felt needs, culture, etiology, model building, framework development, interviews

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Authors: Morgan Dombroski, Alexis Hartman

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Purpose: The present study aimed to explore factors related to overtraining within a female collegiate sample by analyzing the aftereffects of overtraining on athletes' physical and emotional well-being. Methods: 51 female collegiate athletes participated in a de-identified survey to assess factors related to overtraining. All survey questions were derived from the Recovery-Stress Questionnaire. Descriptive and bivariate correlations were conducted to test for significant factors related to the athletes' physical and emotional well-being relating to sports engagement. Results: Descriptive statistics indicated: 80.4% of athletes reported feeling tired from sport-related work, 72.5% reported parts of their body were aching, 47.1% reported feeling emotionally drained, and 37.3% reported feeling burnt out by sport. These findings were consistent with bivariate correlations, which yielded statistically significant findings between physical fatigue and emotional distress. Discussion: In a general sense, athletes increase their training to maximize their performance. The current study aimed to analyze how this training process can result in overtraining of female collegiate athletes, which in turn may negatively impact their physical and emotional functioning. Overtraining syndrome can occur as a maladaptive response to excessive exercise and inappropriate rest caused by systemic inflammation, which negatively affects the central nervous system. The physical manifestations of overtraining can then lead to depressed mood, fatigue, and neurohormonal changes in athletes. To remain competitive and high performing in sports, athletes partaking in excessive training can result in overtraining syndrome, athlete burnout, and compulsive exercise. Additionally, overtrained athletes were defined by displaying high levels of perfectionism, maladaptive coping, and training distress. The current study supported these findings, which yielded a strong correlation between physical and emotional functioning in the context of overtraining in sports. All in all, the environment revolving around sports and the intensity of training can be extremely stressful for athletes. There is a need to monitor athletes’ subjective responses to training, which will allow for early identification of at-risk athletes giving clinicians various opportunities to reduce the negative consequences of overtraining. By better understanding symptoms of emotional and physical fatigue, collegiate sports can become more aware of overtraining symptoms to prevent further detriment to female athletes' overall well-being.

Keywords: burnout, emotionally drained, overtraining, performance, well-being

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Authors: Peter Ekene Egwu

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Waste management is of critical importance in Africa for reasons related to public health, human dignity, climate resilience and environmental preservation. However, delivering waste management services requires adequate funding, which has generally been lacking in a context where the generation of waste is outpacing the development of waste management infrastructure in most cities. The sector represents a growing percentage of cities’ greenhouse gas (GHG) emissions, and some of the African cities profiled in this study are now designing waste management strategies with emission reduction in mind.

Keywords: management waste material, Africa, uses of new technology to manage waste, waste management

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