Transformational Leadership, Secondary Traumatic Stress, and Burnout of Child Welfare Workers: Multilevel Moderation Effects.

This study examines the moderating effects of distant leader's practice of transformational leadership on the relationship between secondary traumatic stress (STS) and burnout among child welfare workers. Caseworkers and supervisors in a Midwest U.S. state (N = 210) rated their regional director's use of transformational leadership skills using a survey. Given the nature of the clustered data, multilevel modeling was employed to examine the main effects of transformational leadership on worker burnout and its cross-level interaction effect on the association between worker STS and burnout. Multilevel modeling demonstrated that worker burnout was positively associated with STS and negatively associated with organizational-level transformational leadership. The cross-level interaction between transformational leadership and STS was significant. Specifically, the positive association between workers' STS and burnout decreased as transformational leadership increased. These findings suggest that organizational approaches such as transformational leadership can influence workforce results. Further research will guide child welfare policymakers to develop more sophisticated training programs in leadership skills and strategies.

The accuracy of patient specific implant prebented with 3D-printed rapid prototype model for orbital wall reconstruction.

BACKGROUND: This study evaluated the accuracy of blow out fracture reduction using 3D-printed rapid prototyping (RP) skull modeling. PATIENTS AND METHODS: Retrospective review was performed for 82 patients who underwent post-traumatic orbital wall fracture reduction between 2012 and 2014. Patients were divided into two groups according to the use of 3D-printed RP skull model reproduced by mirroring technique, onto which a titanium mesh was anatomically molded. Using computed tomographic scans, the areas of pre- and post-operative orbital wall defect, the layout angles of the titanium mesh, and the gap lengths between the implant and fracture margin were compared between the two groups. RESULTS: Of the 82 patients identified, 46 and 36 were diagnosed with medial and inferior orbital wall fractures, respectively. Bone defect area of the RP group was significantly reduced in comparison with that of the conventional group (8.03 ± 3.5% versus 18.7 ± 15.41% for medial wall fractures, 7.14 ± 5.74% versus 12.8 ± 4.92% for inferior wall fractures, respectively, p < 0.01). Satisfactory results were achieved regarding the layout angles and the gap lengths, presenting significantly reduced values in the RP group compared to that in the conventional group (p < 0.01). CONCLUSIONS: More accurate restoration of traumatic orbital wall fractures can be achieved using patient-specific 3D-printed RP skull models.

Relationship between mitochondria and α-synuclein: a study of single substantia nigra neurons.

OBJECTIVE: To explore the relationship between α-synuclein pathology and mitochondrial respiratory chain protein levels within single substantia nigra neurons. DESIGN: We examined α-synuclein and mitochondrial protein expression in substantia nigra neurons of 8 patients with dementia with Lewy bodies, 5 patients with Parkinson disease, and 8 control subjects. Protein expression was determined using immunocytochemistry followed by densometric analysis. PATIENTS: We examined single substantia nigra neurons from 5 patients with idiopathic Parkinson disease (mean age, 81.2 years), 8 patients with dementia with Lewy bodies (mean age, 75 years), and 8 neurologically and pathologically normal control subjects (mean age, 74.5 years). The control cases showed minimal Lewy body pathology and cell loss. Patients with dementia with Lewy bodies and idiopathic Parkinson disease fulfilled the clinical and neuropathologic criteria for these diseases. RESULTS: Our results showed that mitochondrial density is the same in nigral neurons with and without α-synuclein pathology. However, there are significantly higher levels of the respiratory chain subunits in neurons containing α-synuclein pathology. CONCLUSIONS: The finding of increased levels of respiratory chain complex subunits within neurons containing α-synuclein does not support a direct association between mitochondrial respiratory chain dysfunction and the formation of α-synuclein pathology.

Changes in the area of the anterior capsule opening after intraocular lens implantation.

PURPOSE: To evaluate the reduction rate of the area of the anterior capsule opening after continuous curvilinear capsulorhexis (CCC) with 3 types of intraocular lenses (IOLs). SETTING: St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea. METHODS: Sixty-five eyes of 51 patients having phacoemulsification and IOL implantation were assigned to 1 of 3 groups based on type of IOL: 1-piece acrylic (n = 16), 3-piece acrylic (n = 26), or silicone (n = 23). The area of the anterior capsule opening was measured 1 day and 1, 2, 3, 6, and 12 months postoperatively. RESULTS: There was significant reduction in the area of the anterior capsule opening 1 day to 3 months postoperatively in all 3 groups (P <.001). There was no further reduction after 3 months in any group. The reduction in the area of the anterior capsule opening was significantly less in both acrylic IOL groups than in the silicone IOL group at 3 months (P =.040) and 12 months (P =.023); however, there was no significant difference between the 2 types of acrylic IOLs (P =.933). CONCLUSIONS: Although there was a reduction in the area of the anterior capsule opening in all patients, the amount was significantly less in the 2 acrylic IOL groups than in the silicone IOL group. This should be considered when selecting an IOL, especially for eyes at risk for capsule contraction.