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Articles 1201 - 1230 of 1795

Full-Text Articles in Psychology

A Systematic Review Of Universal, Teacher-Led Interventions Targeting Anxiety In U.S. Schools, Sonja F. Tutsch, Patrick Fowler, Gaurav Kumar, Adam Weaver, Brian Mckevitt, Denise Britigan, Christian I.J. Minter, Lorena Baccaglini Feb 2018

A Systematic Review Of Universal, Teacher-Led Interventions Targeting Anxiety In U.S. Schools, Sonja F. Tutsch, Patrick Fowler, Gaurav Kumar, Adam Weaver, Brian Mckevitt, Denise Britigan, Christian I.J. Minter, Lorena Baccaglini

Posters and Presentations: College of Public Health

Implications of anxiety symptomatology experienced among children and adolescents in the US constitute a major public health crisis, calling for promising universal mental health interventions in K-12 schools. Schools represent an ideal setting for the implementation of population based, public health interventions, as children and adolescents spend a significant proportion of time in school. Discussions within the scientific community document several advantages to utilization of universal, Tier1 interventions. However, the efficacy of universal, school-based anxiety interventions in the US are not consistently documented. The purpose of this study is to systematically review the literature to identify the efficacy of universal …


Prescription Drug Abuse, Jiaxi Tian Jan 2018

Prescription Drug Abuse, Jiaxi Tian

Global Issues in Public Health

Prescription drug abuse is an action that portrayed as misuse or overuse of prescription drugs. It is a prevalent problem all over the world. U.S is a particular country that has drug abuse as a serious problem has several different causes of the drug abuse. In the U.S., most prescription drugs are pain killers. The outcomes of drug abuse vary but may lead to death.


Assessment Of Pain-Related Fear In Individuals With Chronic Painful Conditions, Manasi M. Mittinty, Daniel W. Mcneil, David S. Brennan, Cameron L. Randall, Murthy N. Mittinty, Lisa Jamieson Jan 2018

Assessment Of Pain-Related Fear In Individuals With Chronic Painful Conditions, Manasi M. Mittinty, Daniel W. Mcneil, David S. Brennan, Cameron L. Randall, Murthy N. Mittinty, Lisa Jamieson

Faculty & Staff Scholarship

Background: Heightened fear and anxiety related to pain may result in emotional and behavioral avoidance responses causing disability, distress, and depression. Fear and anxiety associated with pain can potentially change the course of the pain experience. It is plausible that fear and anxiety related to pain affect the duration and frequency of pain experienced by the patient. Aim: The study aimed to examine the applicability of the Fear of Pain Questionnaire-III (FPQ-III) in identifying who are likely to report longer duration and greater frequency of pain experience. Methods: To test this hypothesis, a cross-sectional study was conducted with 579 individuals …


Decreasing Stigma Against Depression In Chinese International Students, Elizabeth Trader Jan 2018

Decreasing Stigma Against Depression In Chinese International Students, Elizabeth Trader

Mahurin Honors College Capstone Experience/Thesis Projects

Higher levels of stress and a shift in support systems during the transition to another culture can put international students at risk for mood disorders like depression. Previous research supports there is also a higher level of depression stigma within Eastern cultures in comparison to Western cultures (Rao, Feinglass, & Corrigan, 2007). This may account for the strikingly low numbers from the Chinese population that seek and maintain professional counseling services while studying in the U.S. (Yakushko, Davidson, & Sandford-Martens, 2008). The present study sought to determine whether two self-produced Chinese videos regarding information about stigma, symptoms, and treatment of …


Widening The Disparity Gap: Differences In Outcomes For Racial And Ethnic Groups In Youth Substance Abuse Prevention Programming, Changsoo Song, Jennifer N. Rutt, Mindy Anderson-Knott Jan 2018

Widening The Disparity Gap: Differences In Outcomes For Racial And Ethnic Groups In Youth Substance Abuse Prevention Programming, Changsoo Song, Jennifer N. Rutt, Mindy Anderson-Knott

UNL Office of Research and Innovation, Social/Behavioral Sciences Research Consortium

This study examined racial and ethnic differences in the outcomes of a universal evidence-based program targeted to children and adolescents. Using data collected in 2015 and 2016 from the Alcohol: True Stories Hosted by Matt Damon program (N = 925), the study found the outcome of perceptions on risk of harm from alcohol use significantly different between the group of White respondents and the group of non-White respondents, and between the group of Hispanic respondents and the group of non-Hispanic respondents. Program effectiveness was found only among White and non-Hispanic respondents, widening the already existing gap between these populations.


"Burned Out" At Work But Satisfied With One's Job: Anatomy Of A False Paradox, Eric Laurent, Irvin Sam Schonfeld, Renzo Bianchi Jan 2018

"Burned Out" At Work But Satisfied With One's Job: Anatomy Of A False Paradox, Eric Laurent, Irvin Sam Schonfeld, Renzo Bianchi

Publications and Research

In a recent study of 346 US neurosurgery residents Attenello et al reported that 67% of their participants suffered from burnout. The authors also found that 81% of surveyed residents were satisfied with their career. Attenello et al described their results as paradoxical. We criticize their methodology.


A Single Campus Study Of The Green Dot Bystander Intervention Program, Brittany F. Hollis Jan 2018

A Single Campus Study Of The Green Dot Bystander Intervention Program, Brittany F. Hollis

Psychology Theses & Dissertations

Sexual assault is a serious public health issue that is especially problematic on college campuses. To combat sexual violence on college campuses prevention programs have been instituted by many universities. One such prevention program, the Green Dot program, works to teach students what constitutes sexual violence and how to prevent it by increasing bystander intervention. The current study examined the effectiveness of Green Dot at a large southeastern university. The Theory of Planned Behavior (TPB) was used as the theoretical framework. TPB examines how efficacy, attitudes, and norms influence behavior. Students were recruited to participate in the Green Dot program …


Substance Abuse And Mental Illness Among Youth In The United States, Emmanuel Xavier Okoro Jan 2018

Substance Abuse And Mental Illness Among Youth In The United States, Emmanuel Xavier Okoro

Walden Dissertations and Doctoral Studies

Despite the trends showing a reduction in the use and abuse of drugs among American adolescents, the prevalence rates remain high. There is also comorbidity of mental illnesses among the adolescents using drugs. The aim of this study was to determine the presence and nature of the association between the use and abuse of marijuana and alcohol and mental illnesses among the American adolescent population. The noted comorbidities and the hypothesized association between the substance abuse and mental illnesses were explained using the expectancy theory. Using a quantitative research methodology, secondary data from the National Survey on Drug Use and …


The Impact Of Adverse Childhood Experiences On Mental Health, Executive Functioning, And Emotion Regulation Across Childhood : Which Family And Community Factors Mitigate Risk?, Atara Siegel Jan 2018

The Impact Of Adverse Childhood Experiences On Mental Health, Executive Functioning, And Emotion Regulation Across Childhood : Which Family And Community Factors Mitigate Risk?, Atara Siegel

Legacy Theses & Dissertations (2009 - 2024)

It is well established that adverse childhood experiences (ACEs) increase risk of developing mental health disorders later in life. It is unclear how early in childhood these effects can be seen. Executive functioning (EF) and emotion regulation (ER) have been proposed as potential mechanisms which mediate the effect of ACEs on mental health. Individual ACEs have been associated with poor EF and ER. It is unclear whether ACE scores impact EF and ER in a graded, dose-response manner. It is also unclear how early in childhood these effects can be seen. Finally, more research is needed to identify family and …


Occupational Health Psychology, Irvin Sam Schonfeld Jan 2018

Occupational Health Psychology, Irvin Sam Schonfeld

Publications and Research

Occupational health psychology (OHP) is a cross-disciplinary subspecialty within psychology. OHP derives from two disciplines within applied psychology, health psychology and industrial/organizational psychology. OHP is also linked to disciplines outside of psychology, such as occupational medicine and public health. The discipline has roots in eighteenth, nineteenth, and twentieth century thinkers, including Adam Smith, Friedrich Engels, Karl Marx, Émile Durkheim, and Max Weber. These thinkers were concerned with the impact of the organization of work and the business cycle on human life. Later research by Elton Mayo, Marie Jahoda, Walter B. Cannon, Hans Selye, and investigators at the University of Michigan’s …


Incredible Years (Iy) Parents & Babies Well-Baby Program: Expanding The Reach Through Cultural Adaptation, Ayanda Chakawa, Briana Woods-Jaeger Jan 2018

Incredible Years (Iy) Parents & Babies Well-Baby Program: Expanding The Reach Through Cultural Adaptation, Ayanda Chakawa, Briana Woods-Jaeger

Posters

No abstract provided.


Acceptability Study And Pilot Rct Of A Guide To Understanding Reproductive Health For Ladeez (Gurhl) Code: An Hiv Risk Reduction App Intervention For Black And Latina Young Women In New York City, Sonia K. Gonzalez Gladstein Jan 2018

Acceptability Study And Pilot Rct Of A Guide To Understanding Reproductive Health For Ladeez (Gurhl) Code: An Hiv Risk Reduction App Intervention For Black And Latina Young Women In New York City, Sonia K. Gonzalez Gladstein

Dissertations and Theses

Background: Young Black and Latina women suffer from higher sexually transmitted disease (STD) incidences than White women, increasing their susceptibility to contracting human immunodeficiency virus (HIV). The adoption and widespread usage of mobile devices has contributed to the public’s ability to access available information at all hours, including information on sexual and reproductive health (SRH). Despite a growing body of mobile health literature, there is limited understanding of how mobile-based sexual and reproductive health interventions for use by young adult Black and Latina women could improve sexual health knowledge and connection to clinical care.

Methods: This pilot randomized controlled trial …


Burnout Syndrome And Depression, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent Jan 2018

Burnout Syndrome And Depression, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

In this chapter, we proposed an overview of burnout, from the introduction of the construct in the mid-1970s to the growing realization that the syndrome was better conceived of as a depressive condition. Recent studies have shown that the distinction between burnout and depression is problematic, both theoretically and empirically. The history of burnout research suggests that transdisciplinary communication and methodological standards should be strengthened to avoid the proliferation of constructs that, in fact, refer to the same phenomena. Construct proliferation, a transgression of the scientific canon of parsimony, is considered a major problem today because it undermines theory building …


Development And Validation Of A Measure Assessing Blind Patients' Perceptions Of Their Healthcare Providers' Stereotype Content, Nazanin Mina Heydarian Jan 2018

Development And Validation Of A Measure Assessing Blind Patients' Perceptions Of Their Healthcare Providers' Stereotype Content, Nazanin Mina Heydarian

Open Access Theses & Dissertations

People with disabilities (PWDs) constitute about 15-20% of the total population. Health disparities among PWD's are due, in part, to stereotypes about PWDs as incompetent. These stereotypes may lead some healthcare providers (HCP) to patronize PWDs, over-focus on the PWDs' impairments and potentially neglect their presenting problem. Moreover, if the PWD violates stereotypical assumptions, the HCP may actively interfere with the PWD's goals. This Dissertation focused on the blind population because this is a large, stigmatized and understudied subpopulation of PWDs. In Study 1, the content of stereotypes about blind patients in the clinical setting were examined from the patient …


Scaling Out Evidence-Based Interventions Outside The U.S. Mainland: Social Justice Or Trojan Horse?, Melanie M. Domenech-Rodriguez, Ana A. L. Baumann, Alejandro L. Vázquez, Nancy G. Amador-Buenabad, Natalie Franceschi Rivera, Nydia Ortiz-Pons, J. Rubén Parra-Cardona Jan 2018

Scaling Out Evidence-Based Interventions Outside The U.S. Mainland: Social Justice Or Trojan Horse?, Melanie M. Domenech-Rodriguez, Ana A. L. Baumann, Alejandro L. Vázquez, Nancy G. Amador-Buenabad, Natalie Franceschi Rivera, Nydia Ortiz-Pons, J. Rubén Parra-Cardona

Psychology Faculty Publications

Global health disparities continue to widen as professional standards for effectiveness of mental health services provision become more precise and difficult to achieve across varied economic and social contexts. Within the U.S., health disparities are evident in Latinx populations. Globally, the health disparities are also evident in Latin America as compared to the U.S. and other economically affluent nations. The diversification of psychology in content and persons has led to a unique opportunity to build bridges that can help reduce disparities in- and outside of the U.S. mainland. Collaborations can be of great use in addressing health disparities internationally but …


Nutrition Label Accuracy And The Theory Of Triadic Influence: The Impact Of Knowledge On Healthy Food Choices In A Predominantly Hispanic Sample, Mosi Staudt Dane'el Jan 2018

Nutrition Label Accuracy And The Theory Of Triadic Influence: The Impact Of Knowledge On Healthy Food Choices In A Predominantly Hispanic Sample, Mosi Staudt Dane'el

Open Access Theses & Dissertations

Unhealthy food choices and the outcomes of those choices are a significant concern in the United States. Multiple governmental agencies recommend using nutrition labels to promote healthier food choices. This study investigated this claim using the theory of triadic influence to examine the efficacious use of nutrition labels on food choices. The theory of triadic influence presents a model of variables that affect food choice, including knowledge pathways on which this study focuses. Within the model, we expected increased scores on two measures of health knowledge to predict nutrition label understanding, which predict healthy food attitudes. Next, we expected that …


Understanding Feeding Style And Young Children's Consumption Of Food, Mary W. Bean Jan 2018

Understanding Feeding Style And Young Children's Consumption Of Food, Mary W. Bean

Walden Dissertations and Doctoral Studies

Due to increased rates of childhood obesity since 2010, researchers have examined family environmental factors and family influences on children's consumption of healthy foods. While previous research has examined how factors such as food presentation and the food intake of other family members can predict a child's body mass index, there has been little research examining whether parent factors predict the amount of healthy foods children eat. This quantitative survey study examined whether certain parent factors, specifically parents' attitudes about food, parents' feeding styles, and parents' attachment styles, predicted the amount of fruits and vegetables children ate. Understanding the extent …


Childhood Lead Exposure And Attention-Deficit/Hyperactivity Disorder Symptoms: A Meta-Analysis, Megan Glenn Brown Jan 2018

Childhood Lead Exposure And Attention-Deficit/Hyperactivity Disorder Symptoms: A Meta-Analysis, Megan Glenn Brown

Walden Dissertations and Doctoral Studies

Lead exposure during childhood is a significant global public health concern as the potential effects of exposure can result in the need for long-term treatment, diminished productivity in society, and financial strain on the health care system. There is strong evidence of a relationship between lead exposure and attention-deficit/hyperactivity disorder (ADHD); however, there is a gap in the current literature regarding the relationship between lead exposure and specific symptoms of ADHD and the strength of that relationship. The purpose of this meta-analysis was to examine and help quantify this relationship. Cohen's d was used as the standardized mean effect size …


Holistic Health And Hawaii's Renewable Energy Future, Richard M. Esterle Jan 2018

Holistic Health And Hawaii's Renewable Energy Future, Richard M. Esterle

Walden Dissertations and Doctoral Studies

Collective efficacy, time urgency, and health literacy have been a focus of research since the 1970s. Researchers have demonstrated that these factors influence health and decision making. However, researchers have yet to establish how these factors may be connected to the achievement of policy aims that impact holistic or environmental health. This study utilized the health belief model, social cognitive theory, time urgency theory, health education and promotion theory, Bronfenbrenner's ecological systems theory, and the Meikirch model. The purpose of this quantitative study was to determine if the factors of collective efficacy, perceived time urgency, perceived health literacy, ethnicity, age, …


Penalized Mixed-Effects Ordinal Response Models For High-Dimensional Genomic Data In Twins And Families, Amanda E. Gentry Jan 2018

Penalized Mixed-Effects Ordinal Response Models For High-Dimensional Genomic Data In Twins And Families, Amanda E. Gentry

Theses and Dissertations

The Brisbane Longitudinal Twin Study (BLTS) was being conducted in Australia and was funded by the US National Institute on Drug Abuse (NIDA). Adolescent twins were sampled as a part of this study and surveyed about their substance use as part of the Pathways to Cannabis Use, Abuse and Dependence project. The methods developed in this dissertation were designed for the purpose of analyzing a subset of the Pathways data that includes demographics, cannabis use metrics, personality measures, and imputed genotypes (SNPs) for 493 complete twin pairs (986 subjects.) The primary goal was to determine what combination of SNPs and …


Quality Of Life Among Entrepreneurs With Chronic Fatigue Syndrome, Brittany Kesler Jan 2018

Quality Of Life Among Entrepreneurs With Chronic Fatigue Syndrome, Brittany Kesler

Walden Dissertations and Doctoral Studies

The impacts of chronic fatigue syndrome (CFS) are far reaching, resulting in many burdens in the individual lives of CFS patients. One notable challenge lies in the inability to participate in the workforce due to associated physical, mental, and emotional symptoms. Previous research indicates that alternative employment options may help to overcome work related barriers presented with various types of chronic illness. Entrepreneurship is one path to working that offers many benefits, including autonomy, flexibility of work schedule, choice of work environment, and control. Questions though remain as to whether entrepreneurship enhances QOL or exacerbates symptoms among individuals with CFS. …


Understanding Perceptions Of Child Maltreatment Risk: A Qualitative Study Of Early Head Start Home Visitors, Alayna Schreier, Kelsey Mccoy, Mary F. Flood, Brian Wilcox, David J. Hansen Jan 2018

Understanding Perceptions Of Child Maltreatment Risk: A Qualitative Study Of Early Head Start Home Visitors, Alayna Schreier, Kelsey Mccoy, Mary F. Flood, Brian Wilcox, David J. Hansen

Department of Psychology: Faculty Publications

Infants and toddlers enrolled in Early Head Start are at increased risk for child maltreatment. Within Early Head Start, home visitors are in a unique position to identify the families most likely to experience maltreatment by identifying characteristics and behaviors of children, caregivers, families, and environments that are of concern. However, research has demonstrated that home visitors are often ill-equipped to identify and address risk factors such as parental mental health concerns, substance abuse, and domestic violence. Further, little is known about how home visitors understand and perceive risk for maltreatment and identify vulnerable families. The study sought to identify …


On The “Bubble” Of Burnout's Prevalence Estimates, Eric Laurent, Irvin Sam Schonfeld, Renzo Bianchi, Laura Hawryluck, Peter G. Brindley Jan 2018

On The “Bubble” Of Burnout's Prevalence Estimates, Eric Laurent, Irvin Sam Schonfeld, Renzo Bianchi, Laura Hawryluck, Peter G. Brindley

Publications and Research

Hawryluck and Brindley (2018) addressed the issue of burnout—a syndrome thought to be induced by job stress—among critical care medicine (CCM) practitioners. Although we agree that the practice of CCM can be stressful, relying on burnout as an indicator of the practitioners’ response to occupational adversity is unwarranted. Despite its popularity, burnout remains poorly defined. Disconcertingly, investigators have widely relied on the Maslach Burnout Inventory (MBI) for “diagnosing” burnout in spite of the fact that the MBI is not a diagnostic instrument.Experiencing fatigue or distancing oneself from one’ work—what burnout is about—is not necessarily a sign of ill-being in itself. …


Is A Meta-Analytic Approach To Burnout’S Prevalence Timely?, Eric Laurent, Irvin Sam Schonfeld, Renzo Bianchi Jan 2018

Is A Meta-Analytic Approach To Burnout’S Prevalence Timely?, Eric Laurent, Irvin Sam Schonfeld, Renzo Bianchi

Publications and Research

Cañadas‐De la Fuente et al. performed a meta‐analysis of the prevalence of emotional exhaustion, depersonalization, and diminished personal accomplishment—the three definitional components of the burnout syndrome—among nursing professionals working in oncology units. All in all, their meta‐analysis was inconclusive because of the very state of burnout research. Because there is mounting evidence that burnout is a depressive condition, we recommend that investigators focus on depression, rather than burnout, in occupational health research and practice.


When We Say 'Physician Burnout,' We Really Mean Depression, Irvin Sam Schonfeld Jan 2018

When We Say 'Physician Burnout,' We Really Mean Depression, Irvin Sam Schonfeld

Publications and Research

There has been controversy regarding the extent to which burnout overlaps depression. I enumerate eight reasons explaining to why depression is at the heart of burnout. Some of these reasons pertain to the highly similar work-related causes of burnout and depression, burnout adherents' faulty categorical and dimensional conceptualizations of burnout and depression, problematically high correlations between emotional exhaustion (the core of burnout) and depressive symptoms, research on physicians and dentists that underline burnout-depression overlap, and the problem of alexithymia being similarly related to burnout and depression. Suggestions for addressing the problem of burnout-depression among physicians are presented.


What Is The Difference Between Depression And Burnout? An Ongoing Debate, Irvin Sam Schonfeld, Renzo Bianchi, Stefano Palazzi Jan 2018

What Is The Difference Between Depression And Burnout? An Ongoing Debate, Irvin Sam Schonfeld, Renzo Bianchi, Stefano Palazzi

Publications and Research

Il burnout è concepito come una sindrome che si sviluppa in risposta a condizioni di lavoro cronicamente avverse. Si ritiene che il burnout comporti esaurimento emotivo, depersonalizzazione e riduzione della realizzazione personale. Storicamente, tuttavia, il burnout è stato difficile da separare dalla depressione. In effetti, i sintomi del burnout coincidono con i sintomi della depressione. L'evidenza della validità discriminante del burnout nei confronti della depressione è debole, sia a livello empirico sia a livello teorico. L'esaurimento emotivo, il nucleo del burnout, riflette una combinazione di umore depresso e affaticamento / perdita di energia e si correla molto bene con altri …


Burnout And Depressive Symptoms Are Not Primarily Linked To Perceived Organizational Problems, Renzo Bianchi, Eric Mayor, Irvin Sam Schonfeld, Eric Laurent Jan 2018

Burnout And Depressive Symptoms Are Not Primarily Linked To Perceived Organizational Problems, Renzo Bianchi, Eric Mayor, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

In this 257-participant study (76% female; mean age: 44.84), we examined two ideas that are widespread among burnout researchers: (a) the idea that burnout is primarily related to occupational-level factors; and (b) the idea that burnout should be considered a sentinel indicator in research on negative occupational outcomes. We investigated the links between burnout and a series of generic and work-related variables, namely, depressive symptoms, neuroticism, extraversion, effort-reward imbalance in the job (ERI), social support at work (SSW), and turnover intention. Burnout was assessed with the Shirom-Melamed Burnout Measure, depressive symptoms with the PHQ-9, neuroticism and extraversion with the NEO-Five …


The Effect Of Fast Food Restaurants On Type 2 Diabetes Rates, Grace Bailey Jan 2018

The Effect Of Fast Food Restaurants On Type 2 Diabetes Rates, Grace Bailey

CMC Senior Theses

This paper conducts an analysis of county level data to determine the effect of fast food restaurants on type 2 diabetes rates. Due to endogeneity concerns with respect to the location of fast food restaurants, this paper follows the work of Dunn (2010) and uses the number of interstate exits in a given county to serve as an instrument for fast food restaurants. The strength of the instrument, which is theoretically and empirically tested in this paper, imposes some restraints on the interpretation of the findings. Using the Two-Stage Least Squares estimation method, I find that the presence of fast …


Black Males, Trauma, And Mental Health Service Use: A Systematic Review., Robert Motley, Andrae Banks Jan 2018

Black Males, Trauma, And Mental Health Service Use: A Systematic Review., Robert Motley, Andrae Banks

Brown School Faculty Publications

Objective: To systematically review the evidence of and synthesize results from relevant studies that have examined barriers and facilitators to professional mental health service use for Black male trauma survivors ages 18 and older.

Methods: A thorough search of selected databases that included EBSCO, ProQuest, and Web of Science Core Collection and careful consideration of inclusion and exclusion criteria yielded a final six studies for detailed review.

Results: Black male trauma survivors were significantly less likely to be utilizing mental health services than other sex-ethnic groups. High levels of daily crises, a lack of knowledge of steps to …


Burnout Research: Eyes Wide Shut, Irvin Sam Schonfeld, Eric Laurent, Renzo Bianchi Jan 2018

Burnout Research: Eyes Wide Shut, Irvin Sam Schonfeld, Eric Laurent, Renzo Bianchi

Publications and Research

In a study published in a recent issue of Critical Care Medicine, Colville and Smith (2017) found modest overlap between burnout and depression and assumed that burnout and depression are distinct entities. For four reasons, we think that the study is seriously flawed. First, Colville and Smith assessed burnout symptoms with an abbreviated version of the Maslach Burnout Inventory (MBI), the psychometric properties of which are unclear. Second, they used clinically and theoretically arbitrary cutoff scores for categorizing burnout, a modus operandi that, unfortunately, has become commonplace in studies of medical professionals. Third, participants could be categorized as “burned out” …