No abstract

Objective Physicians, including psychiatrists and psychiatry trainees, are at higher risk of burnout compared to the average working population. The COVID-19 pandemic heightens this risk. This pilot aims to enhance professional fulfillment and support while decreasing risk and prevalence of burnout in Child and Adolescent Psychiatry (CAP) trainees through virtual delivery of a Balint-like group incorporating brief emotional awareness modules. Methods Six CAP trainees participated. Eight 60-min sessions held every 2 weeks were co-facilitated by a psychologist and psychiatrist who developed the curricular content. Five of the eight semi-structured sessions combined a brief emotional awareness enhancing module with a Balint-based approach to case review. The authors assessed trainee well-being, professional fulfillment, and sense of professional support pre- and post-intervention with the Well-being Index (WBI), Stanford Professional Fulfillment Index (PFI), and the authors’ own supplemental survey. Descriptive statistics were reported. Results Trainees found the curriculum feasible and useful. Surveys showed a reduction in burnout from three to zero participants ( p = 0.03) and specific improvements in enthusiasm ( p = 0.013), empathy with colleagues ( p = 0.093), and connectedness with colleagues ( p = 0.007) and patients ( p = 0.042) at work. There were also improvements in happiness ( p = 0.042) and valued contributions at work ( p = 0.004). Conclusions A novel well-being curriculum focused on combining brief emotional awareness enhancing modules with a Balint-like approach enhances professional fulfillment and a sense of professional support and decreases the risk and prevalence of burnout, even when delivered virtually to a group of CAP fellows. Results support the planned expansion of this low-cost, high-value intervention for trainee well-being.

No abstract

Steam injection in heavy oil reservoirs produces hydrothermal reactions which can lower producing potential by reducing permeability and causing well bore damage.Effluents from once-through steam generators often have pH values above 12 due to the use of high bicarbonate surface waters as feeds. Injection of these high pH and low ionic strength waters causes expansion and dispersion of water-sensitive clays and solubilization of silica and aluminum minerals. The hydroxide and carbonate ions in the effluents react with magnesium, calcium and other salts in formation waters to form precipitates.Laboratory experiments showed that these alkaline boiler effluents irreversibly reduced the permeability of cores (by up to 70%), dispersed clays and solubilized quartz sands.In the field, large quantities of amorphous precipitates containing magnesium, calcium and aluminum as well as clays, micas and quartz grains were produced from two wells with low oil/steam ratios. The quartz grains showed substantial changes in surface morphology similar to those produced by quartz solubilization experiments in the laboratory.To minimize reservoir damage, steam generator effluents with reduced pH and increased ionic strength are being injected at two field pilots.