WorldWideScience

Sample records for extreme distress class

  1. A new Class of Extremal Composites

    DEFF Research Database (Denmark)

    Sigmund, Ole

    2000-01-01

    The paper presents a new class of two-phase isotropic composites with extremal bulk modulus. The new class consists of micro geometrics for which exact solutions can be proven and their bulk moduli are shown to coincide with the Hashin-Shtrikman bounds. The results hold for two and three dimensions...... and for both well- and non-well-ordered isotropic constituent phases. The new class of composites constitutes an alternative to the three previously known extremal composite classes: finite rank laminates, composite sphere assemblages and Vigdergauz microstructures. An isotropic honeycomb-like hexagonal...... microstructure belonging to the new class of composites has maximum bulk modulus and lower shear modulus than any previously known composite. Inspiration for the new composite class comes from a numerical topology design procedure which solves the inverse homogenization problem of distributing two isotropic...

  2. "Extreme Programming" in a Bioinformatics Class

    Science.gov (United States)

    Kelley, Scott; Alger, Christianna; Deutschman, Douglas

    2009-01-01

    The importance of Bioinformatics tools and methodology in modern biological research underscores the need for robust and effective courses at the college level. This paper describes such a course designed on the principles of cooperative learning based on a computer software industry production model called "Extreme Programming" (EP).…

  3. A New Stress-Based Model of Political Extremism: Personal Exposure to Terrorism, Psychological Distress, and Exclusionist Political Attitudes

    Science.gov (United States)

    Canetti-Nisim, Daphna; Halperin, Eran; Sharvit, Keren; Hobfoll, Stevan E.

    2009-01-01

    Does exposure to terrorism lead to hostility toward minorities? Drawing on theories from clinical and social psychology, we propose a stress-based model of political extremism in which psychological distress--which is largely overlooked in political scholarship--and threat perceptions mediate the relationship between exposure to terrorism and…

  4. A New Stress-Based Model of Political Extremism: Personal Exposure to Terrorism, Psychological Distress, and Exclusionist Political Attitudes

    Science.gov (United States)

    Canetti-Nisim, Daphna; Halperin, Eran; Sharvit, Keren; Hobfoll, Stevan E.

    2009-01-01

    Does exposure to terrorism lead to hostility toward minorities? Drawing on theories from clinical and social psychology, we propose a stress-based model of political extremism in which psychological distress--which is largely overlooked in political scholarship--and threat perceptions mediate the relationship between exposure to terrorism and…

  5. An old male patient with paroxysmal chest distress,shortness of breath and edema of both lower extremities (the 27th case)

    Institute of Scientific and Technical Information of China (English)

    陈琪

    2008-01-01

    @@ The patient,a 78-year-old male,was admitted to the hospital on Nov.15,2007 because of paroxysmal chest distress and shortness of breath for 11years and edema of lower extremities for 3 days.The patient began to suffer from paroxysmal chest distress and shortness of breath after exertion in 1997,then these symptoms recurred frequently,which lasted 10 min to several hours.

  6. Prevention of postnatal distress or depression: an evaluation of an intervention at preparation for parenthood classes.

    Science.gov (United States)

    Matthey, Stephen; Kavanagh, David J; Howie, Pauline; Barnett, Bryanne; Charles, Margaret

    2004-04-01

    control conditions. There were no main or interaction effects by 6 months postpartum. The beneficial effect at 6 weeks was related to partners of these women being more aware of how the mother was feeling, and with women reporting greater satisfaction with the sharing of home and baby tasks. There were no significant main or interaction effects for men at either time point, other than men with low self-esteem reporting poorer adjustment. This brief and inexpensive intervention was effective in reducing postpartum distress in some first-time mothers at 6 weeks postpartum. The effectiveness of this intervention was related to an increased level of awareness in the men as to how their partners were experiencing the early postpartum weeks. That the effect was only evident for women who, antenatally, reported being low in self-esteem, is an important advance in our knowledge of the effectiveness of such prevention programs. No previous studies have investigated the differential effectiveness of such programs depending upon the woman's level of self-esteem, and this finding indicates that future work should measure this variable. These findings should be understood in the context that the population sampled were those attending preparation for parenthood classes, and thus different interventions will be needed for couples who do not attend such classes. This brief psychosocial intervention can be readily applied to antenatal classes routinely conducted in hospitals or the community.

  7. A class of not max-stable extreme value distributions

    Institute of Scientific and Technical Information of China (English)

    JIANG Yue-xiang

    2005-01-01

    The sequences {Zi,n, l≤i≤n}, n≥l have multi-nomial distribution among i.i.d. random variables {X1,i, i≥1}, {X2,i,u≥l }, …, {Xm,i, i≥1 }. The extreme value distribution Gz(x) of this particular triangular array of i.i.d, random variables Z1,n, Z2Zn,n is discussed in this paper. We found a new type of not max-stable extreme value distributions, i) Gz(x) = r-1∏i=1ФAiαi(x) × Фαr (x);ii) Gz (x) = r-1∏i=1ψAiαi (x) × ψαr (x); iii) Gz (x) = r-1∏i=1 ∧Ai (λix) × A(x), r≥2, 0<α1≤α2≤…≤αr and λi∈ (0,1] for i, l≤i≤r-1 which occur if Fj, …, Fm belong to the same MDA.

  8. Gender differences in the relationship between school problems, school class context and psychological distress: results from the Young-HUNT 3 study.

    Science.gov (United States)

    Dalen, Joakim D

    2014-02-01

    Few studies have examined the relationship between shared school classroom environment and psychological distress. The aim of this study is to investigate whether there are gender differences in the clustering of psychological distress within school classes as well as to assess individual and contextual effects of school problems. Data were obtained from the Young-HUNT 3 study (2006-2008), a population study of adolescents attending school in the Norwegian county of Nord-Trøndelag. A total of 6,379 pupils were analysed using multilevel models. The results suggest that the amount of variation in psychological distress attributable to school class context was higher among girls (4.5%) compared to boys (1.0%). Furthermore, individual school problems were associated with psychological distress for both genders, although the effects were greater for girls. The effects of school class variables were limited for both genders, although gender composition was associated with higher levels of psychological distress among girls. This study suggests that researchers should account for possible gender differences when examining the association between classroom environment and psychological distress.

  9. Extremes of Interferon-Stimulated Gene Expression Associate with Worse Outcomes in the Acute Respiratory Distress Syndrome

    Science.gov (United States)

    Nick, Jerry A.; Caceres, Silvia M.; Kret, Jennifer E.; Poch, Katie R.; Strand, Matthew; Faino, Anna V.; Nichols, David P.; Saavedra, Milene T.; Taylor-Cousar, Jennifer L.; Geraci, Mark W.; Burnham, Ellen L.; Fessler, Michael B.; Suratt, Benjamin T.; Abraham, Edward; Moss, Marc; Malcolm, Kenneth C.

    2016-01-01

    Acute Respiratory Distress Syndrome (ARDS) severity may be influenced by heterogeneity of neutrophil activation. Interferon-stimulated genes (ISG) are a broad gene family induced by Type I interferons, often as a response to viral infections, which evokes extensive immunomodulation. We tested the hypothesis that over- or under-expression of immunomodulatory ISG by neutrophils is associated with worse clinical outcomes in patients with ARDS. Genome-wide transcriptional profiles of circulating neutrophils isolated from patients with sepsis-induced ARDS (n = 31) and healthy controls (n = 19) were used to characterize ISG expression. Hierarchical clustering of expression identified 3 distinct subject groups with Low, Mid and High ISG expression. ISG accounting for the greatest variability in expression were identified (MX1, IFIT1, and ISG15) and used to analyze a prospective cohort at the Colorado ARDS Network site. One hundred twenty ARDS patients from four urban hospitals were enrolled within 72 hours of initiation of mechanical ventilation. Circulating neutrophils were isolated from patients and expression of ISG determined by PCR. Samples were stratified by standard deviation from the mean into High (n = 21), Mid, (n = 82) or Low (n = 17) ISG expression. Clinical outcomes were compared between patients with High or Low ISG expression to those with Mid-range expression. At enrollment, there were no differences in age, gender, co-existing medical conditions, or type of physiologic injury between cohorts. After adjusting for age, race, gender and BMI, patients with either High or Low ISG expression had significantly worse clinical outcomes than those in the Mid for number of 28-day ventilator- and ICU-free days (P = 0.0006 and 0.0004), as well as 90-day mortality and 90-day home with unassisted breathing (P = 0.02 and 0.004). These findings suggest extremes of ISG expression by circulating neutrophils from ARDS patients recovered early in the syndrome are associated

  10. Implications of discrimination based on sexuality, gender, and race/ethnicity for psychological distress among working-class sexual minorities: the United for Health Study, 2003-2004.

    Science.gov (United States)

    Chae, David H; Krieger, Nancy; Bennett, Gary G; Lindsey, Jane C; Stoddard, Anne M; Barbeau, Elizabeth M

    2010-01-01

    This study investigated the distribution of demographic characteristics, the prevalence of discrimination based on sexuality, gender, and race, and relationships with psychological distress among 178 working-class sexual minorities (i.e., who identified as lesbian, gay, or bisexual (LGB) or had ever engaged in same-sex sexual behaviors) recruited to the United for Health Study (2003-2004). The results indicated considerable heterogeneity in responses to items assessing sexual orientation and sexual behavior, with a majority of sexual minority participants not identifying as LGB (74.2%). The authors found significant demographic differences in LGB identification by gender, race/ethnicity, nativity, and socioeconomic factors. In addition, LGB participants had higher levels of psychological distress than non-LGB-identified sexual minorities. Linear regression analyses revealed that reports of racial/ethnic discrimination and sexuality discrimination were associated with higher levels of psychological distress among sexual minority participants. The results underscore the need to collect multiple measures of sexuality in conducting research on racially diverse working-class communities; to consider demographic factors in collecting sexuality data; and to disaggregate information on sexuality by LGB identification. Findings also highlight the importance of addressing discrimination in ameliorating problematic mental health outcomes among working-class sexual minorities.

  11. Extremal multicenter black holes: nilpotent orbits and Tits Satake universality classes

    Science.gov (United States)

    Fré, Pietro; Sorin, Alexander S.

    2013-01-01

    Four dimensional supergravity theories whose scalar manifold is a symmetric coset manifold UD=4/Hc are arranged into a finite list of Tits Satake universality classes. Stationary solutions of these theories, spherically symmetric or not, are identified with those of an euclidian three-dimensional σ-model, whose target manifold is a Lorentzian coset UD=3/H* and the extremal ones are associated with H* nilpotent orbits in the K* representation emerging from the orthogonal decomposition of the algebra {U} D=3 with respect to H*. It is shown that the classification of such orbits can always be reduced to the Tits-Satake projection and it is a class property of the Tits Satake universality classes. The construction procedure of Bossard et al of extremal multicenter solutions by means of a triangular hierarchy of integrable equations is completed and converted into a closed algorithm by means of a general formula that provides the transition from the symmetric to the solvable gauge. The question of the relation between H* orbits and charge orbits W of the corresponding black holes is addressed and also reduced to the corresponding question within the Tits Satake projection. It is conjectured that on the vanishing locus of the Taub-NUT current the relation between H*-orbit and W-orbit is rigid and one-to-one. All black holes emerging from multicenter solutions associated with a given H* orbit have the same W-type. For the S 3 model we provide a complete survey of its multicenter solutions associated with all of the previously classified nilpotent orbits of {s}{l}(2)× {s}{l}(2) within {{{g}}_{2,2 }} . We find a new intrinsic classification of the W-orbits of this model that might provide a paradigm for the analogous classification in all the other Tits Satake universality classes.

  12. 454 sequencing reveals extreme complexity of the class II Major Histocompatibility Complex in the collared flycatcher

    Directory of Open Access Journals (Sweden)

    Gustafsson Lars

    2010-12-01

    Full Text Available Abstract Background Because of their functional significance, the Major Histocompatibility Complex (MHC class I and II genes have been the subject of continuous interest in the fields of ecology, evolution and conservation. In some vertebrate groups MHC consists of multiple loci with similar alleles; therefore, the multiple loci must be genotyped simultaneously. In such complex systems, understanding of the evolutionary patterns and their causes has been limited due to challenges posed by genotyping. Results Here we used 454 amplicon sequencing to characterize MHC class IIB exon 2 variation in the collared flycatcher, an important organism in evolutionary and immuno-ecological studies. On the basis of over 152,000 sequencing reads we identified 194 putative alleles in 237 individuals. We found an extreme complexity of the MHC class IIB in the collared flycatchers, with our estimates pointing to the presence of at least nine expressed loci and a large, though difficult to estimate precisely, number of pseudogene loci. Many similar alleles occurred in the pseudogenes indicating either a series of recent duplications or extensive concerted evolution. The expressed alleles showed unambiguous signals of historical selection and the occurrence of apparent interlocus exchange of alleles. Placing the collared flycatcher's MHC sequences in the context of passerine diversity revealed transspecific MHC class II evolution within the Muscicapidae family. Conclusions 454 amplicon sequencing is an effective tool for advancing our understanding of the MHC class II structure and evolutionary patterns in Passeriformes. We found a highly dynamic pattern of evolution of MHC class IIB genes with strong signals of selection and pronounced sequence divergence in expressed genes, in contrast to the apparent sequence homogenization in pseudogenes. We show that next generation sequencing offers a universal, affordable method for the characterization and, in perspective

  13. A New Class of Nascent Eclipsing Binaries with Extreme Mass Ratios

    CERN Document Server

    Moe, Maxwell

    2014-01-01

    Early B-type main-sequence (MS) stars (M$_1$ = 5-16 M$_{\\odot}$) with closely orbiting low-mass stellar companions (q = M$_2$/M$_1$ < 0.25) can evolve to produce Type Ia supernovae, low-mass X-ray binaries, and millisecond pulsars. However, the formation mechanism and intrinsic frequency of such close extreme mass-ratio binaries have been debated, especially considering none have hitherto been detected. Utilizing observations of the Large Magellanic Cloud galaxy conducted by the Optical Gravitational Lensing Experiment, we have discovered a new class of eclipsing binaries in which a luminous B-type MS star irradiates a closely orbiting low-mass pre-MS companion that has not yet fully formed. The primordial pre-MS companions have large radii and discernibly reflect much of the light they intercept from the B-type MS primaries ($\\Delta$I$_{\\rm refl}$ = 0.02-0.14 mag). For the 18 definitive MS + pre-MS eclipsing binaries in our sample with good model fits to the observed light curves, we measure short orbital...

  14. A NEW CLASS OF NASCENT ECLIPSING BINARIES WITH EXTREME MASS RATIOS

    Energy Technology Data Exchange (ETDEWEB)

    Moe, Maxwell; Stefano, Rosanne Di, E-mail: mmoe@cfa.harvard.edu [Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, MS-10, Cambridge, MA 02138 (United States)

    2015-03-10

    Early B-type main-sequence (MS) stars (M {sub 1} ≈ 5-16 M {sub ☉}) with closely orbiting low-mass stellar companions (q = M {sub 2}/M {sub 1} < 0.25) can evolve to produce Type Ia supernovae, low-mass X-ray binaries, and millisecond pulsars. However, the formation mechanism and intrinsic frequency of such close extreme mass-ratio binaries have been debated, especially considering none have hitherto been detected. Utilizing observations of the Large Magellanic Cloud galaxy conducted by the Optical Gravitational Lensing Experiment, we have discovered a new class of eclipsing binaries in which a luminous B-type MS star irradiates a closely orbiting low-mass pre-MS companion that has not yet fully formed. The primordial pre-MS companions have large radii and discernibly reflect much of the light they intercept from the B-type MS primaries (ΔI {sub refl} ≈ 0.02-0.14 mag). For the 18 definitive MS + pre-MS eclipsing binaries in our sample with good model fits to the observed light-curves, we measure short orbital periods P = 3.0-8.5 days, young ages τ ≈ 0.6-8 Myr, and small secondary masses M {sub 2} ≈ 0.8-2.4 M {sub ☉} (q ≈ 0.07-0.36). The majority of these nascent eclipsing binaries are still associated with stellar nurseries, e.g., the system with the deepest eclipse ΔI {sub 1} = 2.8 mag and youngest age τ = 0.6 ± 0.4 Myr is embedded in the bright H II region 30 Doradus. After correcting for selection effects, we find that (2.0 ± 0.6)% of B-type MS stars have companions with short orbital periods P = 3.0-8.5 days and extreme mass ratios q ≈ 0.06-0.25. This is ≈10 times greater than that observed for solar-type MS primaries. We discuss how these new eclipsing binaries provide invaluable insights, diagnostics, and challenges for the formation and evolution of stars, binaries, and H II regions.

  15. [Respiratory distress].

    Science.gov (United States)

    Galili, D; Garfunkel, A; Elad, S; Zusman, S P; Malamed, S F; Findler, M; Kaufman, E

    2002-01-01

    Dental treatment is usually conducted in the oral cavity and in very close proximity to the upper respiratory airway. The possibility of unintentionally compromising this airway is high in the dental environment. The accumulation of fluid (water or blood) near to the upper respiratory airway or the loosening of teeth fragmentations and fallen dental instruments can occur. Also, some of the drugs prescribed in the dental practice are central nervous system depressants and some are direct respiratory drive depressors. For this reason, awareness of the respiratory status of the dental patient is of paramount importance. This article focuses on several of the more common causes of respiratory distress, including airway obstruction, hyperventilation, asthma, bronchospasm, pulmonary edema, pulmonary embolism and cardiac insufficiency. The common denominator to all these conditions described here is that in most instances the patient is conscious. Therefore, on the one hand, valuable information can be retrieved from the patient making diagnosis easier than when the patient is unconscious. On the other hand, the conscious patient is under extreme apprehension and stress under such situations. Respiratory depression which occurs during conscious sedation or following narcotic analgesic medication will not be dealt with in this article. Advanced pain and anxiety control techniques such as conscious sedation and general anesthesia should be confined only to operators who undergo special extended training.

  16. EEG classification for motor imagery and resting state in BCI applications using multi-class Adaboost extreme learning machine

    Science.gov (United States)

    Gao, Lin; Cheng, Wei; Zhang, Jinhua; Wang, Jue

    2016-08-01

    Brain-computer interface (BCI) systems provide an alternative communication and control approach for people with limited motor function. Therefore, the feature extraction and classification approach should differentiate the relative unusual state of motion intention from a common resting state. In this paper, we sought a novel approach for multi-class classification in BCI applications. We collected electroencephalographic (EEG) signals registered by electrodes placed over the scalp during left hand motor imagery, right hand motor imagery, and resting state for ten healthy human subjects. We proposed using the Kolmogorov complexity (Kc) for feature extraction and a multi-class Adaboost classifier with extreme learning machine as base classifier for classification, in order to classify the three-class EEG samples. An average classification accuracy of 79.5% was obtained for ten subjects, which greatly outperformed commonly used approaches. Thus, it is concluded that the proposed method could improve the performance for classification of motor imagery tasks for multi-class samples. It could be applied in further studies to generate the control commands to initiate the movement of a robotic exoskeleton or orthosis, which finally facilitates the rehabilitation of disabled people.

  17. Table-Top Milliwatt-Class Extreme Ultraviolet High Harmonic Light Source

    CERN Document Server

    Klas, Robert; Tschernajew, Maxim; Hädrich, Steffen; Shamir, Yariv; Tünnermann, Andreas; Rothhardt, Jan; Limpert, Jens

    2016-01-01

    Extreme ultraviolet (XUV) lasers are essential for the investigation of fundamental physics. Especially high repetition rate, high photon flux sources are of major interest for reducing acquisition times and improving signal to noise ratios in a plethora of applications. Here, an XUV source based on cascaded frequency conversion is presented, which delivers due to the drastic better single atom response for short wavelength drivers, an average output power of (832 +- 204) {\\mu}W at 21.7 eV. This is the highest average power produced by any HHG source in this spectral range surpassing precious demonstrations by more than a factor of four. Furthermore, a narrow-band harmonic at 26.6 eV with a relative energy bandwidth of only {\\Delta}E/E= 1.8 x 10E-3 has been generated, which is of high interest for high precision spectroscopy experiments.

  18. Galaxy Zoo Green Peas: Discovery of A Class of Compact Extremely Star-Forming Galaxies

    CERN Document Server

    Cardamone, Carolin N; Sarzi, Marc; Bamford, Steven P; Bennert, Nicola; Urry, C M; Lintott, Chris; Keel, William C; Parejko, John; Nichol, Robert C; Thomas, Daniel; Andreescu, Dan; Murray, Phil; Raddick, M Jordan; Slosar, Anze; Szalay, Alex; VandenBerg, Jan

    2009-01-01

    We investigate a class of rapidly growing emission line galaxies, known as "Green Peas", first noted by volunteers in the Galaxy Zoo project because of their peculiar bright green colour and small size, unresolved in SDSS imaging. Their appearance is due to very strong optical emission lines, namely [O III] 5007 A, with an unusually large equivalent width of up to ~1000 A. We discuss a well-defined sample of 251 colour-selected objects, most of which are strongly star forming, although there are some AGN interlopers including 8 newly discovered narrow Line Seyfert 1 galaxies. The star-forming Peas are low mass galaxies (M~10^8.5 - 10^10 M_sun) with high star formation rates (~10 M_sun/yr), low metallicities (log[O/H] + 12 ~ 8.7) and low reddening (E(B-V) < 0.25) and they reside in low density environments. They have some of the highest specific star formation rates (up to ~10^{-8} yr^{-1}) seen in the local Universe, yielding doubling times for their stellar mass of hundreds of Myrs. The few star-forming P...

  19. Respiratory Distress

    Science.gov (United States)

    1976-01-01

    The University of Miami School of Medicine asked the Research Triangle Institute for assistance in improvising the negative pressure technique to relieve respiratory distress in infants. Marshall Space Flight Center and Johnson Space Center engineers adapted this idea to the lower-body negative-pressure system seals used during the Skylab missions. Some 20,000 babies succumb to respiratory distress in the U.S. each year, a condition in which lungs progressively lose their ability to oxygenate blood. Both positive and negative pressure techniques have been used - the first to force air into lungs, the second to keep infant's lungs expanded. Negative pressure around chest helps the baby expand his lungs and maintain proper volume of air. If doctors can keep the infant alive for four days, the missing substance in the lungs will usually form in sufficient quantity to permit normal breathing. The Skylab chamber and its leakproof seals were adapted for medical use.

  20. Degradation, Promoter Recruitment and Transactivation Mediated by the Extreme N-Terminus of MHC Class II Transactivator CIITA Isoform III.

    Directory of Open Access Journals (Sweden)

    Yves B Beaulieu

    Full Text Available Multiple relationships between ubiquitin-proteasome mediated protein turnover and transcriptional activation have been well documented, but the underlying mechanisms are still poorly understood. One way to induce degradation is via ubiquitination of the N-terminal α-amino group of proteins. The major histocompatibility complex (MHC class II transactivator CIITA is the master regulator of MHC class II gene expression and we found earlier that CIITA is a short-lived protein. Using stable and transient transfections of different CIITA constructs into HEK-293 and HeLa cell lines, we show here that the extreme N-terminal end of CIITA isoform III induces both rapid degradation and transactivation. It is essential that this sequence resides at the N-terminal end of the protein since blocking of the N-terminal end with an epitope-tag stabilizes the protein and reduces transactivation potential. The first ten amino acids of CIITA isoform III act as a portable degron and transactivation sequence when transferred as N-terminal extension to truncated CIITA constructs and are also able to destabilize a heterologous protein. The same is observed with the N-terminal ends of several known N-terminal ubiquitination substrates, such as Id2, Cdt1 and MyoD. Arginine and proline residues within the N-terminal ends contribute to rapid turnover. The N-terminal end of CIITA isoform III is responsible for efficient in vivo recruitment to the HLA-DRA promoter and increased interaction with components of the transcription machinery, such as TBP, p300, p400/Domino, the 19S ATPase S8, and the MHC-II promoter binding complex RFX. These experiments reveal a novel function of free N-terminal ends of proteins in degradation-dependent transcriptional activation.

  1. Neonatal respiratory distress syndrome

    Science.gov (United States)

    Hyaline membrane disease (HMD); Infant respiratory distress syndrome; Respiratory distress syndrome in infants; RDS - infants ... improves slowly after that. Some infants with severe respiratory distress syndrome will die. This most often occurs between days ...

  2. ON CRITERION OF THE EXTREMALITY AND CONSTRUCTION OF HAMILTON SEQUENCES FOR A CLASS OF TEICHM(U)LLER MAPPINGS

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    It is proved that if f is a Teichmüller self-mapping of the unit disk with a holomorphic quadratic differential φ1, and φ satisfies the growth condition m(φ,r) = 1/2π f02π |φ(reiθ)| dθ =o((1 - r)-s), r → 1, for any s > 1, then f is extremal, and there exists a sequence {tn}, 0 < tn < 1, lim tn = 1, such that {φ(tnz)} is a Hamilton sequence. It is the precision of a n→∞ theorem of Reich-Strebel in 1974, and gives a fairly satisfactory answer to a question of Reich in 1988.

  3. Identification and mapping stripe rust resistance gene YrLM168a using extreme individuals and recessive phenotype class in a complicate genetic background.

    Science.gov (United States)

    Feng, Junyan; Chen, Guoyue; Wei, Yuming; Liu, Yaxi; Jiang, Qiantao; Li, Wei; Pu, Zhien; Lan, Xiujin; Dai, Shoufen; Zhang, Min; Zheng, Youliang

    2015-12-01

    The identification and characterization of resistance genes effective against stripe rust of wheat is beneficial for modern wheat breeding programs. Molecular markers to such genes facilitate their deployment. The variety Milan has resistance that is effective against the predominant stripe rust races in the Sichuan region. Two resistant and two susceptible F8 lines from a cross between Milan and the susceptible variety Chuannong 16 were used to investigate inheritance of the Milan resistance. Three F2 populations were developed from crosses between the resistant lines and their susceptible sibling lines (LM168a × LM168c, LM168c × LM168a, LM168b × LM168d) and used for genetic analysis and molecular mapping of the genes for resistance. The stripe rust resistance in LM168a and LM168b was conferred by a single dominant gene, temporarily designated as YrLM168a. Forty-five extreme susceptible plants from the F2 families of LM168d × LM168b were genotyped with 836 simple sequence repeat (SSR) markers to map YrLM168a. YrLM168a was mapped in chromosome 6BL. The nearest flanking markers Xwmc756 and Xbarc146 were 4.6 and 4.6 cM away from the gene at both sides, respectively. The amplification results of twenty extreme resistant (IT 0) and susceptible (IT 4) F2 plants of LM168c × LM168a and LM168a × LM168c with marker Xwmc756 further validated the mapping results. The study suggested that extreme individuals and recessive phenotype class can be successfully used for mapping genes, which should be efficient and reliable. In addition, the flanking markers near YrLM168a should be helpful in marker-assisted breeding.

  4. Multi-modal, Multi-measure, and Multi-class Discrimination of ADHD with Hierarchical Feature Extraction and Extreme Learning Machine Using Structural and Functional Brain MRI.

    Science.gov (United States)

    Qureshi, Muhammad Naveed Iqbal; Oh, Jooyoung; Min, Beomjun; Jo, Hang Joon; Lee, Boreom

    2017-01-01

    Structural and functional MRI unveil many hidden properties of the human brain. We performed this multi-class classification study on selected subjects from the publically available attention deficit hyperactivity disorder ADHD-200 dataset of patients and healthy children. The dataset has three groups, namely, ADHD inattentive, ADHD combined, and typically developing. We calculated the global averaged functional connectivity maps across the whole cortex to extract anatomical atlas parcellation based features from the resting-state fMRI (rs-fMRI) data and cortical parcellation based features from the structural MRI (sMRI) data. In addition, the preprocessed image volumes from both of these modalities followed an ANOVA analysis separately using all the voxels. This study utilized the average measure from the most significant regions acquired from ANOVA as features for classification in addition to the multi-modal and multi-measure features of structural and functional MRI data. We extracted most discriminative features by hierarchical sparse feature elimination and selection algorithm. These features include cortical thickness, image intensity, volume, cortical thickness standard deviation, surface area, and ANOVA based features respectively. An extreme learning machine performed both the binary and multi-class classifications in comparison with support vector machines. This article reports prediction accuracy of both unimodal and multi-modal features from test data. We achieved 76.190% (p multi-class settings as well as 92.857% (p multi-modal group analysis approach with multi-measure features may improve the accuracy of the ADHD differential diagnosis.

  5. The career distress scale

    DEFF Research Database (Denmark)

    Creed, Peter; Hood, Michelle; Praskova, Anna

    2016-01-01

    Career distress is a common and painful outcome of many negative career experiences, such as career indecision, career compromise, and discovering career barriers. However, there are very few scales devised to assess career distress, and the two existing scales identified have psychometric...... weaknesses. The absence of a practical, validated scale to assess this construct restricts research related to career distress and limits practitioners who need to assess and treat it. Using a sample of 226 young adults (mean age 20.5 years), we employed item response theory to assess 12 existing career......, which we combined into a scale labelled the Career Distress Scale, demonstrated excellent psychometric properties, meaning that both researchers and practitioners can use it with confidence, although continued validation is required, including testing its relationship to other nomological net variables...

  6. Responsiveness to conspecific distress calls is influenced by day-roost proximity in bats (Saccopteryx bilineata)

    Science.gov (United States)

    Eckenweber, Maria; Knörnschild, Mirjam

    2016-01-01

    Distress calls signal extreme physical distress, e.g. being caught by a predator. In many bat species, distress calls attract conspecifics. Because bats often occupy perennial day-roosts, they might adapt their responsiveness according to the social relevance in which distress calls are broadcast. Specifically, we hypothesized that conspecific distress calls broadcast within or in proximity to the day-roost would elicit a stronger responsiveness than distress calls broadcast at a foraging site. We analysed the distress calls and conducted playback experiments with the greater sac-winged bat, Saccopteryx bilineata, which occupies perennial day-roosts with a stable social group composition. S. bilineata reacted significantly differently depending on the playback's location. Bats were attracted to distress call playbacks within the day-roost and in proximity to it, but showed no obvious response to distress call playbacks at a foraging site. Hence, the bats adapted their responsiveness towards distress calls depending on the social relevance in which distress calls were broadcast. Distress calls within or in proximity to the day-roost are probably perceived as a greater threat and thus have a higher behavioural relevance than distress calls at foraging sites, either because bats want to assess the predation risk or because they engage in mobbing behaviour. PMID:27293797

  7. Loneliness and psychological distress.

    Science.gov (United States)

    Jackson, J; Cochran, S D

    1991-05-01

    Research on relationships between loneliness and psychological symptoms has generally shown significant positive associations across a wide spectrum of psychopathologies. However, such results may be artificial, to some extent, given the high intercorrelations of typical psychopathology measures. In the current study, we examined associations between psychological symptoms, assessed by the Symptom Check List-90 (SCL-90; Derogatis, Lipman, & Covi, 1973) and loneliness, as measured by the UCLA-R Loneliness Scale (Russell, Peplau, & Cutrona, 1980), in college students. Using partial correlations to control for the confounding influence of generalized distress, relationships between loneliness and individual dimensions of distress were examined. Results indicate a significant association between loneliness and interpersonal sensitivity (low self-esteem) and depression. Other dimensions of distress were not significantly related to loneliness. In addition, no sex differences in patterns of association were observed. Results support the notion that self-blame and self-devaluation are strong correlates of loneliness.

  8. Psychological distress and patient satisfaction.

    Science.gov (United States)

    Greenley, J R; Young, T B; Schoenherr, R A

    1982-04-01

    Psychologically distressed patients and clients of health care and social service organizations are found to report somewhat more dissatisfaction with services than do the nondistressed. Four explanations for this relationship are examined: 1) the psychologically distressed are generally dissatisfied; 2) service providers react negatively to the psychologically distressed; 3) psychologically distressed patients are dissatisfied when service providers do not respond to their psychological needs; and 4) patients who deny their psychological distress tend to be dissatisfied. The results show that the psychologically distressed report more dissatisfaction because of the very high levels of dissatisfaction found among patients who deny having personal problems.

  9. The career distress scale

    DEFF Research Database (Denmark)

    Creed, Peter; Hood, Michelle; Praskova, Anna

    2016-01-01

    weaknesses. The absence of a practical, validated scale to assess this construct restricts research related to career distress and limits practitioners who need to assess and treat it. Using a sample of 226 young adults (mean age 20.5 years), we employed item response theory to assess 12 existing career...

  10. Distress about mating rivals

    NARCIS (Netherlands)

    Buss, DM; Shackelford, TK; Choe, J; Buunk, BP; Dijkstra, P

    2000-01-01

    This research tested the evolutionary psychological hypothesis that men and women would be most distressed about threats from rivals who surpass them on sex-linked components of mate value. Six predictions were tested in samples from three cultures, the United States (N = 208), the Netherlands (N =

  11. Dealing with Diabetes Distress

    Science.gov (United States)

    ... screening and treating people with diabetes for distress, depression and other mental health concerns. The new guidelines, published recently in the journal Diabetes Care , suggest that providers screen all of their diabetes patients with standardized tests for these conditions. A demanding ...

  12. Distress about mating rivals

    NARCIS (Netherlands)

    Buss, DM; Shackelford, TK; Choe, J; Buunk, BP; Dijkstra, P

    2000-01-01

    This research tested the evolutionary psychological hypothesis that men and women would be most distressed about threats from rivals who surpass them on sex-linked components of mate value. Six predictions were tested in samples from three cultures, the United States (N = 208), the Netherlands (N =

  13. How extreme are extremes?

    Science.gov (United States)

    Cucchi, Marco; Petitta, Marcello; Calmanti, Sandro

    2016-04-01

    High temperatures have an impact on the energy balance of any living organism and on the operational capabilities of critical infrastructures. Heat-wave indicators have been mainly developed with the aim of capturing the potential impacts on specific sectors (agriculture, health, wildfires, transport, power generation and distribution). However, the ability to capture the occurrence of extreme temperature events is an essential property of a multi-hazard extreme climate indicator. Aim of this study is to develop a standardized heat-wave indicator, that can be combined with other indices in order to describe multiple hazards in a single indicator. The proposed approach can be used in order to have a quantified indicator of the strenght of a certain extreme. As a matter of fact, extremes are usually distributed in exponential or exponential-exponential functions and it is difficult to quickly asses how strong was an extreme events considering only its magnitude. The proposed approach simplify the quantitative and qualitative communication of extreme magnitude

  14. Moral Distress among Iranian Nurses.

    Directory of Open Access Journals (Sweden)

    Mohammad Hosein Vaziri

    2015-03-01

    Full Text Available The purpose of this study was to describe the moral distress among Iranian registered nurses.This was a descriptive -analytic study, in which 264 out of 1000 nurses were randomly selected as a sample group and completed the questionnaire. The nurses' moral distress was assessed using Corley's 30-item Moral Distress Scale adapted for use in an Iranian population. The collected data were analyzed by SPSS version 19.In this study, no correlation was found between the level of moral distress and any of the demographic data. The mean moral distress score ranged from 3.56 to 5.83, indicating moderate to high levels of moral distress. The item with the highest mean score was "working with unsafe levels of nurse staffing". The item with the lowest mean score was "giving medication intravenously to a patient who has refused to take it". Nurses working in EMS and NICU units had the highest levels of moral distress.A higher degree of moral distress is observed among nurses who work in health care systems. The results of this study highly recommend practical and research-oriented evaluation of moral distress in the medical society in Iran. Our findings suggest that Iranian version of MDS is a reliable instrument to measure moral distress in nurses.

  15. Maternal psychological distress and child decision-making.

    Science.gov (United States)

    Flouri, Eirini; Ioakeimidi, Sofia; Midouhas, Emily; Ploubidis, George B

    2017-08-15

    There is much research to suggest that maternal psychological distress is associated with many adverse outcomes in children. This study examined, for the first time, if it is related to children's affective decision-making. Using data from 12,080 families of the Millennium Cohort Study, we modelled the effect of trajectories of maternal psychological distress in early-to-middle childhood (3-11 years) on child affective decision-making, measured with a gambling task at age 11. Latent class analysis showed four longitudinal types of maternal psychological distress (chronically high, consistently low, moderate-accelerating and moderate-decelerating). Maternal distress typology predicted decision-making but only in girls. Specifically, compared to girls growing up in families with never-distressed mothers, those exposed to chronically high maternal psychological distress showed more risk-taking, bet more and exhibited poorer risk-adjustment, even after correction for confounding. Most of these effects on girls' decision-making were not robust to additional controls for concurrent internalising and externalising problems, but chronically high maternal psychological distress was associated positively with risk-taking even after this adjustment. Importantly, this association was similar for those who had reached puberty and those who had not. Given the study design, causality cannot be inferred. Therefore, we cannot propose that treating chronic maternal psychological distress will reduce decision-making pathology in young females. Our study suggests that young daughters of chronically distressed mothers tend to be particularly reckless decision-makers. Copyright © 2017. Published by Elsevier B.V.

  16. Adult respiratory distress syndrome.

    Science.gov (United States)

    Cutts, S; Talboys, R; Paspula, C; Prempeh, E M; Fanous, R; Ail, D

    2017-01-01

    Adult respiratory distress syndrome (ARDS) has now been described as a sequela to such diverse conditions as burns, amniotic fluid embolism, acute pancreatitis, trauma, sepsis and damage as a result of elective surgery in general. Patients with ARDS require immediate intubation, with the average patient now being ventilated for between 8 and 11 days. While the acute management of ARDS is conducted by the critical care team, almost any surgical patient can be affected by the condition and we believe that it is important that a broader spectrum of hospital doctors gain an understanding of the nature of the pathology and its current treatment.

  17. Researching Distressing Topics

    Directory of Open Access Journals (Sweden)

    Sharon Jackson

    2013-05-01

    Full Text Available Qualitative researchers who explore sensitive topics may expose themselves to emotional distress. Consequently, researchers are often faced with the challenge of maintaining emotional equilibrium during the research process. However, discussion on the management of difficult emotions has occupied a peripheral place within accounts of research practice. With rare exceptions, the focus of published accounts is concentrated on the analysis of the emotional phenomena that emerge during the collection of primary research data. Hence, there is a comparative absence of a dialogue around the emotional dimensions of working with secondary data sources. This article highlights some of the complex ways in which emotions enter the research process during secondary analysis, and the ways in which we engaged with and managed emotional states such as anger, sadness, and horror. The concepts of emotional labor and emotional reflexivity are used to consider the ways in which we “worked with” and “worked on” emotion. In doing so, we draw on our collective experiences of working on two collaborative projects with ChildLine Scotland in which a secondary analysis was conducted on children’s narratives of distress, worry, abuse, and neglect.

  18. Congenital rickets presenting as refractory respiratory distress at birth.

    Science.gov (United States)

    Tiwari, Soumya; Kumar, Rajesh; Singla, Shilpy; Dudeja, Ajay; Nangia, Sushma; Saili, Arvind

    2014-08-01

    Congenital rickets is a very rare entity in the spectrum of metabolic bone disease in children. The authors report an as yet unreported case of congenital rickets presenting with respiratory distress at birth. The radiographs of long bones and wrist showed generalized osteopenia with cupping and fraying of epiphyseal ends in the second week of life. The patient was managed with very high doses of vitamin D which led to clinico-radiological and biochemical improvement. More than being interesting for its extreme rarity, this report assumes importance as it brings forth the possibility of congenital rickets being a differential diagnosis for a newborn with respiratory distress.

  19. Acute Respiratory Distress Syndrome

    Directory of Open Access Journals (Sweden)

    Carmen Sílvia Valente Barbas

    2012-01-01

    Full Text Available This paper, based on relevant literature articles and the authors' clinical experience, presents a goal-oriented respiratory management for critically ill patients with acute respiratory distress syndrome (ARDS that can help improve clinicians' ability to care for these patients. Early recognition of ARDS modified risk factors and avoidance of aggravating factors during hospital stay such as nonprotective mechanical ventilation, multiple blood products transfusions, positive fluid balance, ventilator-associated pneumonia, and gastric aspiration can help decrease its incidence. An early extensive clinical, laboratory, and imaging evaluation of “at risk patients” allows a correct diagnosis of ARDS, assessment of comorbidities, and calculation of prognostic indices, so that a careful treatment can be planned. Rapid administration of antibiotics and resuscitative measures in case of sepsis and septic shock associated with protective ventilatory strategies and early short-term paralysis associated with differential ventilatory techniques (recruitment maneuvers with adequate positive end-expiratory pressure titration, prone position, and new extracorporeal membrane oxygenation techniques in severe ARDS can help improve its prognosis. Revaluation of ARDS patients on the third day of evolution (Sequential Organ Failure Assessment (SOFA, biomarkers and response to infection therapy allows changes in the initial treatment plans and can help decrease ARDS mortality.

  20. Distress During the Menopause Transition

    Directory of Open Access Journals (Sweden)

    Marcianna Nosek

    2012-07-01

    Full Text Available In 2010, nearly 400 million women worldwide were of menopause age (45-54. Although many women transition through menopause with ease, some experience distress and a subsequent decrease in quality of life. The purpose of this qualitative study was to examine the experiences of distress in women during the menopause transition. A narrative analysis methodology was used maintaining participants’ complete narratives when possible. In-person interviews of 15 midlife women were digitally audio recorded and transcribed verbatim. Women shared narratives of distress related to menstrual changes, emotional instability, vaginal dryness, and decreased libido affected by their relationships with self, partners, work, and family. Some experiences were presented against a backdrop of the past and influenced by concerns for the future. Detailed stories illuminated the effect that distressful symptoms had on quality of life and captured how intricately woven symptoms were with the women’s interpersonal and social lives.

  1. Social capital and psychological distress.

    Science.gov (United States)

    Song, Lijun

    2011-12-01

    The author proposes a conceptual model to explain the diverse roles of social capital--resources embedded in social networks--in the social production of health. Using a unique national U.S. sample, the author estimated a path analysis model to examine the direct and indirect effects of social capital on psychological distress and its intervening effects on the relationships between other structural antecedents and psychological distress. The results show that social capital is inversely associated with psychological distress, and part of that effect is indirect through subjective social status. Social capital also acts as an intervening mechanism to link seven social factors (age, gender, race-ethnicity, education, occupational prestige, annual family income, and voluntary participation) with psychological distress. This study develops the theory of social capital as network resources and demonstrates the complex functions of social capital as a distinct social determinant of health.

  2. 46 CFR 28.145 - Distress signals.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Distress signals. 28.145 Section 28.145 Shipping COAST... VESSELS Requirements for All Vessels § 28.145 Distress signals. Except as provided by 28.305, each vessel must be equipped with the distress signals specified in table 28.145. Table 28.145—Distress Signals...

  3. Moral Distress in Pediatric Healthcare Providers.

    Science.gov (United States)

    Trotochaud, Karen; Coleman, Joyce Ramsey; Krawiecki, Nicolas; McCracken, Courtney

    2015-01-01

    Pediatric providers across professions and clinical settings experience moral distress. Higher moral distress correlates with intent to leave for all professionals. Physicians as professional group had the highest moral distress. Intensive care nurses had the highest moral distress for nurses. While all providers describe distressing scenarios as disturbing, physicians report situations as occurring more frequently. The most distressing situations include requests for aggressive treatments not in child's best interest, poor team communication and lack of provider continuity. Understanding moral distress as experienced by all pediatric providers is needed to create interventions with a goal of reducing provider turnover.

  4. Moral distress among Norwegian doctors.

    Science.gov (United States)

    Førde, R; Aasland, O G

    2008-07-01

    Medicine is full of value conflicts. Limited resources and legal regulations may place doctors in difficult ethical dilemmas and cause moral distress. Research on moral distress has so far been mainly studied in nurses. To describe whether Norwegian doctors experience stress related to ethical dilemmas and lack of resources, and to explore whether the doctors feel that they have good strategies for the resolution of ethical dilemmas. Postal survey of a representative sample of 1497 Norwegian doctors in 2004, presenting statements about different ethical dilemmas, values and goals at their workplace. The response rate was 67%. 57% admitted that it is difficult to criticize a colleague for professional misconduct and 51% for ethical misconduct. 51% described sometimes having to act against own conscience as distressing. 66% of the doctors experienced distress related to long waiting lists for treatment and to impaired patient care due to time constraints. 55% reported that time spent on administration and documentation is distressing. Female doctors experienced more stress that their male colleagues. 44% reported that their workplace lacked strategies for dealing with ethical dilemmas. Lack of resources creates moral dilemmas for physicians. Moral distress varies with specialty and gender. Lack of strategies to solve ethical dilemmas and low tolerance for conflict and critique from colleagues may obstruct important and necessary ethical dialogues and lead to suboptimal solutions of difficult ethical problems.

  5. Extreme Heat

    Science.gov (United States)

    ... Landslides & Debris Flow Nuclear Blast Nuclear Power Plants Power Outages Pandemic Radiological Dispersion Device Severe Weather Snowstorms & Extreme ... Landslides & Debris Flow Nuclear Blast Nuclear Power Plants Power Outages Pandemic Radiological Dispersion Device Severe Weather Snowstorms & Extreme ...

  6. Mandelbrot's Extremism

    NARCIS (Netherlands)

    Beirlant, J.; Schoutens, W.; Segers, J.J.J.

    2004-01-01

    In the sixties Mandelbrot already showed that extreme price swings are more likely than some of us think or incorporate in our models.A modern toolbox for analyzing such rare events can be found in the field of extreme value theory.At the core of extreme value theory lies the modelling of maxima

  7. Acute respiratory distress syndrome.

    Science.gov (United States)

    Wilkins, Pamela A; Seahorn, Thomas

    2004-04-01

    all species that we work with? What do we define as acute onset? Most human ARDS cases occur while patients are in hospital being treated for other problems, whereas many of our patients present already in respiratory distress. If we are unable to ventilate patients for economic or practical reasons, what do we use as the equivalent of the Pao2/Flo, ratio'? Reliance on the pathologist is not reasonable, because many disease processes can look similar to ARDS under the microscope. If anything, ALI and ARDS are clinical diagnoses. It is time for veterinarians to reach a consensus on the definition for ALI and ARDS in our patients. Only when we have a consensus of definition can rational prospective clinical trials of therapies be designed.

  8. Corporate governance effect on financial distress likelihood: Evidence from Spain

    Directory of Open Access Journals (Sweden)

    Montserrat Manzaneque

    2016-01-01

    Full Text Available The paper explores some mechanisms of corporate governance (ownership and board characteristics in Spanish listed companies and their impact on the likelihood of financial distress. An empirical study was conducted between 2007 and 2012 using a matched-pairs research design with 308 observations, with half of them classified as distressed and non-distressed. Based on the previous study by Pindado, Rodrigues, and De la Torre (2008, a broader concept of bankruptcy is used to define business failure. Employing several conditional logistic models, as well as to other previous studies on bankruptcy, the results confirm that in difficult situations prior to bankruptcy, the impact of board ownership and proportion of independent directors on business failure likelihood are similar to those exerted in more extreme situations. These results go one step further, to offer a negative relationship between board size and the likelihood of financial distress. This result is interpreted as a form of creating diversity and to improve the access to the information and resources, especially in contexts where the ownership is highly concentrated and large shareholders have a great power to influence the board structure. However, the results confirm that ownership concentration does not have a significant impact on financial distress likelihood in the Spanish context. It is argued that large shareholders are passive as regards an enhanced monitoring of management and, alternatively, they do not have enough incentives to hold back the financial distress. These findings have important implications in the Spanish context, where several changes in the regulatory listing requirements have been carried out with respect to corporate governance, and where there is no empirical evidence regarding this respect.

  9. Planck cold clumps in the $\\lambda$ Orionis complex: I. Discovery of an extremely young Class 0 protostellar object and a proto-brown dwarf candidate in a bright rimmed clump PGCC G192.32-11.88

    CERN Document Server

    Liu, Tie; Kim, Kee-Tae; Wu, Yuefang; Lee, Chang Won; Lee, Jeong-Eun; Tatematsu, Kenichi; Choi, Minho; Juvela, Mika; Thompson, Mark; Goldsmith, Paul F; Liu, Sheng-yuan; Naomi, Hirano; Koch, Patrick; Henkel, Christian; Sanhueza, Patricio; He, JinHua; Rivera-Ingraham, Alana; Wang, Ke; Cunningham, Maria R; Tang, Ya-Wen; Lai, Shih-Ping; Yuan, Jinghua; Li, Di; Fuller, Gary; Kang, Miju; Luong, Quang Nguyen; Liu, Hauyu Baobab; Ristorcelli, Isabelle; Yang, Ji; Xu, Ye; Hirota, Tomoya; Mardones, Diego; Qin, Sheng-Li; Chen, Huei-Ru; Kwon, Woojin; Meng, FanYi; Zhang, Huawei; Kim, Mi-Ryang; Yi, Hee-Weon

    2015-01-01

    We are performing a series of observations with ground-based telescopes toward Planck Galactic cold clumps (PGCCs) in the $\\lambda$ Orionis complex in order to systematically investigate the effects of stellar feedback. In the particular case of PGCC G192.32-11.88, we discovered an extremely young Class 0 protostellar object (G192N) and a proto-brown dwarf candidate (G192S). G192N and G192S are located in a gravitationally bound bright-rimmed clump. The velocity and temperature gradients seen in line emission of CO isotopologues indicate that PGCC G192.32-11.88 is externally heated and compressed. G192N probably has the lowest bolometric luminosity ($\\sim0.8$ L$_{\\sun}$) and accretion rate (6.3$\\times10^{-7}$ M$_{\\sun}$~yr$^{-1}$) when compared with other young Class 0 sources (e.g. PACS Bright Red sources (PBRs)) in the Orion complex. It has slightly larger internal luminosity ($0.21\\pm0.01$ L$_{\\sun}$) and outflow velocity ($\\sim$14 km~s$^{-1}$) than the predictions of first hydrostatic cores (FHSCs). G192N...

  10. Stress and distress.

    Science.gov (United States)

    Selye, H

    1975-12-01

    I must ask the reader's indulgence for this article's concern with applications of the stress concept, which are distinct from, although related to clinical medicine. It has not been my object to deal with the way physicians have been aided by stress research in the practice of medicine--that information is already widely available. Rather, I have attempted to sketch briefly the history of the stress theory and to demonstrate how this information can help anyone, physician or layman, lead a more complete and satisfying life. The applications of the stress theory have been dealt with at length elsewhere. I believe that we can find within scientifically verified observations the basis of a code of behavior suited to our century. The great laws of nature that regulate the defenses of living beings against stress of any kind are essentially the same at all levels of life, from individual cells to entire complex human organisms and societies. It helps a great deal to understand the fundamental advantages and disadvantages of catatoxic and syntoxic attitudes by studying the biologic basis of self-preservation as reflected in syntoxic and catatoxic chemical mechanisms. When applied to everyday problems, this understanding should lead to choices most likely to provide us the pleasant eustress (from the Greek eu meaning good, as in euphoria) involved in achieving fulfillment and victory, thereby avoiding the self-destructive distress of frustration and failure. So the translation of the laws governing resistance of cells and organs to a code of behavior comes down to three basic precepts: 1. Find your own natural stress level. People differ with regard to the amount and kind of work they consider worth doing to meet the exigencies of daily life and to assure their future security and happiness. In this respect, all of us are influenced by hereditary predispositions and the expectations of our society. Only through planned self-analysis can we establish what we really want

  11. Psychological Distress and Lifestyle of Malay Medical Students

    Directory of Open Access Journals (Sweden)

    Salmi Razali

    2016-03-01

    Full Text Available Background and Purpose: Medical education is a laborious program which may give negative consequences on the physical and psychological health of medical students. The aims of this study were to evaluate psychological distress among Malay medical students and to assess its relationship with their lifestyle. Methods: A cross-sectional study was conducted among 221 Malay medical students. Psychological distress and lifestyle were assessed using Depression, Anxiety and Stress Scale (DASS-21 and Health-Promoting Lifestyle Profile II (HPLPII respectively. Results: About 30.8% of Malay medical students had mild to extremely severe depressive symptoms, 62.9 % showed mild to extremely severe anxiety symptoms, and 34.9% of them had mild to extremely severe stress. The depressive subscale was significantly higher among female than male students (Z=-2.613, P=0.009. There was a significant negative correlation between total psychological distress and spiritual growth (r=-0.217, P=0.001. Depression was found not only negatively correlated with spiritual growth (r =-0.328, P=0.000 but also interpersonal relationship (r=-0.161, P=0.016. Stress was inversely correlated with physical activity (r =-0.172, P=0.011. Preclinical students had significantly better scores in health responsibility (Z=-2.301, P=0.021, interpersonal relationship (Z=-2.840, P=0.005, stress management (Z=-2.339, P=0.019, spiritual growth (Z=-2.483, P=0.013 and nutrition and diet (Z =-2.456, P=0.014 than clinical students. Conclusions: Malay medical students had significant symptoms that indicate psychological distress that related to their lifestyle. This warrants further psychiatric evaluation and management for them to be good and safe future doctors. Keywords: DEPRESSION, ANXIETY, STRESS, LIFESTYLE, MEDICAL STUDENTS

  12. Moral Distress, Workplace Health, and Intrinsic Harm.

    Science.gov (United States)

    Weber, Elijah

    2016-05-01

    Moral distress is now being recognized as a frequent experience for many health care providers, and there's good evidence that it has a negative impact on the health care work environment. However, contemporary discussions of moral distress have several problems. First, they tend to rely on inadequate characterizations of moral distress. As a result, subsequent investigations regarding the frequency and consequences of moral distress often proceed without a clear understanding of the phenomenon being discussed, and thereby risk substantially misrepresenting the nature, frequency, and possible consequences of moral distress. These discussions also minimize the intrinsically harmful aspects of moral distress. This is a serious omission. Moral distress doesn't just have a negative impact on the health care work environment; it also directly harms the one who experiences it. In this paper, I claim that these problems can be addressed by first clarifying our understanding of moral distress, and then identifying what makes moral distress intrinsically harmful. I begin by identifying three common mistakes that characterizations of moral distress tend to make, and explaining why these mistakes are problematic. Next, I offer an account of moral distress that avoids these mistakes. Then, I defend the claim that moral distress is intrinsically harmful to the subject who experiences it. I conclude by explaining how acknowledging this aspect of moral distress should reshape our discussions about how best to deal with this phenomenon. © 2015 John Wiley & Sons Ltd.

  13. Extremal almost-Kahler metrics

    CERN Document Server

    Lejmi, Mehdi

    2009-01-01

    We generalize the notion of the Futaki invariant and extremal vector field to the general almost-Kahler case and we prove the periodicity of the extremal vector field when the symplectic form represents an integral cohomology class modulo torsion. We give also an explicit formula of the hermitian scalar curvature which allows us to obtain examples of non-integrable extremal almost-Kahler metrics saturating LeBrun's estimates.

  14. The association between nightmares and daily distress

    NARCIS (Netherlands)

    Lancee, J.; Schrijnemaekers, N.C.M.L.

    2013-01-01

    Nightmares are a prevalent disorder with negative consequences. This study investigated the association between nightmares and daily distress. Fifty-six participants with frequent nightmares filled out questionnaires and a 10-day diary. The questionnaire concerned: sleep, nightmare distress,

  15. Maternal postpartum distress and childhood overweight

    DEFF Research Database (Denmark)

    Ajslev, Teresa A; Andersen, Camilla S; Ingstrup, Katja G;

    2010-01-01

    We investigated associations between maternal postpartum distress covering anxiety, depression and stress and childhood overweight.......We investigated associations between maternal postpartum distress covering anxiety, depression and stress and childhood overweight....

  16. Mindfulness and bodily distress.

    Science.gov (United States)

    Fjorback, Lone Overby

    2012-11-01

    We have created a mindfulness approach to treat patients who experience multiple, persistent, and disabling physical symptoms that cannot be explained by a well-defined medical or surgical condition. Randomized controlled trials in this area are few, and research is hampered by the lack of clear definitions. Bodily distress syndrome (BDS) or bodily stress is an empirically defined definition unifying various conditions such as fibromyalgia, chronic fatigue syndrome, and somatization disorder. In the present PhD, we explored whether patients suffering from BDS may be committed to mental training in the form of mindfulness therapy, which is a mindfulness program specifically targeted patients suffering from BDS. The theoretical model for including mindfulness training in the treatment of BDS is based on identified neurobiological impairments in these patients and the neurobiological improvements that mindfulness training may offer. BDS is a major public health issue possibly associated with the pathology of the immuno-endocrine and autonomic nervous system. BDS patients are often stigmatized, and effective treatment is rarely delivered, which leaves these patients isolated, left by themselves, vulnerable to potentially harming medical and/or alternative treatments. Accordingly, there is a need for non-harming practical tools that patients can learn to master so that they can improve the ability to take responsibility for their own health and wellbeing. Mindfulness-Based Stress Reduction (MBSR) is a group program that employs mindfulness practice to alleviate suffering associated with physical, psychosomatic, and psychiatric disorders. Mindfulness-Based Cognitive Therapy (MBCT) is designed to prevent depressive relapse. Paper I and II present systematic literature reviews only of randomized controlled trials on MBSR and MBCT. The effect of MBSR has been explored on fibromyalgia in three studies, none of them showed convincing results, but gave some indications as to

  17. Why Do Distressed Firms Acquire?

    NARCIS (Netherlands)

    Q. Zhang (Quxian)

    2016-01-01

    textabstractAcquisitions made by distressed firms in recent years are economically important. This paper explores the rationale behind such acquisitions using a natural experiment. Exploiting a recent tax change which reduces debt restructuring costs for certain creditors and decreases bankruptcy

  18. Perfectionism, Procrastination, and Psychological Distress

    Science.gov (United States)

    Rice, Kenneth G.; Richardson, Clarissa M. E.; Clark, Dustin

    2012-01-01

    Using a cross-panel design and data from 2 successive cohorts of college students ( N = 357), we examined the stability of maladaptive perfectionism, procrastination, and psychological distress across 3 time points within a college semester. Each construct was substantially stable over time, with procrastination being especially stable. We also…

  19. Wavelet-aided pavement distress image processing

    Science.gov (United States)

    Zhou, Jian; Huang, Peisen S.; Chiang, Fu-Pen

    2003-11-01

    A wavelet-based pavement distress detection and evaluation method is proposed. This method consists of two main parts, real-time processing for distress detection and offline processing for distress evaluation. The real-time processing part includes wavelet transform, distress detection and isolation, and image compression and noise reduction. When a pavement image is decomposed into different frequency subbands by wavelet transform, the distresses, which are usually irregular in shape, appear as high-amplitude wavelet coefficients in the high-frequency details subbands, while the background appears in the low-frequency approximation subband. Two statistical parameters, high-amplitude wavelet coefficient percentage (HAWCP) and high-frequency energy percentage (HFEP), are established and used as criteria for real-time distress detection and distress image isolation. For compression of isolated distress images, a modified EZW (Embedded Zerotrees of Wavelet coding) is developed, which can simultaneously compress the images and reduce the noise. The compressed data are saved to the hard drive for further analysis and evaluation. The offline processing includes distress classification, distress quantification, and reconstruction of the original image for distress segmentation, distress mapping, and maintenance decision-making. The compressed data are first loaded and decoded to obtain wavelet coefficients. Then Radon transform is then applied and the parameters related to the peaks in the Radon domain are used for distress classification. For distress quantification, a norm is defined that can be used as an index for evaluating the severity and extent of the distress. Compared to visual or manual inspection, the proposed method has the advantages of being objective, high-speed, safe, automated, and applicable to different types of pavements and distresses.

  20. Predictors of Maternal Sensitivity to Infant Distress

    Science.gov (United States)

    Leerkes, Esther M.

    2010-01-01

    SYNOPSIS Objective The present study was designed to examine the extent to which mothers’ emotional (i.e., empathy, negative emotions) and cognitive (i.e., accurate detection of distress, goals about infant crying, and emotion efficacy) responses to infant distress are related to maternal sensitivity in tasks designed to elicit infant distress. Mothers’ emotional and cognitive responses to distress were assessed both prenatally in response to unfamiliar infants and postnatally in response to own infant. The extent to which prenatal and postnatal measures correlated with one another and with sensitivity to distress was examined. Design One-hundred and one mothers were interviewed prenatally about their responses to videotapes of crying infants, then videotaped interacting with their own infants at 6-months postpartum in two emotionally arousing tasks during which maternal sensitivity and infant distress were rated, and participated in a video-recall interview about their thoughts and feelings during the emotionally arousing tasks. Results Mothers’ prenatal and postnatal goals in relation to infant distress and emotional reactions to infant distress were the most consistent predictors of sensitivity, but prenatal accurate detection of infant distress also predicted sensitivity. Furthermore, mothers’ goals, emotional reactions to crying, and accurate distress detection buffered maternal sensitivity from the negative effect of observed infant distress. That is, infant distress was less strongly negatively associated with sensitivity when mothers had more infant-oriented goals, reported fewer negative emotions in response to infant crying, or were skilled at detecting infant distress. Conclusions Assessing mothers’ emotional and cognitive responses to infant distress provides insights into the origins of sensitivity to infant distress. Methodological issues relevant to assessing mothers’ emotional and cognitive responses to infant distress are raised. PMID

  1. The Psychosocial Impact of Lymphedema-related Distress among Breast Cancer Survivors in the WHEL Study

    Science.gov (United States)

    Dominick, Sally A.; Natarajan, Loki; Pierce, John P.; Madanat, Hala; Madlensky, Lisa

    2014-01-01

    Objective Lymphedema is a distressing and chronic condition affecting up to 30% of breast cancer survivors. Using a cross-sectional study design, we examined the impact of self-reported lymphedema-related distress on psychosocial functioning among breast cancer survivors in the Women’s Healthy Eating and Living (WHEL) Study. The WHEL Study has a dataset that includes self-report data on lymphedema status, symptoms and distress. Methods Chi-square tests and binary logistic regression models were used to examine how specific participant characteristics, including lymphedema-related distress, were associated with physical health and mental health as measured by the SF-36 and depressive symptoms assessed by the CES-Dsf. Results Of the 2,431 participants included in the current study population, 692 (28.5%) self-reported ever having lymphedema. A total of 335 (48.9%) women reported moderate to extreme distress as a result of their lymphedema and were classified as having lymphedema-related distress. The logistic regression models showed that women with lymphedema-related distress had 50% higher odds of reporting poor physical health (p=0.01) and 73% higher odds of having poor mental health (plymphedema. In contrast, even though lymphedema-related distress was significantly associated (p=0.03) with elevated depressive symptoms in the bivariate analyses, it was not significant in the logistic regression models. Conclusion Breast cancer survivors with lymphedema-related distress had worse physical and mental health outcomes than women with lymphedema who were not distressed and women with no lymphedema. Our findings provide further evidence of the relationship between lymphedema and psychosocial outcomes in breast cancer survivors. PMID:24615880

  2. 47 CFR 2.402 - Control of distress traffic.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false Control of distress traffic. 2.402 Section 2... distress traffic. The control of distress traffic is the responsibility of the mobile station in distress... distress call. These stations may, however, delegate the control of the distress traffic to another station. ...

  3. Extreme cosmos

    CERN Document Server

    Gaensler, Bryan

    2011-01-01

    The universe is all about extremes. Space has a temperature 270°C below freezing. Stars die in catastrophic supernova explosions a billion times brighter than the Sun. A black hole can generate 10 million trillion volts of electricity. And hypergiants are stars 2 billion kilometres across, larger than the orbit of Jupiter. Extreme Cosmos provides a stunning new view of the way the Universe works, seen through the lens of extremes: the fastest, hottest, heaviest, brightest, oldest, densest and even the loudest. This is an astronomy book that not only offers amazing facts and figures but also re

  4. Weight Status and Psychological Distress in a Mediterranean Spanish Population: A Symmetric U-Shaped Relationship

    Directory of Open Access Journals (Sweden)

    Elena Villalobos Martínez

    2014-04-01

    Full Text Available Psychological disorders in people with extreme weight (low weight or obesity should be taken into consideration by health professionals in order to practice an effective treatment to these patients. This study evaluates the association between body mass index (BMI and psychological distress in 563 inhabitants of Málaga (South of Spain. Participants were classified in four categories of BMI: Underweight (BMI <18.5 Kg/m2, Normal weight (BMI 18.5–24.99 Kg/m2, Overweight (BMI 25.0–29.99 Kg/m2 and Obesity (BMI >30 Kg/m2. Psychological distress was measured with the Spanish version of the Derogatis’ Symptoms Checklist Revised (SCL-90-R. We observed a symmetric U-shaped relationship between weight status and psychological distress in all SCL-90-R dimensions (p for quadratic trend <0.001 for both men and women. Participants with extreme weight showed the worst psychological status, and participants with normal weight exhibited the best. We found no statistically significant differences between underweight and obese participants in 9 of the 10 SCL-90-R dimensions analyzed among men, and in 8 of the 10 dimensions among women. Underweight and obese participants showed no gender differences in psychological distress levels. Psychological treatment of Mediterranean people with extreme weight, should consider underweight and obese patients at the same level of psychological distress.

  5. Precursors of extreme increments

    CERN Document Server

    Hallerberg, S; Holstein, D; Kantz, H; Hallerberg, Sarah; Altmann, Eduardo G.; Holstein, Detlef; Kantz, Holger

    2006-01-01

    We investigate precursors and predictability of extreme events in time series, which consist in large increments within successive time steps. In order to understand the predictability of this class of extreme events, we study analytically the prediction of extreme increments in AR(1)-processes. The resulting strategies are then applied to predict sudden increases in wind speed recordings. In both cases we evaluate the success of predictions via creating receiver operator characteristics (ROC-plots). Surprisingly, we obtain better ROC-plots for completely uncorrelated Gaussian random numbers than for AR(1)-correlated data. Furthermore, we observe an increase of predictability with increasing event size. Both effects can be understood by using the likelihood ratio as a summary index for smooth ROC-curves.

  6. Respiratory Distress Syndrome and its Complications

    Directory of Open Access Journals (Sweden)

    Eren Kale Cekinmez

    2013-08-01

    Full Text Available Respiratory distress syndrome in premature babies is one of the most common and most important health problems in newborns. Respiratory distress syndrome of newborn is a syndrome in premature infants caused by developmental insufficiency of surfactant production and structural immaturity in the lungs. Respiratory distress syndrome begins shortly after birth and is manifest by tachypnea, tachycardia, chest wall retractions, expiratory grunting, nasal flaring and cyanosis during breathing efforts. Respiratory distress syndrome or complications caused by respiratory distress syndrome are the most important causes of mortality and morbidity in premature infants. This article briefly reviews respiratory distress syndrome and its complications. [Archives Medical Review Journal 2013; 22(4.000: 615-630

  7. Respiratory distress of the term newborn infant.

    Science.gov (United States)

    Edwards, Martin O; Kotecha, Sarah J; Kotecha, Sailesh

    2013-03-01

    Respiratory distress is recognised as any signs of breathing difficulties in neonates. In the early neonatal period respiratory distress is common, occurring in up to 7% of newborn infants, resulting in significant numbers of term-born infants being admitted to neonatal units. Many risk factors are involved; the increasing number of term infants delivered by elective caesarean section has also increased the incidence. Additionally the risk decreases with each advancing week of gestation. At 37 weeks, the chances are three times greater than at 39-40 weeks gestation. Multiple conditions can present with features of respiratory distress. Common causes in term newborn infants include transient tachypnoea of the newborn, respiratory distress syndrome, pneumonia, meconium aspiration syndrome, persistent pulmonary hypertension of the neonate and pneumothorax. Early recognition of respiratory distress and initiation of appropriate treatment is important to ensure optimal outcomes. This review will discuss these common causes of respiratory distress in term-born infants.

  8. Chief Nursing Officers' Experiences With Moral Distress.

    Science.gov (United States)

    Prestia, Angela S; Sherman, Rose O; Demezier, Christopher

    2017-02-01

    This study explores if moral distress and its lingering residue were experienced by chief nursing officers (CNOs). Chief nursing officers, by virtue of their position and experience, are expected to uphold their professional values and act for the benefit of others. Exploration is needed to determine if the inability to do so contributes to the moral distress of these leaders. Twenty CNOs were interviewed to determine the lived experience related to moral distress and moral residue. An interpretive phenomenological analysis approach was used. Six themes emerged describing CNO experience of moral distress including lacking psychological safety, feeling a sense of powerlessness, seeking to maintain moral compass, drawing strength from networking, moral residue, and living with the consequences. Moral distress is a common experience for CNOs. Although CNOs act with moral courage, they still experience moral distress. Further research and professional discussion are needed to support nurse executive leaders.

  9. Reducing psychological distress in patients undergoing chemotherapy.

    Science.gov (United States)

    Milanti, Ariesta; Metsälä, Eija; Hannula, Leena

    Psychological distress is a common problem among patients with cancer, yet it mostly goes unreported and untreated. This study examined the association of a psycho-educational intervention with the psychological distress levels of breast cancer and cervical cancer patients undergoing chemotherapy. The design of the study was quasi-experimental, pretest-posttest design with a comparison group. One hundred patients at a cancer hospital in Jakarta, Indonesia, completed Distress Thermometer screening before and after chemotherapy. Fifty patients in the intervention group were given a psycho-educational video with positive reappraisal, education and relaxation contents, while receiving chemotherapy. Patients who received the psycho-educational intervention had significantly lower distress levels compared with those in the control group. Routine distress screening, followed by distress management and outcome assessment, is needed to improve the wellbeing of cancer patients.

  10. Comprehensive description of newborn distress behavior in response to acute pain (newborn male circumcision).

    Science.gov (United States)

    Warnock, Fay; Sandrin, Dilma

    2004-02-01

    One of the most difficult challenges still facing researchers and clinicians is assessing pain in the newborn. Behaviors provide one of the most promising avenues for deepening our fundamental understanding of complex phenomenon like newborn pain, and are key to developing descriptive-level knowledge to further newborn pain assessment efforts. In this ethologically based research, we report on the duration and frequency of neonatal distress behavior to seven distinct noxious and non-noxious but distress-provoking events including baseline (diaper change, post-diaper change, application of arm and leg restraints, post-application of arm and leg restraints, circumcision, post-circumcision) associated with newborn surgical pain. Approximately 67 min of videotaped data, involving four neonates who had undergone newborn male circumcision, were coded at 1-s intervals (4010 s in total). A reliably established coding scheme was used to code behaviors as they were observed on videotape for the duration of the seven designated events. This led to the identification of (1) 40 distress behaviors as they occurred along the continuum of distress, (2) eight distress behaviors specific to surgery, (3) 11 classes of behaviors occurring within the five sub-phases of circumcision, and (4) a description of 25 distinct post-distress behaviors. Findings support the ability to distinguish distress behaviors specific to pain and the ability to detect prolonged distress as well as individual differences in distress-related pain expression. Findings also justify ongoing use of ethological approaches to further newborn pain assessment and to investigate poorly understood topics such as infant self-regulation within the context of pain (pain recovery).

  11. Respiratory Distress Syndrome and its Complications

    OpenAIRE

    2013-01-01

    Respiratory distress syndrome in premature babies is one of the most common and most important health problems in newborns. Respiratory distress syndrome of newborn is a syndrome in premature infants caused by developmental insufficiency of surfactant production and structural immaturity in the lungs. Respiratory distress syndrome begins shortly after birth and is manifest by tachypnea, tachycardia, chest wall retractions, expiratory grunting, nasal flaring and cyanosis during breathing effor...

  12. A "wreckers theory" of financial distress

    OpenAIRE

    Von Kalckreuth, Ulf

    2005-01-01

    In recent years, a number of papers have established a new empirical regularity. Stocks of distressed firms vastly underperform those of financially healthy firms. It is not necessary to attribute the negative excess returns of distressed firms to inefficient or irrational markets. We show that negative excess returns are the equilibrium outcome when a subset of participants is able to draw returns "in kind" from distressed companies. For firms close to bankruptcy, non-cash returns to ownersh...

  13. Airline Financial Distress and Customer Satisfaction

    OpenAIRE

    Ribbink, Dina; Hofer, Christian; Dresner, Martin

    2009-01-01

    An investigation is conducted on the effect of financial distress on customer service levels in the U.S. airline industry. Using data from the first quarter of 1998 to the third quarter of 2006, we employ a seemingly unrelated regressions (SUR) model to analyze the impact of financial distress on three measures of customer service. We find that higher financial distress is associated with better on-time performance of airlines and fewer lost bags. The relationship of airline financial distres...

  14. Respiratory distress in the newborn.

    Science.gov (United States)

    Reuter, Suzanne; Moser, Chuanpit; Baack, Michelle

    2014-10-01

    Respiratory distress presents as tachypnea, nasal flaring, retractions, and grunting and may progress to respiratory failure if not readily recognized and managed. Causes of respiratory distress vary and may not lie within the lung. A thorough history, physical examination, and radiographic and laboratory findings will aid in the differential diagnosis. Common causes include transient tachypnea of the newborn, neonatal pneumonia, respiratory distress syndrome (RDS), and meconium aspiration syndrome (MAS). Strong evidence reveals an inverse relationship between gestational age and respiratory morbidity. (1)(2)(9)(25)(26) Expert opinion recommends careful consideration about elective delivery without labor at less than 39 weeks’ gestation. Extensive evidence, including randomized control trials, cohort studies, and expert opinion, supports maternal group B streptococcus screening, intrapartum antibiotic prophylaxis, and appropriate followup of high-risk newborns according to guidelines established by the Centers for Disease Control and Prevention. (4)(29)(31)(32)(34) Following these best-practice strategies is effective in preventing neonatal pneumonia and its complications. (31)(32)(34). On the basis of strong evidence, including randomized control trials and Cochrane Reviews, administration of antenatal corticosteroids (5) and postnatal surfactant (6) decrease respiratory morbidity associated with RDS. Trends in perinatal management strategies to prevent MAS have changed. There is strong evidence that amnioinfusion, (49) oropharyngeal and nasopharyngeal suctioning at the perineum, (45) or intubation and endotracheal suctioning of vigorous infants (46)(47) do not decrease MAS or its complications. Some research and expert opinion supports endotracheal suctioning of nonvigorous meconium-stained infants (8) and induction of labor at 41 weeks’ gestation (7) to prevent MAS.

  15. Prone position in patients with acute respiratory distress syndrome

    Science.gov (United States)

    Setten, Mariano; Plotnikow, Gustavo Adrián; Accoce, Matías

    2016-01-01

    Acute respiratory distress syndrome occupies a great deal of attention in intensive care units. Despite ample knowledge of the physiopathology of this syndrome, the focus in intensive care units consists mostly of life-supporting treatment and avoidance of the side effects of invasive treatments. Although great advances in mechanical ventilation have occurred in the past 20 years, with a significant impact on mortality, the incidence continues to be high. Patients with acute respiratory distress syndrome, especially the most severe cases, often present with refractory hypoxemia due to shunt, which can require additional treatments beyond mechanical ventilation, among which is mechanical ventilation in the prone position. This method, first recommended to improve oxygenation in 1974, can be easily implemented in any intensive care unit with trained personnel. Prone position has extremely robust bibliographic support. Various randomized clinical studies have demonstrated the effect of prone decubitus on the oxygenation of patients with acute respiratory distress syndrome measured in terms of the PaO2/FiO2 ratio, including its effects on increasing patient survival. The members of the Respiratory Therapists Committee of the Sociedad Argentina de Terapia Intensiva performed a narrative review with the objective of discovering the available evidence related to the implementation of prone position, changes produced in the respiratory system due to the application of this maneuver, and its impact on mortality. Finally, guidelines are suggested for decision-making. PMID:27925054

  16. Financial Distress Comparison Across Three Global Regions

    Directory of Open Access Journals (Sweden)

    Harlan D. Platt

    2008-12-01

    Full Text Available Globalization has precipitated movement of output and employment between regions. We examine factors related to corporate financial distress across three continents. Using a multidimensional definition of financial distress we test three hypotheses to explain financial distress using historical financial data. A null hypothesis of a single global model was rejected in favor of a fully relaxed model which created individual financial distress models for each region. This result suggests that despite other indications of worldwide convergence, international differences in accounting rules, lending practices, managements skill levels, and legal requirements among others has kept corporate decline from becoming commoditized.

  17. Outcome predictors for patients delivered by cesarean section for fetal distress.

    Science.gov (United States)

    Harrigan; Muscio

    1998-07-01

    fetal distress in labor at term, and the group with antepartum complications or subtle reduction in birth weight are at extreme risk for adverse outcome. It appears that cesarean section for fetal distress may rescue infants without antepartum problems but may not rescue those with a challenging antepartum course, lending credence to the feeling that fetal distress in labor may be an indicator of prior stress in many patients.

  18. 47 CFR 80.325 - Control of distress traffic.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 5 2010-10-01 2010-10-01 false Control of distress traffic. 80.325 Section 80... Safety Procedures § 80.325 Control of distress traffic. (a) Distress traffic consists of all messages relating to the immediate assistance required by the mobile station in distress. In distress traffic, the...

  19. [Moral distress in nursing care].

    Science.gov (United States)

    Negrisolo, Adriana; Brugnaro, Luca

    2012-01-01

    In nursing practice, the ability to make decisions regarding patients and to act on them is considered to be an expression of the professional nursing role. Problems may arise when a nurses would like to perform an action they believe morally correct but which are conflictual with the habits, organization or politics of the health structure in which they work. This inevitably produces moral distress in nurses who feel impotent to act as they feel they should. Although a certain amount of moral distress is part and parcel of the nursing profession , when it is excessive or prolonged it may become unacceptable and culminate in burn-out and the relative consequences. The aim of the study was to compare the level of moral stress in 111 Italian nurses working in different Operative Units to identify those clinical situations significantly associated with moral stress using the MDS scale. Similarly to studies performed in the USA, the level of moral stress in the 3 different work contexts was moderate, although some clinical situations were related to significant stress levels.

  20. Distress attributed to negative symptoms in schizophrenia

    NARCIS (Netherlands)

    Selten, JP; Wiersma, D; van den Bosch, RJ

    2000-01-01

    The purpose of the study was to examine (1) to which negative symptoms schizophrenia patients attribute distress and (2) whether clinical variables can predict the levels of reported distress. With the help of a research assistant, 86 hospitalized patients completed a self-rating scale for negative

  1. Special Populations. Distress Therapy through Leisure.

    Science.gov (United States)

    Martin, P. Kelly

    1982-01-01

    Education for leisure and stress management, combined with carefully planned recreational experiences, are the key components for distress therapy through leisure. The ultimate goal is to design and implement leisure programs, for special populations, which alleviate distress, channel stress into positive avenues, and enhance their quality of…

  2. Pain and Distress in Cancer Patients

    Directory of Open Access Journals (Sweden)

    Anna Burger-Szabo

    2015-09-01

    Full Text Available Background: A significant number of patients with cancer suffer from anxiety and depressive disorder. Perceived emotional distress, anxiety and depressive symptoms are significantly more frequent in cancer patients with pain than in patients without pain. Despite their high prevalence cancer pain and distress are frequently undertreated.

  3. Psychological Distress Among Young Norwegian Health Professionals

    Directory of Open Access Journals (Sweden)

    Per Nerdrum

    2014-03-01

    Full Text Available In this study, we present longitudinal data on psychological distress among 169 young Norwegian health professionals. Psychological distress was measured at the end of their studies, and three years later on, when being professional nurses, physiotherapists and occupational therapists. Psychological distress was assessed by applying the 12-item version of the General Health Questionnaire (GHQ 12. Twenty-seven percent of the nursing students scored higher than the GHQ 12 case score at the end of the study, but as nurses, they became significantly less distressed three years later (13 percent. The other two professions showed relatively small and non-significant reductions in psychological distress during the first three years as a professional. Hierarchical multiple analyses showed that the level of psychological distress when finishing the study, the young professionals’ experience of personal support from colleagues, the experience of work-home conflicts and the experience of methodological coping at work were significant predictors of psychological distress three years after working as young health professionals. These four predictors explained together 29 percent in the variance in GHQ 12 three years after graduation. Belonging to any of the three professions did not contribute to the explained variance in psychological distress three years after graduation.

  4. Screening for distress in cancer patients

    DEFF Research Database (Denmark)

    Grassi, Luigi; Johansen, Christoffer; Annunziata, Maria Antonietta;

    2013-01-01

    Routine screening for distress is internationally recommended as a necessary standard for good cancer care, given its high prevalence and negative consequences on quality of life. The objective of the current study was to contribute to the Italian validation of the Distress Thermometer (DT...

  5. A preliminary investigation on the utility of temporal features of Force Myography in the two-class problem of grasp vs. no-grasp in the presence of upper-extremity movements.

    Science.gov (United States)

    Sadarangani, Gautam P; Menon, Carlo

    2017-05-16

    In upper-extremity stroke rehabilitation applications, the potential use of Force Myography (FMG) for detecting grasping is especially relevant, as the presence of grasping may be indicative of functional activity, which is a key goal of rehabilitation. To date, most FMG research has focused on the classification of the raw FMG signal (i.e. instantaneous FMG samples) in order to determine the state of the hand. However, given the temporal nature of force generation during grasping, the use of temporal feature extraction techniques may yield increased accuracy. In this study, the effectiveness of classifying temporal features of the FMG signal for the two-class grasp detection problem of "grasp" versus "no grasp" (i.e. no object in hand) was evaluated with ten healthy participants. The experimental protocol comprised grasp and move tasks, requiring the use of six different grasp types frequently used in daily living, in conjunction with arm and hand movements. Data corresponding to arm and hand movements without grasping were also included to evaluate robustness to false positives. The temporal features evaluated were mean absolute value (MAV), root mean squared (RMS), linear fit (LF), parabolic fit (PF), and autoregressive model (AR). Off-line classification performance of the five temporal features, with a 0.5 s extraction window, were determined and compared to that of the raw FMG signal using area under the receiver operating curve (AUC). The raw FMG signal yielded AUC of 0.819 ± 0.098. LF and PF resulted in the greatest increases in classification performance, and provided statistically significant increases in performance. The largest increase obtained was with PF, yielding AUC of 0.869 ± 0.061, corresponding to a 6.1% relative increase over the raw FMG signal. Despite the additional fitting term provided by PF, classification performance did not significantly improve with PF when compared to LF. The results obtained indicate that temporal feature

  6. Marital Adjustment and Psychological Distress in Japan.

    Science.gov (United States)

    Li, Angela; Robustelli, Briana L; Whisman, Mark A

    2016-11-01

    This study was conducted to examine the association between marital adjustment and psychological distress in a large, probability sample of married adults in Japan (N = 710) from the Midlife Development in Japan (MIDJA) study. Results indicate that positive and negative dimensions of marital adjustment were significantly associated with dimensional and categorical measures of psychological distress. Furthermore, the associations between marital adjustment and psychological distress remained significant when statistically controlling for neuroticism, quality of friend and family relationships, and demographic variables. These results demonstrate that the well-established association between marital adjustment and psychological distress found in European-American countries is also found in Japan. Findings support continued research on marital functioning and psychological distress in East Asian countries.

  7. Moral Distress: Recognition, Diagnosis, and Treatment.

    Science.gov (United States)

    Trautmann, Jennifer

    2015-01-01

    Infusion nursing is a unique hybrid of inpatient and ambulatory nursing. The subspecialty of nurses cares for patients requiring treatment over long periods, including cancer patients receiving chemotherapy and patients who require short bursts of treatment, such as those with multiple sclerosis, Crohn's disease, and rheumatoid arthritis. Infusion nurses are exposed to many of the common root causes of moral distress in their practice, similar to nurses caring for terminally ill or critically ill patients. The specific aims of this article are to (1) define moral distress, moral residue, and the crescendo effect; (2) describe ethical stressors that can be confused with moral distress; (3) review the effects of moral distress on different health care providers; and (4) provide strategies to manage moral distress in the workplace using a case example.

  8. Piracetam for fetal distress in labour.

    Science.gov (United States)

    Hofmeyr, G Justus; Kulier, Regina

    2012-06-13

    Piracetam is thought to promote the metabolism of brain cells when they are hypoxic. It has been used to prevent adverse effects of fetal distress. The objective of this review was to assess the effects of piracetam for suspected fetal distress in labour on method of delivery and perinatal morbidity. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (15 February 2012). Randomised trials of piracetam compared with placebo or no treatment for suspected fetal distress in labour. Both review authors assessed eligibility and trial quality. One study of 96 women was included. Piracetam compared with placebo was associated with a trend to reduced need for caesarean section (risk ratio 0.57, 95% confidence interval 0.32 to 1.03). There were no statistically significant differences between the piracetam and placebo group for neonatal morbidity (measured by neonatal respiratory distress) or Apgar score. There is not enough evidence to evaluate the use of piracetam for fetal distress in labour.

  9. Trajectories of fathers' psychological distress across the early parenting period: Implications for parenting.

    Science.gov (United States)

    Giallo, Rebecca; Cooklin, Amanda; Brown, Stephanie; Christensen, Daniel; Kingston, Dawn; Liu, Cindy H; Wade, Catherine; Nicholson, Jan M

    2015-10-01

    Fathers' parenting behavior is a likely key mechanism underlying the consistent associations between paternal mental health difficulties and poor emotional-behavioral outcomes for children. This study investigates the association between fathers' mental health trajectories and key parenting behaviors (warmth, hostility, consistency) spanning the first 8-9 years postpartum. Secondary analyses of 5 waves of data from 2,662 fathers participating in the Longitudinal Study of Australian Children were conducted. Latent growth class analysis was used to identify distinct trajectories of fathers' distress (Kessler-6; Kessler et al., 2003), and latent growth models estimated parenting warmth, hostility, and consistency. Multiple group analyses were conducted to describe and compare the course of parenting behaviors for fathers assigned to the distress trajectories identified. Two distinct classes of fathers were identified based on the trajectories of distress: minimal distress (92%) and persistent and increasing distress (8%). The latter group reported significantly lower parenting warmth when their children were 8-9 years and lower consistency and higher hostility across all study intervals. The postnatal and early parenting period is a critical time for the development of parenting behaviors that are important for children's development. Engagement and support for fathers around well-being and parenting is vital for promoting optimal family and child developmental outcomes.

  10. Teaching Very Large Classes

    Science.gov (United States)

    DeRogatis, Amy; Honerkamp, Kenneth; McDaniel, Justin; Medine, Carolyn; Nyitray, Vivian-Lee; Pearson, Thomas

    2014-01-01

    The editor of "Teaching Theology and Religion" facilitated this reflective conversation with five teachers who have extensive experience and success teaching extremely large classes (150 students or more). In the course of the conversation these professors exchange and analyze the effectiveness of several active learning strategies they…

  11. "Racializing" Class

    Science.gov (United States)

    Hatt-Echeverria, Beth; Urrieta, Luis, Jr.

    2003-01-01

    In an effort to explore how racial and class oppressions intersect, the authors use their autobiographical narratives to depict cultural and experiential continuity and discontinuity in growing up white working class versus Chicano working class. They specifically focus on "racializing class" due to the ways class is often used as a copout by…

  12. Psychological Distress in Acute Low Back Pain

    DEFF Research Database (Denmark)

    Shaw, William S; Hartvigsen, Jan; Woiszwillo, Mary J

    2016-01-01

    (study populations, definitions of LBP, distress measures) were systematically extracted and reviewed for risk of bias. Distress measures were described, and data were pooled in cases of identical measures. Reported levels of distress were contextualized using available population norms, clinical......-Depression Scale, and the Medical Outcomes Study 12-Item Short-Form Health Survey and Medical Outcomes Study 36-Item Short-Form Health Survey. Pooled results for these scales showed consistent elevations in depression, but not anxiety, and reduced mental health status in comparison with the general population...

  13. ADOLESCENTS COMMUNICATING DISTRESS THROUGH SUICIDAL BEHAVIORS

    Directory of Open Access Journals (Sweden)

    Poonam Singh

    2015-06-01

    Full Text Available Background: Different risk factors associated with adolescent suicide attempts have been identified across the globe. Relatively few Indian studies are available on this data. Aims: To study the sociodemographic and clinical variables associated with adolescent suicide attempts. Setting and design: tertiary care hospital, retrospective descriptive study. Materials and methods: Participants: - ninety four patients admitted in the pediatric units who had attempted suicide by ingestion. A pretested, semi-open-ended questionnaire was filled for each patient. This data was then compiled and analyzed using statistical methods. Results: Among a total of 94 cases, sociodemographic patient risk factors found were:- male to female ratio is 1:3.5. Mean age found was 14.64 years. 58.5% were in age of 15 - 18 yrs., 54.9% were unemployed and 43.6% were educated only till middle school. Nuclear families with family members more than 5, siblings more than 3, a lower income class, single parents (10.6%, broken homes (9.6%, a history of suicide and alcoholism in family (9.6% were found as familial risk factors associated with suicide attempts. The interpersonal problems (29% and depression (19.1% were the important psychological risk factors. Period prevalence was and #8776;1 per 1000. Case fatality rate was found to be 2.12 Conclusion: The adolescents used the method of deliberate self-harm only to get attention and had no intention of really dying. This was the distress call used by these adolescents. [Natl J Med Res 2015; 5(2.000: 132-135

  14. Psychological distress and intelligence in young men

    DEFF Research Database (Denmark)

    Teasdale, T. W.; Antal, K.

    2016-01-01

    This study has primarily aimed to investigate first, the prevalence of psychological distress complaints among a population-representative sample of young men, second, whether psychological distress is associated with poorer performance on an intelligence test and third, whether any association...... is a purely linear function. Specifically, we have examined self-reported symptoms of psychological distress, and IQ, among 1869 young men appearing before the Danish Draft Board with a view to assessing suitability for conscription. The assessment included a 25-item questionnaire concerning a broad range...... of distress-related items, the Personal Health Schema (PHS), having yes/no responses, together with a general IQ test, the Børge Prien's Prøve (BPP). The rate of endorsement of the PHS items was low, ranging between 3% and 29% with a median of two/three items. The Pearson correlation between the two variables...

  15. Predicting symptomatic distress in emergency services personnel.

    Science.gov (United States)

    Weiss, D S; Marmar, C R; Metzler, T J; Ronfeldt, H M

    1995-06-01

    This study identified predictors of symptomatic distress in emergency services (EMS) personnel exposed to traumatic critical incidents. A replication was performed in 2 groups: 154 EMS workers involved in the 1989 Interstate 880 freeway collapse during the San Francisco Bay area earthquake, and 213 counterparts from the Bay area and from San Diego. Evaluated predictors included exposure, social support, and psychological traits. Replicated analyses showed that levels of symptomatic distress were positively related to the degree of exposure to the critical incident. Level of adjustment was also related to symptomatic distress. After exposure, adjustment, social support, years of experience on the job, and locus of control were controlled, 2 dissociative variables remained strongly predictive of symptomatic response. The study strengthens the literature linking dissociative tendencies and experiences to distress from exposure to traumatic stressors.

  16. Is viewing ostracism on television distressing?

    Science.gov (United States)

    Coyne, Sarah M; Nelson, David A; Robinson, Simon L; Gundersen, Nicola C

    2011-01-01

    Being ostracized can be a painful and distressing experience and can lead to subsequent aggression by the victim. However, it is unknown whether watching someone else be ostracized either in real life or on television is similarly distressing. The purpose of the current study was to examine what type of distress (if any) is induced after viewing ostracism on television. The study consisted of 50 participants, half who viewed a movie clip containing ostracism and half who viewed a control clip. Physiological and self-report data revealed that viewing ostracism was distressing to participants. In particular, participants who viewed the ostracism clip reported a lower sense of belonging, self esteem, and mood, and a greater increase in heart rate and skin conductivity than those who viewed the control clip.

  17. Moral distress experienced by intensive care nurses

    African Journals Online (AJOL)

    interference, deteriorating infrastructure, corruption and wasting of public resources. ... namely credibility, dependability, confirmability and transferability were applied to .... and moral distress, because it was perceived that the patients' lives.

  18. Buprenorphine During Pregnancy Reduces Neonate Distress

    Science.gov (United States)

    ... less neonatal distress. Buprenorphine, like methadone, reduces opioid craving and alleviates withdrawal symptoms without the safety and ... her first pregnancy. In each instance, the child born following buprenorphine treatment exhibited milder NAS symptoms than ...

  19. Fibromyalgia: When Distress Becomes (Unsympathetic Pain

    Directory of Open Access Journals (Sweden)

    Manuel Martinez-Lavin

    2012-01-01

    Full Text Available Fibromyalgia is a painful stress-related disorder. A key issue in fibromyalgia research is to investigate how distress could be converted into pain. The sympathetic nervous system is the main element of the stress response system. In animal models, physical trauma, infection, or distressing noise can induce abnormal connections between the sympathetic nervous system and the nociceptive system. Dorsal root ganglia sodium channels facilitate this type of sympathetic pain. Similar mechanisms may operate in fibromyalgia. Signs of sympathetic hyperactivity have been described in this condition. Genetic factors and/or distressful lifestyle may lead to this state of sympathetic hyperactivity. Trauma and infection are recognized fibromyalgia triggers. Women who suffer from fibromyalgia have catecholamine-evoked pain. Sympathetic dysfunction may also explain nonpain-related fibromyalgia symptoms. In conclusion, in fibromyalgia, distress could be converted into pain through forced hyperactivity of the sympathetic component of the stress response system.

  20. Financial distress prediction and operating leases

    NARCIS (Netherlands)

    Lückerath – Rovers, M.

    2009-01-01

    This study investigates whether including operating lease commitments in financial distress prediction models would increase the classification accuracy of these models. Classification accuracy measures the percentages of correctly classified companies in either of the two categories (healthy or fin

  1. AN EXTREMAL APPROACH TO BIRKHOFF QUADRATURE FORMULAS

    Institute of Scientific and Technical Information of China (English)

    Ying-guang Shi

    2001-01-01

    As we know, a solution of an extremal problem with Hermite interpolation constraints is a system of nodes of corresponding Gaussian Hermite quadrature formula (the so-called Jacobi approach). But this conclusion is violated for a Birkhoff quadrature formula. In this paper an extremal problem with Birkhoff interpolation constraints is discussed, from which a large class of Birkhoff quadrature formulas may be derived.

  2. Behavioral Intervention to Reduce Child and Parent Distress during Venipuncture.

    Science.gov (United States)

    Manne, Sharon L.; And Others

    1990-01-01

    Investigated behavioral intervention to control child distress during invasive cancer treatment. Children (n=23) requiring physical restraint to complete venipuncture were alternately assigned to behavioral intervention or attention control condition. Observed child distress, parent-rated child distress, and parent ratings of own distress were…

  3. Alternatives to Pyrotechnic Distress Signals; Supplemental Report

    Science.gov (United States)

    2015-08-01

    34 background lighting condition, because of vehicular traffic in the vicinity of the signal generator, including cars that parked with their headlights on, we...Alternatives to Pyrotechnic Distress Signals ; Supplemental Report Distribution Statement A: Approved for public release; distribution is...unlimited. August 2015 Report No. CG-D-17-15 Alternatives to Pyrotechnic Distress Signals ; Supplemental Report ii UNCLAS//Public | CG-926 RDC

  4. Moral Distress Model Reconstructed Using Grounded Theory.

    Science.gov (United States)

    Ko, Hsun-Kuei; Chin, Chi-Chun; Hsu, Min-Tao

    2016-12-29

    The problems of nurse burnout and manpower shortage relate to moral distress. Thus, having a good understanding of moral distress is critical to developing strategies that effectively improve the clinical ethical climate and improve nursing retention in Taiwan. The aim of this study was to reconstruct the model of moral distress using the grounded theory. Twenty-five staff nurses at work units who attend to the needs of adult, pediatric, acute, and critical disease or end-of-life-care patients were recruited as participants using theoretical sampling from three teaching hospitals in Taiwan. Data were collected using intensive, 2- to 3-hour interviews with each participant. Audio recordings of the interviews were made and then converted into transcripts. The data were analyzed using the grounded theory. In the clinical setting, the perspective that nurses take toward clinical moral events reflects their moral values, which trigger moral cognition, provocation, and appraisal. The moral barriers that form when moral events that occur in clinical settings contradict personal moral values may later develop into moral distress. In handling moral barriers in the clinical environment, nurses make moral judgments and determine what is morally correct. Influenced by moral efficacy, the consequence may either be a moral action or an expression of personal emotion. Wasting National Health Insurance resources and Chinese culture are key sources of moral distress for nurses in Taiwan. The role of self-confidence in promoting moral efficacy and the role of heterodox skills in promoting moral actions represent findings that are unique to this study. The moral distress model was used in this study to facilitate the development of future nursing theories. On the basis of our findings, we suggested that nursing students be encouraged to use case studies to establish proper moral values, improve moral cognition and judgment capabilities, and promote moral actions to better handle the

  5. Distress, demoralization and psychopathology: Diagnostic boundaries

    Directory of Open Access Journals (Sweden)

    John M. de Figueiredo

    2013-03-01

    Full Text Available Background and Objectives: The objectives of the manuscript are: (a to review the understanding of demoralization and its assessment; (b to describe its clinical progression; (c to explain the differences between demoralization and other form of psychological distress; (d to propose a set of criteria for future research on demoralization. Methods: A MEDLINE search using the keywords distress, subjective incompetence, depression, demoralization, helplessness, hopelessness and psychopathology was conducted. This was supplemented by a manual search of the literature. Results: Demoralization can be distinguished from passing or transient distress, non-specific distress, sub-threshold depression or anxiety, and certain mental disorders. Demoralization can be a risk factor for the manifestation of psychopathology, the prodromal phase of a mental disorder, or a trigger for exacerbation or recurrence of psychiatric distress symptoms. The domains of distress and demoralization are described and research diagnostic criteria for demoralization are presented. Conclusions: The scales discussed in this article differ in their time frames and have not yet been applied to the same population at the same time. The role of demoralization as a risk factor for mental disorders is just beginning to be understood. The domains and the diagnostic criteria for demoralization presented in this article need to be confirmed by epidemiological and empirical studies. Future research should continue to clarify its role in the pathogenesis of both mental disorders and physical illnesses and identify appropriate interventions for its arrest or prevention.

  6. Distress, demoralization and psychopathology: Diagnostic boundaries

    Directory of Open Access Journals (Sweden)

    John M. de Figueiredo

    Full Text Available Background and Objectives: The objectives of the manuscript are: (a to review the understanding of demoralization and its assessment; (b to describe its clinical progression; (c to explain the differences between demoralization and other form of psychological distress; (d to propose a set of criteria for future research on demoralization. Methods: A MEDLINE search using the keywords distress, subjective incompetence, depression, demoralization, helplessness, hopelessness and psychopathology was conducted. This was supplemented by a manual search of the literature. Results: Demoralization can be distinguished from passing or transient distress, non-specific distress, sub-threshold depression or anxiety, and certain mental disorders. Demoralization can be a risk factor for the manifestation of psychopathology, the prodromal phase of a mental disorder, or a trigger for exacerbation or recurrence of psychiatric distress symptoms. The domains of distress and demoralization are described and research diagnostic criteria for demoralization are presented. Conclusions: The scales discussed in this article differ in their time frames and have not yet been applied to the same population at the same time. The role of demoralization as a risk factor for mental disorders is just beginning to be understood. The domains and the diagnostic criteria for demoralization presented in this article need to be confirmed by epidemiological and empirical studies. Future research should continue to clarify its role in the pathogenesis of both mental disorders and physical illnesses and identify appropriate interventions for its arrest or prevention.

  7. Dependent Classes

    DEFF Research Database (Denmark)

    Gasiunas, Vaidas; Mezini, Mira; Ostermann, Klaus

    2007-01-01

    Virtual classes allow nested classes to be refined in subclasses. In this way nested classes can be seen as dependent abstractions of the objects of the enclosing classes. Expressing dependency via nesting, however, has two limitations: Abstractions that depend on more than one object cannot...... be modeled and a class must know all classes that depend on its objects. This paper presents dependent classes, a generalization of virtual classes that expresses similar semantics by parameterization rather than by nesting. This increases expressivity of class variations as well as the flexibility...... of their modularization. Besides, dependent classes complement multi-methods in scenarios where multi-dispatched abstractions rather than multi-dispatched method are needed. They can also be used to express more precise signatures of multi-methods and even extend their dispatch semantics. We present a formal semantics...

  8. Moderate and extreme maternal obesity.

    LENUS (Irish Health Repository)

    Abdelmaboud, M O

    2012-05-01

    The aim of this study was to investigate the prevalence of moderate and extreme obesity among an Irish obstetric population over a 10-year period, and to evaluate the obstetric features of such pregnancies. Of 31,869 women delivered during the years 2000-2009, there were 306 women in the study group, including 173 in the moderate or Class 2 obese category (BMI 35-39.9) and 133 in the extreme or Class 3 obese category (BMI > or = 40).The prevalence of obese women with BMI > or = 35 was 9.6 per 1000 (0.96%), with an upward trend observed from 2.1 per 1000 in the year 2000, to 11.8 per 1000 in the year 2009 (P = 0.001). There was an increase in emergency caesarean section (EMCS) risk for primigravida versus multigravid women, within both obese categories (P < 0.001). However, there was no significant difference in EMCS rates observed between Class 2 and Class 3 obese women, when matched for parity. The prevalence of moderate and extreme obesity reported in this population is high, and appears to be increasing. The increased rates of abdominal delivery, and the levels of associated morbidity observed, have serious implications for such women embarking on pregnancy.

  9. Psychological distress among women with newly diagnosed breast cancer

    DEFF Research Database (Denmark)

    Mertz, Birgitte; Bistrup, Pernille Envold; Johansen, Christoffer

    2012-01-01

    PURPOSE: Psychological distress is common in the cancer continuum. Our objectives were to determine the prevalence of distress and to investigate the related problems and the characteristics of women with breast cancer who experienced psychological distress at the time of diagnosis. METHODS: We...... thermometer' to measure psychological distress and the accompanying 'problem list' to identify related problems. Logistic regression models with 95% confidence intervals were used to estimate the associations between psychological distress, age, social support and domains on the problem list. RESULTS...

  10. Evaluating Nonattachment and Decentering as Possible Mediators of the Link Between Mindfulness and Psychological Distress in a Nonclinical College Sample.

    Science.gov (United States)

    Bhambhani, Yash; Cabral, Gail

    2016-10-01

    Although increasing evidence shows that mindfulness is positively related to mental health, the nature and mechanisms of this relationship are not fully understood. Based on previous research findings and suggestions, the authors of the current study hypothesized that decentering and nonattachment are 2 variables that mediate the relationship between mindfulness and psychological distress. A nonclinical, non-treatment-seeking sample of 308 students and employees from a middle-class, primarily Caucasian university filled out mindfulness, decentering, nonattachment, and mental distress measures online. Mediational analyses failed to support the hypothesis. Results suggest that mindfulness and nonattachment are independent predictors of nonclinical psychological distress and fully explain the effect of decentering on psychological distress. Results should be interpreted with caution and not generalized to clinical issues. A more comprehensive look into the mechanisms of mindfulness, especially with rigorous experimental, longitudinal studies, is warranted. The authors stress the importance of checking alternative, equivalent models in mediation studies. © The Author(s) 2015.

  11. Pathobiology of acute respiratory distress syndrome.

    Science.gov (United States)

    Sapru, Anil; Flori, Heidi; Quasney, Michael W; Dahmer, Mary K

    2015-06-01

    The unique characteristics of pulmonary circulation and alveolar-epithelial capillary-endothelial barrier allow for maintenance of the air-filled, fluid-free status of the alveoli essential for facilitating gas exchange, maintaining alveolar stability, and defending the lung against inhaled pathogens. The hallmark of pathophysiology in acute respiratory distress syndrome is the loss of the alveolar capillary permeability barrier and the presence of protein-rich edema fluid in the alveoli. This alteration in permeability and accumulation of fluid in the alveoli accompanies damage to the lung epithelium and vascular endothelium along with dysregulated inflammation and inappropriate activity of leukocytes and platelets. In addition, there is uncontrolled activation of coagulation along with suppression of fibrinolysis and loss of surfactant. These pathophysiological changes result in the clinical manifestations of acute respiratory distress syndrome, which include hypoxemia, radiographic opacities, decreased functional residual capacity, increased physiologic deadspace, and decreased lung compliance. Resolution of acute respiratory distress syndrome involves the migration of cells to the site of injury and re-establishment of the epithelium and endothelium with or without the development of fibrosis. Most of the data related to acute respiratory distress syndrome, however, originate from studies in adults or in mature animals with very few studies performed in children or juvenile animals. The lack of studies in children is particularly problematic because the lungs and immune system are still developing during childhood and consequently the pathophysiology of pediatric acute respiratory distress syndrome may differ in significant ways from that seen in acute respiratory distress syndrome in adults. This article describes what is known of the pathophysiologic processes of pediatric acute respiratory distress syndrome as we know it today while also presenting the much

  12. Extreme skin depth waveguides

    CERN Document Server

    Jahani, Saman

    2014-01-01

    Recently, we introduced a paradigm shift in light confinement strategy and introduced a class of extreme skin depth (e-skid) photonic structures (S. Jahani and Z. Jacob, "Transparent sub-diffraction optics: nanoscale light confinement without metal," Optica 1, 96-100 (2014)). Here, we analytically establish that figures of merit related to light confinement in dielectric waveguides are fundamentally tied to the skin depth of waves in the cladding. We contrast the propagation characteristics of the fundamental mode of e-skid waveguides and conventional waveguides to show that the decay constant in the cladding is dramatically larger in e-skid waveguides, which is the origin of sub-diffraction confinement. Finally, we propose an approach to verify the reduced skin depth in experiment using the decrease in the Goos-H\\"anchen phase shift.

  13. Distress screening using distress thermometer in head and neck cancer patients undergoing radiotherapy and evaluation of causal factors predicting occurrence of distress

    Directory of Open Access Journals (Sweden)

    Shirley Lewis

    2013-01-01

    Full Text Available Introduction: Distress is commonly seen in head and neck cancer patients undergoing radiotherapy. Causal factors of distress are multifactorial; which encompasses physical, psychological, spiritual, and existential factors with complex interrelationship among the factors. Materials and Methods: Thirty patients undergoing head and neck radiotherapy were included in the study. Patients were screened for pain scores, distress scores, physical and psychological symptoms, and spiritual and emotional distress. Results: Significant increasing trend seen for pain score, distress score, and total number of symptoms during 2 nd week, 4 th week, and on completion of radiotherapy treatment (all P′s < 0.001 compared to pretreatment. Those who had chemotherapy (CT along with radiation had significantly greater pain score (t = 5.54, P = 0.03 and distress score (t = 3.9, P = 0.05 at 2 weeks into radiotherapy compared to those who did not receive CT. There was significantly higher grade of skin toxicity in those with spiritual distress (Somers′ d = 0.36, P = 0.02 and higher grade of mucositis in those with existential distress (d = 0.34, P = 0.02 at 4 weeks into radiotherapy. Conclusion: Positive correlation between distress score and pain score and occurrence of physical symptoms. Increasing trend seen for pain score, distress score, and total number of symptoms during 2 nd week, 4 th week, and completion of radiotherapy treatment compared to pretreatment. Increase in distress score in those with existential and spiritual distress.

  14. Stigma and psychological distress in suicide survivors.

    Science.gov (United States)

    Scocco, Paolo; Preti, Antonio; Totaro, Stefano; Ferrari, Alessandro; Toffol, Elena

    2017-03-01

    Suicide bereavement is frequently related to clinically significant psychological distress and affected by stigma. This study was designed to evaluate the relationship between psychological distress by psychopathological domains and stigma, in a sample of individuals bereaved by suicide (suicide survivors). The data were collected between January 2012 and December 2014 and included information on sociodemographic variables (gender, age, marital status and education level) and responses to the Stigma of Suicide Survivor scale (STOSSS) and the Brief Symptom Inventory (BSI). One hundred and fifty-five suicide survivors completed the evaluation and were included in the study. Levels of psychological distress in suicide survivors, as measured by BSI, were positively related to levels of perceived stigma toward suicide survivors, as measured by STOSSS. The association was not affected by age and gender, or by marital status, education level, days from suicide or a personal history of suicide attempt. Participants with higher scores on almost all subscales of the BSI, particularly the interpersonal sensitivity and paranoid ideation subscales, reported the highest levels of perceived stigma toward suicide survivors. Levels of distress in subjects bereaved by the suicide of a relative or friend were positively associated with levels of perceived stigma toward suicide survivors. Specific interventions dedicated to the bereavement of suicide survivors might help to alleviate not only psychological distress but also stigma towards loss by suicide. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Psychological distress among patients with epilepsy

    Directory of Open Access Journals (Sweden)

    Asma Khalid

    2011-01-01

    Full Text Available Background: Epilepsy is a disorder of the brain characterized by recurrent seizures which are physical reactions to sudden, usually brief, too much electrical discharges in a group of brain cells. Psychological distress often accompanies epilepsy. It badly affects the disease and the treatment outcome. Whereas, familial social support is a positive factor. The objective of the present study was to see the difference of Psychological distress among the patients of Epilepsy; the comparisons on the variables of the study were made between gender, age, marital status, education, socio-economic status and type of Epilepsy. Materials and Methods: Sample comprised of 50 patients with epilepsy. These participants were divided into three subgroups according to their ages that are children, adolescence and adults. Patients were taken from hospitals Islamabad and Muzaffarabad (AJK. Results: The result showed that psychological distress is higher among male patients with generalized epilepsy and among those who are un-married, un-educated, having low socioeconomic status and lower familial social support. Conclusion: It can be concluded that psychological distress is common co morbidity in patients with epilepsy. During treatment, Counseling to the patients and the family can better help in coping with distress during their illness.

  16. Late Financial Distress Process Stages and Financial Ratios

    DEFF Research Database (Denmark)

    Sormunen, Nina; Laitinen, Teija

    2012-01-01

    and usefulness of single financial ratios in short-term financial distress prediction when the effect of each different financial distress process stage is considered; (2) the effects of recognition of the financial distress process stage on the financial distress prediction model. The time horizon...... stage affects the classification ability of single financial ratios and financial distress prediction models in short-term financial distress prediction. The study shows that the auditor's GC task could be supported by paying attention to the financial distress process stage. The implications......The present study adds to our understanding and knowledge of financial distress predictions regarding the usefulness of financial ratios in the late stages of the financial distress process. The study contributes to previous research by generating information concerning: (1) the behavior...

  17. Birthing Classes

    Science.gov (United States)

    ... first birth and hope to have a vaginal delivery this time, there is a class for that, too. Choose ... t covered in your birthing class, it’s a good idea to take an individual class on it, especially if you are a first-time mother. The health benefits of breastfeeding your baby ...

  18. Sources of distress for physicians and nurses working in Swiss neonatal intensive care units.

    Science.gov (United States)

    Klein, Sabine D; Bucher, Hans Ulrich; Hendriks, Manya J; Baumann-Hölzle, Ruth; Streuli, Jürg C; Berger, Thomas M; Fauchère, Jean-Claude; On Behalf Of The Swiss Neonatal End-Of-Life Study Group

    2017-08-14

    Medical personnel working in intensive care often face difficult ethical dilemmas. These may represent important sources of distress and may lead to a diminished self-perceived quality of care and eventually to burnout. The aim of this study was to identify work-related sources of distress and to assess symptoms of burnout among physicians and nurses working in Swiss neonatal intensive care units (NICUs). In summer 2015, we conducted an anonymous online survey comprising 140 questions about difficult ethical decisions concerning extremely preterm infants. Of these 140 questions, 12 questions related to sources of distress and 10 to burnout. All physicians and nurses (n = 552) working in the nine NICUs in Switzerland were invited to participate. The response rate was 72% (398). The aspects of work most commonly identified as sources of distress were: lack of regular staff meetings, lack of time for routine discussion of difficult cases, lack of psychological support for the NICU staff and families, and missing transmission of important information within the caregiver team. Differences between physicians' and nurses' perceptions became apparent: for example, nurses were more dissatisfied with the quality of the decision-making process. Different perceptions were also noted between staff in the German- and French- speaking parts of Switzerland: for example, respondents from the French part rated lack of regular staff meetings as being more problematic. On the other hand, personnel in the French part were more satisfied with their accomplishments in the job. On average, low levels of burnout symptoms were revealed, and only 6% of respondents answered that the work-related burden often affected their private life. Perceived sources of distress in Swiss NICUs were similar to those in ICU studies. Despite rare symptoms of burnout, communication measures such as regular staff meetings and psychological support to prevent distress were clearly requested.

  19. Social inequality in psychological distress among young people in five countries with little economic disparity

    DEFF Research Database (Denmark)

    Nielsen, Line; Damsgaard, Mogens Trab; Meilstrup, Charlotte

    in the family (high, medium, low) and 2) parents’ occupational social class (OSC) measured by father’s and mother’s occupation (highest ranking parent: high, medium, low, unclassifiable). We performed age-adjusted multilevel logistic regression analyses stratified by sex and country. Results The overall country...... used data from the international Health Behaviour in School-aged Children (HBSC) study 2005/2006 in five Nordic countries: Denmark, Finland, Iceland, Norway and Sweden. In each country, the study population was 11-, 13- and 15-years old students in a random sample of schools or school-classes, n=28......Introduction Psychological distress is widespread among young people and seems to be socially patterned. However, socioeconomic differences in psychological distress among children and adolescents may be less pronounced in welfare states with low economic disparity, e.g. the Nordic countries...

  20. Associations between obesity and mental distress in late midlife

    DEFF Research Database (Denmark)

    Wimmelmann, Cathrine Lawaetz; Lund, Rikke; Christensen, Ulla

    2016-01-01

    BACKGROUND: To examine associations of Body mass Index (BMI) and mental distress in late midlife in a large Danish community sample and to investigate the effect of socio-demographic factors. METHODS: The study sample comprised 3613 Danish men and 1673 women aged 49-63 years from the Copenhagen...... Ageing and Midlife Biobank (CAMB) with complete information on measured BMI, severity of mental symptoms assessed by the Symptom Check-List' (SCL-90), and socio-demographic factors including sex, age, occupational social class, and educational duration. Linear and logistic regression were used...... was not associated with BMI category in women. In the adjusted analyses, all symptom scales remained significantly associated with BMI among men after adjusting for socio-demographic factors while only associations with somatization and depression scales remained significant for women.. When SCL-90 case status...

  1. [Moral distress and leadership in nursing].

    Science.gov (United States)

    Ko, Hsun-Kuei; Yang, Mei-Sang

    2009-06-01

    While nursing staff learn the rules of ethical behavior in nursing education programs, they commonly experience confusion, frustration and stress in practice settings due to barriers to moral action faced in the work environment. "Moral distress" is a term used to describe the situation in which a decision-maker cannot carry out an ethical or moral action due to the presence of an obstacle. In this article, we described the meaning of and factors influencing moral distress in nursing work settings in relation to nursing leader management strategies. Goals of the article were to help nursing leaders appreciate their personal beliefs as well as to develop strategies to alleviate emotional distress and promote self-efficacy among nursing staff members. One favorable benefit is expected to be greater retention of nursing staff.

  2. Does High Tobacco Consumption Cause Psychological Distress?

    DEFF Research Database (Denmark)

    Skov-Ettrup, Lise S; Nordestgaard, Børge G; Petersen, Christina B

    2017-01-01

    BACKGROUND: Increasing evidence suggests that smoking influences mental health negatively. This study investigated whether high tobacco consumption is causally related to psychological distress in a Mendelian randomization design, using a variant in the nicotine acetylcholine receptor gene CHRNA3......-known to influence individual tobacco consumption-as instrumental variable for tobacco consumption. METHODS: Data from 90 108 participants in the Copenhagen General Population Study was used. Exposures included self-reported cigarettes/day and pack years and the CHRNA3 rs1051730 genotype as instrumental...... variable for tobacco consumption. Three dimensions of psychological distress were studied: Stress, fatigue, and hopelessness. Analyses with the CHRNA3 genotype were stratified by smoking status. RESULTS: Self-reported amount of smoking was associated with all three dimensions of psychological distress...

  3. Hereditary mucoepithelial dysplasia and severe respiratory distress

    Directory of Open Access Journals (Sweden)

    Mahmoud Halawa

    2015-01-01

    Full Text Available Hereditary mucoepithelial dysplasia (HMD is a rare autosomal dominant disorder characterized by mucoepithelial disruption of the skin, hair and mucous membranes. It results from defective gap junction formation and leads to non-scarring alopecia, mucosal erythema, perineal erythematous intertrigo, involvement of the conjunctival mucosa, and pulmonary disease. We present a case of severe respiratory distress in an initially healthy full term infant born to a mother with HMD. This infant later developed signs and symptoms of HMD. A high index of suspicion for pulmonary infection with atypical organism is essential in infants with a family history of HMD who present with respiratory distress.

  4. Extremely Preterm Birth

    Science.gov (United States)

    ... Events Advocacy For Patients About ACOG Extremely Preterm Birth Home For Patients Search FAQs Extremely Preterm Birth ... Spanish FAQ173, June 2016 PDF Format Extremely Preterm Birth Pregnancy When is a baby considered “preterm” or “ ...

  5. Hoarseness of voice, respiratory distress and dysphagia due to giant primary posterior mediastinal ectopic goitre: a rare clinical entity.

    Science.gov (United States)

    Chaudhry, Ikram Ulhaq; Cheema, Ahsan Iqbal; AlShamasi, Zahra; Mutairi, Hadi

    2016-04-25

    Primary posterior mediastinal ectopic goitre is an extremely rare entity; we report a case of a 28-year-old man who presented with dysphagia, respiratory distress and hoarseness of voice, gradually worsening over a period of 3 months. CT scan of the thorax revealed a giant posterior mediastinal ectopic goitre. The mass was removed through a right posterolateral thoracotomy. The patient's symptoms, respiratory distress and dysphagia disappeared immediately after surgery while his voice gradually returned to normal after 6 weeks.

  6. Predicting Financial Distress in the Hong Kong Growth Enterprises Market from the Perspective of Financial Sustainability

    Directory of Open Access Journals (Sweden)

    Hui Hu

    2015-01-01

    Full Text Available The present study, according to our knowledge, is the first attempt to establish a financial distress prediction model for a unique set of enterprises, which are the enterprises listed on the specialized Hong Kong Growth Enterprise Market. It also makes an analysis of corporate financial sustainability and its relationship to financial distress prediction. The logistic regression and jackknife method are used to test the predictability of various models with data drawn from the Growth Enterprise Market for the years 2000–2010. The study finds that a model that includes firm-specific financial variables, firm-specific non-financial variables and a macro-economic variable is a better predictor of financial distress than is a model that includes only the first set of variables or a model that includes the latter two sets of variables. It also finds that a model that includes the latter two sets of variables is a better predictor of financial distress than is a model that includes only the first set of variables. These findings are vital for financial sustainability, as investors, policymakers, auditors and stakeholders of this market would find the conclusions emanating from the study extremely useful.

  7. Respiratory Distress Secondary to Rhabdomyosarcoma of the Tongue and Co-existent Choanal Atresia.

    Science.gov (United States)

    Chatopadhayay, Rahul; Tiwari, Preeti; Gangopadhyay, A N; Pandey, Vaibhav

    2016-07-01

    Whilst rhabdomyosarcoma (RMS) is the third most common solid tumour in children, congenital RMS of the tongue is extremely rare and usually present as painless progressive mass since birth (Dagher and Helman in Oncologist 4:34-44, 1999; Childs and Goudy in Int J Pediatr Otorhinolaryngol 5:126-128, 2010). In neonates, presentation with respiratory distress is unexpected as neonates are preferential nasal breathers and restricted oral breathing due to tumour usually poses no problem. We herein report a case of rhabdomyosarcoma of the tongue with co-existent unilateral choanal atresia, presenting with respiratory distress. The baby developed upper respiratory tract infection following which developed severe respiratory distress. Airway symptoms were precipitated as there was combined obstruction of both the nostrils due to infection or adenoid enlargement and unilateral chonal atresia. Treatment of respiratory distress in the presence of RMS and bilateral nasal pathology must first prioritise the security of the airway, before taking a multi-factorial approach to the therapy of the lingual mass (Childs and Goudy in Int J Pediatr Otorhinolaryngol 5:126-128, 2010). This case illustrates the importance of vigilance with respect to co-existent nasal pathology, in order to avoid the occurrence of complete airway obstruction. We therefore feel that any diagnosis of lingual RMS should warrant a formal examination of both nasal cavities.

  8. Development of a model of moral distress in military nursing.

    Science.gov (United States)

    Fry, Sara T; Harvey, Rose M; Hurley, Ann C; Foley, Barbara Jo

    2002-07-01

    The purpose of this article is to describe the development of a model of moral distress in military nursing. The model evolved through an analysis of the moral distress and military nursing literature, and the analysis of interview data obtained from US Army Nurse Corps officers (n = 13). Stories of moral distress (n = 10) given by the interview participants identified the process of the moral distress experience among military nurses and the dimensions of the military nursing moral distress phenomenon. Models of both the process of military nursing moral distress and the phenomenon itself are proposed. Recommendations are made for the use of the military nursing moral distress models in future research studies and in interventions to ameliorate the experience of moral distress in crisis military deployments.

  9. Prevalence And Correlates Of Mental Distress Among Regular ...

    African Journals Online (AJOL)

    There is high level of mental distress in the community. ... 2007, which was after the mid semester exam in the second semester of the academic year September, ... Highest levels of mental distress were observed among students of the Main

  10. Late Financial Distress Process Stages and Financial Ratios

    DEFF Research Database (Denmark)

    Sormunen, Nina; Laitinen, Teija

    2012-01-01

    The present study adds to our understanding and knowledge of financial distress predictions regarding the usefulness of financial ratios in the late stages of the financial distress process. The study contributes to previous research by generating information concerning: (1) the behavior...... and usefulness of single financial ratios in short-term financial distress prediction when the effect of each different financial distress process stage is considered; (2) the effects of recognition of the financial distress process stage on the financial distress prediction model. The time horizon...... for prediction is less than one year, and the empirical data consist of financial statement information from 106 distressed firms undergoing reorganization and their matched counterparts for 2003-2007. To analyze the effects of the specific distress process stage, the sample has been divided into two groups...

  11. Religion and Psychological Distress in Japan

    Science.gov (United States)

    Roemer, Michael K.

    2010-01-01

    This study introduces data from a new random sample of Japanese adults. Findings show that reporting of distress symptoms are: (1. positively associated with a religious coping index (i.e., beliefs that religion or supernatural beings provide comfort, support or protection), (2. associated in different directions with ownership of different…

  12. Respiratory Development and Respiratory Distress Syndrome.

    Science.gov (United States)

    Rubarth, Lori Baas; Quinn, Jenny

    2015-01-01

    Respiratory development is crucial for all newborn infants. Premature infants may be born at an early stage of development and lack sufficient surfactant production. This results in respiratory distress syndrome. This article reviews the normal fetal development of the lung as well as the disorder that develops because of an early birth.

  13. Disordered Eating and Psychological Distress among Adults

    Science.gov (United States)

    Patrick, Julie Hicks; Stahl, Sarah T.; Sundaram, Murali

    2011-01-01

    The majority of our knowledge about eating disorders derives from adolescent and young adult samples; knowledge regarding disordered eating in middle and later adulthood is limited. We examined the associations among known predictors of eating disorders for younger adults in an age-diverse sample and within the context of psychological distress.…

  14. Associations between faith, distress and mental adjustment

    DEFF Research Database (Denmark)

    Johannessen-Henry, Christine Tind

    2013-01-01

    ), specific aspects of faith ('belief in a god', 'belief in a god with whom I can talk' and 'experiences of god or a higher power'), religious community and church attendance (DUREL), distress (POMS-SF), adjustment to cancer (Mini-MAC) and sociodemographic factors. Linear regression models were used...

  15. Assessment of distress associated with tinnitus.

    NARCIS (Netherlands)

    Veen, E.D. van; Jacobs, J.B.; Bensing, J.M.

    1998-01-01

    This paper focuses upon the quality of the Dutch translation of the STSS (Subjective Tinnitus Severity Scale), a scale which assesses the severity of tinnitus and the related distress. Research has been done on the psychometric qualities of this scale, its relationship with loudness-matching procedu

  16. Maternal postpartum distress and childhood overweight.

    Directory of Open Access Journals (Sweden)

    Teresa A Ajslev

    Full Text Available OBJECTIVE: We investigated associations between maternal postpartum distress covering anxiety, depression and stress and childhood overweight. METHODS: We performed a prospective cohort study, including 21,121 mother-child-dyads from the Danish National Birth Cohort (DNBC. Maternal distress was measured 6 months postpartum by 9 items covering anxiety, depression and stress. Outcome was childhood overweight at 7-years-of age. Multiple logistic regression analyses were performed and information on maternal age, socioeconomic status, pre-pregnancy BMI, gestational weight gain, parity, smoking during pregnancy, paternal BMI, birth weight, gestational age at birth, sex, breastfeeding and finally infant weight at 5 and 12 month were included in the analyses. RESULTS: We found, that postpartum distress was not associated with childhood risk of overweight, OR 1.00, 95%CI [0.98-1.02]. Neither was anxiety, depression, or stress exposure, separately. There were no significant differences between the genders. Adjustment for potential confounders did not alter the results. CONCLUSION: Maternal postpartum distress is apparently not an independent risk factor for childhood overweight at 7-years-of-age. However, we can confirm previous findings of perinatal determinants as high maternal pre-pregnancy BMI, and smoking during pregnancy being risk factors for childhood overweight.

  17. Disordered Eating and Psychological Distress among Adults

    Science.gov (United States)

    Patrick, Julie Hicks; Stahl, Sarah T.; Sundaram, Murali

    2011-01-01

    The majority of our knowledge about eating disorders derives from adolescent and young adult samples; knowledge regarding disordered eating in middle and later adulthood is limited. We examined the associations among known predictors of eating disorders for younger adults in an age-diverse sample and within the context of psychological distress.…

  18. Interpersonal Relationships and Emotional Distress in Adolescence

    Science.gov (United States)

    Kenny, Rachel; Dooley, Barbara; Fitzgerald, Amanda

    2013-01-01

    The aim of this study was to examine positive and negative qualities in adolescents' interpersonal relationships and their relative importance in predicting emotional distress. Participants were 260 students from three schools in the Dublin area (119 girls; 141 boys), aged 12-18 years (M = 15.32, SD = 1.91). Students completed questionnaires…

  19. Psychological Distress and Emotional Expression on Facebook.

    Science.gov (United States)

    Bazarova, Natalya N; Choi, Yoon Hyung; Whitlock, Janis; Cosley, Dan; Sosik, Victoria

    2017-03-01

    Social network sites (SNS) are a novel social environment for college students with psychological distress to connect with their peers, but the nature and effects of these interactions are not well understood. This study reports findings from a Facebook study among 238 college students reporting nonspecific psychological distress using the K-6 scale. Behavioral data included Facebook status updates containing affect words written by participants within the past 60 days and the number of responses (comments and likes) each update received. The updates were also coded for depression symptoms. Self-report data included participants' self-presentational concerns, the affective valence of each post, effects of responses on mood, and satisfaction with the responses to and outcome of each status update. Higher psychological distress was associated with displaying depression language on Facebook, with higher self-presentational concerns, and with less satisfaction with audiences' responses and less overall satisfaction with the outcome of the interaction. These results offer a unique glimpse into the social world of college students with psychological distress through their everyday use of Facebook, and how the interplay of this novel environment and students' mental health impacts their social behaviors and interaction meaning-making on Facebook.

  20. Trauma and Psychological Distress among Ethnically Diverse Community College Students

    Science.gov (United States)

    Edman, Jeanne L.; Watson, Susan B.; Patron, David J.

    2016-01-01

    An association has been found between traumatic experiences and psychological distress; however, the impact of ethnicity on psychological distress is less clear. The present study examined the relationship between traumatic experiences and measures of psychological distress among a multiethnic sample of community college students. A total of 389…

  1. 33 CFR 175.110 - Visual distress signals required.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Visual distress signals required... (CONTINUED) BOATING SAFETY EQUIPMENT REQUIREMENTS Visual Distress Signals § 175.110 Visual distress signals... signals selected from the list in § 175.130 or the alternatives in § 175.135, in the number required, are...

  2. 33 CFR 83.37 - Distress signals (Rule 37).

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Distress signals (Rule 37). 83.37... NAVIGATION RULES RULES Sound and Light Signals § 83.37 Distress signals (Rule 37). When a vessel is in distress and requires assistance she shall use or exhibit the signals described in Annex IV to these Rules. ...

  3. 46 CFR 169.553 - Pyrotechnic distress signals.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Pyrotechnic distress signals. 169.553 Section 169.553... Lifesaving and Firefighting Equipment Additional Lifesaving Equipment § 169.553 Pyrotechnic distress signals. (a) All pyrotechnic distress signals must be of an approved type. (b) Replacement must be made no...

  4. 33 CFR 175.130 - Visual distress signals accepted.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Visual distress signals accepted... (CONTINUED) BOATING SAFETY EQUIPMENT REQUIREMENTS Visual Distress Signals § 175.130 Visual distress signals accepted. (a) Any of the following signals, when carried in the number required, can be used to meet the...

  5. 46 CFR 25.25-19 - Visual distress signals.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Visual distress signals. 25.25-19 Section 25.25-19... Other Lifesaving Equipment § 25.25-19 Visual distress signals. Each uninspected passenger vessel must meet the visual distress signal requirements of 33 CFR part 175 applicable to the vessel. ...

  6. Trauma and Psychological Distress among Ethnically Diverse Community College Students

    Science.gov (United States)

    Edman, Jeanne L.; Watson, Susan B.; Patron, David J.

    2016-01-01

    An association has been found between traumatic experiences and psychological distress; however, the impact of ethnicity on psychological distress is less clear. The present study examined the relationship between traumatic experiences and measures of psychological distress among a multiethnic sample of community college students. A total of 389…

  7. The spiritual distress assessment tool: an instrument to assess spiritual distress in hospitalised elderly persons

    Directory of Open Access Journals (Sweden)

    Martin Estelle

    2010-12-01

    Full Text Available Abstract Background Although spirituality is usually considered a positive resource for coping with illness, spiritual distress may have a negative influence on health outcomes. Tools are needed to identify spiritual distress in clinical practice and subsequently address identified needs. This study describes the first steps in the development of a clinically acceptable instrument to assess spiritual distress in hospitalized elderly patients. Methods A three-step process was used to develop the Spiritual Distress Assessment Tool (SDAT: 1 Conceptualisation by a multidisciplinary group of a model (Spiritual Needs Model to define the different dimensions characterizing a patient's spirituality and their corresponding needs; 2 Operationalisation of the Spiritual Needs Model within geriatric hospital care leading to a set of questions (SDAT investigating needs related to each of the defined dimensions; 3 Qualitative assessment of the instrument's acceptability and face validity in hospital chaplains. Results Four dimensions of spirituality (Meaning, Transcendence, Values, and Psychosocial Identity and their corresponding needs were defined. A formalised assessment procedure to both identify and subsequently score unmet spiritual needs and spiritual distress was developed. Face validity and acceptability in clinical practice were confirmed by chaplains involved in the focus groups. Conclusions The SDAT appears to be a clinically acceptable instrument to assess spiritual distress in elderly hospitalised persons. Studies are ongoing to investigate the psychometric properties of the instrument and to assess its potential to serve as a basis for integrating the spiritual dimension in the patient's plan of care.

  8. Multidimensional extremal dependence coefficients

    OpenAIRE

    2017-01-01

    Extreme values modeling has attracting the attention of researchers in diverse areas such as the environment, engineering, or finance. Multivariate extreme value distributions are particularly suitable to model the tails of multidimensional phenomena. The analysis of the dependence among multivariate maxima is useful to evaluate risk. Here we present new multivariate extreme value models, as well as, coefficients to assess multivariate extremal dependence.

  9. The European Extreme Right and Religious Extremism

    Directory of Open Access Journals (Sweden)

    Jean-Yves Camus

    2007-12-01

    Full Text Available The ideology of the Extreme Right in Western Europe is rooted in Catholic fundamentalism and Counter-Revolutionary ideas. However, the Extreme Right, like all other political families, has had to adjust to an increasingly secular society. The old link between religion and the Extreme Right has thus been broken and in fact already was when Fascism overtook Europe: Fascism was secular, sometimes even anti-religious, in its essence. Although Catholic fundamentalists still retain strong positions within the apparatus of several Extreme Right parties (Front National, the vote for the Extreme Right is generally weak among regular churchgoers and strong among non-believers. In several countries, the vote for the Extreme Right is stronger among Protestant voters than among Catholics, since while Catholics may support Christian-Democratic parties, there are very few political parties linked to Protestant churches. Presently, it also seems that Paganism is becoming the dominant religious creed within the Extreme Right. In a multicultural Europe, non-Christian forms of religious fundamentalism such as Islamism also exist with ideological similarities to the Extreme Right, but this is not sufficient to categorize Islamism as a form of Fascism. Some Islamist groups seek alliances with the Extreme Right on the basis of their common dislike for Israel and the West, globalization and individual freedom of thought.

  10. Acute respiratory distress syndrome in a pregnant woman with systemic lupus erythematosus: a case report.

    Science.gov (United States)

    Chen, Y-J A; Tseng, J-J; Yang, M-J; Tsao, Y-P; Lin, H-Y

    2014-12-01

    When the disease activity of systemic lupus erythematosus (SLE) is controlled appropriately, a pregnant woman who has lupus is able to carry safely to term and deliver a healthy infant. While the physiology of a healthy pregnancy itself influences ventilatory function, acute pulmonary distress may decrease oxygenation and influence both mother and fetus. Though respiratory failure in pregnancy is relatively rare, it remains one of the leading conditions requiring intensive care unit admission in pregnancy and carries a high risk of maternal and fetal morbidity and mortality, not to mention the complexity caused by lupus flare. We report a case of SLE complicated with lupus pneumonitis and followed by acute respiratory distress during pregnancy. Though there is a high risk of maternal and fetal morbidity and mortality, maternal respiratory function improved after cesarean section and treatment of the underlying causes. The newborn had an extremely low birth weight but was well at discharge.

  11. Two Mutations in Surfactant Protein C Gene Associated with Neonatal Respiratory Distress

    Directory of Open Access Journals (Sweden)

    Anna Tarocco

    2015-01-01

    Full Text Available Multiple mutations of surfactant genes causing surfactant dysfunction have been described. Surfactant protein C (SP-C deficiency is associated with variable clinical manifestations ranging from neonatal respiratory distress syndrome to lethal lung disease. We present an extremely low birth weight male infant with an unusual course of respiratory distress syndrome associated with two mutations in the SFTPC gene: C43-7G>A and 12T>A. He required mechanical ventilation for 26 days and was treated with 5 subsequent doses of surfactant with temporary and short-term efficacy. He was discharged at 37 weeks of postconceptional age without any respiratory support. During the first 16 months of life he developed five respiratory infections that did not require hospitalization. Conclusion. This mild course in our patient with two mutations is peculiar because the outcome in patients with a single SFTPC mutation is usually poor.

  12. Pigmentação exógena em pododáctilos simulando isquemia de extremidades: um desafio diagnóstico provocado por artrópodos da classe Diplopoda ("piolhos-de-cobra" Exogenous pigmentation in toes feigning ischemia of the extremities: a diagnostic challenge brought by arthropods of the Diplopoda Class ("millipedes"

    Directory of Open Access Journals (Sweden)

    Carlos Alberto Jatobá Lima

    2010-06-01

    Full Text Available Um paciente de 24 anos relatou ter pisado em um "piolho de cobra". Ao ser examinado, este apresentava máculas eritêmato-cianóticas, nos três primeiros pododáctilos do pé direito, com queixas de dor local e parestesias, com fluxos arteriais palpáveis. Os diplopodas são artrópodos cilíndricos segmentados que assumem posição enrodilhada - quando ameaçados - liberam quinonas e outros agentes irritativos e pigmentantes. A coloração de aspecto cianótico lembra sofrimento tissular isquêmico, o que pode confundir profissionais em atendimentos de Emergência, quando a história não apresenta clareza e coerência.A 24 year-old patient reported having stepped on a millipede. When examined the patient presented cyanotic and erythematous macules on the first three toes of his right foot, and also complained of local pain and paresthesia, with palpable arterial flows. Millipedes are cylindrical segmented arthropods that when threatened form into curls and release quinones and other irritant and pigmentary substances. The cyanotic color reminds ischaemic tissular distress fact that may confuse professionals in Emergency Rooms when the clinical report is unclear.

  13. Word classes

    DEFF Research Database (Denmark)

    Rijkhoff, Jan

    2007-01-01

    This article provides an overview of recent literature and research on word classes, focusing in particular on typological approaches to word classification. The cross-linguistic classification of word class systems (or parts-of-speech systems) presented in this article is based on statements found...... a parts-of-speech system that includes the categories Verb, Noun, Adjective and Adverb, other languages may use only a subset of these four lexical categories. Furthermore, quite a few languages have a major word class whose members cannot be classified in terms of the categories Verb – Noun – Adjective...

  14. Moral distress and moral conflict in clinical ethics.

    Science.gov (United States)

    Fourie, Carina

    2015-02-01

    Much research is currently being conducted on health care practitioners' experiences of moral distress, especially the experience of nurses. What moral distress is, however, is not always clearly delineated and there is some debate as to how it should be defined. This article aims to help to clarify moral distress. My methodology consists primarily of a conceptual analysis, with especial focus on Andrew Jameton's influential description of moral distress. I will identify and aim to resolve two sources of confusion about moral distress: (1) the compound nature of a narrow definition of distress which stipulates a particular cause, i.e. moral constraint, and (2) the distinction drawn between moral dilemma (or, more accurately, moral conflict) and moral distress, which implies that the two are mutually exclusive. In light of these concerns, I argue that the definition of moral distress should be revised so that moral constraint should not be a necessary condition of moral distress, and that moral conflict should be included as a potential cause of distress. Ultimately, I claim that moral distress should be understood as a specific psychological response to morally challenging situations such as those of moral constraint or moral conflict, or both.

  15. Prenatal distress in Turkish pregnant women and factors associated with maternal prenatal distress.

    Science.gov (United States)

    Yuksel, Fatma; Akin, Semiha; Durna, Zehra

    2014-01-01

    To assess: (1) the prenatal distress level in Turkish pregnant women and (2) to examine the association between prenatal maternal distress and personal and pregnancy-specific factors. Pregnant women experience stress originating from a variety of pregnancy-specific issues, including physical symptoms and changes, changes in body image, physiological, social and emotional changes, parenting concerns, changes in relationships with significant others, medical problems, anxiety about labour and delivery, concerns about birth and the baby's health. A descriptive cross-sectional study. This study was conducted at a gynaecology clinic of a private hospital in Istanbul, Turkey within a 12-month period. The study sample comprised 522 pregnant women continuing their regular visits for prenatal care. Pregnancy Description Form and Turkish Version of Revised Version of Prenatal Distress Questionnaire [(NUPDQ)-17 Item Version] were used for data collection. Study sample was moderately distressed. Turkish pregnant women were mostly distressed and concerned about premature delivery, having an unhealthy baby, labour and delivery, feeling tired and having low energy during pregnancy. Prenatal distress in Turkish pregnant women was associated with personal and pregnancy-related characteristics. This study found that pregnant women need to be supported emotionally, physically and socially. A better understanding of prenatal maternal distress could assist in informing healthcare professionals about the provision of physically, emotionally, socially and behaviourally appropriate support for achieving a healthy pregnancy. It is crucial for pregnant women to be regularly assessed and educated for dealing successfully with concerns and fears about prenatal period, birth and postnatal period and about difficulties that women may encounter during their pregnancy. © 2013 Blackwell Publishing Ltd.

  16. The Indirect Costs of Financial Distress in Indonesia

    Directory of Open Access Journals (Sweden)

    Wijantini Wijantini

    2007-06-01

    Full Text Available This paper presents quantitative estimates of the indirect cost of financial distress and its determinants. In order to measure the cost, this study estimates the annualized changes in industry-adjusted operation profit and sales from a year before the onset of distress to the resolution year. Using those approaches, the median of indirect financial distress cost is estimated between three and 11 percent annually. To the extent that the direct cost of financial distress reduces reported operating income, the estimated costs are overstated. The simple regressions analysis suggest that the indirect cost of financial distress significantly increases with size, leverage, number of creditors, and poor industry performance, but is not related to degree of bank loan reliance. The findings provide a weak support for the financial distress theory which suggests that conflicts of interest render the costs of financial distress.

  17. Miliary tuberculosis and adult respiratory distress syndrome.

    Science.gov (United States)

    Piqueras, A R; Marruecos, L; Artigas, A; Rodriguez, C

    1987-01-01

    Although, miliary tuberculosis is an unusual cause of severe acute respiratory failure, we describe nine patients with miliary tuberculosis who developed adult respiratory distress syndrome. This complication occurred in seven patients despite treatment with antituberculous drugs. In two patients who developed the syndrome, miliary tuberculosis was diagnosed only at postmortem. The presence of pulmonary hypertension in all cases and disseminated intravascular coagulation in seven cases suggests a possible pathophysiologic relationship with severe pulmonary vascular damage. The high mortality rate (88.8%) was associated with nonpulmonary organ system failure. Miliary tuberculosis should be considered in patients with adult respiratory distress syndrome of unknown etiology, and simple diagnostic procedures such as sputum, bronchial brushing, and gastric examination should be followed by invasive diagnostic procedures to confirm this etiology. Since untreated miliary tuberculosis is usually fatal, early recognition of this disease is of great importance, and specific therapy may play a lifesaving role.

  18. Psychological distress of marital and cohabitation breakups.

    Science.gov (United States)

    Tavares, Lara Patrício; Aassve, Arnstein

    2013-11-01

    Using data from a large survey, the British Household Panel Survey (BHPS), this paper explores the extent to which marital and cohabiting unions differ with respect to the short-term effects of union dissolution on mental health. We compare married individuals who divorced or separated with cohabitors whose first union ended and test the hypothesis that married individuals experience larger negative effects. Results show that initial differences are not statistically significant once the presence of children is controlled for, suggesting that the presence of children is a particularly significant source of increased psychological distress in union dissolutions. However, parenthood does not explain serious psychological distress, which appears to be associated with enduring traits (the personality trait neuroticism). Copyright © 2013 Elsevier Inc. All rights reserved.

  19. Prediction of surface distress using neural networks

    Science.gov (United States)

    Hamdi, Hadiwardoyo, Sigit P.; Correia, A. Gomes; Pereira, Paulo; Cortez, Paulo

    2017-06-01

    Road infrastructures contribute to a healthy economy throughout a sustainable distribution of goods and services. A road network requires appropriately programmed maintenance treatments in order to keep roads assets in good condition, providing maximum safety for road users under a cost-effective approach. Surface Distress is the key element to identify road condition and may be generated by many different factors. In this paper, a new approach is aimed to predict Surface Distress Index (SDI) values following a data-driven approach. Later this model will be accordingly applied by using data obtained from the Integrated Road Management System (IRMS) database. Artificial Neural Networks (ANNs) are used to predict SDI index using input variables related to the surface of distress, i.e., crack area and width, pothole, rutting, patching and depression. The achieved results show that ANN is able to predict SDI with high correlation factor (R2 = 0.996%). Moreover, a sensitivity analysis was applied to the ANN model, revealing the influence of the most relevant input parameters for SDI prediction, namely rutting (59.8%), crack width (29.9%) and crack area (5.0%), patching (3.0%), pothole (1.7%) and depression (0.3%).

  20. Combination of Biorthogonal Wavelet Hybrid Kernel OCSVM with Feature Weighted Approach Based on EVA and GRA in Financial Distress Prediction

    Directory of Open Access Journals (Sweden)

    Chao Huang

    2014-01-01

    Full Text Available Financial distress prediction plays an important role in the survival of companies. In this paper, a novel biorthogonal wavelet hybrid kernel function is constructed by combining linear kernel function with biorthogonal wavelet kernel function. Besides, a new feature weighted approach is presented based on economic value added (EVA and grey relational analysis (GRA. Considering the imbalance between financially distressed companies and normal ones, the feature weighted one-class support vector machine based on biorthogonal wavelet hybrid kernel (BWH-FWOCSVM is further put forward for financial distress prediction. The empirical study with real data from the listed companies on Growth Enterprise Market (GEM in China shows that the proposed approach has good performance.

  1. Class size versus class composition

    DEFF Research Database (Denmark)

    Jones, Sam

    Raising schooling quality in low-income countries is a pressing challenge. Substantial research has considered the impact of cutting class sizes on skills acquisition. Considerably less attention has been given to the extent to which peer effects, which refer to class composition, also may affect...... bias from omitted variables, the preferred IV results indicate considerable negative effects due to larger class sizes and larger numbers of overage-for-grade peers. The latter, driven by the highly prevalent practices of grade repetition and academic redshirting, should be considered an important...

  2. Legacy to the extreme

    NARCIS (Netherlands)

    A. van Deursen (Arie); T. Kuipers (Tobias); L.M.F. Moonen (Leon)

    2000-01-01

    textabstractWe explore the differences between developing a system using extreme programming techniques, and maintaining a legacy system. We investigate whether applying extreme programming techniques to legacy maintenance is useful and feasible.

  3. Legacy to the extreme

    NARCIS (Netherlands)

    Deursen, A. van; Kuipers, T.; Moonen, L.M.F.

    2000-01-01

    We explore the differences between developing a system using extreme programming techniques, and maintaining a legacy system. We investigate whether applying extreme programming techniques to legacy maintenance is useful and feasible.

  4. Extreme environment electronics

    CERN Document Server

    Cressler, John D

    2012-01-01

    Unfriendly to conventional electronic devices, circuits, and systems, extreme environments represent a serious challenge to designers and mission architects. The first truly comprehensive guide to this specialized field, Extreme Environment Electronics explains the essential aspects of designing and using devices, circuits, and electronic systems intended to operate in extreme environments, including across wide temperature ranges and in radiation-intense scenarios such as space. The Definitive Guide to Extreme Environment Electronics Featuring contributions by some of the world's foremost exp

  5. Moral distress related to ethical dilemmas among Spanish podiatrists.

    Science.gov (United States)

    Losa Iglesias, Marta Elena; Becerro de Bengoa Vallejo, Ricardo; Salvadores Fuentes, Paloma

    2010-05-01

    To describe the distress experienced by Spanish podiatrists related to ethical dilemmas, organisational matters, and lack of resources. A 2008 email survey of a representative sample of 485 Spanish podiatrists presenting statements about different ethical dilemmas, values and goals at the workplace. The response rate was 44.8%. Of all the respondents, 57% described sometimes having to act against their own conscience as distressing. Time constraints is the main cause of moral distress (67%) and 58% of respondents said that they found it distressing that patients have long waits for treatment. Distress related to inadequate treatment due to economical constraints or ineffectiveness was described by 60% of the podiatrists. Another 51% reported that time spent on administration and documentation is distressing. Female doctors experienced more distress than their male colleagues. Last, 36% of respondents reported that their workplace lacked strategies for dealing with ethical dilemmas. These study results identify moral distress among Spanish podiatrists mainly related to time constraints, patient demands and lack of resources. Moral distress varies with sex and age. Organisational strategies such as moral deliberation and responsive evaluation offer the potential to address moral distress.

  6. Iyengar yoga for distressed women: a 3-armed randomized controlled trial.

    Science.gov (United States)

    Michalsen, Andreas; Jeitler, Michael; Brunnhuber, Stefan; Lüdtke, Rainer; Büssing, Arndt; Musial, Frauke; Dobos, Gustav; Kessler, Christian

    2012-01-01

    Distress is an increasing public health problem. We aimed to investigate the effects of an Iyengar yoga program on perceived stress and psychological outcomes in distressed women and evaluated a potential dose-effect relationship. Seventy-two female distressed subjects were included into a 3-armed randomized controlled trial and allocated to yoga group 1 (n = 24) with twelve 90 min sessions over 3 months, yoga group 2 (n = 24) with 24 sessions over 3 months, or a waiting list control group (n = 24). The primary outcome was stress perception, measured by Cohen Stress Scale; secondary outcomes included state trait anxiety, depression, psychological and physical quality of life (QOL), profile of Mood States, well being, and bodily complaints. After three months, women in the yoga groups showed significant improvements in perceived stress (P = 0.003), state trait anxiety (P = 0.021 and P = 0.003), depression (P = 0.008), psychological QOL (P = 0.012), mood states being (P = 0.007), and bodily complaints well(P = 0.012) when compared to controls. Both yoga programs were similarly effective for these outcomes; however, compliance was better in the group with fewer sessions (yoga group 1). Dose effects were seen only in the analysis of group-independent effects for back pain, anxiety, and depression. These findings suggest that Iyengar yoga effectively reduces distress and improves related psychological and physical outcomes. Furthermore, attending twice-weekly yoga classes was not superior to once-weekly classes, as a result of limited compliance in the twice-weekly group.

  7. Iyengar Yoga for Distressed Women: A 3-Armed Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Andreas Michalsen

    2012-01-01

    Full Text Available Distress is an increasing public health problem. We aimed to investigate the effects of an Iyengar yoga program on perceived stress and psychological outcomes in distressed women and evaluated a potential dose-effect relationship. Seventy-two female distressed subjects were included into a 3-armed randomized controlled trial and allocated to yoga group 1 (n=24 with twelve 90 min sessions over 3 months, yoga group 2 (n=24 with 24 sessions over 3 months, or a waiting list control group (n=24. The primary outcome was stress perception, measured by Cohen Stress Scale; secondary outcomes included state trait anxiety, depression, psychological and physical quality of life (QOL, profile of Mood States, well being, and bodily complaints. After three months, women in the yoga groups showed significant improvements in perceived stress (P=0.003, state trait anxiety (P=0.021 and P=0.003, depression (P=0.008, psychological QOL (P=0.012, mood states being (P=0.007, and bodily complaints well(P=0.012 when compared to controls. Both yoga programs were similarly effective for these outcomes; however, compliance was better in the group with fewer sessions (yoga group 1. Dose effects were seen only in the analysis of group-independent effects for back pain, anxiety, and depression. These findings suggest that Iyengar yoga effectively reduces distress and improves related psychological and physical outcomes. Furthermore, attending twice-weekly yoga classes was not superior to once-weekly classes, as a result of limited compliance in the twice-weekly group.

  8. Deficiently Extremal Gorenstein Algebras

    Indian Academy of Sciences (India)

    Pavinder Singh

    2011-08-01

    The aim of this article is to study the homological properties of deficiently extremal Gorenstein algebras. We prove that if / is an odd deficiently extremal Gorenstein algebra with pure minimal free resolution, then the codimension of / must be odd. As an application, the structure of pure minimal free resolution of a nearly extremal Gorenstein algebra is obtained.

  9. Crafting, Crafting, Crafting - Extreme Programming in Classroom?

    Directory of Open Access Journals (Sweden)

    Marcus BITZL

    2008-10-01

    Full Text Available Extreme Programming (XP shows several interesting approaches which are very attractive for education. It is centered around early and incremental creation of working software. In the following, the chances XP offers for class are shown - especially for use in a class project, but also for practical phases in all lessons where programming is useful. Finally several common problems which can occur with XP will be shown as well as how to deal with them to make the use in class as smooth as possible.

  10. Adaptive multilayer optics for extreme ultraviolet wavelengths

    NARCIS (Netherlands)

    Bayraktar, Muharrem

    2015-01-01

    In this thesis we describe the development of a new class of optical components to enhance the imaging performance by enabling adaptations of the optics. When used at extreme ultraviolet (EUV) wavelengths, such ‘adaptive optics’ offers the potential to achieve the highest spatial resolution in imagi

  11. Severe Acute Infection Due to Serratia marcescens Causing Respiratory Distress in An Immunocompetent Adult.

    Science.gov (United States)

    Ruiz-Sada, Pablo; Escalante, Mikel; Lizarralde, Eva

    2016-01-01

    The role of Serratia marcescens changed from a harmless saprophytic microorganism to an important opportunistic human pathogen. It often causes nosocomial device-associated outbreaks and rarely serious invasive community acquired infections. We present a case of a community-acquired Serratia marcescens bacteremia leading to Respiratory Distress Syndrome in a previously healthy 51-year-old man without identifiable risk factors. Full recovery was achieved with solely medical treatment and observation in ICU during three days. To our knowledge it is an extremely uncommon presentation and just few cases have been previously reported in the literature.

  12. Extreme value distributions

    CERN Document Server

    Ahsanullah, Mohammad

    2016-01-01

    The aim of the book is to give a through account of the basic theory of extreme value distributions. The book cover a wide range of materials available to date. The central ideas and results of extreme value distributions are presented. The book rwill be useful o applied statisticians as well statisticians interrested to work in the area of extreme value distributions.vmonograph presents the central ideas and results of extreme value distributions.The monograph gives self-contained of theory and applications of extreme value distributions.

  13. Nebraska School Facilities: Educational Adequacy of Class III School District Structures

    Science.gov (United States)

    Weidner, John M., Sr.

    2009-01-01

    In 2009, a replication of the Pool study was conducted. This study, however, focused on the school systems classified as Class III districts. Nebraska has 252 Class III districts. Compared with Class II (21), Class IV (1), and Class V(1) districts, the Class III districts offer a wide array of school settings, from urban to extremely rural, and…

  14. Psychological and physical distress of cancer patients during radiotherapy

    CERN Document Server

    König, A

    2001-01-01

    Purpose: patients undergoing radiotherapy have physical and psychological symptoms related to the underlying disease and the treatment. In order to give the best possible support to the patients, more knowledge about the amount and the changing of distress in the course of radiotherapy is of essentially importance. Methods: The distress was measured in a consecutive sample of cancer patients (n=82) undergoing radiotherapy. Each patient was given the EORTC-QLQ-C30, the HADS and a special questionnaire which ascertain radiotherapy-specific items before starting the radiotherapy, at the onset of radiotherapy, in the third week of radiotherapy and 3 weeks after the end of radiotherapy. Results: within the first week of treatment the psychological distress of the patients is increasing; 98.8 % of the patients are 'moderate distressed', 46 % 'severe distressed'. General physical symptoms seem not to be affected by the radiotherapy, there is no changing. The distress caused by the organization of the radiotherapy is...

  15. Psychological Distress in Iranian International Students at an Australian University.

    Science.gov (United States)

    Nahidi, Shizar; Blignault, Ilse; Hayen, Andrew; Razee, Husna

    2017-05-03

    This study investigated psychological distress in Iranian international students at UNSW Australia, and explored the psychosocial factors associated with high levels of distress. A total of 180 Iranian international students pursuing undergraduate and postgraduate degrees during 2012/2013 completed an email questionnaire containing socio-demographic items and five standardized and validated scales. Multivariable logistic regression was used to analyse the predictors of psychological distress. Compared to domestic and international students at two other Australian universities, a significantly smaller proportion of Iranian international students scored as distressed on the Kessler Psychological Distress Scale (K10). Greater levels of psychological distress were associated with being female, poorer physical health, less social support, less religious involvement and spirituality, and negative attitudes towards seeking professional psychological help. Findings from this growing group of international students can help inform culturally competent mental health promotion and service provision in their host countries.

  16. Authenticity, life satisfaction, and distress: a longitudinal analysis.

    Science.gov (United States)

    Boyraz, Güler; Waits, J Brandon; Felix, Victoria A

    2014-07-01

    The purpose of the present study was to examine the reciprocal relationships between authenticity and measures of life satisfaction and distress using a 2-wave panel study design. Data were collected from 232 college students attending 2 public universities. Structural equation modeling was used to analyze the data. The results of the cross-lagged panel analysis indicated that after controlling for temporal stability, initial authenticity (Time 1) predicted later distress and life satisfaction (Time 2). Specifically, higher levels of authenticity at Time 1 were associated with increased life satisfaction and decreased distress at Time 2. Neither distress nor life satisfaction at Time 1 significantly predicted authenticity at Time 2. However, the relationship between Time 1 distress and Time 2 authenticity was not significantly different from the relationship between Time 1 authenticity and Time 2 distress. Results are discussed in light of humanistic-existential theories and the empirical research on well-being.

  17. Resilience and Psychological Distress in Psychology and Medical Students.

    Science.gov (United States)

    Bacchi, Stephen; Licinio, Julio

    2017-04-01

    The authors investigated levels of resilience and psychological distress in medical and psychology students, factors that may affect these levels, the relationship between resilience and psychological distress, and student opinion on causes of stress and possible interventions. A voluntary anonymous online survey was distributed to University of Adelaide medical and psychology students. Medical and psychology students (n = 560; response rate = 24.7%) had similar mean resilience and psychological distress scores, and 47.9% of medical students and 55.1% of psychology students were psychologically distressed. Higher levels of resilience were associated with lower levels of distress (p resilience-based interventions, greater financial support, clearer learning objectives and more continuous assessment as potential means to reduce the effects of stress. Higher levels of resilience were associated with lower levels of psychological distress. Further studies are required to determine the efficacy of resilience-based interventions in these groups.

  18. Psychological Distress in Norwegian Nurses and Teachers over Nine Years

    Directory of Open Access Journals (Sweden)

    Per Nerdrum

    2016-11-01

    Full Text Available Psychological distress have been found to be high and influence negatively nurses’ and teachers’ work. In this nine-year project, we present the first longitudinal study comparing psychological distress from 1467 students and young professionals in nursing and teaching. Psychological distress was measured with GHQ 12 at the start and the end of their studies and three and six years after graduation. Both descriptive statistics and estimated models were used to assess psychological distress over time. Psychological distress increased significantly in both groups during education. The reduction of psychological distress was significant among the nurses, and they clearly showed a “healthy worker effect” when coming into clinical work. The teachers had a small and non-significant reduction in the same period and did not show a positive effect after starting pedagogical work.

  19. Factors associated with financial distress of nonprofit hospitals.

    Science.gov (United States)

    Kim, Tae Hyun

    2010-01-01

    Financial distress can have a detrimental influence on the performance of hospitals. Hospital management needs to monitor potential financial distress effectively and know how it will respond depending on the severity of the circumstances. This study examined the multiple factors that may explain the financial distress of nonprofit hospitals during 1998 to 2001 and discussed their importance. To obtain more robust results, financial distress was assessed in 2 ways: first, financial strength index was used to incorporate 4 financial dimensions including profitability, liquidity, leverage, and physical facilities; second, cash flow (CF) was used to address the issues of accrual-based accounting in hospitals. This study finds that decrease in occupancy rate and increase in Medicaid payer mix, health maintenance organization penetration, market competition, physician supply, and percentage of the elderly are associated with increased likelihood of financial distress of urban hospitals. Increases in both Medicare and Medicaid payer mix, however, are related to higher likelihood of financial distress of rural hospitals.

  20. Assessment of Distress Associated to Psychopathology in Children and Adolescents

    Directory of Open Access Journals (Sweden)

    Wendy Reich

    2009-04-01

    Full Text Available The aim of this paper was to study the distress associated to psychopathology in children and adolescents. The sample included 330 children aged 8 to 17 years attending outpatient mental health services of the public network in Barcelona(Spain assessed using a structured diagnostic interview. A substantial part of children brought to treatment suffered distress associated to internalizing and externalizing psychological symptoms. Psychological distress was most frequent among girls and among adolescents, and was more frequently reported by children and adolescents than by their parents. It was also a marker of perception of need of psychological help, and it was significantly related to diagnosis, subthreshold conditions and functional impairment. Individual symptoms of depression, dysthymia, generalized anxiety disorder and oppositional defiant disorder were most associated with psychological distress. Given the potential importance of subjective distress as well as impairment for the identification and definition of psychopathology and planning of treatment, diagnostic assessment should include questions related to distress.

  1. Psychological distress two years after diagnosis of breast cancer

    DEFF Research Database (Denmark)

    Bleiker, E M; Pouwer, F; Van Der Ploeg, Henk M

    2000-01-01

    on two occasions. Two months after surgery, patients completed questionnaires measuring psychosocial variables (e.g., stressful life-events, health complaints, sleep problems, social support, subjective distress, personality factors), demographic and biomedical variables (e.g., TNM status, type...... of distress were: intrusive thoughts about the disease, trait-anxiety, health complaints and problems with sleeping. No significant association was found between previous life-events, social support or biomedical variables and levels of distress....

  2. Nurse moral distress: A survey identifying predictors and potential interventions.

    Science.gov (United States)

    Rathert, Cheryl; May, Douglas R; Chung, Hye Sook

    2016-01-01

    Ethical dilemmas and conflicts are inherent in today's health care organizations and may lead to moral distress, which is often associated with physical and psychological symptoms. Although the existence of moral distress has been observed by scholars for decades, most of the research has been descriptive and has examined what types of health care conflicts lead to distress. This study tested a comprehensive model, underpinned by Social Cognitive Theory, that examined work environment and intrapersonal variables that may influence moral distress. We surveyed nursing staff employed in a U.S. acute care hospital (response rate=45%; n=290). More than half of the respondents reported they experience ethical dilemmas and conflicts from several times a month to daily, and nearly half reported they experience moral distress at least several times a month. Structural equation modeling analysis simultaneously examined the effects of five independent variables on moral distress and moral voice: (a) frequency of ethical dilemmas and conflicts; (b) moral efficacy; (c) ethics communication; (d) ethical environment; and (e) organizational ethics support. Results revealed significant independent effects of the frequency of ethics issues and organizational ethics support on moral distress. Bootstrapping analysis indicated that voice fully mediated the relationship between moral efficacy and moral distress, and partially mediated the relationship between organizational ethics support and distress. Supplemental analysis revealed that organizational ethics support moderated the moral efficacy-voice-moral distress relationship such that when organizational support was low, moral efficacy was negatively related to moral distress via voice. Although it may be impossible to eliminate all ethical dilemmas and conflicts, leaders and organizations may wish to help improve nurses' moral efficacy, which appears to give rise to voice, and reduced moral distress. Increasing organizational

  3. Predicting financial distress in teaching hospitals.

    Science.gov (United States)

    Langabeer, Jim

    2006-01-01

    Despite the prestige and reputation of teaching hospitals, as a group they are in financial distress. If this trend continues, one would expect to see a higher incidence of mergers and acquisitions or divestitures of assets and services, and other strategies designed to combat failing businesses. Nearly one out of every six teaching hospitals sampled was predicted to be near immediate bankruptcy, and the overwhelming majority was not far behind. It will take a significant effort for these hospitals to continue to treat their operations as a clinical and research "business," but they must do just that if they are to survive the continually turbulent market.

  4. Neuroleptic-induced acute respiratory distress syndrome

    Directory of Open Access Journals (Sweden)

    Francisco Garcia Soriano

    Full Text Available CONTEXT: A case of neuroleptic malignant syndrome and acute respiratory distress syndrome is presented and discussed with emphasis on the role of muscle relaxation, creatine kinase, and respiratory function tests. CASE REPORT: A 41-year-old man presented right otalgia and peripheral facial paralysis. A computed tomography scan of the skull showed a hyperdense area, 2 cm in diameter, in the pathway of the anterior intercommunicating cerebral artery. Preoperative examination revealed: pH 7.4, PaCO2 40 torr, PaO2 80 torr (room air, Hb 13.8 g/dl, blood urea nitrogen 3.2 mmol/l, and creatinine 90 mmol/l. The chest x-ray was normal. The patient had not eaten during the 12-hour period prior to anesthesia induction. Intravenous halothane, fentanyl 0.5 mg and droperidol 25 mg were used for anesthesia. After the first six hours, the PaO2 was 65 torr (normal PaCO2 with FiO2 50% (PaO2/FiO2 130, and remained at this level until the end of the operation 4 hours later, maintaining PaCO2 at 35 torr. A thrombosed aneurysm was detected and resected, and the ends of the artery were closed with clips. No vasospasm was present. This case illustrates that neuroleptic drugs can cause neuroleptic malignant syndrome associated with acute respiratory distress syndrome. Neuroleptic malignant syndrome is a disease that is difficult to diagnose. Acute respiratory distress syndrome is another manifestation of neuroleptic malignant syndrome that has not been recognized in previous reports: it may be produced by neuroleptic drugs independent of the manifestation of neuroleptic malignant syndrome. Some considerations regarding the cause and effect relationship between acute respiratory distress syndrome and neuroleptic drugs are discussed. Intensive care unit physicians should consider the possibility that patients receiving neuroleptic drugs could develop respiratory failure in the absence of other factors that might explain the syndrome.

  5. Household Financial Distress and Initial Endowments

    DEFF Research Database (Denmark)

    Olafsson, Arna

    2016-01-01

    This paper studies in utero exposure to the 2008 financial crisis. Exploiting the sudden and unexpected collapse of the Icelandic economy, I find that first-trimester exposure to the crisis led to a sizable and significant reduction in birth weight, increased the probability of a low birth weight...... – because children with worse health at birth can expect substantially lower lifetime earnings – and suggest that economic hardships may in general exacerbate income inequalities in the long run as low-income households are typically more exposed to financial distress....

  6. Development of a distress inventory for cancer: preliminary results.

    Directory of Open Access Journals (Sweden)

    Thomas B

    2002-01-01

    Full Text Available CONTEXT: Advances in cancer treatment have led to cure and prolongation of patients′ lives; however associated psychosocial problems, including distress, can detrimentally affect patients′ compliance with treatment and ultimately, their outcome. Symptom distress has been well addressed in many studies; however, psychological distress has only been quantified by using depression or anxiety scales/checklists or quality of life scales containing a distress sub scale/component or by the use of scales that are not psychological distress-specific. AIMS: The present study is an attempt to construct a psychological distress inventory for specific use with cancer patients. SETTINGS AND DESIGN: The standardisation sample consisted of 63 randomly selected patients with head and neck cancer who had undergone/ were undergoing curative treatment at the Regional Cancer Centre, Trivandrum. PATIENTS AND METHODS: The Distress Inventory for Cancer contained 57 positively and negatively toned items. An item analysis was conducted, followed by a factor analysis, thereby identifying the domains influencing distress. RESULTS: The final questionnaire contained 26 items subdivided into four domains viz. the personal, spiritual, physical, and the family domains, with each domain providing a sub score. The reliability coefficient (Cronbach′s alpha of the scale was found to be 0.85. CONCLUSIONS: These are the preliminary results of an ongoing study on global distress and tool development process. Reported here is the first step towards development of such tool.

  7. Confronting moral distress in Nursing: recognizing nurses as moral agents

    Directory of Open Access Journals (Sweden)

    Franco A. Carnevale

    2013-09-01

    Full Text Available The concept of moral distress has brought forth a substantively different way of understanding some of the difficulties confronted by nurses in their practice. This concept highlights that nurses' distress can be an indication of nurses' conscientious moral engagement with their professional practice that has confronted practices or an environment that impedes them from acting according to their own ethical standards. Moral distress can be an indicator of problems in nurses' practice environments. This concept is described and related to moral agency in nursing practice. Selected research on moral distress is reviewed, followed by a discussion of recommendations for addressing this problem.

  8. CE: Moral Distress: A Catalyst in Building Moral Resilience.

    Science.gov (United States)

    Rushton, Cynda Hylton; Caldwell, Meredith; Kurtz, Melissa

    2016-07-01

    : Moral distress is a pervasive problem in the nursing profession. An inability to act in alignment with one's moral values is detrimental not only to the nurse's well-being but also to patient care and clinical practice as a whole. Moral distress has typically been seen as characterized by powerlessness and victimization; we offer an alternate view. Ethically complex situations and experiences of moral distress can become opportunities for growth, empowerment, and increased moral resilience. This article outlines the concept and prevalence of moral distress, describes its impact and precipitating factors, and discusses promising practices and interventions.

  9. Moral distress experienced by nurses: a quantitative literature review.

    Science.gov (United States)

    Oh, Younjae; Gastmans, Chris

    2015-02-01

    Nurses are frequently confronted with ethical dilemmas in their nursing practice. As a consequence, nurses report experiencing moral distress. The aim of this review was to synthesize the available quantitative evidence in the literature on moral distress experienced by nurses. We appraised 19 articles published between January 1984 and December 2011. This review revealed that many nurses experience moral distress associated with difficult care situations and feel burnout, which can have an impact on their professional position. Further research is required to examine worksite strategies to support nurses in these situations and to develop coping strategies for dealing with moral distress.

  10. Healthcare provider moral distress as a leadership challenge.

    Science.gov (United States)

    Bell, Jennifer; Breslin, Jonathan M

    2008-01-01

    Healthcare leaders are responsible for using strategies to promote an organizational ethical climate. However, these strategies are limited in that they do not directly address healthcare provider moral distress. Since healthcare provider moral distress and the establishment of a positive ethical climate are both linked to an organization's ability to retain healthcare professionals and increase their level of job satisfaction, leaders have a corollary responsibility to address moral distress. We recommend that leaders should provide access to ethics education and resources, offer interventions such as ethics debriefings, establish ethics committees, and/or hire a bioethicist to develop ethics capacity and to assist with addressing healthcare provider moral distress.

  11. Reduction in mental distress among substance users receiving inpatient treatment

    Directory of Open Access Journals (Sweden)

    Friborg Oddgeir

    2010-12-01

    Full Text Available Abstract Background Substance users being admitted to inpatient treatment experience a high level of mental distress. In this study we explored changes in mental distress during treatment. Methods Mental distress, as measured by the HSCL-10, was registered at admission and at discharge among 164 substance users in inpatient treatment in Northern Norway. Predictors of reduction in mental distress were examined utilizing hierarchical regression analysis. Results We found a significant reduction in mental distress in the sample, but the number of patients scoring above cut-off on the HSCL-10 at discharge was still much higher than in the general population. A more severe use of substances as measured by the AUDIT and the DUDIT, and being female, predicted a higher level of mental distress at admission to treatment as well as greater reduction in mental distress during treatment. Holding no education beyond 10 year compulsory school only predicted a reduction in mental distress. Conclusions The toxic and withdrawal effects of substances, level of education as well as gender, contributed to the differences in change in mental distress during treatment. Regression to the mean may in part explain some of the findings.

  12. Class size versus class composition

    DEFF Research Database (Denmark)

    Jones, Sam

    Raising schooling quality in low-income countries is a pressing challenge. Substantial research has considered the impact of cutting class sizes on skills acquisition. Considerably less attention has been given to the extent to which peer effects, which refer to class composition, also may affect...... outcomes. This study uses new microdata from East Africa, incorporating test score data for over 250,000 children, to compare the likely efficacy of these two types of interventions. Endogeneity bias is addressed via fixed effects and instrumental variables techniques. Although these may not fully mitigate...

  13. [Latent classes of personality disorders: group comparisons and course of psychotherapy].

    Science.gov (United States)

    Lange, Julia; Schöttke, Henning

    2013-09-01

    Using latent class analysis the Personality Disorder Screening (PDS) classifies patients into 4 groups: personality disordered (PD) patients (PDS+), healthy patients (PDS -) and 2 hybrid classes with exaggerated personality styles (histrionic/dependent and avoidant/obsessive-compulsive). The present study investigated if the PDS groups differ concerning sociodemographic and clinical variables, psychological distress and treatment outcome. We analyzed the PDS response patterns of 555 outpatients. PDS+ group membership is associated with typical PD characteristics, chronic depression and a high level of general psychological distress. Patients of both hybrid classes are found to show average psychological distress. The treatment was effective for all patients. Membership in the histrionic/dependent hybrid class is associated with early drop out from outpatient therapy.

  14. 47 CFR 80.335 - Procedures for canceling false distress alerts.

    Science.gov (United States)

    2010-10-01

    ... the distress alert orally over the telephony distress traffic channel associated with each DSC channel... DSC channel on which the distress alert was transmitted; and (3) Tune for radiotelephony transmission... telephony distress traffic channel associated with each DSC channel on which the distress alert...

  15. Mental distress: strategies of sense-making.

    Science.gov (United States)

    Cardano, Mario

    2010-05-01

    The irruption of severe mental distress into the life of an individual determines a deep biographical disruption. To cope with this crisis, individuals are involved in a laborious sense-making activity, through the composition of narratives intended to create a new link between past, present and future. This essay analyses the sense-making strategies that follow this dramatic experience through the comparison of four illness narratives composed by Italian participants. The narratives are selected from a broader textual corpus in a way that authorizes their connotation as 'flesh and blood' ideal types. These narratives illustrate three kinds of explanation for the outset of mental distress: the biomedical adopted by Vito; the spiritual-religious adopted by Marta; and the psycho-social adopted by Giacomo. Vito, Marta and Giacomo are still inside the story they are telling, and compose the events by observing them through the eyes of a patient, qualifying their diversity as a stigma. The fourth narrative is different, composed by Serena, a 'voices hearer' who comes to terms with her voices not by silencing them with drugs, but by accepting them as a charisma that has transformed her into a medium and, on final analysis, a balanced woman.

  16. Assessment of work intensification by managers and psychological distressed and non-distressed employees: a multilevel comparison.

    Science.gov (United States)

    Bamberger, Simon Grandjean; Larsen, Anelia; Vinding, Anker Lund; Nielsen, Peter; Fonager, Kirsten; Nielsen, René Nesgaard; Ryom, Pia; Omland, Øyvind

    2015-01-01

    Work intensification is a popular management strategy to increase productivity, but at the possible expense of employee mental stress. This study examines associations between ratings of work intensification and psychological distress, and the level of agreement between compared employee-rated and manager-rated work intensification. Multi-source survey data were collected from 3,064 employees and 573 company managers from the private sector in 2010. Multilevel regression models were used to compare different work intensification ratings across psychological distress strata. Distressed employees rated higher degree of total work intensification compared to non-distressed employees, and on three out of five sub ratings there were an increased prevalence of work intensification in the case group. In general, there was poor agreement between employee and company work intensification rating. Neither manager-rated work intensification nor employee/manager discrepancy in work intensification ratings was associated with psychological distress. Distressed employees had a higher total score of employee/manager agreed work intensification, and a higher prevalence of increased demands of labour productivity. This study demonstrates higher ratings of employee/manager agreed work intensification in distressed employees compared to non-distressed employees, challenging previous findings of reporting bias in distressed employees' assessment of work environment.

  17. Extreme Velocity Wind Sensor

    Science.gov (United States)

    Perotti, Jose; Voska, Ned (Technical Monitor)

    2002-01-01

    This presentation provides an overview of the development of new hurricane wind sensor (Extreme Velocity Wind Sensor) for the Kennedy Space Center (KSC) which is designed to withstand winds of up to three hundred miles an hour. The proposed Extreme Velocity Wind Sensor contains no moveable components that would be exposed to extreme wind conditions. Topics covered include: need for new hurricane wind sensor, conceptual design, software applications, computational fluid dynamic simulations of design concept, preliminary performance tests, and project status.

  18. A philosophical taxonomy of ethically significant moral distress.

    Science.gov (United States)

    Thomas, Tessy A; McCullough, Laurence B

    2015-02-01

    Moral distress is one of the core topics of clinical ethics. Although there is a large and growing empirical literature on the psychological aspects of moral distress, scholars, and empirical investigators of moral distress have recently called for greater conceptual clarity. To meet this recognized need, we provide a philosophical taxonomy of the categories of what we call ethically significant moral distress: the judgment that one is not able, to differing degrees, to act on one's moral knowledge about what one ought to do. We begin by unpacking the philosophical components of Andrew Jameton's original formulation from his landmark 1984 work and identify two key respects in which that formulation remains unclear: the origins of moral knowledge and impediments to acting on that moral knowledge. We then selectively review subsequent literature that shows that there is more than one concept of moral distress and that explores the origin of the values implicated in moral distress and impediments to acting on those values. This review sets the stage for identifying the elements of a philosophical taxonomy of ethically significant moral distress. The taxonomy uses these elements to create six categories of ethically significant moral distress: challenges to, threats to, and violations of professional integrity; and challenges to, threats to, and violations of individual integrity. We close with suggestions about how the proposed philosophical taxonomy of ethically significant moral distress sheds light on the concepts of moral residue and crescendo effect of moral distress and how the proposed taxonomy might usefully guide prevention of and future qualitative and quantitative empirical research on ethically significant moral distress. © The Author 2014. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  19. How extreme is extreme hourly precipitation?

    Science.gov (United States)

    Papalexiou, Simon Michael; Dialynas, Yannis G.; Pappas, Christoforos

    2016-04-01

    The importance of accurate representation of precipitation at fine time scales (e.g., hourly), directly associated with flash flood events, is crucial in hydrological design and prediction. The upper part of a probability distribution, known as the distribution tail, determines the behavior of extreme events. In general, and loosely speaking, tails can be categorized in two families: the subexponential and the hyperexponential family, with the first generating more intense and more frequent extremes compared to the latter. In past studies, the focus has been mainly on daily precipitation, with the Gamma distribution being the most popular model. Here, we investigate the behaviour of tails of hourly precipitation by comparing the upper part of empirical distributions of thousands of records with three general types of tails corresponding to the Pareto, Lognormal, and Weibull distributions. Specifically, we use thousands of hourly rainfall records from all over the USA. The analysis indicates that heavier-tailed distributions describe better the observed hourly rainfall extremes in comparison to lighter tails. Traditional representations of the marginal distribution of hourly rainfall may significantly deviate from observed behaviours of extremes, with direct implications on hydroclimatic variables modelling and engineering design.

  20. Comparison of spatial extreme value models for snow depth extremes in Austria

    Science.gov (United States)

    Schellander, Harald; Hell, Tobias

    2017-04-01

    In Alpine regions like Austria a spatial representation of extreme snow depth is of crucial importance for numerous purposes such as the designing of construction projects. Extreme value theory builds the well-established foundation of modeling extremes. Two different approaches for the spatial modeling of snow depth extremes have been extensively investigated lately: Smooth Spatial Modeling (Blanchet and Lehning, 2010) and different classes of max-stable processes (Blanchet and Davison, 2011; Nicolet et al., 2015), both outperforming classical interpolation techniques. While max-stable models are generally considered as improvement over smooth modeling, the methods have not been compared in the context of extreme snow depth. In the present study a great variety of different GEV models is fitted to seasonal snow depth maxima measured at more than 200 Austrian weather stations. Return levels of smooth spatial models and several max-stable representations (Schlather, Brown-Resnick, Geometric Gaussian, Extremal-t) and covariance models (Powered Exponential, Brown, Whittle-Matern), also allowing for anisotropic extremal dependence are compared by a modified Anderson-Darling score and a normalized RMSE. Preliminary results show, that for snow depth extremes in Austria smooth spatial modeling and a version with extremal coefficients as covariates deliver slightly better scores than (an)-isotropic max-stable models.

  1. Distress tolerance is linked to unhealthy eating through pain catastrophizing.

    Science.gov (United States)

    Emami, Ashley S; Woodcock, Anna; Swanson, Heidi E; Kapphahn, Teresa; Pulvers, Kim

    2016-12-01

    Low distress tolerance, an important component of emotion regulation, is a risk factor for unhealthy eating. Identifying factors which explain the link between distress tolerance and unhealthy eating can advance the understanding of problematic eating and inform prevention and treatment of obesity and eating disorders. The present study examines pain catastrophizing as a mediator between distress tolerance and unhealthy eating in a nonclinical population, which has received little attention despite being a risk factor for unhealthy eating behaviors. The Distress Tolerance Scale (DTS), Pain Catastrophizing Scale (PCS), and the Dutch Eating Behavior Questionnaire (DEBQ), were administered to 171 college students (62.6% female, 38.6% White, 28.1% Hispanic). There was no evidence of a significant direct effect of distress tolerance on unhealthy eating. However, as hypothesized, there was a significant indirect or mediated effect of pain catastrophizing on the relationship between distress tolerance and unhealthy eating. Individuals low in distress tolerance reported higher pain catastrophizing, and a result, these individuals also reported higher levels of unhealthy eating. These findings introduce pain catastrophizing as an influential variable in the link between distress tolerance and unhealthy eating. Findings suggest that reducing catastrophic thinking about pain may be a worthy target of intervention in reducing unhealthy eating. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. BABY EMPATHY: INFANT DISTRESS AND PEER PROSOCIAL RESPONSES.

    Science.gov (United States)

    Liddle, Mitzi-Jane E; Bradley, Ben S; Mcgrath, Andrew

    2015-01-01

    Empathy is an important competence in our social world, a motivator of prosocial behavior, and thought to develop throughout the second year of life. The current study examined infants' responses to naturalistic peer distress to explore markers of empathy and prosocial behavior in young babies. Seventeen 8-month-old infants participated in a repeated measures design using the "babies-in-groups" paradigm, with maternal presence as the independent variable. Significant differences were found between response types: Gaze was the standard response to infant distress, followed by socially directed behaviors and affect, with self-distress rarely occurring. Maternal presence was not found to impact the nature or frequency of babies' responses to peer distress. During distress episodes, babies looked preferentially at the distressed peer, then other mothers, and least to their own mother. Data revealed that infant responses to peer distress resulted in a successful cessation of that distress episode over one third of the time. Case studies are provided to illustrate the quantitative data. The results provided evidence of empathic concern and prosocial behavior in the first year of life, and provoke a challenge to developmental theories of empathy. © 2015 Michigan Association for Infant Mental Health.

  3. Psychological distress and mortality in systolic heart failure

    DEFF Research Database (Denmark)

    Pelle, Aline J; Pedersen, Susanne S.; Schiffer, Angélique A

    2010-01-01

    Depression, anxiety, and type D ("distressed") personality (tendency to experience negative emotions paired with social inhibition) have been associated with poor prognosis in coronary heart disease, but little is known about their role in chronic heart failure. Therefore, we investigated whether...... these indicators of psychological distress are associated with mortality in chronic heart failure....

  4. Pulmonary and extrapulmonary acute respiratory distress syndrome: myth or reality?

    Science.gov (United States)

    Rocco, Patricia R M; Pelosi, Paolo

    2008-02-01

    The pathogenesis of acute respiratory distress syndrome has been explained by the presence of a direct (pulmonary) or indirect (extrapulmonary) insult to the lung parenchyma. Evidence indicates that the pathophysiology of acute respiratory distress syndrome may differ according to the type of the insult. This article presents a brief overview of the differences between pulmonary and extrapulmonary acute respiratory distress syndrome, and discusses the interactions between lung functional, morphological aspects, and response to different therapies, both in experimental models and in patients with acute respiratory distress syndrome. Many researchers recognize that experimental pulmonary and extrapulmonary acute respiratory distress syndrome are not identical when considering morpho-functional aspects, the response to positive end-expiratory pressure and recruitment manoeuvre, prone position and other adjunctive therapies. Contradictory results have been reported in different clinical studies, however, which may be attributed to the difficulty of classifying acute respiratory distress syndrome in one or the other category, and being confident of the onset, the phase and the severity of acute respiratory distress syndrome in all patients. Heterogeneous acute respiratory distress syndrome patients are still considered to suffer from one syndrome, and are treated in the same way. Understanding the range of different pathways that lead to pulmonary dysfunction makes it possible to better target clinical treatment.

  5. Joy, Distress, Hope, and Fear in Reinforcement Learning (Extended Abstract)

    NARCIS (Netherlands)

    Jacobs, E.J.; Broekens, J.; Jonker, C.M.

    2014-01-01

    In this paper we present a mapping between joy, distress, hope and fear, and Reinforcement Learning primitives. Joy / distress is a signal that is derived from the RL update signal, while hope/fear is derived from the utility of the current state. Agent-based simulation experiments replicate psychol

  6. Psychological Distress and Pain Reporting in Australian Coal Miners

    Directory of Open Access Journals (Sweden)

    Kristy N. Carlisle

    2014-12-01

    Conclusion: The study findings support the existence of widespread musculoskeletal pain among the coal-mining workforce, and this pain is associated with increased psychological distress. Operators (truck drivers and workers reporting poor sleep quality during work periods are most likely to report increased distress, which highlights the importance of supporting the mining workforce for sustained productivity.

  7. What is the best measure for assessing diabetes distress?

    DEFF Research Database (Denmark)

    Fenwick, Eva K; Rees, Gwyn; Holmes-Truscott, Elizabeth

    2017-01-01

    This study used Rasch analysis to examine the psychometric validity of the Diabetes Distress Scale and the Problem Areas in Diabetes scale to assess diabetes distress in 3338 adults with diabetes (1609 completed the Problem Areas in Diabetes scale (n = 675 type 1 diabetes; n = 934 type 2 diabetes...

  8. Psychological Distress and Mortality: Are Women More Vulnerable?

    Science.gov (United States)

    Ferraro, Kenneth F.; Nuriddin, Tariqah A.

    2006-01-01

    Does psychological distress increase mortality risk? If it does, are women more vulnerable than men to the effect of distress on mortality? Drawing from cumulative disadvantage theory, these questions are addressed with data from a 20-year follow-up of a national sample of adults ages 25-74. Event history analyses were performed to examine…

  9. 46 CFR 117.68 - Distress flares and smoke signals.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Distress flares and smoke signals. 117.68 Section 117.68 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS CARRYING MORE... AND ARRANGEMENTS Emergency Communications § 117.68 Distress flares and smoke signals. (a)...

  10. Relaxation Training and Expectation in the Treatment of Postpartum Distress.

    Science.gov (United States)

    Halonen, Jane S.; Passman, Richard H.

    1985-01-01

    Examined the effectiveness of relaxation training in reducing postpartum distress for 48 first-time mothers-to-be via a treatment-component strategy. Compared with nonrelaxation conditions, relaxation treatments reduced reported postpartal distress. Expectations about treatment effectiveness were not significant factors in treatment outcome.…

  11. 46 CFR 180.68 - Distress flares and smoke signals.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Distress flares and smoke signals. 180.68 Section 180.68... signals. (a) Oceans, coastwise, limited coastwise, and Great Lakes routes. A vessel on an oceans, coastwise, limited coastwise, or Great Lakes route must carry— (1) Six hand red flare distress signals...

  12. Marital Distress and Mental Health Care Service Utilization

    Science.gov (United States)

    Schonbrun, Yael Chatav; Whisman, Mark A.

    2010-01-01

    Objective: This study was designed to evaluate the association between marital distress and mental health service utilization in a population-based sample of men and women (N = 1,601). Method: The association between marital distress and mental health care service utilization was evaluated for overall mental health service utilization and for…

  13. Psychological Distress of Caregivers: The Mediator Effect of Caregiving Appraisal.

    Science.gov (United States)

    Pot, A. M.; Deeg, D. J. H.; van Dyck, R.; Jonker, C.

    1998-01-01

    Examines whether the role of caregiving appraisal explains why stressors in the caregiving situation affect caregivers' psychological distress. Results show that for spouse caregivers, perceived pressure explains the association between their caregiving tasks and psychological distress. Results also show clear mediator effects of perceived…

  14. Moral distress and burnout in internal medicine residents

    Science.gov (United States)

    Sajjadi, Sharareh; Norena, Monica; Wong, Hubert; Dodek, Peter

    2017-01-01

    Background Residents frequently encounter situations in their workplace that may induce moral distress or burnout. The objective of this study was to measure overall and rotation-specific moral distress and burnout in medical residents, and the relationship between demographics and moral distress and burnout. Methods The revised Moral Distress Scale and the Maslach Burnout Inventory (Human Service version) were administered to Internal Medicine residents in the 2013–2014 academic year at the University of British Columbia. Results Of the 88 residents, 45 completed the surveys. Participants (mean age 30+/−3; 46% male) reported a median moral distress score (interquartile range) of 77 (50–96). Twenty-six percent of residents had considered quitting because of moral distress, 21% had a high level of burnout, and only 5% had a low level of burnout. Moral distress scores were highest during Intensive Care Unit (ICU) and Clinical Teaching Unit (CTU) rotations, and lowest during elective rotations (pburnout were associated with intention to leave the job. Conclusion Internal Medicine residents report moral distress that is greatest during ICU and CTU rotations, and is associated with burnout and intention to leave the job.

  15. Examining Victimization and Psychological Distress in Transgender College Students

    Science.gov (United States)

    Effrig, Jessica C.; Bieschke, Kathleen J.; Locke, Benjamin D.

    2011-01-01

    Treatment-seeking and non-treatment-seeking transgender college students were examined with regard to victimization and psychological distress. Findings showed that transgender college students had elevated rates of distress as compared with college students who identified as men or women. Results indicated that treatment-seeking and non-treatment…

  16. The Role of Emotional Dysregulation in Perfectionism and Psychological Distress

    Science.gov (United States)

    Aldea, Mirela A.; Rice, Kenneth G.

    2006-01-01

    Data from a sample of university students (N = 349) were used to test a model in which emotional dysregulation (a composite of emotional reactivity and splitting) was expected to account for the effect of perfectionism on general psychological distress. Significant positive effects were observed between maladaptive perfectionism and distress,…

  17. Preoperative distress predicts persistent pain after breast cancer treatment

    DEFF Research Database (Denmark)

    Mejdahl, Mathias Kvist; Mertz, Birgitte Goldschmidt; Bidstrup, Pernille Envold Hansen;

    2015-01-01

    at the Department of Breast Surgery, Rigshospitalet, Denmark, were invited to participate in the study. Patients filled out a questionnaire preoperatively, and 4 and 8 months after surgery. Preoperative distress was measured with the Distress Thermometer (DT; 11-point scale, 0-10). We examined the association...

  18. A neonate with respiratory distress and a chest wall deformity.

    Science.gov (United States)

    Kerrey, Benjamin; Reed, Jennifer

    2007-08-01

    Infants with respiratory distress commonly present to a pediatric emergency department. There are rare but serious conditions that need to be considered in the differential diagnosis. We report the history of an infant that presented to our institution with respiratory distress ultimately diagnosed with a mesenchymal hamartoma of the chest wall. The presentation, diagnosis, and treatment options for mesenchymal hamartoma are discussed.

  19. Sexual Abuse Victimization and Psychological Distress among Adolescent Offenders.

    Science.gov (United States)

    Phan, Debra L.; Kingree, J. B.

    2001-01-01

    This study focused on sexual abuse victimization and psychological distress among 272 adolescent offenders. Female respondents reported more sexual abuse victimization and psychological distress than did their male counterparts. Furthermore, church attendance moderated the association between sexual abuse victimization and psychological distress…

  20. Effects of screening for psychological distress on patient outcomes in cancer : A systematic review

    NARCIS (Netherlands)

    Meijer, Anna; Roseman, Michelle; Delisle, Vanessa C.; Milette, Katherine; Levis, Brooke; Syamchandra, Achyuth; Stefanek, Michael E.; Stewart, Donna E.; de Jonge, Peter; Coyne, James C.; Thombs, Brett D.

    2013-01-01

    Objective: Several practice guidelines recommend routine screening for psychological distress in cancer care. The objective was to evaluate the effect of screening cancer patients for psychological distress by assessing the (1) effectiveness of interventions to reduce distress among patients identif

  1. Effects of screening for psychological distress on patient outcomes in cancer : A systematic review

    NARCIS (Netherlands)

    Meijer, Anna; Roseman, Michelle; Delisle, Vanessa C.; Milette, Katherine; Levis, Brooke; Syamchandra, Achyuth; Stefanek, Michael E.; Stewart, Donna E.; de Jonge, Peter; Coyne, James C.; Thombs, Brett D.

    Objective: Several practice guidelines recommend routine screening for psychological distress in cancer care. The objective was to evaluate the effect of screening cancer patients for psychological distress by assessing the (1) effectiveness of interventions to reduce distress among patients

  2. Acute respiratory distress in a silversmith

    Science.gov (United States)

    Parikh, Jignesh Mukeshkumar; Dhareshwar, Shashank; Sharma, Anand; Karanth, Raghuveer; Ramkumar, V. S.; Ramaiah, Indira

    2014-01-01

    A 25-year-old young male patient presented in casualty department with severe respiratory distress on the fourth day from onset of symptoms. The patient was nonsmoker and had no antecedent medical or drug history. Prior to admission, patient had dry cough and bilateral pleuritic chest pain for the last three days. He was in severe respiratory distress with use of accessory muscles of respiration. On examination, he had heart rate of 120 beats/min, blood pressure (BP) of 150/80, respiratory rate of 48-52/min and central cyanosis present. On systemic examination, reduced intensity of breath sounds with extensive rhonchi and crepitation was found in both lung fields, with other examination being within normal limits. On pulse oximetry, oxygen saturation was 28% on room air, which increased up to 36% with the help of 4 L oxygen via nasal prongs. PaO2/FiO2 ratio was 100. Chest X-ray analysis was suggestive of non-cardiac pulmonary edema in view of bilateral fluffy opacity without cardiomegaly. In view of 2/3 positive criteria, his provisional diagnosis was Acute Respiratory Distress Syndrome (ARDS). He required mechanical ventilatory support and was gradually weaned over a period of 10 days. The patient was treated with broad spectrum antibiotics and other supportive measures. On re-evaluation of history, we found that he was a goldsmith by occupation, smelting silver and gold for the past 8-10 years. On the day of onset of symptoms, while smelting silver he was exposed to golden yellow fumes for around 15 minutes, with the quantum of exposure more than any other day earlier. From previous experience and analysis of similar silver metals, he was able to tell us that the silver was adulterated with large amount of cadmium on that day than before. Serum level of cadmium was 2.9 μg/L 6 days after initial exposure. At the time of discharge, he had residual opacities in the chest radiograph and resting oxygen saturation was 94% on room air. PMID:25006313

  3. Acute respiratory distress in a silversmith

    Directory of Open Access Journals (Sweden)

    Jignesh Mukeshkumar Parikh

    2014-01-01

    Full Text Available A 25-year-old young male patient presented in casualty department with severe respiratory distress on the fourth day from onset of symptoms. The patient was nonsmoker and had no antecedent medical or drug history. Prior to admission, patient had dry cough and bilateral pleuritic chest pain for the last three days. He was in severe respiratory distress with use of accessory muscles of respiration. On examination, he had heart rate of 120 beats/min, blood pressure (BP of 150/80, respiratory rate of 48-52/min and central cyanosis present. On systemic examination, reduced intensity of breath sounds with extensive rhonchi and crepitation was found in both lung fields, with other examination being within normal limits. On pulse oximetry, oxygen saturation was 28% on room air, which increased up to 36% with the help of 4 L oxygen via nasal prongs. PaO 2 /FiO 2 ratio was 100. Chest X-ray analysis was suggestive of non-cardiac pulmonary edema in view of bilateral fluffy opacity without cardiomegaly. In view of 2/3 positive criteria, his provisional diagnosis was Acute Respiratory Distress Syndrome (ARDS. He required mechanical ventilatory support and was gradually weaned over a period of 10 days. The patient was treated with broad spectrum antibiotics and other supportive measures. On re-evaluation of history, we found that he was a goldsmith by occupation, smelting silver and gold for the past 8-10 years. On the day of onset of symptoms, while smelting silver he was exposed to golden yellow fumes for around 15 minutes, with the quantum of exposure more than any other day earlier. From previous experience and analysis of similar silver metals, he was able to tell us that the silver was adulterated with large amount of cadmium on that day than before. Serum level of cadmium was 2.9 μg/L 6 days after initial exposure. At the time of discharge, he had residual opacities in the chest radiograph and resting oxygen saturation was 94% on room air.

  4. Classifying Returns as Extreme

    DEFF Research Database (Denmark)

    Christiansen, Charlotte

    2014-01-01

    I consider extreme returns for the stock and bond markets of 14 EU countries using two classification schemes: One, the univariate classification scheme from the previous literature that classifies extreme returns for each market separately, and two, a novel multivariate classification scheme tha...

  5. Class distinction

    Science.gov (United States)

    White, M. Catherine

    Typical 101 courses discourage many students from pursuing higher level science and math courses. Introductory classes in science and math serve largely as a filter, screening out all but the most promising students, and leaving the majority of college graduates—including most prospective teachers—with little understanding of how science works, according to a study conducted for the National Science Foundation. Because few teachers, particularly at the elementary level, experience any collegiate science teaching that stresses skills of inquiry and investigation, they simply never learn to use those methods in their teaching, the report states.

  6. An investigation of moral distress experienced by occupational therapists.

    Science.gov (United States)

    Penny, Neil H; Ewing, Timothy L; Hamid, Rachel C; Shutt, Kimberly A; Walter, Amy S

    2014-10-01

    This study used a quantitative survey design to investigate the existence of moral distress among occupational therapists. The Moral Distress Scale-Revised (MDS-R-OHPA) was distributed to a random sample of 600 members of the American Occupational Therapy Association (AOTA). The results of this explorative study found that occupational therapists reported moderate levels of moral distress with occupational therapists working in geriatric settings reporting higher levels of moral distress than occupational therapists who work in physical disability settings, although the difference was not statistically significant. However, occupational therapists who were considering leaving their current position reported the highest levels of moral distress. These initial findings are discussed as well as the need for further research.

  7. Anxious attachment and psychological distress in cardiac rehabilitation patients.

    Science.gov (United States)

    West, M; Sarah Rose, M; Brewis, C S

    1995-06-01

    This study investigated the relevance of anxious attachment to the differentiation of psychologically distressed and non-psychologically distressed cardiac patients. Attachment is a biologically based behavioral system in which proximity to a special other is sought or maintained to achieve a sense of safety and security. Anxious attachment, as the name denotes, fails to achieve the function of attachment in the sense of individuals having little or no confidence in the availability of their attachment figures. Empirically, three scales (feared loss of the attachment figure, proximity seeking and separation protest) capture the features of anxious attachment as elaborated by Bowlby. These scales were administered to 178 cardiac rehabilitation patients drawn from the cardiac rehabilitation program of the Calgary General Hospital. The results indicate that feared loss and proximity seeking differentiated psychologically distressed from non-psychologically distressed patients. The implications of this finding for the understanding of psychologically distressed cardiac patients are discussed.

  8. Emotional distress among adult survivors of childhood cancer.

    Science.gov (United States)

    Oancea, S Cristina; Brinkman, Tara M; Ness, Kirsten K; Krull, Kevin R; Smith, Webb A; Srivastava, D Kumar; Robison, Leslie L; Hudson, Melissa M; Gurney, James G

    2014-06-01

    The purposes of this study were to estimate the prevalence of emotional distress in a large cohort of adult survivors of childhood cancer and to evaluate the interrelationship of risk factors including cancer-related late effects. Adult survivors of childhood cancer (N = 1,863), median age of 32 years at follow-up, completed comprehensive medical evaluations. Clinically relevant emotional distress was assessed using the Brief Symptom Inventory 18 and was defined as T-scores ≥63. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using multivariable logistic regression models to identify risk factors for distress. Path analysis was used to examine associations among identified risk factors. Elevated global distress was reported by 15.1% of survivors. Cancer-related pain was associated with elevated distress (OR 8.72; 95% CI, 5.32-14.31). Survivors who reported moderate learning or memory problems were more likely to have elevated distress than survivors who reported no learning or memory problems (OR 3.27; 95% CI, 2.17-4.93). Path analysis implied that cancer-related pain has a direct effect on distress symptoms and an indirect effect through socioeconomic status and learning or memory problems. Similar results were observed for learning or memory problems. Childhood cancer-related morbidities including pain and learning or memory problems appear to be directly and indirectly associated with elevated distress symptoms decades after treatment. Understanding these associations may help inform intervention targets for survivors of childhood cancer experiencing symptoms of distress. A subset of long-term childhood cancer survivors experience significant emotional distress. Physical and cognitive late effects may contribute to these symptoms.

  9. Impact of ethical climate on moral distress revisited: multidimensional view.

    Science.gov (United States)

    Atabay, Gülem; Çangarli, Burcu Güneri; Penbek, Şebnem

    2015-02-01

    Moral distress is a major problem in nursing profession. Researchers identified that the stronger the ethical basis of the organization, the less moral distress is reported. However, different ethical climates may have different impacts on moral distress. Moreover, conceptualization of moral distress and ethical climate as well as their relationship may change according to the cultural context. The main aim of the study is to investigate the relationship between different types of ethical climate as described in Victor and Cullen's framework, and moral distress intensity among nurses in Turkish healthcare settings. An online survey was administrated to collect data. Questionnaires included moral distress and ethical climate scales in addition to demographic questions. Data were collected from registered nurses in Turkey. In all, 201 of 279 nurses completed questionnaires, resulting in a response rate of 72%. Ethical approval was obtained from the university to which the authors were affiliated, after a detailed investigation of the content and data collection method. Factor analyses showed that moral distress had three dimensions, namely, organizational constraints, misinformed and over-treated patients, and lack of time and resources, while ethical climate had four types, namely, rules, well-being of stakeholders, individualism, and organizational interests. Positive correlations were identified between certain types of ethical climate (rules, individualism, or organizational interests) and moral distress intensity. Factor distribution of the scales shows some commonalities with the findings of previous research. However, context-specific dimensions and types were also detected. No particular ethical climate type was found to have a negative correlation with moral distress. Recommendations were made for reducing the negative impact of ethical climate on moral distress. These include solving the nursing-shortage problem, increasing autonomy, and improving physical

  10. Longitudinal relationships between workplace bullying and psychological distress.

    Science.gov (United States)

    Nielsen, Morten Birkeland; Hetland, Jørn; Matthiesen, Stig Berge; Einarsen, Ståle

    2012-01-01

    The aims of this study were to examine reciprocal longitudinal associations between exposure to workplace bullying and symptoms of psychological distress and to investigate how self-labeled victimization from bullying explains the effects of bullying on health. Logistic regression analysis was employed to examine the longitudinal relationships between workplace bullying and psychological distress in a representative cohort sample of 1775 Norwegian employees. The time-lag between baseline and follow-up was two years. Exposure to bullying behavior was measured with the revised version of the Negative Acts Questionnaire. Perceived victimization from bullying was measured by a single self-labeling question. Psychological distress was measured with the 25-item Hopkins Symptom Checklist. All variables were measured at both baseline and follow-up. After adjustment for psychological distress at baseline, exposure to bullying behavior [odds ratio (OR) 1.68, 95% confidence interval (95% CI) 1.07-2.62) was found to predict subsequent psychological distress. This effect of bullying behaviors disappeared when victimization from bullying (OR 2.47, 95% CI 1.17-5.22) was entered into the regression. Both psychological distress (OR 2.49, 95% CI 1.64-3.80) and victimization (OR 2.61, 95% CI 1.42-4.81) at baseline were associated with increased risks of being a target of bullying behaviors at follow-up. Psychological distress (OR 2.51, 95% CI 1.39-4.52) and bullying behaviors (OR 2.95, 95% CI 1.39-4.52) at follow-up were associated with victimization. The mutual relationship between bullying and psychological distress indicates a vicious circle where bullying and distress reinforce their own negative effects. This highlights the importance of early interventions to stop workplace bullying and provide treatment options to employees with psychological distress.

  11. ACUTE RESPIRATORY DISTRESS SYNDROME IN PREGNANCY

    Directory of Open Access Journals (Sweden)

    Madhumala

    2015-04-01

    Full Text Available Acute respiratory distress syndrome (ARDS is a clinical syndrome of severe dyspnea of rapid onset, hypoxemia, and diffuse pulmonary infiltrates leading to respiratory failure. ARDS occurs in pregnancy and may have unique causes. Overall mortality for both the mother and the fetus is high and significant morbidity can persist even after initial recovery. ARDS is associated with obstetric causes such as amniotic fluid embolism, preeclampsia, septic abortion, and retained products of conception or non - obstetr ic causes that include sepsis, aspiration pneumonitis, influenza pneumonia, blood transfusions, and trauma. Here is a 24 years old female admitted with 7months of amenorrhea, who presented with respiratory failure, she was intubated and ventilated for 47da ys. She recovered, and a live baby was delivered. She was discharged after 73days.

  12. Psychosocial distress and periodontitis in adolescents

    DEFF Research Database (Denmark)

    Lopez, Rodrigo; Ramírez, Valeria; Marró, Patricio

    2012-01-01

    Periodontitis is an inflammatory disease associated with predominantly gram negative biofilms and characterized by the progressive destruction of the supporting tissues of the teeth. Some studies conducted among adults have found a significant association between periodontitis and dimensions...... of psychosocial distress and it is unclear whether this association can be found among younger subjects in which destruction of periodontal tissues as a result of periodontitis are less severe. Purpose: The main aim of this study was to assess whether adolescents with periodontitis presented with higher scores...... for non-psychotic psychosocial disorders than control subjects without periodontitis. Materials and Methods: We used a case control study (n=160) nested in a well-defined adolescent population (n=9,163) and the 28-item Spanish version of the General Health Questionnaire. The inclusion criterion for being...

  13. EXPRESSING DISTRESS IN PATIENTS WITH ADVANCED CANCER

    Directory of Open Access Journals (Sweden)

    Maura Gabriela FELEA

    2014-11-01

    Full Text Available Negative emotions (distress are recognized as part of the psychological profile of patients diagnosed with advanced stage cancer. However, most patients are not accustomed to verbalize feelings towards their physician, and generally towards family and medical care personnel. The purpose of this paper is to analyze the expression of emotions by patients in advanced stages of cancer, respectively the means by which they get to express emotions. To this respect, we identified the most common types of emotions expressed, or metaphors used by patients to describe their emotions and topics that trigger emotions. Words and phrases most commonly used are in relation to: fear, anxiety, depression, guilt, negligence, concern. They are uttered in order to depict the network created between disclosed emotions and topics on health status, symptoms, adverse effects and therapeutic choice, patient privacy, and social and family issues.

  14. Prone positioning in acute respiratory distress syndrome.

    Science.gov (United States)

    Gibson, Kristy; Dufault, Marlene; Bergeron, Kathy

    2015-08-12

    Acute respiratory distress syndrome (ARDS) is a condition with a high morbidity and mortality rate, and treatment is often long and costly. Prone positioning is a rarely used intervention for patients with this syndrome, although research suggests it may be effective. A literature search was undertaken to examine the effects of prone positioning on oxygenation, morbidity and mortality in patients with ARDS. It revealed that prone positioning, when used with low tidal volume ventilation over an extended period, may reduce mortality rates in selected patients with severe ARDS. The selection of patients with severe ARDS for prone positioning should be done on a case-by-case basis to maximise benefits and minimise complications. Further research is required on the use of prone positioning in patients with severe ARDS to support or disclaim the therapy's use in practice, and to compare confounding variables such as ideal prone duration and mechanical versus manual pronation.

  15. Psychosocial distress and periodontitis in adolescents

    DEFF Research Database (Denmark)

    Lopez, Rodrigo; Ramírez, Valeria; Marró, Patricio

    2012-01-01

    Periodontitis is an inflammatory disease associated with predominantly gram negative biofilms and characterized by the progressive destruction of the supporting tissues of the teeth. Some studies conducted among adults have found a significant association between periodontitis and dimensions...... of psychosocial distress and it is unclear whether this association can be found among younger subjects in which destruction of periodontal tissues as a result of periodontitis are less severe. Purpose: The main aim of this study was to assess whether adolescents with periodontitis presented with higher scores...... for non-psychotic psychosocial disorders than control subjects without periodontitis. Materials and Methods: We used a case control study (n=160) nested in a well-defined adolescent population (n=9,163) and the 28-item Spanish version of the General Health Questionnaire. The inclusion criterion for being...

  16. Sharing, liking, commenting, and distressed? The pathway between Facebook interaction and psychological distress.

    Science.gov (United States)

    Chen, Wenhong; Lee, Kye-Hyoung

    2013-10-01

    Studies on the mental health implications of social media have generated mixed results. Drawing on a survey of college students (N=513), this research uses structural equation modeling to assess the relationship between Facebook interaction and psychological distress and two underlying mechanisms: communication overload and self-esteem. It is the first study, to our knowledge, that examines how communication overload mediates the mental health implications of social media. Frequent Facebook interaction is associated with greater distress directly and indirectly via a two-step pathway that increases communication overload and reduces self-esteem. The research sheds light on new directions for understanding psychological well-being in an increasingly mediated social world as users share, like, and comment more and more.

  17. Pathogenesis of Acute Respiratory Distress Syndrome

    Directory of Open Access Journals (Sweden)

    A. M. Golubev

    2012-01-01

    Full Text Available Acute respiratory distress syndrome (ARDS is a common complication of many diseases. Its polyetiological pattern determines the specific features of lung morphological changes and the clinical course of ARDS. Objective: to analyze the pathogenesis of ARDS in the context of the general pathological processes underlying its development. Material and methods. More than 200 lungs from the people who had died from severe concomitant injury or ARDS-complicated pneumonia were investigated. More than 150 rat experiments simulated various types of lung injury: ventilator-induced lung injury with different ventilation parameters; reperfusion injuries (systemic circulation blockade due to 12-minute vascular fascicle ligation, followed by the recovery of cardiac performance and breathing; microcirculatory disorder (injection of a thromboplastin solution into the jugular vein; blood loss; betaine-pepsin aspiration; and closed chest injury. Different parts of the right and left lungs were histologically examined 1 and 3 hours and 1 and 3 days after initiation of the experiment. Lung pieces were fixed in 10% neutral formalin solution and embedded in paraffin. Histological sections were stained with hematoxylin and eosin and using the van Gieson and Weigert procedures; the Schiff test was used. Results. The influence of aggression factors (trauma, blood loss, aspiration, infection, etc. results in damage to the lung and particularly air-blood barrier structures (endothelium, alveolar epithelium, their basement membrane. In turn the alteration of cellular and extracellular structures is followed by the increased permeability of hemomicrocirculatory bed vessels, leading to the development of non-cardiogenic (interstitial, alveolar pulmonary edema that is a central component in the pathogenesis of ARDS. Conclusion. The diagnosis of the early manifestations of ARDS must account for the nature of an aggression factor, the signs confirming the alteration of the lung

  18. Acute Respiratory Distress Syndrome in Obstetric Patients

    Directory of Open Access Journals (Sweden)

    S. V. Galushka

    2007-01-01

    Full Text Available Objective: to define the specific features of the course of acute respiratory distress syndrome (ARDS in puer-peras with a complicated postpartum period. Subjects and methods. Sixty-seven puerperas with ARDS were examined. Group 1 included 27 puerperas with postpartum ARDS; Group 2 comprised 10 puerperas who had been treated in an intensive care and died; Group 3 consisted of nonobstetric patients with ARDS of various genesis (a control group. Results. In obstetric patients, the baseline oxygenation index was significantly lower than that in the control group. However, Group 1 patients showed a rapid increase in PaO2/FiO2 on days 3—4 of treatment. In the control group, the changes occurred later — on days 5—6. The baseline alveolar-arterial oxygen difference was significantly higher in the obstetric patients than that in the controls. In Group 1, AaDpO2 drastically decreased on days 3—4, which took place in parallel with an increase in the oxygenation index. At the beginning of the study, pulmonary shunting was high in the group of survivors, deceased, and controls. In Group 1, the shunting decreased on days 3—4 whereas in the control group this index normalized later — only by days 6—7. In Group 1, compliance remained lower throughout the observation, but on day 7 there was a significant difference in this index between the deceased, survivors, and controls. Conclusion. Thus, more severe baseline pulmonary gas exchange abnormalities are observed in obstetric patients than in general surgical and traumatological patients; the oxygenation index, alveolar-arterial oxygen difference, and pulmonary shunting index more rapidly change in patients with severe obstetric disease in its favorable course than in general surgical and traumatological patients; throughout the observation, thoracopulmonary compliance was less in obstetric patients than in the controls. Key words: acute respiratory distress syndrome, puerperium.

  19. A Generalization of Uniformly Extremely Convex Banach Spaces

    OpenAIRE

    Suyalatu Wulede; Wurichaihu Bai; Wurina Bao

    2016-01-01

    We discuss a new class of Banach spaces which are the generalization of uniformly extremely convex spaces introduced by Wulede and Ha. We prove that the new class of Banach spaces lies strictly between either the classes of k-uniformly rotund spaces and k-strongly convex spaces or classes of fully k-convex spaces and k-strongly convex spaces and has no inclusive relation with the class of locally k-uniformly convex spaces. We obtain in addition some characterizations and properties of this ne...

  20. Who’s Distressed : A Comparison of Diabetes Related Distress by Type of Diabetes and Medication

    Science.gov (United States)

    2018-04-21

    those groups with elevated ORD. Research Design and Methods : The Diabetes Center of Excellence administered the 17-item Diabetes-related Distress Scale...ORD. Research Design and Methods Wilford Hall Ambulatory Surgical Center Institutional Review Board approval was obtained for this retrospective data...perform additional teaching regarding how to use new equipment (e.g., insulin pens, continuous glucose monitors, insulin pumps, etc.). A patient-centered

  1. 男子游泳二级运动员下肢力量训练方法的实验研究--以保定市游泳业余体校为例%Experimental Study of Men's Swimming Second-class Athletes Lower Extremity Strength Training Methods--Take Baoding Swim Amateur Sports School as an example

    Institute of Scientific and Technical Information of China (English)

    戚务丽

    2014-01-01

    本文以河北省保定市游泳业余体校男子二级运动员共20人为研究对象,选取下蹲、侧箭步蹲、俯卧腿弯曲、水中牵拉等具有针对性的方法与手段对游泳运动员下肢力量训练方法进行实验研究,以期能对提高运动员的竞技能力和运动成绩提供有益参考与借鉴。%In this paper, take Hebei Baoding Amateur Sports School swim second-class men a total of 20 human subjects athletes selected squat, side lunges, prone leg bent, pulling water and other targeted methods and means of Swimmers lower extremity strength training methods experimental study in order to be able to improve athletic ability and athletic performance athletes to provide useful information and reference.

  2. Sequential analysis of mothers' and fathers' reassurance and children's postoperative distress

    National Research Council Canada - National Science Library

    Martin, Sarah R; Chorney, Jill M; Cohen, Lindsey L; Kain, Zeev N

    2013-01-01

    ...") and child distress, but little is known about the causal direction of these interactions. This study examined sequential relations between mothers' and fathers' reassurance and children's distress...

  3. Student Graffiti and Social Class: Clues for Counselors.

    Science.gov (United States)

    Peters, Thomas C.

    1990-01-01

    Executed systematic content analysis on written symbols (graffiti) in a school for delinquent high school boys. Compared graffiti themes by social class. Identified three classes of graffiti: love-courtship-sex; belonging-identity; and extremism. Found little difference between classes on love-courtship-sex theme but significant differences in…

  4. Moving in extreme environments

    DEFF Research Database (Denmark)

    Lucas, Samuel J E; Helge, Jørn W; Schütz, Uwe H W;

    2016-01-01

    This review addresses human capacity for movement in the context of extreme loading and with it the combined effects of metabolic, biomechanical and gravitational stress on the human body. This topic encompasses extreme duration, as occurs in ultra-endurance competitions (e.g. adventure racing...... and transcontinental races) and expeditions (e.g. polar crossings), to the more gravitationally limited load carriage (e.g. in the military context). Juxtaposed to these circumstances is the extreme metabolic and mechanical unloading associated with space travel, prolonged bedrest and sedentary lifestyle, which may...

  5. Extremal surface barriers

    Energy Technology Data Exchange (ETDEWEB)

    Engelhardt, Netta; Wall, Aron C. [Department of Physics, University of California,Santa Barbara, CA 93106 (United States)

    2014-03-13

    We present a generic condition for Lorentzian manifolds to have a barrier that limits the reach of boundary-anchored extremal surfaces of arbitrary dimension. We show that any surface with nonpositive extrinsic curvature is a barrier, in the sense that extremal surfaces cannot be continuously deformed past it. Furthermore, the outermost barrier surface has nonnegative extrinsic curvature. Under certain conditions, we show that the existence of trapped surfaces implies a barrier, and conversely. In the context of AdS/CFT, these barriers imply that it is impossible to reconstruct the entire bulk using extremal surfaces. We comment on the implications for the firewall controversy.

  6. Disentangling depression and distress networks in the tinnitus brain.

    Directory of Open Access Journals (Sweden)

    Kathleen Joos

    Full Text Available Tinnitus is the continuous perception of an internal auditory stimulus. This permanent sound often affects a person's emotional state inducing distress and depressive feelings changes in 6-25% of the affected population. Distress and depression are two distinct emotional states. Whereas distress describes a transient aversive state, interfering with a person's ability to adequately adapt to stressors, depressive feelings should rather be considered as a more constant emotional state. Based on previous observations in chronic pain, posttraumatic stress disorder and depression, we assume that both states are related to separate neural circuits. We used the Dutch version of the Tinnitus Questionnaire to assess the global index of distress together with the Beck Depression Inventory to evaluate the depressive symptoms accompanying tinnitus. Furthermore sLORETA analysis was performed to correlate current density distribution with distress and depression scores, revealing a lateralization effect of depression versus distress. Distress is mainly correlated with alpha 2, beta 1 and beta 2 activity of the right frontopolar cortex and orbitofrontal cortex in combination with beta 2 activation of the anterior cingulate cortex. In contrast, the more permanent depressive alterations induced by tinnitus are associated with activity of alpha 2 activity in the left frontopolar and orbitofrontal cortex. These specific neural circuits are embedded in a greater neural network, with the parahippocampal region functioning as a crucial linkage between both tinnitus related pathways.

  7. Disentangling depression and distress networks in the tinnitus brain.

    Science.gov (United States)

    Joos, Kathleen; Vanneste, Sven; De Ridder, Dirk

    2012-01-01

    Tinnitus is the continuous perception of an internal auditory stimulus. This permanent sound often affects a person's emotional state inducing distress and depressive feelings changes in 6-25% of the affected population. Distress and depression are two distinct emotional states. Whereas distress describes a transient aversive state, interfering with a person's ability to adequately adapt to stressors, depressive feelings should rather be considered as a more constant emotional state. Based on previous observations in chronic pain, posttraumatic stress disorder and depression, we assume that both states are related to separate neural circuits. We used the Dutch version of the Tinnitus Questionnaire to assess the global index of distress together with the Beck Depression Inventory to evaluate the depressive symptoms accompanying tinnitus. Furthermore sLORETA analysis was performed to correlate current density distribution with distress and depression scores, revealing a lateralization effect of depression versus distress. Distress is mainly correlated with alpha 2, beta 1 and beta 2 activity of the right frontopolar cortex and orbitofrontal cortex in combination with beta 2 activation of the anterior cingulate cortex. In contrast, the more permanent depressive alterations induced by tinnitus are associated with activity of alpha 2 activity in the left frontopolar and orbitofrontal cortex. These specific neural circuits are embedded in a greater neural network, with the parahippocampal region functioning as a crucial linkage between both tinnitus related pathways.

  8. Oxidative Stress in Fetal Distress: Potential Prospects for Diagnosis

    Directory of Open Access Journals (Sweden)

    Saša Raicevic

    2010-01-01

    Full Text Available Our aim was to investigate the relation between fetal distress and oxidative stress. Fetal distress was associated with increased concentration of superoxide in the fetal blood and with significant increase of the level of H2O2 in both maternal and fetal blood. The activity of superoxide dismutase was increased roughly sixfold (p < 0.01 in the maternal [7330 ± 2240 U/g of hemoglobin in controls (C and 36811 ± 16862 U/g in fetal distress (FD] and fetal blood (C: 5930 ± 2641 U/g; FD: 41912 ± 17133 U/g. In contrast, fetal distress was related to a considerable decrease of catalase activity in both maternal (C: 26011 ± 8811 U/g; FD: 7212 ± 1270 U/g and fetal blood (C: 37194 ± 9191 U/g; FD: 6173 ± 1965 U/g. From this we concluded that in fetal distress, the maternal and fetal bloods are exposed to superoxide- and H2O2-mediated oxidative stress, which could be initiated by hypoxic conditions in the fetal blood and placenta. A tremendous increase/decrease of the activities of superoxide dismutase/catalase in the blood of women bearing a distressed fetus in comparison to healthy subjects implies that the assessment of superoxide dismutase/catalase activity could be of use for establishing a timely and accurate ante- or intrapartum diagnosis of fetal distress.

  9. Analysis of extreme events

    CSIR Research Space (South Africa)

    Khuluse, S

    2009-04-01

    Full Text Available ) determination of the distribution of the damage and (iii) preparation of products that enable prediction of future risk events. The methodology provided by extreme value theory can also be a powerful tool in risk analysis...

  10. Extreme environments and exobiology.

    Science.gov (United States)

    Friedmann, E I

    1993-01-01

    Ecological research on extreme environments can be applied to exobiological problems such as the question of life on Mars. If life forms (fossil or extant) are found on Mars, their study will help to solve fundamental questions about the nature of life on Earth. Extreme environments that are beyond the range of adaptability of their inhabitants are defined as "absolute extreme". Such environments can serve as terrestrial models for the last stages of life in the history of Mars, when the surface cooled down and atmosphere and water disappeared. The cryptoendolithic microbial community in porous rocks of the Ross Desert in Antarctica and the microbial mats at the bottom of frozen Antarctic lakes are such examples. The microbial communities of Siberian permafrost show that, in frozen but stable communities, long-term survival is possible. In the context of terraforming Mars, selected microorganisms isolated from absolute extreme environments are considered for use in creation of a biological carbon cycle.

  11. Venous Ultrasound (Extremities)

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Ultrasound - Venous (Extremities) Venous ultrasound uses sound waves to ... limitations of Venous Ultrasound Imaging? What is Venous Ultrasound Imaging? Ultrasound is safe and painless, and produces ...

  12. Statistics of extremes

    CERN Document Server

    Gumbel, E J

    2012-01-01

    This classic text covers order statistics and their exceedances; exact distribution of extremes; the 1st asymptotic distribution; uses of the 1st, 2nd, and 3rd asymptotes; more. 1958 edition. Includes 44 tables and 97 graphs.

  13. Measuring Moral Distress Among Critical Care Clinicians: Validation and Psychometric Properties of the Italian Moral Distress Scale-Revised.

    Science.gov (United States)

    Lamiani, Giulia; Setti, Ilaria; Barlascini, Luca; Vegni, Elena; Argentero, Piergiorgio

    2017-03-01

    Moral distress is a common experience among critical care professionals, leading to frustration, withdrawal from patient care, and job abandonment. Most of the studies on moral distress have used the Moral Distress Scale or its revised version (Moral Distress Scale-Revised). However, these scales have never been validated through factor analysis. This article aims to explore the factorial structure of the Moral Distress Scale-Revised and develop a valid and reliable scale through factor analysis. Validation study using a survey design. Eight medical-surgical ICUs in the north of Italy. A total of 184 clinicians (64 physicians, 94 nurses, and 14 residents). The Moral Distress Scale-Revised was translated into Italian and administered along with a measure of depression (Beck Depression Inventory-Second Edition) to establish convergent validity. Exploratory factor analysis was conducted to explore the Moral Distress Scale-Revised factorial structure. Items with low (less than or equal to 0.350) or multiple saturations were removed. The resulting model was tested through confirmatory factor analysis. The Italian Moral Distress Scale-Revised is composed of 14 items referring to four factors: futile care, poor teamwork, deceptive communication, and ethical misconduct. This model accounts for 59% of the total variance and presents a good fit with the data (root mean square error of approximation = 0.06; comparative fit index = 0.95; Tucker-Lewis index = 0.94; weighted root mean square residual = 0.65). The Italian Moral Distress Scale-Revised evinces good reliability (α = 0.81) and moderately correlates with Beck Depression Inventory-Second Edition (r = 0.293; p moral distress total score between physicians and nurses. However, nurses scored higher on futile care than physicians (t = 2.051; p = 0.042), whereas physicians scored higher on deceptive communication than nurses (t = 3.617; p Moral distress was higher for those clinicians considering to give up their position

  14. Moral distress and professional freedom of speech among doctors.

    Science.gov (United States)

    Førde, Reidun; Aasland, Olaf Gjerløw

    2013-06-25

    Previous studies indicate that Norwegian doctors experience distress in their encounter with differing and partly contradictory ideals, such as the obligation to criticise unethical and inappropriate practices. The objective of this study was to investigate the perception of moral distress and professional freedom of speech among Norwegian doctors as of today, as well as identify changes that have occurred since the previous study undertaken in 2004. A total of 1,522 economically active doctors received a questionnaire listing various statements describing the perception of moral distress and professional freedom of speech. The responses were compared to responses to the 2004 study. Altogether 67% of the doctors responded to the questionnaire. The proportion who reported «fairly strong» or «strong» moral distress varied from 24% to 70% among the different statements. On the whole, the «rank and file» hospital doctors reported the highest degree of moral distress. Nevertheless, a decrease in the scores for moral distress could be observed from 2004 to 2010. During the same period, the perception of professional freedom of speech increased slightly. A reduced level of distress associated with ethical conflicts in working life may be due to improved methods for handling distressing situations, or because the consequences of the health services reorganisations are perceived as less threatening now than in 2004, immediately after the introduction of the hospital reform. However, the perceived lower distress level may also be due to professional and ethical resignation. These findings should be followed up by a qualitative study.

  15. A note on extremal quasi-conformal mappings

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    An extremal quasi-conformal mapping f of a domain D is said to be of non-landslide type if the set Ef(δ):= {z∈D:|μf(z)|≤||μ|| ∞ -δ} has no interior points for any δ > 0. In this paper,we construct a quasi-conformal mapping f of the unit disc D such that its Teichmu¨ller equivalence class [f] contains infinitely many extremal mappings of non-landslide type. The relation between extremal mappings of non-landslide type and locally extremal mappings is also discussed.

  16. How the interbank market becomes systemically dangerous: an agent-based network model of financial distress propagation

    CERN Document Server

    Serri, Matteo; Cimini, Giulio

    2016-01-01

    Assessing the stability of economic systems is a fundamental research focus in economics, that has become increasingly interdisciplinary in the currently troubled economic situation. In particular, much attention has been devoted to the interbank lending market as an important diffusion channel for financial distress during the recent crisis. In this work we study the stability of the interbank market to exogenous shocks using an agent-based network framework. Our model encompasses several ingredients that have been recognized in the literature as pro-cyclical triggers of financial distress in the banking system: credit and liquidity shocks through bilateral exposures, liquidity hoarding due to counterparty creditworthiness deterioration, target leveraging policies and fire-sales spillovers. But we exclude the possibility of central authorities intervention. We implement this framework on a dataset of 183 European banks that were publicly traded between 2004 and 2013. We document the extreme fragility of the ...

  17. Correction of extreme overjet in 2 phases.

    Science.gov (United States)

    Wong, Louise; Hägg, Urban; Wong, George

    2006-10-01

    This case report describes the treatment of a 12-year-old Chinese boy with a Class II skeletal profile, an extreme overjet, and a retrusive mandible. The patient was teased at school because of his appearance, and he was experiencing negative psychosocial impacts, including shyness and falling grades. Orthodontic treatment had a positive psychosocial impact on his life over a period of 10 years. The advantages of using functional appliances are highlighted in this report.

  18. The Resolution of Distressed Financial Conglomerates

    Directory of Open Access Journals (Sweden)

    Howell E. Jackson

    2017-01-01

    Full Text Available One of the most elegant legal innovations to emerge from the Dodd-Frank Wall Street Reform and Consumer Protection Act of 2010 is the FDIC’s single-point-of-entry (SPOE initiative, whereby regulatory authorities will be in a position to resolve the failure of large financial conglomerates (corporate groups with regulated financial entities as subsidiaries by seizing a top-tier holding company, downstreaming holding-company resources to distressed subsidiaries, wiping out holding-company shareholders while simultaneously imposing additional losses on holding-company creditors, and allowing the government to resolve the entire group without disrupting the business operations of operating subsidiaries (even those operating overseas or risking systemic consequences for the broader economy. Although there is much to admire in the creativity underlying SPOE, the approach’s design also raises a host of novel and challenging questions of implementation. This chapter explores a number of these questions and elaborates upon the following points. First, in contrast to traditional approaches to resolving financial conglomerates, SPOE is premised on the continued support of all material operating subsidiaries, thereby potentially extending the scope of government support and thus posing the possibility of mission creep and expanded moral hazard. Second, SPOE contemplates the automatic downstreaming of resources to operating subsidiaries in distress, but effecting that support is likely to be more difficult than commonly understood. If too much support is positioned in advance, there may be inadequate reserves at the top level to support a single subsidiary that gets into an unexpectedly large amount of trouble. Alternatively, if too many reserves are retained at the holding-company level, commitments of subsidiary support may not be credible (especially to foreign authorities and it may become difficult legally and practically to deploy those resources

  19. Pushing the Envelope of Extreme Space Weather

    Science.gov (United States)

    Pesnell, W. D.

    2014-12-01

    Extreme Space Weather events are large solar flares or geomagnetic storms, which can cost billions of dollars to recover from. We have few examples of such events; the Carrington Event (the solar superstorm) is one of the few that had superlatives in three categories: size of solar flare, drop in Dst, and amplitude of aa. Kepler observations show that stars similar to the Sun can have flares releasing millions of times more energy than an X-class flare. These flares and the accompanying coronal mass ejections could strongly affect the atmosphere surrounding a planet. What level of solar activity would be necessary to strongly affect the atmosphere of the Earth? Can we map out the envelope of space weather along the evolution of the Sun? What would space weather look like if the Sun stopped producing a magnetic field? To what extreme should Space Weather go? These are the extremes of Space Weather explored in this talk.

  20. Extremism without extremists: Deffuant model with emotions

    Science.gov (United States)

    Sobkowicz, Pawel

    2015-03-01

    The frequent occurrence of extremist views in many social contexts, often growing from small minorities to almost total majority, poses a significant challenge for democratic societies. The phenomenon can be described within the sociophysical paradigm. We present a modified version of the continuous bounded confidence opinion model, including a simple description of the influence of emotions on tolerances, and eventually on the evolution of opinions. Allowing for psychologically based correlation between the extreme opinions, high emotions and low tolerance for other people's views leads to quick dominance of the extreme views within the studied model, without introducing a special class of agents, as has been done in previous works. This dominance occurs even if the initial numbers of people with extreme opinions is very small. Possible suggestions related to mitigation of the process are briefly discussed.

  1. Intrauterine extremity gangrene and cerebral infarction at term

    DEFF Research Database (Denmark)

    Tanvig, M; Jørgensen, J S; Nybo, M;

    2011-01-01

    Intrauterine extremity gangrene in combination with cerebral infarction is a serious and rare event. We present a case with a healthy mother who gave birth to a child with this condition. At term, the mother presented at the antenatal clinic with decreased fetal movements. Cardiotocography (CTG......) showed signs of fetal distress and a caesarean section was performed. The left arm of the newborn was found gangrenous. Amputation of the arm was necessary and the child was subsequently treated with anticoagulant therapy due to thrombosis and cerebral infarction in the left hemisphere found by magnetic...

  2. Prolonged Extracorporeal Membrane Oxygenation Support for Acute Respiratory Distress Syndrome

    Directory of Open Access Journals (Sweden)

    Wen-Je Ko

    2006-01-01

    Full Text Available When all conventional treatments for respiratory failure in patients with acute respiratory distress syndrome (ARDS have failed, extracorporeal membrane oxygenation (ECMO can provide a chance of survival in these desperately ill patients. A 49-year-old male patient developed septic shock and progressive ARDS after liver abscess drainage. Venovenous ECMO was given due to refractory respiratory failure on postoperative day 6. Initially, two heparin-binding hollow-fiber microporous membrane oxygenators in parallel were used in the ECMO circuit. Twenty-two oxygenators were changed in the first 22 days of ECMO support because of plasma leak in the oxygenators. Each oxygenator had an average life of 48 hours. Thereafter, a single silicone membrane oxygenator was used in the ECMO circuit, which did not require change during the remaining 596 hours of ECMO. The patient's tidal volume was only 90 mL in the nadir and less than 300 mL for 26 days during the ECMO course. The patient required ECMO support for 48 days and survived despite complications, including septic shock, ARDS, acute renal failure, drug-induced leukopenia, and multiple internal bleeding. This patient received an unusually long duration of ECMO support. However, he survived, recovered well, and was in New York Heart Association functional class I-II, with a forced expiratory volume in 1 second of 81% of the predicted level 18 months later. In conclusion, ECMO can provide a chance of survival for patients with refractory ARDS. The reversibility of lung function is possible in ARDS patients regardless of the severity of lung dysfunction at the time of treatment.

  3. Stability of extremal metrics under complex deformations

    CERN Document Server

    Rollin, Yann; Tipler, Carl

    2011-01-01

    Let $(\\mathcal {X},\\Omega)$ be a closed polarized complex manifold, $g$ be an extremal metric on $\\mathcal X$ that represents the K\\"ahler class $\\Omega$, and $G$ be a compact connected subgroup of the isometry group $Isom(\\mathcal{X},g)$. Assume that the Futaki invariant relative to $G$ is nondegenerate at $g$. Consider a smooth family $(\\mathcal{M}\\to B)$ of polarized complex deformations of $(\\mathcal{X},\\Omega)\\simeq (\\mathcal{M}_0,\\Theta_0)$ provided with a holomorphic action of $G$. Then for every $t\\in B$ sufficiently small, there exists an $h^{1,1}(\\cX)$-dimensional family of extremal K\\"ahler metrics on $\\mathcal{M}_t$ whose K\\"ahler classes are arbitrarily close to $\\Theta_t$. We apply this deformation theory to analyze the Mukai-Umemura 3-fold and its complex deformations. In particular, we prove that there are certain complex deformation of the Mukai-Umemura 3-folds which have extremal metric of non constant scalar curvature with Kaehler class $c_1$.

  4. Extreme Programming: Maestro Style

    Science.gov (United States)

    Norris, Jeffrey; Fox, Jason; Rabe, Kenneth; Shu, I-Hsiang; Powell, Mark

    2009-01-01

    "Extreme Programming: Maestro Style" is the name of a computer programming methodology that has evolved as a custom version of a methodology, called extreme programming that has been practiced in the software industry since the late 1990s. The name of this version reflects its origin in the work of the Maestro team at NASA's Jet Propulsion Laboratory that develops software for Mars exploration missions. Extreme programming is oriented toward agile development of software resting on values of simplicity, communication, testing, and aggressiveness. Extreme programming involves use of methods of rapidly building and disseminating institutional knowledge among members of a computer-programming team to give all the members a shared view that matches the view of the customers for whom the software system is to be developed. Extreme programming includes frequent planning by programmers in collaboration with customers, continually examining and rewriting code in striving for the simplest workable software designs, a system metaphor (basically, an abstraction of the system that provides easy-to-remember software-naming conventions and insight into the architecture of the system), programmers working in pairs, adherence to a set of coding standards, collaboration of customers and programmers, frequent verbal communication, frequent releases of software in small increments of development, repeated testing of the developmental software by both programmers and customers, and continuous interaction between the team and the customers. The environment in which the Maestro team works requires the team to quickly adapt to changing needs of its customers. In addition, the team cannot afford to accept unnecessary development risk. Extreme programming enables the Maestro team to remain agile and provide high-quality software and service to its customers. However, several factors in the Maestro environment have made it necessary to modify some of the conventional extreme

  5. [Kinetic therapy for acute respiratory distress syndrome].

    Science.gov (United States)

    Chechenin, M G; Voevodin, S V; Pronichev, E Iu; Shuliveĭstrov, Iu V

    2004-01-01

    The authors evaluated the clinical and physiological effects of kinetic therapy (KT) in the treatment of acute respiratory distress syndrome (ARDS). Forty-six patients with ARDS underwent successive postural positioning in accordance with two regimens: 1) lateral, prone, contralateral, supine positions; 2) prone, lateral, contralateral, supine positions. The criterion for changing each position was the change in monitoring indices: SpO2, PaO2, and thoracopulmonary compliance (C). KT was performed until a respirator was withdrawn from the patient. In 25 patients, each maneuver of positioning was made during 30-minute propofol sedation. The control group included 24 patients with ARDS who received neither KT nor propofol sedation. KT caused a decrease in Vd/Vt, Qs/Qt and an increase in PaO2/FiO2 and C was more intensive, as compared with the control group. The duration of the patient's prone position was 3.2-0.7 hours and that of the supine position was 3.4-0.8 hours. The right and left lateral positions lasted 1.1-0.2 and 1.3-0.2 hours, respectively. KT regimen 1 was found to be more effective than KT regimen 2. Propofol sedation enhanced the efficiency of KT. The latter reduced death rates in patients with ARDS.

  6. Prone ventilation in acute respiratory distress syndrome

    Directory of Open Access Journals (Sweden)

    Claude Guérin

    2014-06-01

    Full Text Available Prone positioning has been used for many years in patients with acute lung injury (ALI/acute respiratory distress syndrome (ARDS, with no clear benefit for patient outcome. Meta-analyses have suggested better survival in patients with an arterial oxygen tension (PaO2/inspiratory oxygen fraction (FIO2 ratio <100 mmHg. A recent randomised controlled trial was performed in ARDS patients after a 12–24 h stabilisation period and severity criteria (PaO2/FIO2 <150 mmHg at a positive end-expiratory pressure ≥5 cmH2O. This trial has demonstrated a significant reduction in mortality from 32.8% in the supine group to 16% in the prone group (p<0.001. The reasons for this dramatic effect are not clear but probably involves a reduction in ventilator-induced lung injury due to prone positioning, for which there is ample evidence in experimental and clinical studies. The aims of this article are to discuss: the rationale of prone positioning in patients with ALI/ARDS; the evidence of its use based on trial analysis; and the limitations of its use as well as the current place of prone positioning in the management of patients with ALI/ARDS. From the currently available data, prone positioning should be used as a first-line therapy in patients with severe ALI/ARDS.

  7. Acute Respiratory Distress: from syndrome to disease.

    Science.gov (United States)

    Cardinal-Fernández, P; Correger, E; Villanueva, J; Rios, F

    2016-04-01

    The acute respiratory distress syndrome (ARDS) is currently one of the most important critical entities given its high incidence, rate of mortality, long-term sequelae and non-specific pharmacological treatment. The histological hallmark of ARDS is diffuse alveolar damage (DAD). Approximately 50% of ARDS patients present DAD, the rest is made up of a heterogeneous group of histological patterns, many of which correspond to a well-recognized disease. For that reason, if these patterns could be diagnosed, patients could benefit from a treatment. Recently, the effect of DAD in clinical and analytical evolution of ARDS has been demonstrated, so the classical approach to ARDS as an entity defined solely by clinical, radiological and gasometrical variables should be reconsidered. This narrative review aims to examine the need to evolve from the concept of ARDS as a syndrome to ARDS as a specific disease. So we have raised 4 critical questions: a) What is a disease?; b) what is DAD?; c) how is DAD considered according to ARDS definition?, and d) what is the relationship between ARDS and DAD? Copyright © 2015 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

  8. An Unusual Cause of Recurrent Respiratory Distress

    Directory of Open Access Journals (Sweden)

    Joshi Neha

    2010-12-01

    Full Text Available A one and a half years old boy presented with recurrent episodes of respiratory distress, accompanied by dry non spasmodic cough and characterized by appearance of a continuous stridor showing no positional variation. The child was symptomatic since early infancy. Parents also complained of inability to gain weight as compared to other siblings.  There was no history of foreign body ingestion or complaints of asthma or tuberculosis in the family. General physical examination revealed tachypnea and biphasic stridor in a malnourished and stunted child in the absence of any significant lymphadenopathy or oral thrush.On systemic examination, bilaterally, stridorous sounds were auscultated. Primary investigations on the child showed minimal reflux on gastro-esophageal reflux isotope scan, a normal chest roentgenogram, negative sweat chloride test and negative serology for HIV (Human immuno­deficiency virus. Echocardiography performed on the child revealed a structurally normal heart. On conducting further investigations, bronchoscopy detected a bulge in the anterior tracheal wall while barium swallow displayed indentation in the upper esophagus. The MRI (magnetic resonance imaging subsequently conducted clinched the underlying clinical condition. The MRI images are depicted below.

  9. Do anticipatory grief and preparedness affect distress in bereaved caregivers?

    DEFF Research Database (Denmark)

    Nielsen, Mette Kjærgaard

    Objective Family caregivers of terminally ill patients are in a vulnerable position, and previous studies show that bereaved caregivers are at risk of psychological distress. Pre-loss grief symptoms seem to predict post-loss psychological distress, while preparedness for a looming loss tends...... to decrease distress. The aim of this nation-wide study was to investigate the association of both anticipatory grief symptoms and preparedness with psychological distress in bereaved family caregivers. Methods A list of all adult patients in Denmark receiving drug reimbursement for terminal illness...... months after the loss. The baseline questionnaire included a pre-loss version of the Prolonged Grief-13 and one question regarding caregiver preparedness, while the follow-up questionnaire contained the Prolonged Grief-13 and Beck’s Depression Inventory II. Results Of the contacted 9,512 patients 3...

  10. Cultural Consonance, Religion and Psychological Distress in an Urban Community

    Directory of Open Access Journals (Sweden)

    William W. Dressler

    2013-08-01

    Full Text Available Cultural consonance is the degree to which individuals approximate prototypes encoded in cultural models. Low cultural consonance is associated with higher psychological distress. Religion may moderate the association between cultural consonance and psychological distress. Brazil, with substantial variation in religion, is an important society for the examination of this hypothesis. Research was conducted in Ribeirão Preto, Brazil, using a mixed-methods design. Measures of cultural consonance were derived using ethnographic methods and then applied in a survey of 271 individuals drawn from four distinct social strata. Low cultural consonance was associated with higher psychological distress in multiple regression analysis ( B = -.430, p < .001. Members of Pentecostal Protestant churches reported lower psychological distress independently of the effect of cultural consonance ( B = -.409, p < .05. There was no buffering effect of religion. Implications of these results for the study of religion and health are discussed.

  11. CORRELATES OF MENTAL DISTRESS IN JIMMA TOWN, ETHIOPIA

    African Journals Online (AJOL)

    HAFIZ & FET PL.C

    The main objective of this study was to determine the prevalence of mental distress and related ... man made and natural affliction that took ... stressful circumstances in the last two ..... such as conflicts and disasters, the presence of major ...

  12. Non-pharmacological approaches to alleviate distress in dementia care.

    Science.gov (United States)

    Mitchell, Gary; Agnelli, Joanne

    2015-11-25

    Distress is one of the most common clinical manifestations associated with dementia. Pharmacological intervention may be appropriate in managing distress in some people. However, best practice guidelines advocate non-pharmacological interventions as the preferred first-line treatment. The use of non-pharmacological interventions encourages healthcare professionals to be more person-centred in their approach, while considering the causes of distress. This article provides healthcare professionals with an overview of some of the non-pharmacological approaches that can assist in alleviating distress for people living with dementia including: reminiscence therapy, reality orientation, validation therapy, music therapy, horticultural therapy, doll therapy and pet therapy. It provides a summary of their use in clinical practice and links to the relevant literature.

  13. 'Moral distress'--time to abandon a flawed nursing construct?

    Science.gov (United States)

    Johnstone, Megan-Jane; Hutchinson, Alison

    2015-02-01

    Moral distress has been characterised in the nursing literature as a major problem affecting nurses in all healthcare systems. It has been portrayed as threatening the integrity of nurses and ultimately the quality of patient care. However, nursing discourse on moral distress is not without controversy. The notion itself is conceptually flawed and suffers from both theoretical and practical difficulties. Nursing research investigating moral distress is also problematic on account of being methodologically weak and disparate. Moreover, the ultimate purpose and significance of the research is unclear. In light of these considerations, it is contended that the notion of moral distress ought to be abandoned and that concerted attention be given to advancing inquiries that are more conducive to improving the quality and safety of moral decision-making, moral conduct and moral outcomes in nursing and healthcare domains. © The Author(s) 2013.

  14. Psychological distress and salivary cortisol covary within persons during pregnancy

    NARCIS (Netherlands)

    Giesbrecht, Gerald F.; Campbell, Tavis; Letourneau, Nicole; Kooistra, Libbe; Kaplan, Bonnie

    The mechanisms whereby maternal stress during pregnancy exerts organizational effects on fetal development require elaboration. The aim of this study was to assess the plausibility of cortisol as a biological link between maternal psychological distress during pregnancy and fetal development.

  15. Patterns of gender equality at workplaces and psychological distress

    National Research Council Canada - National Science Library

    Elwér, Sofia; Harryson, Lisa; Bolin, Malin; Hammarström, Anne

    2013-01-01

    ... that are at play simultaneously. To overcome this shortcoming this study aims to identify patterns of gender equality at workplaces and to investigate how these patterns are associated with psychological distress...

  16. Ordered LOGIT Model approach for the determination of financial distress.

    Science.gov (United States)

    Kinay, B

    2010-01-01

    Nowadays, as a result of the global competition encountered, numerous companies come up against financial distresses. To predict and take proactive approaches for those problems is quite important. Thus, the prediction of crisis and financial distress is essential in terms of revealing the financial condition of companies. In this study, financial ratios relating to 156 industrial firms that are quoted in the Istanbul Stock Exchange are used and probabilities of financial distress are predicted by means of an ordered logit regression model. By means of Altman's Z Score, the dependent variable is composed by scaling the level of risk. Thus, a model that can compose an early warning system and predict financial distress is proposed.

  17. Ethical dilemma and moral distress: proposed new NANDA diagnoses.

    Science.gov (United States)

    Kopala, Beverly; Burkhart, Lisa

    2005-01-01

    To propose two NANDA diagnoses--ethical dilemma and moral distress--and to distinguish between the NANDA diagnosis decisional conflict and the proposed nursing diagnosis of ethical dilemma. Journal articles, books, and focus group research findings. Moral/ethical situations exist in health care. Nurses' experiences of ethical dilemmas and moral distress are extrapolated to the types and categories of ethical dilemmas and moral distress that patients experience and are used as the basis for development of two new nursing diagnoses. The two proposed NANDA diagnoses fill a void in current standardized terminology. It is important that nurses have the ability to diagnose ethical or moral situations in health care. Currently, NANDA does not offer a means to document this important phenomenon. The creation of two sets of nursing diagnoses, ethical dilemma and moral distress, will enable nurses to recognize and track nursing care related to ethical or moral situations.

  18. Nurse middle manager ethical dilemmas and moral distress.

    Science.gov (United States)

    Ganz, Freda D; Wagner, Nurit; Toren, Orly

    2015-02-01

    Nurse managers are placed in a unique position within the healthcare system where they greatly impact upon the nursing work environment. Ethical dilemmas and moral distress have been reported for staff nurses but not for nurse middle managers. To describe ethical dilemmas and moral distress among nurse middle managers arising from situations of ethical conflict. The Ethical Dilemmas in Nursing-Middle Manager Questionnaire and a personal characteristics questionnaire were administered to a convenience sample of middle managers from four hospitals in Israel. Middle managers report low to moderate levels of frequency and intensity of ethical dilemmas and moral distress. Highest scores were for administrative dilemmas. Middle managers experience lower levels of ethical dilemmas and moral distress than staff nurses, which are irrespective of their personal characteristics. Interventions should be developed, studied, and then incorporated into institutional frameworks in order to improve this situation. © The Author(s) 2014.

  19. Longitudinal relationships between workplace bullying and psychological distress

    National Research Council Canada - National Science Library

    Morten Birkeland Nielsen; Jørn Hetland; Stig Berge Matthiesen; Ståle Einarsen

    Objectives The aims of this study were to examine reciprocal longitudinal associations between exposure to workplace bullying and symptoms of psychological distress and to investigate how self-labeled...

  20. Progress and perspectives in pediatric acute respiratory distress syndrome.

    Science.gov (United States)

    Rotta, Alexandre Tellechea; Piva, Jefferson Pedro; Andreolio, Cinara; de Carvalho, Werther Brunow; Garcia, Pedro Celiny Ramos

    2015-01-01

    Acute respiratory distress syndrome is a disease of acute onset characterized by hypoxemia and infiltrates on chest radiographs that affects both adults and children of all ages. It is an important cause of respiratory failure in pediatric intensive care units and is associated with significant morbidity and mortality. Nevertheless, until recently, the definitions and diagnostic criteria for acute respiratory distress syndrome have focused on the adult population. In this article, we review the evolution of the definition of acute respiratory distress syndrome over nearly five decades, with a special focus on the new pediatric definition. We also discuss recommendations for the implementation of mechanical ventilation strategies in the treatment of acute respiratory distress syndrome in children and the use of adjuvant therapies.

  1. Psychological distress, personality, and adjustment among nursing students.

    Science.gov (United States)

    Warbah, L; Sathiyaseelan, M; Vijayakumar, C; Vasantharaj, B; Russell, S; Jacob, K S

    2007-08-01

    Psychological distress and poor adjustment among a significant number of nursing students is an important issue facing nursing education. The concerns need to be studied in detail and solutions need to be built into the nursing course in order to help students with such difficulty. This study used a cross-sectional survey design to study psychological distress, personality and adjustment among nursing students attending the College of Nursing, Christian Medical College, Vellore, India. One hundred and forty five nursing students were assessed using the General Health Questionnaire 12, the Eysenck Personality Questionnaire, and the Bell's Adjustment Inventory to investigate psychological distress, personality profile and adjustment, respectively. Thirty participants (20.7%) of the 145 students assessed reported high scores on the General Health Questionnaire. Psychological distress was significantly associated with having neurotic personality and adjustment difficulties in different areas of functioning.

  2. Association of psychological distress and work psychosocial factors with self-reported musculoskeletal pain among secondary school teachers in Malaysia

    Science.gov (United States)

    Zamri, E. N.; Moy, F. M.; Hoe, V. C. W.

    2017-01-01

    Background Musculoskeletal pain is common among teachers. Work-related psychosocial factors are found to be associated with the development of musculoskeletal pain, however psychological distress may also play an important role. Objectives To assess the prevalence of self-reported low back pain (LBP), and neck and/or shoulder pain (NSP) among secondary school teachers; and to evaluate the association of LBP and NSP with psychological distress and work-related psychosocial factors. Methods This was a cross-sectional study conducted among teachers in the state of Penang, Malaysia. The participants were recruited via a two stage sampling method. Information on demographic, psychological distress, work-related psychosocial factors, and musculoskeletal pain (LBP and NSP) in the past 12 months was collected using a self-administered questionnaire. Poisson regression was used to estimate the prevalence ratio (PR) for the associations between psychological distress and work-related psychosocial factors with LBP and NSP. Results The prevalence of self-reported LBP and NSP among 1482 teachers in the past 12 months was 48.0% (95% Confidence Interval (CI) 45.2%, 50.9%) and 60.1% (95% CI 57.4%, 62.9%) respectively. From the multivariate analysis, self-reported LBP was associated with teachers who reported severe to extremely severe depression (PR: 1.71, 95% CI 1.25, 2.32), severe to extremely severe anxiety (1.46, 95% CI 1.22, 1.75), high psychological job demand (1.29, 95% CI 1.06, 1.57), low skill discretion (1.28, 95% CI 1.13, 1.47) and poorer mental health (0.98, 95% CI 0.97, 0.99). Self-reported NSP was associated with mild to moderate anxiety (1.18, 95% CI 1.06, 1.33), severe to extremely severe anxiety (1.25, 95% CI 1.09, 1.43), low supervisory support (1.13, 95% CI 1.03, 1.25) and poorer mental health (0.98, 95% CI 0.97, 0.99). Conclusions Self-reported LBP and NSP were common among secondary school teachers. Interventions targeting psychological distress and work

  3. If We Build It, They Will Come: Exploring Policy and Practice Implications of Public Support for Couple and Relationship Education for Lower Income and Relationally Distressed Couples.

    Science.gov (United States)

    Bradford, Angela B; Hawkins, Alan J; Acker, Jennifer

    2015-12-01

    Over the past decade, public funding for Couple and Relationship Education programs has expanded. As program administrators have been able to extend their reach to low-income individuals and couples using this support, it has become apparent that greater numbers of relationally distressed couples are attending classes than previously anticipated. Because psychoeducational programs for couples have traditionally served less distressed couples, this dynamic highlights the need to examine the policy and practice implications of more distressed couples accessing these services. This paper reviews some of the most immediate issues, including screening for domestic violence and couple needs, pedagogical considerations, and the potential integration of therapy and education services. We also make suggestions for future research that can inform policy and practice efforts. © 2015 Family Process Institute.

  4. Corporate debt restructuring: Evidence on lender coordination in financial distress

    OpenAIRE

    Brunner, Antje; Krahnen, Jan Pieter

    2001-01-01

    In the recent theoretical literature on lending risk, the coordination problem in multi-creditor relationships have been analyzed extensively. We address this topic empirically, relying on a unique panel data set that includes detailed credit-file information on distressed lending relationships in Germany. In particular, it includes information on creditor pools, a legal institution aiming at coordinating lender interests in borrower distress. We report three major findings. First, the existe...

  5. Corporate Debt Restructuring: Evidence on Lending Coordination in Financial Distress

    OpenAIRE

    Brunner, Antje; Krahnen, Jan Pieter

    2001-01-01

    We analyse the coordination problem in multi-creditor relationships empirically, relying on a unique panel data set that contains detailed credit-file information on distressed lending relationships in Germany, including information on creditor pools, a legal institution aiming at coordinating lender interests in borrower distress. We report three major findings. First, the existence of creditor pools increases the probability of workout success. Second, the results are consistent with coordi...

  6. Multiple Lenders and Corporate Distress: Evidence on Debt Restructuring

    OpenAIRE

    Brunner, Antje; Krahnen, Jan Pieter

    2004-01-01

    In the recent theoretical literature on lending risk, the coordination problem in multi-creditor relationships have been analyzed extensively. We address this topic empirically, relying on a unique panel data set that includes detailed credit-file information on distressed lending relationships in Germany. In particular, it includes information on creditor pools, a legal institution aiming at coordinating lender interests in borrower distress. We report three major findings. First, the existe...

  7. Scaling a Survey Course in Extreme Weather

    Science.gov (United States)

    Samson, P. J.

    2013-12-01

    "Extreme Weather" is a survey-level course offered at the University of Michigan that is broadcast via the web and serves as a research testbed to explore best practices for large class conduct. The course has led to the creation of LectureTools, a web-based student response and note-taking system that has been shown to increase student engagement dramatically in multiple courses by giving students more opportunities to participate in class. Included in this is the capacity to pose image-based questions (see image where question was "Where would you expect winds from the south") as well as multiple choice, ordered list, free response and numerical questions. Research in this class has also explored differences in learning outcomes from those who participate remotely versus those who physically come to class and found little difference. Moreover the technologies used allow instructors to conduct class from wherever they are while the students can still answer questions and engage in class discussion from wherever they are. This presentation will use LectureTools to demonstrate its features. Attendees are encouraged to bring a mobile device to the session to participate.

  8. Asian elephants (Elephas maximus reassure others in distress

    Directory of Open Access Journals (Sweden)

    Joshua M. Plotnik

    2014-02-01

    Full Text Available Contact directed by uninvolved bystanders toward others in distress, often termed consolation, is uncommon in the animal kingdom, thus far only demonstrated in the great apes, canines, and corvids. Whereas the typical agonistic context of such contact is relatively rare within natural elephant families, other causes of distress may trigger similar, other-regarding responses. In a study carried out at an elephant camp in Thailand, we found that elephants affiliated significantly more with other individuals through directed, physical contact and vocal communication following a distress event than in control periods. In addition, bystanders affiliated with each other, and matched the behavior and emotional state of the first distressed individual, suggesting emotional contagion. The initial distress responses were overwhelmingly directed toward ambiguous stimuli, thus making it difficult to determine if bystanders reacted to the distressed individual or showed a delayed response to the same stimulus. Nonetheless, the directionality of the contacts and their nature strongly suggest attention toward the emotional states of conspecifics. The elephants’ behavior is therefore best classified with similar consolation responses by apes, possibly based on convergent evolution of empathic capacities.

  9. Does tinnitus distress depend on age of onset?

    Directory of Open Access Journals (Sweden)

    Winfried Schlee

    Full Text Available OBJECTIVES: Tinnitus is the perception of a sound in the absence of any physical source of it. About 5-15% of the population report hearing such a tinnitus and about 1-2% suffer from their tinnitus leading to anxiety, sleep disorders or depression. It is currently not completely understood why some people feel distressed by their tinnitus, while others don't. Several studies indicate that the amount of tinnitus distress is associated with many factors including comorbid anxiety, comorbid depression, personality, the psychosocial situation, the amount of the related hearing loss and the loudness of the tinnitus. Furthermore, theoretical considerations suggest an impact of the age at tinnitus onset influencing tinnitus distress. METHODS: Based on a sample of 755 normal hearing tinnitus patients we tested this assumption. All participants answered a questionnaire on the amount of tinnitus distress together with a large variety of clinical and demographic data. RESULTS: Patients with an earlier onset of tinnitus suffer significantly less than patients with an onset later in life. Furthermore, patients with a later onset of tinnitus describe their course of tinnitus distress as more abrupt and distressing right from the beginning. CONCLUSION: We argue that a decline of compensatory brain plasticity in older age accounts for this age-dependent tinnitus decompensation.

  10. Acute Respiratory Distress in Children: Croup and Acute Asthma.

    Science.gov (United States)

    Sharma, B S; Shekhawat, Dhananjay S; Sharma, Prity; Meena, Chetan; Mohan, Hari

    2015-07-01

    Acute respiratory distress is one of the most common reason for emergency visits in children under 5 y of age. An accurate understanding of the epidemiology of these diseases, identification of risk factors and etiology is critical for successful treatment and prevention of related mortality. The cause of acute respiratory distress varies in etiology, and hence is amenable to different treatment modalities. Depending on the predominant symptoms and signs, a child presenting to the clinician can be divided into six groups, viz., stridor; cough, fever and difficulty in breathing or fast breathing; wheezing; mediastinal shift with severe respiratory distress; slow or irregular breathing in absence of any pulmonary sign; and respiratory distress with cardiac findings. A detailed history followed by a thorough clinical examination and laboratory evaluation assisted by imaging modalities if indicated, helps to establish the exact cause of respiratory distress in the child. Early recognition and prompt institution of appropriate management or referral can significantly improve the outcome of this illness. This article offers clinicians a brief update on the general management guidelines of respiratory distress in pediatric patients. Specific treatment depends on the exact cause, however croup and acute severe asthma have been discussed in this article.

  11. Psychological distress and prejudice following terror attacks in France.

    Science.gov (United States)

    Goodwin, Robin; Kaniasty, Krzysztof; Sun, Shaojing; Ben-Ezra, Menachem

    2017-03-16

    Terrorist attacks have the capacity to threaten our beliefs about the world, cause distress across populations and promote discrimination towards particular groups. We examined the impact of two different types of attacks in the same city and same year on psychological distress and probable posttraumatic stress symptoms, and the moderating effects of religion or media use on distress/posttraumatic symptoms and inter-group relations. Two panel surveys four weeks after the January 2015 Charlie Hebdo attack (N = 1981) and the November 2015 Bataclan concert hall/restaurant attacks (N = 1878), measured intrinsic religiosity, social and traditional media use, psychological distress (K6), probable posttraumatic stress symptoms (proposed ICD-11), symbolic racism and willingness to interact with Muslims by non-Muslims. Prevalence of serious mental illness (K6 score > 18) was higher after November 2015 attacks (7.0% after the first attack, 10.2% the second, χ2 (1) = 5.67, p < 0.02), as were probable posttraumatic stress symptoms (11.9% vs. 14.1%; χ2 (1) = 4.15, p < 0.04). In structural equation analyses, sex, age, geographic proximity, media use and religiosity were associated with distress, as was the interaction between event and religiosity. Distress was then associated with racism symbolism and willingness to interact with Muslims. Implications are considered for managing psychological trauma across populations, and protecting inter-group harmony.

  12. Statistics of Extremes

    KAUST Repository

    Davison, Anthony C.

    2015-04-10

    Statistics of extremes concerns inference for rare events. Often the events have never yet been observed, and their probabilities must therefore be estimated by extrapolation of tail models fitted to available data. Because data concerning the event of interest may be very limited, efficient methods of inference play an important role. This article reviews this domain, emphasizing current research topics. We first sketch the classical theory of extremes for maxima and threshold exceedances of stationary series. We then review multivariate theory, distinguishing asymptotic independence and dependence models, followed by a description of models for spatial and spatiotemporal extreme events. Finally, we discuss inference and describe two applications. Animations illustrate some of the main ideas. © 2015 by Annual Reviews. All rights reserved.

  13. Extremely deformable structures

    CERN Document Server

    2015-01-01

    Recently, a new research stimulus has derived from the observation that soft structures, such as biological systems, but also rubber and gel, may work in a post critical regime, where elastic elements are subject to extreme deformations, though still exhibiting excellent mechanical performances. This is the realm of ‘extreme mechanics’, to which this book is addressed. The possibility of exploiting highly deformable structures opens new and unexpected technological possibilities. In particular, the challenge is the design of deformable and bi-stable mechanisms which can reach superior mechanical performances and can have a strong impact on several high-tech applications, including stretchable electronics, nanotube serpentines, deployable structures for aerospace engineering, cable deployment in the ocean, but also sensors and flexible actuators and vibration absorbers. Readers are introduced to a variety of interrelated topics involving the mechanics of extremely deformable structures, with emphasis on ...

  14. Lux in obscuro: Photon Orbits of Extremal Black Holes Revisited

    CERN Document Server

    Khoo, Fech Scen

    2016-01-01

    It has been shown in the literature that the event horizon of an asymptotically flat extremal Reissner-Nordstr\\"om black hole is also a stable photon sphere. We further clarify this statement and give a general proof that this holds for a large class of static spherically symmetric black hole spacetimes with an extremal horizon. In contrast, an asymptotically flat extremal Kerr black hole has an unstable photon orbit on the equatorial plane of its horizon. In addition, we show that an asymptotically flat extremal Kerr-Newman black hole exhibits two equatorial photon orbits if $a M/2$, there is only one equatorial photon orbit, located on the extremal horizon, and it is unstable. There can be no photon orbit on the horizon of a non-extremal Kerr-Newman black hole.

  15. Weather and Climate Extremes.

    Science.gov (United States)

    1997-09-01

    Antarctica’s highest (New Zealand Antarctic Society, 1974). This extreme exceeded the record of 58°F (14.4°C) that occurred on 20 October 1956 at Esperanza ... Esperanza (also known as Bahia Esperanza , Hope Bay) was in operation from 1945 through the early 1960s. Meteorological/Climatological Factors: This extreme...cm) Location: Grand Ilet, La R’eunion Island [21°00’S, 55°30’E] Date: 26 January 1980 WORLD’S GREATEST 24-HOUR RAINFALL 72 in (182.5 cm

  16. Adventure and Extreme Sports.

    Science.gov (United States)

    Gomez, Andrew Thomas; Rao, Ashwin

    2016-03-01

    Adventure and extreme sports often involve unpredictable and inhospitable environments, high velocities, and stunts. These activities vary widely and include sports like BASE jumping, snowboarding, kayaking, and surfing. Increasing interest and participation in adventure and extreme sports warrants understanding by clinicians to facilitate prevention, identification, and treatment of injuries unique to each sport. This article covers alpine skiing and snowboarding, skateboarding, surfing, bungee jumping, BASE jumping, and whitewater sports with emphasis on epidemiology, demographics, general injury mechanisms, specific injuries, chronic injuries, fatality data, and prevention. Overall, most injuries are related to overuse, trauma, and environmental or microbial exposure.

  17. Extremal graph theory

    CERN Document Server

    Bollobas, Bela

    2004-01-01

    The ever-expanding field of extremal graph theory encompasses a diverse array of problem-solving methods, including applications to economics, computer science, and optimization theory. This volume, based on a series of lectures delivered to graduate students at the University of Cambridge, presents a concise yet comprehensive treatment of extremal graph theory.Unlike most graph theory treatises, this text features complete proofs for almost all of its results. Further insights into theory are provided by the numerous exercises of varying degrees of difficulty that accompany each chapter. A

  18. Symptom incidence, distress, cancer-related distress, and adherence to chemotherapy among African American women with breast cancer.

    Science.gov (United States)

    Yee, Melissa K; Sereika, Susan M; Bender, Catherine M; Brufsky, Adam M; Connolly, Mary C; Rosenzweig, Margaret Q

    2017-06-01

    There is a persistent racial survival disparity between African American (AA) and white women with breast cancer. There is evidence that symptom incidence, associated distress, and overall cancer-related distress may be unexplored, important contributing factors. The purpose of the current study was to: 1) describe and compare the number of chemotherapy-related symptoms and associated distress among AA women with breast cancer over the course of chemotherapy at 3 time points (at baseline before initiating chemotherapy, midpoint, and at the completion of chemotherapy); and 2) to describe the relationship between the number of chemotherapy-related symptoms and overall cancer distress compared with the ability to receive at least 85% of the prescribed chemotherapy within the prescribed timeframe. Descriptive, comparative, and correlational analyses of symptom incidence, symptom distress, cancer-related distress, and prescribed chemotherapy dose received among a cohort of AA women receiving chemotherapy for breast cancer were performed. AA women (121 women) experienced worsening symptoms from baseline to midpoint in chemotherapy and then stabilized for the duration of therapy. The inability to receive 85% of the prescribed chemotherapy within a prescribed time point was found to be significantly correlated with midpoint symptom distress. The main findings of the current study were that AA women experience a deterioration in symptom distress over the course of chemotherapy from baseline (before chemotherapy) to the midpoint, which was found to be associated with less adherence to chemotherapy overall. Thus, the incidence and management of physical and emotional symptoms, as measured through a multidimensional symptom measurement tool, may be contributing to breast cancer dose disparity and should be explored further. Cancer 2017;123:2061-2069. © 2017 American Cancer Society. © 2017 American Cancer Society.

  19. Myofibroblastic tumor causing severe neonatal distress. Successful surgical resection after embolization.

    Science.gov (United States)

    Castañón, Montserrat; Saura, Laura; Weller, Santiago; Prat, Jordi; Thio, Marta; Sorolla, Juan P; Albert, Asteria; Morales, Lluís

    2005-06-01

    This report describes a case of a term male 3.1 kg, normal delivery, 38 weeks of gestation with a record of hydramnios by prenatal sonography. He had fetal acute suffering and respiratory distress. The first radiographic study showed a mass filling the whole left thorax cage causing erosion of the inferior edge of the third rib. The mediastinum was displaced to the right. Computed tomography scan confirmed a homogeneous tumor that filled the left thorax and displaced the mediastinum to the right without invasion. Surgical biopsy informed of a highly vascularized mesenchymal tumor. The tumor was embolized with Ivalon microparticles obtaining a nearly avascular mass. Complete surgical excision was made, including the whole mass and costal segments. Microscopically, it was an inflammatory myofibroblastic tumor. It was composed mainly of spindle-shaped cells without malignant features. On immunohistochemistry, the tumor showed positive staining for vimentin, whereas antidesmin antibodies and S-100 protein were negative. The aim of this article is to present an extremely uncommon case of neonatal distress caused by an intrathoracic, extrapulmonary myofibroblastic tumor. Complete surgical resection was possible after embolization.

  20. Plasma cytokine levels fall in preterm newborn infants on nasal CPAP with early respiratory distress.

    Directory of Open Access Journals (Sweden)

    Clarissa Gutierrez Carvalho

    Full Text Available Early nCPAP seems to prevent ventilator-induced lung injury in humans, although the pathophysiological mechanisms underlying this beneficial effect have not been clarified yet.To evaluate plasma levels IL-1β, IL-6, IL-8, IL-10, and TNF-α immediately before the start of nCPAP and 2 hours later in preterm infants.Prospective cohort including preterm infants with 28 to 35 weeks gestational age with moderate respiratory distress requiring nCPAP. Extreme preemies, newborns with malformations, congenital infections, sepsis, surfactant treatment, and receiving ventilatory support in the delivery room were excluded. Blood samples were collected right before and 2 hours after the start of nCPAP.23 preterm infants (birth weight 1851±403 grams; GA 32.3±1.7 weeks were treated with nCPAP. IL-1β, IL-10, TNF-α levels were similar, IL-8 levels were reduced in 18/23 preterm infants and a significant decrease in IL-6 levels was observed after 2 hours of nCPAP. All newborns whose mothers received antenatal steroids had lower cytokine levels at the onset of nCPAP than those whose mothers didn't receive it; this effect was not sustained after 2 hours of nCPAP.Early use nCPAP is not associated with rising of plasma pro-inflammatory cytokines and it seems to be a less harmful respiratory strategy for preterm with moderate respiratory distress.

  1. Acute respiratory distress syndrome: the Berlin Definition.

    Science.gov (United States)

    Ranieri, V Marco; Rubenfeld, Gordon D; Thompson, B Taylor; Ferguson, Niall D; Caldwell, Ellen; Fan, Eddy; Camporota, Luigi; Slutsky, Arthur S

    2012-06-20

    The acute respiratory distress syndrome (ARDS) was defined in 1994 by the American-European Consensus Conference (AECC); since then, issues regarding the reliability and validity of this definition have emerged. Using a consensus process, a panel of experts convened in 2011 (an initiative of the European Society of Intensive Care Medicine endorsed by the American Thoracic Society and the Society of Critical Care Medicine) developed the Berlin Definition, focusing on feasibility, reliability, validity, and objective evaluation of its performance. A draft definition proposed 3 mutually exclusive categories of ARDS based on degree of hypoxemia: mild (200 mm Hg Definition was empirically evaluated using patient-level meta-analysis of 4188 patients with ARDS from 4 multicenter clinical data sets and 269 patients with ARDS from 3 single-center data sets containing physiologic information. The 4 ancillary variables did not contribute to the predictive validity of severe ARDS for mortality and were removed from the definition. Using the Berlin Definition, stages of mild, moderate, and severe ARDS were associated with increased mortality (27%; 95% CI, 24%-30%; 32%; 95% CI, 29%-34%; and 45%; 95% CI, 42%-48%, respectively; P definition, the final Berlin Definition had better predictive validity for mortality, with an area under the receiver operating curve of 0.577 (95% CI, 0.561-0.593) vs 0.536 (95% CI, 0.520-0.553; P Definition for ARDS addresses a number of the limitations of the AECC definition. The approach of combining consensus discussions with empirical evaluation may serve as a model to create more accurate, evidence-based, critical illness syndrome definitions and to better inform clinical care, research, and health services planning.

  2. Simvastatin in the acute respiratory distress syndrome.

    Science.gov (United States)

    McAuley, Daniel F; Laffey, John G; O'Kane, Cecilia M; Perkins, Gavin D; Mullan, Brian; Trinder, T John; Johnston, Paul; Hopkins, Philip A; Johnston, Andrew J; McDowell, Cliona; McNally, Christine

    2014-10-30

    Studies in animals and in vitro and phase 2 studies in humans suggest that statins may be beneficial in the treatment of the acute respiratory distress syndrome (ARDS). This study tested the hypothesis that treatment with simvastatin would improve clinical outcomes in patients with ARDS. In this multicenter, double-blind clinical trial, we randomly assigned (in a 1:1 ratio) patients with an onset of ARDS within the previous 48 hours to receive enteral simvastatin at a dose of 80 mg or placebo once daily for a maximum of 28 days. The primary outcome was the number of ventilator-free days to day 28. Secondary outcomes included the number of days free of nonpulmonary organ failure to day 28, mortality at 28 days, and safety. The study recruited 540 patients, with 259 patients assigned to simvastatin and 281 to placebo. The groups were well matched with respect to demographic and baseline physiological variables. There was no significant difference between the study groups in the mean (±SD) number of ventilator-free days (12.6±9.9 with simvastatin and 11.5±10.4 with placebo, P=0.21) or days free of nonpulmonary organ failure (19.4±11.1 and 17.8±11.7, respectively; P=0.11) or in mortality at 28 days (22.0% and 26.8%, respectively; P=0.23). There was no significant difference between the two groups in the incidence of serious adverse events related to the study drug. Simvastatin therapy, although safe and associated with minimal adverse effects, did not improve clinical outcomes in patients with ARDS. (Funded by the U.K. National Institute for Health Research Efficacy and Mechanism Evaluation Programme and others; HARP-2 Current Controlled Trials number, ISRCTN88244364.).

  3. The ethics of distress: toward a framework for determining the ethical acceptability of distressing health promotion advertising.

    Science.gov (United States)

    Brown, Stephen L; Whiting, Demian

    2014-04-01

    Distressing health promotion advertising involves the elicitation of negative emotion to increase the likelihood that health messages will stimulate audience members to adopt healthier behaviors. Irrespective of its effectiveness, distressing advertising risks harming audience members who do not consent to the intervention and are unable to withdraw from it. Further, the use of these approaches may increase the potential for unfairness or stigmatization toward those targeted, or be considered unacceptable by some sections of the public. We acknowledge and discuss these concerns, but, using the public health ethics literature as a guide, argue that distressing advertising can be ethically defensible if conditions of effectiveness, proportionality necessity, least infringement, and public accountability are satisfied. We do not take a broad view as to whether distressing advertising is ethical or unethical, because we see the evidence for both the effectiveness of distressing approaches and their potential to generate iatrogenic effects to be inconclusive. However, we believe it possible to use the current evidence base to make informed estimates of the likely consequences of specific message presentations. Messages can be pre-tested and monitored to identify and deal with potential problems. We discuss how advertisers can approach the problems of deciding on the appropriate intensity of ethical review, and evaluating prospective distressing advertising campaigns against the conditions outlined.

  4. Extremity perfusion for sarcoma

    NARCIS (Netherlands)

    Hoekstra, Harald Joan

    2008-01-01

    For more than 50 years, the technique of extremity perfusion has been explored in the limb salvage treatment of local, recurrent, and multifocal sarcomas. The "discovery" of tumor necrosis factor-or. in combination with melphalan was a real breakthrough in the treatment of primarily irresectable ext

  5. Hydrological extremes and security

    Science.gov (United States)

    Kundzewicz, Z. W.; Matczak, P.

    2015-04-01

    Economic losses caused by hydrological extremes - floods and droughts - have been on the rise. Hydrological extremes jeopardize human security and impact on societal livelihood and welfare. Security can be generally understood as freedom from threat and the ability of societies to maintain their independent identity and their functional integrity against forces of change. Several dimensions of security are reviewed in the context of hydrological extremes. The traditional interpretation of security, focused on the state military capabilities, has been replaced by a wider understanding, including economic, societal and environmental aspects that get increasing attention. Floods and droughts pose a burden and serious challenges to the state that is responsible for sustaining economic development, and societal and environmental security. The latter can be regarded as the maintenance of ecosystem services, on which a society depends. An important part of it is water security, which can be defined as the availability of an adequate quantity and quality of water for health, livelihoods, ecosystems and production, coupled with an acceptable level of water-related risks to people, environments and economies. Security concerns arise because, over large areas, hydrological extremes - floods and droughts - are becoming more frequent and more severe. In terms of dealing with water-related risks, climate change can increase uncertainties, which makes the state's task to deliver security more difficult and more expensive. However, changes in population size and development, and level of protection, drive exposure to hydrological hazards.

  6. Acute lower extremity ischaemia

    African Journals Online (AJOL)

    tend to impact at arterial bifurcations, the commonest site being the ... Other ominous signs of advanced ischaemia include bluish ... Recommended standards for lower extremity ischaemia*. Doppler signals ... of the embolectomy procedure. An ... in a cath-lab or angio-suite under local ... We serially measure the aPTT and.

  7. Extremity perfusion for sarcoma

    NARCIS (Netherlands)

    Hoekstra, Harald Joan

    2008-01-01

    For more than 50 years, the technique of extremity perfusion has been explored in the limb salvage treatment of local, recurrent, and multifocal sarcomas. The "discovery" of tumor necrosis factor-or. in combination with melphalan was a real breakthrough in the treatment of primarily irresectable

  8. Statistics of Local Extremes

    DEFF Research Database (Denmark)

    Larsen, Gunner Chr.; Bierbooms, W.; Hansen, Kurt Schaldemose

    2003-01-01

    . A theoretical expression for the probability density function associated with local extremes of a stochasticprocess is presented. The expression is basically based on the lower four statistical moments and a bandwidth parameter. The theoretical expression is subsequently verified by comparison with simulated...

  9. de Sitter Extremal Surfaces

    CERN Document Server

    Narayan, K

    2015-01-01

    We study extremal surfaces in de Sitter space in the Poincare slicing in the upper patch, anchored on spatial subregions at the future boundary ${\\cal I}^+$, restricted to constant boundary Euclidean time slices (focussing on strip subregions). We find real extremal surfaces of minimal area as the boundaries of past lightcone wedges of the subregions in question: these are null surfaces with vanishing area. We find also complex extremal surfaces as complex extrema of the area functional, and the area is not always real-valued. In $dS_4$ the area is real and has some structural resemblance with entanglement entropy in a dual $CFT_3$. There are parallels with analytic continuation from the Ryu-Takayanagi expressions for holographic entanglement entropy in $AdS$. We also discuss extremal surfaces in the $dS$ black brane and the de Sitter "bluewall" studied previously. The $dS_4$ black brane complex surfaces exhibit a real finite cutoff-independent extensive piece. In the bluewall geometry, there are real surface...

  10. Moving in extreme environments

    DEFF Research Database (Denmark)

    Lucas, Samuel J E; Helge, Jørn W; Schütz, Uwe H W

    2016-01-01

    and transcontinental races) and expeditions (e.g. polar crossings), to the more gravitationally limited load carriage (e.g. in the military context). Juxtaposed to these circumstances is the extreme metabolic and mechanical unloading associated with space travel, prolonged bedrest and sedentary lifestyle, which may...

  11. Congenital high-grade sarcoma presenting as skin nodules and respiratory distress in a neonate.

    Science.gov (United States)

    Powers, J W; Teitell, M; Milisavljevic, V

    2008-02-01

    We report, to our knowledge, the first case of a congenital, widespread, aggressive high-grade sarcoma, presented as multiple skin nodules and respiratory distress in a neonate that had a t(9;22)(q22;q11-12) cytogenetic abnormality suggestive of a more indolent extraskeletal myxoid chondrosarcoma (EMC). EMC is generally thought of as a slow-growing tumor that presents between the fourth and sixth decades of life. Our patient was a 45,XY, t(13;14) newborn who presented at birth with subcutaneous nodules involving the face, scalp, back and extremities, as well as multiple intrathoracic, intraabdominal and intracranial masses. Diagnosis was made using electron microscopy and immunohistochemical and cytogenetic studies. Despite attempts to control rapid growth of lesions using high-dose steroids and cis-retinoic acid, patient's clinical status continued to deteriorate and life support was withdrawn at the 26 day of life.

  12. Existence for a class of discrete hyperbolic problems

    Directory of Open Access Journals (Sweden)

    Luca Rodica

    2006-01-01

    Full Text Available We investigate the existence and uniqueness of solutions to a class of discrete hyperbolic systems with some nonlinear extreme conditions and initial data, in a real Hilbert space.

  13. Moral sensitivity and moral distress in Iranian critical care nurses.

    Science.gov (United States)

    Borhani, Fariba; Abbaszadeh, Abbas; Mohamadi, Elham; Ghasemi, Erfan; Hoseinabad-Farahani, Mohammad Javad

    2017-06-01

    Moral sensitivity is the foremost prerequisite to ethical performance; a review of literature shows that nurses are sometimes not sensitive enough for a variety of reasons. Moral distress is a frequent phenomenon in nursing, which may result in paradoxes in care, dealing with patients and rendering high-quality care. This may, in turn, hinder the meeting of care objectives, thus affecting social healthcare standards. The present research was conducted to determine the relationship between moral sensitivity and moral distress of nurses in intensive care units. This study is a descriptive-correlation research. Lutzen's moral sensitivity questionnaire and Corley Moral Distress Questionnaire were used to gather data. Participants and research context: A total of 153 qualified nurses working in the hospitals affiliated to Shahid Beheshti University of Medical Sciences were selected for this study. Subjects were selected by census method. Ethical considerations: After explaining the objectives of the study, all the participants completed and signed the written consent form. To conduct the study, permission was obtained from the selected hospitals. Nurses' average moral sensitivity grade was 68.6 ± 7.8, which shows a moderate level of moral sensitivity. On the other hand, nurses also experienced a moderate level of moral distress (44.8 ± 16.6). Moreover, there was no meaningful statistical relationship between moral sensitivity and moral distress (p = 0.26). Although the nurses' moral sensitivity and moral distress were expected to be high in the intensive care units, it was moderate. This finding is consistent with the results of some studies and contradicts with others. As moral sensitivity is a crucial factor in care, it is suggested that necessary training be provided to develop moral sensitivity in nurses in education and practical environments. Furthermore, removing factors that contribute to moral distress may help decrease it in nurses.

  14. Understanding persons with psychological distress in primary health care.

    Science.gov (United States)

    Arvidsdotter, Tina; Marklund, Bertil; Kylén, Sven; Taft, Charles; Ekman, Inger

    2016-12-01

    The purpose of this study was to gain more knowledge and a deeper understanding of experiences of persons living with psychological distress who seek help in primary care. Psychological distress is a state of emotional suffering associated with stressors and demands that are difficult to cope with in daily life. The lack of effective care for and difficulty in identifying psychological distress is frustrating for patients and health professionals alike. The aim was therefore to gain more knowledge about the experience of living with psychological distress. Twelve persons (nine women and three men) aged 23-51 years were interviewed. Analyses were based on a phenomenological hermeneutic method and indicated that psychological distress may be seen as an imbalance (incongruence) between the self and the ideal self, which slowly breaks down a person's self-esteem. This imbalance was described in three dimensions: Struggling to cope with everyday life, Feeling inferior to others and Losing one's grip on life. It seems to be associated with a gradual depletion of existential capacities and lead to dissatisfaction, suffering, poor self-esteem and lack of control. As psychological distress may be a forerunner to mental, physical and emotional exhaustion, there is a need to initiate preventive or early interventions to avoid mental, physical and emotional chaos in such patients. Patients' with psychological distress need to be involved in a person-centred salutogenic dialogue with health professionals to become aware of and strengthen their own capacities to regain health and well-being. © 2015 The Authors. Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of Nordic College of Caring Science.

  15. Teachers in Class

    Science.gov (United States)

    Van Galen, Jane

    2008-01-01

    In this article, I argue for a closer read of the daily "class work" of teachers, as posited by Reay, 1998. In developing exploratory class portraits of four teachers who occupy distinctive social positions (two from working-class homes now teaching upper-middle-class children and two from upper-middle-class homes now teaching poor children), I…

  16. Trajectories of psychological distress among low-income, female survivors of Hurricane Katrina.

    Science.gov (United States)

    Lowe, Sarah R; Rhodes, Jean E

    2013-01-01

    The purpose of this study was to investigate trajectories of psychological distress among low-income, primarily unmarried and African American women who survived Hurricane Katrina (N = 386). Data were collected in the year prior to the hurricane as well as approximately 1 and 3 years thereafter. Using Latent Class Growth Analysis (LCGA), we detected 6 distinct trajectory groups. Over half of the participants fit into a trajectory consistent with resilience; that is, they maintained low levels of psychological distress over the course of the study, but experienced an elevation in symptoms at the first predisaster time point followed by a return to predisaster levels. The other trajectories reflected a range of psychological responses to disasters and indicated that predisaster functioning had a major influence on postdisaster psychological outcomes. Degree of exposure to hurricane-related stressors, experiences of human and pet bereavement, perceived social support, and socioeconomic status were significant predictors of trajectory group membership. Implications for research and policy are discussed. © 2013 American Orthopsychiatric Association.

  17. The elusive romance of motherhood:drugs, gender, and reproduction in inner-city distressed households.

    Science.gov (United States)

    Dunlap, Eloise; Stürzenhofecker, Gabriele; Johnson, Bruce

    2006-01-01

    This paper explores the social contexts of reproductive decision making among poor African-American women in inner-city distressed households by focusing on women's narratives of their reproductive and maternal experiences. We explore the hidden agendas and motivations that underpin women's reproductive decisions and perceived choices within the turmoil of poverty, domestic instability, economic uncertainty, and addiction. The political economy of reproduction, within which birthing and motherhood in distressed inner-city households take place, generates the conditions for absent fathers, brittle unions, and a highly skewed gendered division of parenting. Locally constituted notions of gender, agency and autonomy are key dimensions in the cultural constructions of motherhood in these female headed households. Woven into the local maternal experiences is also the desire to 'give and receive love'. By focusing on women's own formulations of responsibility and agency in their reproductive decisions, we can see how they make sense of their reproductive histories and maternal experiences amidst the constraints of poverty, class, race, and substance abuse.

  18. The many faces of moral distress among clinicians.

    Science.gov (United States)

    Rushton, Cynda Hylton; Boss, Renee; Hallett, Kristina; Hensel, Jaime; Humphrey, G Bennett; Les, Jessica; Mack, Cheryl; McCammon, Susan; Murray, John S; Nathanson, Esther; Pniewski, Janet; Shuham, A M t; Volpe, Rebecca L

    2013-01-01

    This narrative symposium illuminates the problem of clinician moral distress. NIB editorial staff and narrative symposium editors, Cynda Rushton, PhD, RN, FAAN and Renee Boss, MD, MHS, developed a call for stories, which was sent to several list serves and posted on Narrative Inquiry in Bioethics' website. The request for personal stories from inter-professional healthcare providers asked them to: identify specific clinical situations that give rise to moral distress; discuss the sources of this distress; reflect on how they experienced moral distress-physically, psychologically, socially, or spiritually; assess how they managed their situations; and offer suggestions for avoiding future problems of a similar nature. Twelve stories are found in the print version of the journal and an additional eight supplemental stories are published online only through Project MUSE. The clinicians describe a wide range of experiences with patients, other clinicians, and their own professional and personal identities. Embedded in each of the narratives are deeply felt emotions that accompany their experiences of moral distress. Katherine Brown-Saltzman (a nurse), Alisa Carse (a philosopher), Zhanna Bagdasarov and Shane Connelly (industrial-organizational psychologists), and Nancy Berlinger (a bioethicist) provided commentaries.

  19. Study the Relationship between Pavement Surface Distress and Roughness Data

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    Mubaraki Muhammad

    2016-01-01

    Full Text Available In this paper, pavement sections from the highway connected Jeddah to Jazan were selected and analyzed to investigate the relationship between International Roughness Index (IRI and pavement damage including; cracking, rutting, and raveling. The Ministry of Transport (MOT of Saudi Arabia has been collecting pavement condition data using the Road Surface Tester (RST vehicle. The MOT measures Roughness, Rutting (RUT, Cracking (CRA, raveling (RAV. Roughness measurements are calculated in terms of the International Roughness Index (IRI. The IRI is calculated over equally spaced intervals along the road profile. Roughness measurements are performed at speed between at 80 kilometers per hour. Thus RST vehicle has been used to evaluate highways across the country. The paper shows three relationships including; cracking (CRA verses roughness (IRI, rutting (RUT verses IRI, and raveling (RAV verses IRI. Also, the paper developed two models namely; model relates IRI to the three distress under study, and model relates IRI to ride quality. The results of the analysis claim at 95% confidence that a significant relationship exist between IRI and cracking, and raveling. It’s also shown that rutting did not show significant relationship to IRI values. That’s leads to conclude that the distresses types: cracking and raveling may possibly be described as ride quality distresses at different level of significant. Rutting distress described as non-ride quality type’s distresses.

  20. Love of life and death distress: two separate factors.

    Science.gov (United States)

    Abdel-Khalek, Ahmed M

    2007-01-01

    The objectives of the current investigation were threefold: a) to explore the gender differences on love of life (a new construct in the well-being domain) and death distress (death anxiety, death depression, and death obsession); b) to explore the relationship between the scales of these constructs; and c) to examine the factorial structure of these scales. The sample was 245 volunteer Kuwaiti college students (53.5% women). Their mean age was 21.9 (SD = 2.3). They responded to the Love of Life Scale, the Death Anxiety Scale, the Arabic Scale of Death Anxiety, the Death Depression Scale-Revised, and the Death Obsession Scale. Gender differences on love of life were not significant. However, women had significantly higher mean scores for the four death distress scales than did their male counterparts. All the correlations between love of life and the death distress scales were not significant except one pertaining to love of life and death depression (negative) in women. Two oblique factors were extracted: death distress and love of life. It was concluded that these constructs represent two distinct and independent factors. Counselors and clinicians dealing with death distress would find that it is not associated with love of life.

  1. Toward interventions to address moral distress: navigating structure and agency.

    Science.gov (United States)

    Musto, Lynn C; Rodney, Patricia A; Vanderheide, Rebecca

    2015-02-01

    The concept of moral distress has been the subject of nursing research for the past 30 years. Recently, there has been a call to move from developing an understanding of the concept to developing interventions to help ameliorate the experience. At the same time, the use of the term moral distress has been critiqued for a lack of clarity about the concepts that underpin the experience. Some researchers suggest that a closer examination of how socio-political structures influence healthcare delivery will move moral distress from being seen as located in the individual to an experience that is also located in broader healthcare structures. Informed by new thinking in relational ethics, we draw on research findings from neuroscience and attachment literature to examine the reciprocal relationship between structures and agents and frame the experience of moral distress. We posit moral distress as a form of relational trauma and subsequently point to the need to better understand how nurses as moral agents are influenced by-and influence-the complex socio-political structures they inhabit. In so doing, we identify this reciprocity as a framework for interventions. © The Author(s) 2014.

  2. Executive Summary: Transforming Moral Distress into Moral Resilience in Nursing.

    Science.gov (United States)

    Rushton, Cynda Hylton; Schoonover-Shoffner, Kathy; Kennedy, Maureen Shawn

    To examine practices for addressing moral distress, a collaborative project was developed by the Johns Hopkins Berman Institute of Bioethics, the Johns Hopkins School of Nursing, the American Journal of Nursing, and the Journal of Christian Nursing, along with the American Association of Critical-Care Nurses and the American Nurses Association. Its purpose was to identify strategies that individuals and systems can use to mitigate the detrimental effects of moral distress and foster moral resilience. On August 11 and 12, 2016, an invitational symposium, State of the Science: Transforming Moral Distress into Moral Resilience in Nursing, was held at the Johns Hopkins School of Nursing in Baltimore, Maryland. Forty-five nurse clinicians, researchers, ethicists, organization representatives, and other stakeholders took part. The result of the symposium was group consensus on recommendations for addressing moral distress and building moral resilience in four areas: practice, education, research, and policy. Participants and the organizations represented were energized and committed to moving this agenda forward. The full report is available online at http://journals.lww.com/ajnonline/Pages/Moral-Distress-Supplement.aspx.

  3. Tinnitus-Related Distress and the Personality Characteristic Resilience

    Directory of Open Access Journals (Sweden)

    Elisabeth Wallhäusser-Franke

    2014-01-01

    Full Text Available It has been suggested that personality traits may be prognostic for the severity of suffering from tinnitus. Resilience as measured with the Wagnild and Young resilience scale represents a positive personality characteristic that promotes adaptation to adverse life conditions including chronic health conditions. Aim of the study was to explore the relation between resilience and tinnitus severity. In a cross-sectional study with a self-report questionnaire, information on tinnitus-related distress and subjective tinnitus loudness was recorded together with the personality characteristic resilience and emotional health, a measure generated from depression, anxiety, and somatic symptom severity scales. Data from 4705 individuals with tinnitus indicate that tinnitus-related distress and to a lesser extent the experienced loudness of the tinnitus show an inverse correlation with resilience. A mediation analysis revealed that the relationship between resilience and tinnitus-related distress is mediated by emotional health. This indirect effect indicates that high resilience is associated with better emotional health or less depression, anxiety, and somatic symptom severity, which in turn is associated with a less distressing tinnitus. Validity of resilience as a predictor for tinnitus-related distress is supported but needs to be explored further in longitudinal studies including acute tinnitus patients.

  4. Psychological distress may affect nutrition indicators in Australian adults.

    Science.gov (United States)

    Leske, Stuart; Strodl, Esben; Harper, Catherine; Clemens, Susan; Hou, Xiang-Yu

    2015-07-01

    The purpose of this research was to explore which demographic and health status variables moderated the relationship between psychological distress and three nutrition indicators: the consumption of fruits, vegetables and takeaway. We analysed data from the 2009 Self-Reported Health Status Survey Report collected in the state of Queensland, Australia. Adults (N = 6881) reported several demographic and health status variables. Moderated logistic regression models were estimated separately for the three nutrition indicators, testing as moderators demographic (age, gender, educational attainment, household income, remoteness, and area-level socioeconomic status) and health status indicators (body mass index, high cholesterol, high blood pressure, and diabetes status). Several significant interactions emerged between psychological distress, demographic (age, area-level socio-economic status, and income level), and health status variables (body mass index, diabetes status) in predicting the nutrition indicators. Relationships between distress and the nutrition indicators were not significantly different by gender, remoteness, educational attainment, high cholesterol status, and high blood pressure status. The associations between psychological distress and several nutrition indicators differ amongst population subgroups. These findings suggest that in distressed adults, age, area-level socio-economic status, income level, body mass index, and diabetes status may serve as protective or risk factors through increasing or decreasing the likelihood of meeting nutritional guidelines. Public health interventions for improving dietary behaviours and nutrition may be more effective if they take into account the moderators identified in this study rather than using global interventions. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Discrimination and psychological distress: does Whiteness matter for Arab Americans?

    Science.gov (United States)

    Abdulrahim, Sawsan; James, Sherman A; Yamout, Rouham; Baker, Wayne

    2012-12-01

    The white racial category in the U.S. encompasses persons who have Arab ancestry. Arab Americans, however, have always occupied a precarious position in relationship to Whiteness. This study examined differences in reporting racial/ethnic discrimination among Arab Americans. It also investigated whether and how the association between discrimination and psychological distress varies by characteristics that capture an Arab American's proximity to/distance from Whiteness. We used data from the Detroit Arab American Study (2003; n = 1016), which includes measures of discrimination and the Kessler-10 scale of psychological distress. A series of logistic regression models were specified to test the discrimination-psychological distress association, stratified by five measures that capture Whiteness--subjective racial identification, religion, skin color, ethnic centrality, and residence in the ethnic enclave. Discrimination was more frequently reported by Muslim Arab Americans, those who racially identify as non-white, and who live in the ethnic enclave. Conversely, the association between discrimination and psychological distress was stronger for Christian Arab Americans, those who racially identify as white, who have dark skin color, and who live outside the ethnic enclave. Even though Arab Americans who occupy an identity location close to Whiteness are less subjected to discrimination, they are more negatively affected by it. The findings illuminate the complex pathways through which discrimination associates with psychological distress among 'white' immigrants. Further research on discrimination and health among Arab Americans can help unpack the white racial category and deconstruct Whiteness.

  6. Financial Distress and Bankruptcy Prediction: Evidence from Ghana

    Directory of Open Access Journals (Sweden)

    Solomon SAMANHYIA

    2016-12-01

    Full Text Available The frequent cases of corporate failures within the financial sector necessitates the need to employ models to predict forehand the financial distressed or bankruptcy state of the financial sector. This study aims at predicting financial distress and bankruptcy on selected listed banks on the stock exchange of a developing West African country, Ghana. Data used for the study spanned from 2008 to 2014. The Altman Z-Score and Boone Indicator were the main means of analysis. The study concluded that poor corporate governance contributes to financial distress and that smaller board size negatively affects corporate performance. The study also concludes that, in a high competitive industry, firms become more efficient and their performance enhanced and thus less likely to be financially distressed. Merging the listed banks indicates financial stability of listed banks albeit one distressed bank. Adoption of best corporate governance standards, enhancing competition through effective corporate strategies and the Central Bank ensuring that banks have enough deposit insurance funds in stock to mitigate the effect of bankruptcy are some of the policy suggestions from the study.

  7. Distress, omnipotence, and responsibility beliefs in command hallucinations.

    Science.gov (United States)

    Ellett, Lyn; Luzon, Olga; Birchwood, Max; Abbas, Zarina; Harris, Abi; Chadwick, Paul

    2017-09-01

    Command hallucinations are considered to be one of the most distressing and disturbing symptoms of schizophrenia. Building on earlier studies, we compare key attributes in the symptomatic, affective, and cognitive profiles of people diagnosed with schizophrenia and hearing voices that do (n = 77) or do not (n = 74) give commands. The study employed a cross-sectional design, in which we assessed voice severity, distress and control (PSYRATs), anxiety and depression (HADS), beliefs about voices (BAVQ-R), and responsibility beliefs (RIQ). Clinical and demographic variables were also collected. Command hallucinations were found to be more distressing and controlling, perceived as more omnipotent and malevolent, linked to higher anxiety and depression, and resisted more than hallucinations without commands. Commanding voices were also associated with higher conviction ratings for being personally responsible for preventing harm. The findings suggest key differences in the affective and cognitive profiles of people who hear commanding voices, which have important implications for theory and psychological interventions. Command hallucinations are associated with higher distress, malevolence, and omnipotence. Command hallucinations are associated with higher responsibility beliefs for preventing harm. Responsibility beliefs are associated with voice-related distress. Future psychological interventions for command hallucinations might benefit from focussing not only on omnipotence, but also on responsibility beliefs, as is done in psychological therapies for obsessive compulsive disorder. Limitations The cross-sectional design does not assess issues of causality. We did not measure the presence or severity of delusions. © 2017 The British Psychological Society.

  8. 'The Right Ventricle in Acute Respiratory Distress Syndrome'.

    Science.gov (United States)

    Zochios, Vasileios; Parhar, Ken; Tunnicliffe, William; Roscoe, Andrew; Gao, Fang

    2017-03-03

    Acute respiratory distress syndrome is associated with poor clinical outcomes with a pooled mortality rate of approximately 40% despite best standards of care. Current therapeutic strategies are based upon improving oxygenation and pulmonary compliance while minimizing ventilator induced lung injury. It has been demonstrated that relative hypoxemia can be well tolerated and improvements in oxygenation do not necessarily translate into survival benefit. Cardiac failure, in particular right ventricular dysfunction, is commonly encountered in moderate to severe acute respiratory distress syndrome and is reported to be one of the major determinants of mortality. The prevalence rate of echocardiographically evident right ventricular dysfunction in acute respiratory distress syndrome varies across studies ranging from 22% to 50%. Although there is no definitive causal relationship between right ventricular dysfunction and mortality, severe right ventricular dysfunction is associated with increased mortality. Factors that can adversely affect right ventricular function include hypoxic pulmonary vasoconstriction, hypercapnia, and invasive ventilation with high driving pressure. It might be expected that early diagnosis of right ventricular dysfunction would be of benefit however, echocardiography markers (qualitative and quantitative) used to prospectively evaluate the right ventricle in acute respiratory distress syndrome have not been tested in adequately powered studies. In this review we examine the prognostic implications and pathophysiology of right ventricular dysfunction in acute respiratory distress syndrome and discuss available diagnostic modalities and treatment options. We aim to identify gaps in knowledge and directions for future research that could potentially improve clinical outcomes in this patient population.

  9. Financial Distress Prediction of Iranian Companies Using Data Mining Techniques

    Directory of Open Access Journals (Sweden)

    Moradi Mahdi

    2013-01-01

    Full Text Available Decision-making problems in the area of financial status evaluation are considered very important. Making incorrect decisions in firms is very likely to cause financial crises and distress. Predicting financial distress of factories and manufacturing companies is the desire of managers and investors, auditors, financial analysts, governmental officials, employees. Therefore, the current study aims to predict financial distress of Iranian Companies. The current study applies support vector data description (SVDD to the financial distress prediction problem in an attempt to suggest a new model with better explanatory power and stability. To serve this purpose, we use a grid-search technique using 3-fold cross-validation to find out the optimal parameter values of kernel function of SVDD. To evaluate the prediction accuracy of SVDD, we compare its performance with fuzzy c-means (FCM.The experiment results show that SVDD outperforms the other method in years before financial distress occurrence. The data used in this research were obtained from Iran Stock Market and Accounting Research Database. According to the data between 2000 and 2009, 70 pairs of companies listed in Tehran Stock Exchange are selected as initial data set.

  10. Mindfulness Based Stress Reduction: effect on emotional distress in diabetes

    Science.gov (United States)

    Young, Laura A; Cappola, Anne R; Baime, Michael J

    2017-01-01

    Psychological distress is common in patients with diabetes. Little is known about the impact of Mindfulness Based Stress Reduction (MBSR), a non-traditional, cognitive behavioural intervention designed to improve stress management skills, in patients with diabetes. The purpose of this retrospective analysis was to evaluate the impact of MBSR training on mood states in 25 individuals with diabetes. All participants completed the Profile of Mood States Short Form (POMS-SF) at baseline and following eight weeks of MBSR. Overall psychological distress measured by the total mood score (TMS) and six subscales – including tension/anxiety, depression/dejection, anger/hostility, fatigue/inertia, confusion/bewilderment and vigour/activity – were assessed. Overall mood, measured by the TMS, as well as all subscale mood measurements improved significantly from baseline following MBSR training. Compared to population means, those with diabetes had higher distress at baseline and similar levels of distress following MBSR training. The primary reason participants reported for enrolling in the MBSR course was to improve stress management skills. It was concluded that MBSR training is a promising, group-based intervention that can be used to decrease psychological distress in individuals with diabetes who perceive a need for training in stress management. PMID:28781569

  11. Emotional distress reported by women and husbands prior to a breast biopsy.

    Science.gov (United States)

    Northouse, L L; Jeffs, M; Cracchiolo-Caraway, A; Lampman, L; Dorris, G

    1995-01-01

    The purpose of this study was to describe the emotional distress of women (N = 300) and husbands (N = 265) prior to the women's breast biopsy and to identify factors related to their levels of distress. Standardized instruments were used to measure social support, uncertainty, marital satisfaction, family functioning, concurrent stress, hopelessness, and emotional distress. Women reported moderately high levels of emotional distress and significantly more distress than their husbands. Forty-two percent of the variance in women's distress scores and 42% of the variance in husbands' distress scores were accounted for by the independent variables. Concurrent stress, lower education, hopelessness, and uncertainty explained the most variance in women's distress, while concurrent stress, hopelessness, and family functioning explained the most variance in husbands' distress.

  12. Non-extremal branes

    Directory of Open Access Journals (Sweden)

    Pablo Bueno

    2015-04-01

    Full Text Available We prove that for arbitrary black brane solutions of generic Supergravities there is an adapted system of variables in which the equations of motion are exactly invariant under electric–magnetic duality, i.e. the interchange of a given extended object by its electromagnetic dual. We obtain thus a procedure to automatically construct the electromagnetic dual of a given brane without needing to solve any further equation. We apply this procedure to construct the non-extremal (p,q-string of Type-IIB String Theory (new in the literature, explicitly showing how the dual (p,q-five-brane automatically arises in this construction. In addition, we prove that the system of variables used is suitable for a generic characterization of every double-extremal Supergravity brane solution, which we perform in full generality.

  13. Tibetans at extreme altitude.

    Science.gov (United States)

    Wu, Tianyi; Li, Shupin; Ward, Michal P

    2005-01-01

    Between 1960 and 2003, 13 Chinese expeditions successfully reached the summit of Chomolungma (Mt Everest or Sagarmatha). Forty-five of the 80 summiteers were Tibetan highlanders. During these and other high-altitude expeditions in Tibet, a series of medical and physiological investigations were carried out on the Tibetan mountaineers. The results suggest that these individuals are better adapted to high altitude and that, at altitude, they have a greater physical capacity than Han (ethnic Chinese) lowland newcomers. They have higher maximal oxygen uptake, greater ventilation, more brisk hypoxic ventilatory responses, larger lung volumes, greater diffusing capacities, and a better quality of sleep. Tibetans also have a lower incidence of acute mountain sickness and less body weight loss. These differences appear to represent genetic adaptations and are obviously significant for humans at extreme altitude. This paper reviews what is known about the physiologic responses of Tibetans at extreme altitudes.

  14. Extremal periodic wave profiles

    Directory of Open Access Journals (Sweden)

    E. van Groesen

    2007-01-01

    Full Text Available As a contribution to deterministic investigations into extreme fluid surface waves, in this paper wave profiles of prescribed period that have maximal crest height will be investigated. As constraints the values of the momentum and energy integrals are used in a simplified description with the KdV model. The result is that at the boundary of the feasible region in the momentum-energy plane, the only possible profiles are the well known cnoidal wave profiles. Inside the feasible region the extremal profiles of maximal crest height are "cornered" cnoidal profiles: cnoidal profiles of larger period, cut-off and periodically continued with the prescribed period so that at the maximal crest height a corner results.

  15. Extreme Photonics & Applications

    CERN Document Server

    Hall, Trevor J; Paredes, Sofia A

    2010-01-01

    "Extreme Photonics & Applications" arises from the 2008 NATO Advanced Study Institute in Laser Control & Monitoring in New Materials, Biomedicine, Environment, Security and Defense. Leading experts in the manipulation of light offered by recent advances in laser physics and nanoscience were invited to give lectures in their fields of expertise and participate in discussions on current research, applications and new directions. The sum of their contributions to this book is a primer for the state of scientific knowledge and the issues within the subject of photonics taken to the extreme frontiers: molding light at the ultra-finest scales, which represents the beginning of the end to limitations in optical science for the benefit of 21st Century technological societies. Laser light is an exquisite tool for physical and chemical research. Physicists have recently developed pulsed lasers with such short durations that one laser shot takes the time of one molecular vibration or one electron rotation in an ...

  16. Extremal Hairy Black Holes

    CERN Document Server

    Gonzalez, P A; Saavedra, Joel; Vasquez, Yerko

    2014-01-01

    We consider a gravitating system consisting of a scalar field minimally coupled to gravity with a self-interacting potential and an U(1) electromagnetic field. Solving the coupled Einstein-Maxwell-scalar system we find exact hairy charged black hole solutions with the scalar field regular everywhere. We go to the zero temperature limit and we study the effect of the scalar field on the near horizon geometry of an extremal black hole. We find that except a critical value of the charge of the black hole there is also a critical value of the charge of the scalar field beyond of which the extremal black hole is destabilized. We study the thermodynamics of these solutions and we find that if the space is flat then at low temperature the Reissner-Nordstr\\"om black hole is thermodynamically preferred, while if the space is AdS the hairy charged black hole is thermodynamically preferred at low temperature.

  17. Sexual Distress and Sexual Problems During Pregnancy: Associations With Sexual and Relationship Satisfaction.

    Science.gov (United States)

    Vannier, Sarah A; Rosen, Natalie O

    2017-03-01

    Sexual problems are common during pregnancy, but the proportion of pregnant women who experience sexual distress is unknown. In non-pregnant samples, sexual distress is associated with lower sexual and relationship satisfaction. To identify the proportion of women experiencing sexual distress during pregnancy and to compare the sexual and relationship satisfaction of women who report sexual distress during pregnancy with that of women without distress. Two-hundred sixty-one pregnant women completed a cross-sectional online survey. Women completed validated measurements of sexual functioning (Female Sexual Function Index; score relationship satisfaction (Couples Satisfaction Index). Overall, 42% of women met the clinical cutoff for sexual distress. Of sexually active women (n = 230), 26% reported concurrent sexual problems and distress and 14% reported sexual distress in the absence of sexual problems. Sexual distress and/or problems in sexual functioning were linked to lower sexual and relationship satisfaction compared with pregnant women with lower sexual distress and fewer sexual problems. Sexual distress is common during pregnancy and associated with lower sexual and relationship satisfaction. Health care providers should ask pregnant women about feelings of sexual distress. Identifying pregnant women who experience sexual distress and referring them to appropriate resources could help minimize sexual and relationship problems during pregnancy. Vannier SA, Rosen NO. Sexual Distress and Sexual Problems During Pregnancy: Associations With Sexual and Relationship Satisfaction. J Sex Med 2017;14:387-395. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  18. Religious Extremism in Pakistan

    Science.gov (United States)

    2014-12-01

    Face (July 2008): 32. 21 Ahmed Rashid , Pakistan on the Brink: The Future of America, Pakistan, and Afghanistan (New York: Viking, 2012). 22 Brian J...promoting extremism. Commentators such as Jessica Stern, Alan Richards, Hussain Haqqani, Ahmed Rashid , and Ali Riaz are a few of the scholars who...www.jstor.org/stable/3183558; See also Ahmed Rashid , Descent Into Chaos: The United States and the Failure of Nation Building in Pakistan, Afghanistan, and

  19. USACE Extreme Sea levels

    Science.gov (United States)

    2014-03-14

    report summarising the results of the research, together with a set of recommendations arising from the research. This report describes progress to...Southampton University at HR Wallingford and subsequent teleconference with Heidi Moritz and Kate White. The notes summarising the findings of the...suggestion was made that we may want to begin talking about extreme water levels separate from storms. Ivan mentioned an analysis of storminess which

  20. Extreme geomagnetically induced currents

    Science.gov (United States)

    Kataoka, Ryuho; Ngwira, Chigomezyo

    2016-12-01

    We propose an emergency alert framework for geomagnetically induced currents (GICs), based on the empirically extreme values and theoretical upper limits of the solar wind parameters and of d B/d t, the time derivative of magnetic field variations at ground. We expect this framework to be useful for preparing against extreme events. Our analysis is based on a review of various papers, including those presented during Extreme Space Weather Workshops held in Japan in 2011, 2012, 2013, and 2014. Large-amplitude d B/d t values are the major cause of hazards associated with three different types of GICs: (1) slow d B/d t with ring current evolution (RC-type), (2) fast d B/d t associated with auroral electrojet activity (AE-type), and (3) transient d B/d t of sudden commencements (SC-type). We set "caution," "warning," and "emergency" alert levels during the main phase of superstorms with the peak Dst index of less than -300 nT (once per 10 years), -600 nT (once per 60 years), or -900 nT (once per 100 years), respectively. The extreme d B/d t values of the AE-type GICs are 2000, 4000, and 6000 nT/min at caution, warning, and emergency levels, respectively. For the SC-type GICs, a "transient alert" is also proposed for d B/d t values of 40 nT/s at low latitudes and 110 nT/s at high latitudes, especially when the solar energetic particle flux is unusually high.

  1. Extremes in nature

    CERN Document Server

    Salvadori, Gianfausto; Kottegoda, Nathabandu T

    2007-01-01

    This book is about the theoretical and practical aspects of the statistics of Extreme Events in Nature. Most importantly, this is the first text in which Copulas are introduced and used in Geophysics. Several topics are fully original, and show how standard models and calculations can be improved by exploiting the opportunities offered by Copulas. In addition, new quantities useful for design and risk assessment are introduced.

  2. RxClass

    Data.gov (United States)

    U.S. Department of Health & Human Services — The RxClass Browser is a web application for exploring and navigating through the class hierarchies to find the RxNorm drug members associated with each class....

  3. Unhealthy behaviour modification, psychological distress, and 1-year survival in cardiac rehabilitation.

    Science.gov (United States)

    Gostoli, Sara; Roncuzzi, Renzo; Urbinati, Stefano; Morisky, Donald E; Rafanelli, Chiara

    2016-11-01

    Cardiac rehabilitation (CR) is considered the recommended secondary prevention treatment for cardiovascular diseases (CVD), in terms of health behaviours and, secondarily, better cardiac outcomes promotion. However, the role of psychiatric and psychosomatic distress on the efficacy of CR is unclear. This research aimed to evaluate the impact of CR on unhealthy behaviour modification and cardiac course, considering the moderating role of depression, anxiety, and psychosomatic syndromes. A longitudinal design between and within groups was employed. The assessment was repeated four times: at admission to CR (T1), at discharge (T2), 6 (T3) and 12 months following CR completion (T4). One hundred and eight patients undergoing CR versus 85 patients with CVD not referred to CR, underwent psychiatric, psychosomatic, and health behaviour assessment. The assessment included the Structured Clinical Interview for DSM-IV (depression and anxiety), the interview based on Diagnostic Criteria for Psychosomatic Research, GOSPEL Study questionnaire (health behaviours), Pittsburgh Sleep Quality Index, and 8-item Morisky Medication Adherence Scale. Cardiac rehabilitation was associated with maintenance of physical activity, improvement of behavioural aspects related to food consumption, stress management, and sleep quality. On the contrary, CR was not associated with weight loss, healthy diet, and medication adherence. Depression and psychosomatic syndromes seem to moderate the modification of specific health-related behaviours (physical activity, behavioural aspects of food consumption, stress management, and pharmacological adherence). In CR settings, an integrated assessment including both psychiatric and psychosomatic syndromes is needed to address psychological factors associated with unhealthy behaviour modification. Statement of contribution What is already known on this subject? Cardiac rehabilitation (CR) is considered a class 1A treatment recommendation and the most cost

  4. Early parenting program as intervention strategy for emotional distress in first-time mothers: a propensity score analysis.

    Science.gov (United States)

    Okamoto, Miwako; Ishigami, Hideaki; Tokimoto, Kumiko; Matsuoka, Megumi; Tango, Ryoko

    2013-08-01

    The purpose of this study is to evaluate the effectiveness of a single session intervention designed to reduce emotional distress in first-time mothers. We held a parenting class for first-time mothers who had given birth at a university hospital in Tokyo, Japan. The program of the class consists of lectures on infant care and group discussion, which is a common form of intervention in Japan. The effectiveness of intervention is assessed according to differences in emotional distress experienced by class participants and nonparticipants, and analyzed by the use of a propensity score method to avoid self-selection bias. In order to be more confident about our results, we employ several variations of this method. Results from statistical analysis show that although the effectiveness of the intervention was limited, it was able to alleviate subjects' loss of self-confidence as mothers. Because this outcome shows a good degree of consistency across methods, it can be considered robust. Moreover, it is roughly consistent with previous studies. Effectiveness can probably be increased by developing a program that improves upon the intervention.

  5. Nurses' workplace distress and ethical dilemmas in Tanzanian health care.

    Science.gov (United States)

    Häggström, Elisabeth; Mbusa, Ester; Wadensten, Barbro

    2008-07-01

    The aim of this study was to describe Tanzanian nurses' meaning of and experiences with ethical dilemmas and workplace distress in different care settings. An open question guide was used and the study focused on the answers that 29 registered nurses supplied. The theme, ;Tanzanian registered nurses' invisible and visible expressions about existential conditions in care', emerged from several subthemes as: suffering from (1) workplace distress; (2) ethical dilemmas; (3) trying to maintaining good quality nursing care; (4) lack of respect, appreciation and influence; and (5) a heavy workload that did not prevent registered nurses from struggling for better care for their patients. The analysis shows that, on a daily basis, nurses find themselves working on the edge of life and death, while they have few opportunities for doing anything about this situation. Nurses need professional guidance to gain insight and be able to reflect on their situations, so that they do not become overloaded with ethical dilemmas and workplace distress.

  6. Acute respiratory distress syndrome: epidemiology and management approaches

    Directory of Open Access Journals (Sweden)

    Walkey AJ

    2012-07-01

    Full Text Available Allan J Walkey,1 Ross Summer,1 Vu Ho,1 Philip Alkana21The Pulmonary Center, Boston University School of Medicine, Boston, MA, USA; 2Asthma Research Center, Brigham and Women's Hospital, Boston, MA, USAAbstract: Acute lung injury and the more severe acute respiratory distress syndrome represent a spectrum of lung disease characterized by the sudden onset of inflammatory pulmonary edema secondary to myriad local or systemic insults. The present article provides a review of current evidence in the epidemiology and treatment of acute lung injury and acute respiratory distress syndrome, with a focus on significant knowledge gaps that may be addressed through epidemiologic methods.Keywords: acute lung injury, acute respiratory distress syndrome, review, epidemiology

  7. Discrimination and Psychological Distress among Recently Released Male Prisoners

    Science.gov (United States)

    Turney, Kristin; Lee, Hedwig; Comfort, Megan

    2013-01-01

    Though theoretical perspectives suggest experiences of stigma and discrimination after release may be one pathway through which incarceration leads to poor mental health, little research considers the relationship between discrimination and mental health among former inmates. In this paper, data from a sample of men recently released from prison to Oakland or San Francisco, California (N = 172), is used to consider how criminal record discrimination and racial/ethnic discrimination are independently and cumulatively associated with psychological distress. Results indicate (1) the frequency of criminal record discrimination and racial/ethnic discrimination are similar; (2) both forms of discrimination are independently, negatively associated with psychological distress; and (3) the level of racial/ethnic discrimination does not alter the association between criminal record discrimination and psychological distress. The results highlight that criminal record discrimination is an important social stressor with negative implications for the mental health of previously incarcerated individuals. PMID:23553444

  8. Intrathoracic cystic hygroma with sudden respiratory distress mimicking pneumonia

    Directory of Open Access Journals (Sweden)

    Umesh Goneppanavar

    2012-01-01

    Full Text Available Benign cystic lesions such as cystic hygroma commonly manifest as progressively increasing swelling in the neck with or without compression effects. Rarely, they present with sudden respiratory distress in instances such as infection or haematoma resulting in a sudden increase in the size of the tumour. We present a seven month old child with sudden onset respiratory distress without any obvious neck swelling. The chest X ray findings correlated with the history and were suggestive of right upper lobe pneumonia that leads to a wrong diagnosis of aspiration pneumonia. However, presence of a deviated trachea in the neck raised a suspicion of possible mass. Computed tomogram showed a large cystic mass in the right upper mediastinum with tracheal collapse. We caution intensivists and paediatricians that sudden respiratory distress in infants in the absence of obvious neck swelling does not rule out possibility of intrathoracic tumour.

  9. Plasma Physics of Extreme Astrophysical Environments

    CERN Document Server

    Uzdensky, Dmitri A

    2014-01-01

    Certain classes of astrophysical objects, namely magnetars and central engines of supernovae and gamma-ray bursts (GRBs), are characterized by extreme physical conditions not encountered elsewhere in the Universe. In particular, they possess magnetic fields that exceed the critical quantum field of 44 teragauss. Figuring out how these complex ultra-magnetized systems work requires understanding various plasma processes, both small-scale kinetic and large-scale magnetohydrodynamic (MHD). However, an ultra-strong magnetic field modifies the underlying physics to such an extent that many relevant plasma-physical problems call for building QED-based relativistic quantum plasma physics. In this review, after describing the extreme astrophysical systems of interest and identifying the key relevant plasma-physical problems, we survey the recent progress in the development of such a theory. We discuss how a super-critical field modifies the properties of vacuum and matter and outline the basic theoretical framework f...

  10. On extreme points of the diffusion polytope

    Science.gov (United States)

    Hay, M. J.; Schiff, J.; Fisch, N. J.

    2017-05-01

    We consider a class of diffusion problems defined on simple graphs in which the populations at any two vertices may be averaged if they are connected by an edge. The diffusion polytope is the convex hull of the set of population vectors attainable using finite sequences of these operations. A number of physical problems have linear programming solutions taking the diffusion polytope as the feasible region, e.g. the free energy that can be removed from plasma using waves, so there is a need to describe and enumerate its extreme points. We review known results for the case of the complete graph Kn, and study a variety of problems for the path graph Pn and the cyclic graph Cn. We describe the different kinds of extreme points that arise, and identify the diffusion polytope in a number of simple cases. In the case of increasing initial populations on Pn the diffusion polytope is topologically an n-dimensional hypercube.

  11. Patterns of gender equality at workplaces and psychological distress.

    Directory of Open Access Journals (Sweden)

    Sofia Elwér

    Full Text Available Research in the field of occupational health often uses a risk factor approach which has been criticized by feminist researchers for not considering the combination of many different variables that are at play simultaneously. To overcome this shortcoming this study aims to identify patterns of gender equality at workplaces and to investigate how these patterns are associated with psychological distress. Questionnaire data from the Northern Swedish Cohort (n = 715 have been analysed and supplemented with register data about the participants' workplaces. The register data were used to create gender equality indicators of women/men ratios of number of employees, educational level, salary and parental leave. Cluster analysis was used to identify patterns of gender equality at the workplaces. Differences in psychological distress between the clusters were analysed by chi-square test and logistic regression analyses, adjusting for individual socio-demographics and previous psychological distress. The cluster analysis resulted in six distinctive clusters with different patterns of gender equality at the workplaces that were associated to psychological distress for women but not for men. For women the highest odds of psychological distress was found on traditionally gender unequal workplaces. The lowest overall occurrence of psychological distress as well as same occurrence for women and men was found on the most gender equal workplaces. The results from this study support the convergence hypothesis as gender equality at the workplace does not only relate to better mental health for women, but also more similar occurrence of mental ill-health between women and men. This study highlights the importance of utilizing a multidimensional view of gender equality to understand its association to health outcomes. Health policies need to consider gender equality at the workplace level as a social determinant of health that is of importance for reducing

  12. Patterns of gender equality at workplaces and psychological distress.

    Science.gov (United States)

    Elwér, Sofia; Harryson, Lisa; Bolin, Malin; Hammarström, Anne

    2013-01-01

    Research in the field of occupational health often uses a risk factor approach which has been criticized by feminist researchers for not considering the combination of many different variables that are at play simultaneously. To overcome this shortcoming this study aims to identify patterns of gender equality at workplaces and to investigate how these patterns are associated with psychological distress. Questionnaire data from the Northern Swedish Cohort (n = 715) have been analysed and supplemented with register data about the participants' workplaces. The register data were used to create gender equality indicators of women/men ratios of number of employees, educational level, salary and parental leave. Cluster analysis was used to identify patterns of gender equality at the workplaces. Differences in psychological distress between the clusters were analysed by chi-square test and logistic regression analyses, adjusting for individual socio-demographics and previous psychological distress. The cluster analysis resulted in six distinctive clusters with different patterns of gender equality at the workplaces that were associated to psychological distress for women but not for men. For women the highest odds of psychological distress was found on traditionally gender unequal workplaces. The lowest overall occurrence of psychological distress as well as same occurrence for women and men was found on the most gender equal workplaces. The results from this study support the convergence hypothesis as gender equality at the workplace does not only relate to better mental health for women, but also more similar occurrence of mental ill-health between women and men. This study highlights the importance of utilizing a multidimensional view of gender equality to understand its association to health outcomes. Health policies need to consider gender equality at the workplace level as a social determinant of health that is of importance for reducing differences in health

  13. Psychological distress and coping in military cadre candidates

    Directory of Open Access Journals (Sweden)

    Nakkas C

    2016-08-01

    Full Text Available Can Nakkas,1 Hubert Annen,1 Serge Brand2,3 1Department of Military Psychology Studies, Military Academy at ETH Zurich, Zurich, 2Psychiatric Clinics of the University of Basel, Center for Affective, Stress and Sleep Disorders, 3Department of Sport, Exercise and Health, Sport Science Section, University of Basel, Basel, Switzerland Background: Soldiers must cope with stressors during both military operations and training if they are to accomplish their missions successfully and stay mentally stable. This holds true particularly for military superiors, as they bear greater responsibilities and must meet greater demands during both deployment and training. Accordingly, in the present study, we investigated whether recruits chosen for further promotion at the end of basic training differed with regard to psychological distress and coping strategies from those not chosen for promotion, and whether recruits’ coping styles and distress levels were associated. Methods: A total of 675 Swiss recruits took part in the study. At the beginning of basic training, recruits filled out self-rating questionnaires covering demographic data, psychological distress (depression, somatization, anxiety, interpersonal sensitivity, and hostility, and coping styles. Results were compared between those recruits who received a recommendation for further promotion at the end of basic training and those who did not. Results: Recruits selected for promotion had lower scores for depressive symptoms and hostility, engaged more in active coping, and considered their coping to be more effective. Dysfunctional and functional coping were associated with higher and lower distress levels, respectively. Conclusion: Recruits recommended for promotion exhibited less psychological distress during basic training and exhibited a socially more conducive profile of distress. They also endorsed more efficient and more prosocial coping strategies than those recruits not recommended for

  14. Psychological distress related to BRCA testing in ovarian cancer patients.

    Science.gov (United States)

    Bjørnslett, Merete; Dahl, Alv A; Sørebø, Øystein; Dørum, Anne

    2015-12-01

    An increasing demand for genetic testing has moved the procedure from highly selected at-risk individuals, now also including cancer patients for treatment associated testing. The heritable fraction of ovarian cancer is more than 10%, and our department has offered BRCA testing to such patients irrespective of family history since 2002. This study examined potential psychosocial distress associated with this procedure using The Multidimensional Impact of Cancer Risk Assessment (MICRA) questionnaire and other patient-rated generic distress instruments. Patients were divided into four groups according to cancer risk: mutation carriers, own history of breast cancer and ovarian cancer, family history of breast cancer and/or ovarian cancer, and patients without family history. In a postal survey, 354 patients responded. Good acceptance of the MICRA was observed, and previously described good psychometric properties were confirmed. A significant association between MICRA total score and receiving a positive BRCA test result was found. No significant between-group differences were observed with generic distress instruments. Time since cancer diagnosis, test result, and survey showed no significant associations with MICRA scores. Internal consistencies of instruments were adequate. Exploratory and confirmatory factor analyses showed adequate fit indices for a three factor solution of the MICRA, but further refinement of the items should be considered. In conclusion, the specific types of worry and distress most relevant to receiving genetic testing irrespective of family history were not captured by the generic distress instruments. The MICRA was supported as a useful tool for detection of mental distress related to genetic testing and risk evaluation.

  15. Psychological distress in parents of children with advanced cancer.

    Science.gov (United States)

    Rosenberg, Abby R; Dussel, Veronica; Kang, Tammy; Geyer, J Russel; Gerhardt, Cynthia A; Feudtner, Chris; Wolfe, Joanne

    2013-06-01

    Parent psychological distress can impact the well-being of childhood cancer patients and other children in the home. Recognizing and alleviating factors of parent distress may improve overall family survivorship experiences following childhood cancer. To describe the prevalence and factors of psychological distress (PD) among parents of children with advanced cancer. Cohort study embedded within a randomized clinical trial (Pediatric Quality of Life and Evaluation of Symptoms Technology [PediQUEST] study). Multicenter study conducted at 3 children's hospitals (Boston Children's Hospital, Children's Hospital of Philadelphia, and Seattle Children's Hospital). Parents of children with advanced (progressive, recurrent, or refractory) cancer. Parental PD, as measured by the Kessler-6 Psychological Distress Scale. Eighty-six of 104 parents completed the Survey About Caring for Children With Cancer (83% participation); 81 parents had complete Kessler-6 Psychological Distress Scale data. More than 50% of parents reported high PD and 16% met criteria for serious PD (compared with US prevalence of 2%-3%). Parent perceptions of prognosis, goals of therapy, child symptoms/suffering, and financial hardship were associated with PD. In multivariate analyses, average parent Kessler-6 Psychological Distress Scale scores were higher among parents who believed their child was suffering highly and who reported great economic hardship. Conversely, PD was significantly lower among parents whose prognostic understanding was aligned with concrete goals of care. Parenting a child with advanced cancer is strongly associated with high to severe levels of PD. Interventions aimed at aligning prognostic understanding with concrete care goals and easing child suffering and financial hardship may mitigate parental PD.

  16. Psychological distress and coping in military cadre candidates

    Science.gov (United States)

    Nakkas, Can; Annen, Hubert; Brand, Serge

    2016-01-01

    Background Soldiers must cope with stressors during both military operations and training if they are to accomplish their missions successfully and stay mentally stable. This holds true particularly for military superiors, as they bear greater responsibilities and must meet greater demands during both deployment and training. Accordingly, in the present study, we investigated whether recruits chosen for further promotion at the end of basic training differed with regard to psychological distress and coping strategies from those not chosen for promotion, and whether recruits’ coping styles and distress levels were associated. Methods A total of 675 Swiss recruits took part in the study. At the beginning of basic training, recruits filled out self-rating questionnaires covering demographic data, psychological distress (depression, somatization, anxiety, interpersonal sensitivity, and hostility), and coping styles. Results were compared between those recruits who received a recommendation for further promotion at the end of basic training and those who did not. Results Recruits selected for promotion had lower scores for depressive symptoms and hostility, engaged more in active coping, and considered their coping to be more effective. Dysfunctional and functional coping were associated with higher and lower distress levels, respectively. Conclusion Recruits recommended for promotion exhibited less psychological distress during basic training and exhibited a socially more conducive profile of distress. They also endorsed more efficient and more prosocial coping strategies than those recruits not recommended for promotion. These cognitive–emotional features not only contribute to resilience but are also consistent with leadership research, indicating the importance of emotional stability and prosocial behavior in successful leaders. PMID:27621634

  17. The influence of extreme traumatization on body, mind and social relations

    DEFF Research Database (Denmark)

    Rosenbaum, Bent; Varvin, Sverre

    2007-01-01

    be given to the destruction of the ability to regulate negative emotions (extreme fear, distress, anguish, anger, rage, shame) in relation to others and activate internal good and empathic object relations. Destruction of the capacity for symbolization of traumatic experience may threaten the mind......, the subject-group dimension, and the subject-discourse dimension. All three dimensions have specific structural characteristics that are expressed in the analytic relation. Extreme trauma causes disturbances in each of these dimensions. The authors present clinical material from a traumatized refugee...

  18. Violence against Congolese refugee women in Rwanda and mental health: a cross-sectional study using latent class analysis.

    Science.gov (United States)

    Sipsma, Heather L; Falb, Kathryn L; Willie, Tiara; Bradley, Elizabeth H; Bienkowski, Lauren; Meerdink, Ned; Gupta, Jhumka

    2015-04-23

    To examine patterns of conflict-related violence and intimate partner violence (IPV) and their associations with emotional distress among Congolese refugee women living in Rwanda. Cross-sectional study. Two Congolese refugee camps in Rwanda. 548 ever-married Congolese refugee women of reproductive age (15-49 years) residing in Rwanda. Our primary outcome was emotional distress as measured using the Self-Report Questionnaire-20 (SRQ-20). For analysis, we considered participants with scores greater than 10 to be experiencing emotional distress and participants with scores of 10 or less not to be experiencing emotional distress. Almost half of women (49%) reported experiencing physical, emotional or sexual violence during the conflict, and less than 10% of women reported experiencing of any type of violence after fleeing the conflict. Lifetime IPV was reported by approximately 22% of women. Latent class analysis derived four distinct classes of violence experiences, including the Low All Violence class, the High Violence During Conflict class, the High IPV class and the High Violence During and After Conflict class. In multivariate regression models, latent class was strongly associated with emotional distress. Compared with women in the Low All Violence class, women in the High Violence During and After Conflict class and women in the High Violence During Conflict had 2.7 times (95% CI 1.11 to 6.74) and 2.3 times (95% CI 1.30 to 4.07) the odds of experiencing emotional distress in the past 4 weeks, respectively. Furthermore, women in the High IPV class had a 4.7 times (95% CI 2.53 to 8.59) greater odds of experiencing emotional distress compared with women in the Low All Violence class. Experiences of IPV do not consistently correlate with experiences of conflict-related violence, and women who experience high levels of IPV may have the greatest likelihood for poor mental health in conflict-affected settings. Published by the BMJ Publishing Group Limited. For

  19. [The Life Style Index: correlations with psychological distress and hostility].

    Science.gov (United States)

    Hyphantis, T; Floros, G D; Goulia, P; Iconomou, G; Assimakopoulos, K

    2011-01-01

    The Life Style Index (LSI) was designed to assess defense mechanisms, assuming that their use is related to specific emotional states and diagnostic concepts. Aiming to further investigate the psychometric properties of the Greek version of the LSI, the aim of the present study was to investigate the relationship of specific defense mechanisms with dimensions of psychological distress and hostility features in three different populations. The sample comprised 1261 adults (410 healthy participants, 723 medical patients and 128 psychiatric patients). Along with defense mechanisms (LSI), Psychological Distress (General Health Questionnaire, GHQ-28) and Hostility features (Hostility and Direction of Hostility Questionnaire, HDHQ) were also assessed. The results showed that increased psychological distress is related with increased use of all defenses except Denial, with which psychological distress is negatively associated. Regression is constantly related with psychological distress and differentiates psychiatric patients from the other groups of participants, while Compensation and Reaction Formation are related to depressive symptomatology. In medical patients, Repression was found to increase the physical dimension of psychological distress and the social dysfunction. On the contrary,Denial was negatively associated with these dimensions of psychological distress. In the psychiatric patient and healthy participant samples, Projection plays the most detrimental role. Regarding hostility and direction of hostility, those who were found to introvert their hostility presented with higher scores in Denial, indicating that they possibly 'deny' their hostility, and the degree of the Denial was found to be negatively associated with the degree of Introverted Hostility. Those who directed their hostility towards the others, presented with higher rates of Projection, while neither Denial nor Reaction Formation seemed sufficient enough to temper the degree of Extroverted

  20. Turnaround distressed physician practices. 20 tips for success.

    Science.gov (United States)

    Wolper, L F

    1999-01-01

    Physician practices are restructuring through merger and acquisition, and sale to practice management companies and to hospital systems. Many also are expanding internally by recruiting new physicians and opening additional offices. For many these strategies are working, but many others are experiencing operational and financial distress and failure that arise from rapid organizational growth without concomitant infrastructural change. Further, in the last several months, many national and regional practice management companies have decided to withdraw from the business, and others have declared bankruptcy. The number of physician practices that are in financial and operational distress is unprecedented. These groups require a solution, as proposed in this article.

  1. Successful Solutions to SSME/AT Development Turbine Blade Distress

    Science.gov (United States)

    Montgomery, Stuart K.

    1999-01-01

    As part of the High-Pressure Fuel Turbopump/Alternate Turbopump (HPFTP/AT) turbine blade development program, unique turbine blade design features were implemented to address 2nd stage turbine blade high cycle fatigue distress and improve turbine robustness. Features included the addition of platform featherseal dampers, asymmetric blade tip seal segments, gold plating of the blade attachments, and airfoil tip trailing edge modifications. Development testing shows these features have eliminated turbine blade high cycle fatigue distress and consequently these features are currently planned for incorporation to the flight configuration. Certification testing will begin in 1999. This presentation summarizes these features.

  2. Extreme Programming Pocket Guide

    CERN Document Server

    Chromatic

    2003-01-01

    Extreme Programming (XP) is a radical new approach to software development that has been accepted quickly because its core practices--the need for constant testing, programming in pairs, inviting customer input, and the communal ownership of code--resonate with developers everywhere. Although many developers feel that XP is rooted in commonsense, its vastly different approach can bring challenges, frustrations, and constant demands on your patience. Unless you've got unlimited time (and who does these days?), you can't always stop to thumb through hundreds of pages to find the piece of info

  3. Mycetoma of lower extremity

    Directory of Open Access Journals (Sweden)

    Sahariah S

    1978-01-01

    Full Text Available Ten cases of mycetoma of the lower extremity were seen and treated at the Postgraduate Institute of Medical Education & Research, Chandigarh, India, during the years 1973 to 1975. Six were treated by conservative method e.g. antibiotics, sulfonamides and immobilization of the part while remaining four were submitted t o surgery. Four out o f six from the first group had recurrence and has been put on second line of therapy. Recurrence occurred in only one case from the second group and he required an above knee amputation while the remaining three are free of disease and are well rehabilitated.

  4. Metagenomics of extreme environments.

    Science.gov (United States)

    Cowan, D A; Ramond, J-B; Makhalanyane, T P; De Maayer, P

    2015-06-01

    Whether they are exposed to extremes of heat or cold, or buried deep beneath the Earth's surface, microorganisms have an uncanny ability to survive under these conditions. This ability to survive has fascinated scientists for nearly a century, but the recent development of metagenomics and 'omics' tools has allowed us to make huge leaps in understanding the remarkable complexity and versatility of extremophile communities. Here, in the context of the recently developed metagenomic tools, we discuss recent research on the community composition, adaptive strategies and biological functions of extremophiles.

  5. Characterizing Extreme Ionospheric Storms

    Science.gov (United States)

    Sparks, L.; Komjathy, A.; Altshuler, E.

    2011-12-01

    Ionospheric storms consist of disturbances of the upper atmosphere that generate regions of enhanced electron density typically lasting several hours. Depending upon the storm magnitude, gradients in electron density can sometimes become large and highly localized. The existence of such localized, dense irregularities is a major source of positioning error for users of the Global Positioning System (GPS). Consequently, satellite-based augmentation systems have been implemented to improve the accuracy and to ensure the integrity of user position estimates derived from GPS measurements. Large-scale irregularities generally do not pose a serious threat to estimate integrity as they can be readily detected by such systems. Of greater concern, however, are highly localized irregularities that interfere with the propagation of a signal detected by a user measurement but are poorly sampled by the receivers in the system network. The most challenging conditions have been found to arise following disturbances of large magnitude that occur only rarely over the course of a solar cycle. These extremely disturbed conditions exhibit behavior distinct from moderately disturbed conditions and, hence, have been designated "extreme storms". In this paper we examine and compare the behavior of the extreme ionospheric storms of solar cycle 23 (or, more precisely, extreme storms occurring between January 1, 2000, and December 31, 2008), as represented in maps of vertical total electron content. To identify these storms, we present a robust means of quantifying the regional magnitude of an ionospheric storm. Ionospheric storms are observed frequently to occur in conjunction with magnetic storms, i.e., periods of geophysical activity as measured by magnetometers. While various geomagnetic indices, such as the disturbance storm time (Dst) and the planetary Kp index, have long been used to rank the magnitudes of distinct magnetic storms, no comparable, generally recognized index exists for

  6. Winter Storms and Extreme Cold

    Science.gov (United States)

    ... Landslides & Debris Flow Nuclear Blast Nuclear Power Plants Power Outages Pandemic Radiological Dispersion Device Severe Weather Snowstorms & Extreme ... Landslides & Debris Flow Nuclear Blast Nuclear Power Plants Power Outages Pandemic Radiological Dispersion Device Severe Weather Snowstorms & Extreme ...

  7. Correlates of psychological distress, burnout, and resilience among Chinese female nurses

    Science.gov (United States)

    ZOU, Guiyuan; SHEN, Xiuying; TIAN, Xiaohong; LIU, Chunqin; LI, Guopeng; KONG, Linghua; LI, Ping

    2016-01-01

    The present survey investigated the association between resilience, burnout and psychological distress among Chinese female nurses. A total of 366 female nurses were enrolled in our study. A series of self-reported questionnaires that dispose of the following constructs: psychological distress, burnout, and resilience were estimated. The hierarchical linear regression models were used to evaluate the mediating effect of resilience on the relationship between burnout and psychological distress. Results of the survey showed 85.5% nurses experienced psychological distress. Resilience was negatively related to psychological distress and burnout whereas burnout was positively associated with psychological distress. Mediation analysis revealed that resilience could partially mediate the relationship between the dimensions of emotional exhaustion, depersonalization, and psychological distress. This study highlights the mediator of resilience between burnout and psychological distress of female nurses. As such, interventions that attend to resilience training may be the focus for future clinical and research endeavors. PMID:27021058

  8. Is implementing screening for distress an efficient means to recruit patients to a psychological intervention trial?

    NARCIS (Netherlands)

    van Scheppingen, Corinne; Schroevers, Maya J.; Pool, Grieteke; Smink, Ans; Mul, Veronique E.; Coyne, James C.; Sanderman, Robbert

    2014-01-01

    ObjectivesPsychological interventions show greater efficacy when evaluated with distressed patients. We report on the feasibility of implementing screening for recruiting distressed cancer patients to a randomized controlled trial of problem-solving therapy (PST), characteristics associated with enr

  9. Maternal psychological distress and fetal growth trajectories: the Generation R Study

    NARCIS (Netherlands)

    J. Henrichs (Jens); J.J. Schenk (Jacqueline); S.J. Roza (Sabine); M.P. Lambregtse-van den Berg (Mijke); H.G. Schmidt (Henk); E.A.P. Steegers (Eric); A. Hofman (Albert); V.W.V. Jaddoe (Vincent); F.C. Verhulst (Frank); H.W. Tiemeier (Henning)

    2010-01-01

    textabstractAbstract BACKGROUND: Previous research suggests, though not consistently, that maternal psychological distress during pregnancy leads to adverse birth outcomes. We investigated whether maternal psychological distress affects fetal growth during the period of mid-pregnancy until birth. M

  10. Hearing evaluation of infants with respiratory distress syndrome by TEOAE test

    Directory of Open Access Journals (Sweden)

    Mahya Sharifinik

    2015-02-01

    Conclusion: According to results, it seems that the respiratory distress syndrome could affects the cochlear and the function of outer hair cell in it so in infants who suffer respiratory distress syndrome we should use the test battery of hearing.

  11. Is implementing screening for distress an efficient means to recruit patients to a psychological intervention trial?

    NARCIS (Netherlands)

    van Scheppingen, Corinne; Schroevers, Maya J.; Pool, Grieteke; Smink, Ans; Mul, Veronique E.; Coyne, James C.; Sanderman, Robbert

    2014-01-01

    ObjectivesPsychological interventions show greater efficacy when evaluated with distressed patients. We report on the feasibility of implementing screening for recruiting distressed cancer patients to a randomized controlled trial of problem-solving therapy (PST), characteristics associated with enr

  12. Genetics Home Reference: spinal muscular atrophy with respiratory distress type 1

    Science.gov (United States)

    ... Home Health Conditions SMARD1 spinal muscular atrophy with respiratory distress type 1 Enable Javascript to view the expand/ ... All Close All Description Spinal muscular atrophy with respiratory distress type 1 ( SMARD1 ) is an inherited condition that ...

  13. Maternal psychological distress and fetal growth trajectories : The Generation R Study

    NARCIS (Netherlands)

    Henrichs, Jens; Schenk, J. J.; Roza, S. J.; van den Berg, M. P.; Schmidt, H. G.; Steegers, E. A. P.; Hofman, A.; Jaddoe, V. W. V.; Verhulst, F. C.; Tiemeier, H.

    2010-01-01

    Background. Previous research suggests, though not consistently, that maternal psychological distress during pregnancy leads to adverse birth outcomes. We investigated whether maternal psychological distress affects fetal growth during the period of mid-pregnancy until birth. Method. Pregnant women

  14. Psychological distress in informal caregivers of patients with dementia in primary care: course and determinants

    NARCIS (Netherlands)

    Borsje, P.; Hems, M.A.; Lucassen, P.L.B.J.; Bor, H.; Koopmans, R.T.C.M.; Pot, A.M.

    2016-01-01

    BACKGROUND: The course of psychological distress in informal caregivers of patients with dementia has been investigated in longitudinal studies with conflicting outcomes. OBJECTIVES: We investigated the course and determinants of psychological distress in informal caregivers of patients with

  15. On differential characteristic classes

    OpenAIRE

    Ho, Man-Ho

    2013-01-01

    In this paper we give explicit formulas of differential characteristic classes of principal $G$-bundles with connections and prove their expected properties. In particular, we obtain explicit formulas for differential Chern classes, differential Pontryagin classes and differential Euler class. Furthermore, we show that the differential Chern class is the unique natural transformation from (Simons-Sullivan) differential $K$-theory to (Cheeger-Simons) differential characters that is compatible ...

  16. Emotional Distress among Vietnamese Adolescents: A Statewide Survey.

    Science.gov (United States)

    Charron, Donold W.; Ness, Robert C.

    1981-01-01

    Describes a study designed to provide baseline data for longitudinal research of emotional distress, social adjustment, and academic progress among Vietnamese adolescents in Connecticut. Examined sex differences, relationships with American classmates and with parents, English proficiency, acquisition of American cultural traits, and educational…

  17. Poor health status and distress in cardiac patients

    DEFF Research Database (Denmark)

    Habibović, Mirela; Versteeg, Henneke; Pelle, Aline J M;

    2013-01-01

    Implantable cardioverter defibrillator (ICD) therapy, which includes the risk of shocks, is considered the primary culprit of reductions in patient reported outcomes (PROs; e.g. health status and distress), thereby negating the role of underlying disease severity. We examined the relative influence...

  18. Physical Punishment and Signs of Mental Distress in Normal Adolescents.

    Science.gov (United States)

    Bachar, Eytan; Canetti, Laura; Bonne, Omer; DeNour, Atara Kaplan; Shalev, Arieh Y.

    1997-01-01

    Examines signs of mental distress in the general population of normal adolescents. Results, based on 871 Israeli high school students, indicate that greater physical punishment was associated with higher levels of psychiatric symptoms and lower general well-being. Results persisted after controlling for parental attitudes and socioeconomic status.…

  19. Psychological distress and salivary cortisol covary within persons during pregnancy

    NARCIS (Netherlands)

    Giesbrecht, Gerald F.; Campbell, Tavis; Letourneau, Nicole; Kooistra, Libbe; Kaplan, Bonnie

    2012-01-01

    The mechanisms whereby maternal stress during pregnancy exerts organizational effects on fetal development require elaboration. The aim of this study was to assess the plausibility of cortisol as a biological link between maternal psychological distress during pregnancy and fetal development. Previo

  20. Generational differences in distress, attitudes and incivility among nurses.

    Science.gov (United States)

    Leiter, Michael P; Price, Sheri L; Spence Laschinger, Heather K

    2010-11-01

    The first research objective was to replicate the finding of Leiter et al. [(2008)Journal of Nursing Management, 16, 100-109.] of Generation X nurses (n=338) reporting higher levels of distress than Baby Boomer nurses (n=139). The second objective was to test whether Generation X nurses reported more negative social environments at work than did Baby Boomer nurses. Negative social environments can influence the quality of work and the experience of distress for nurses. Generational differences in the experience of distress and collegiality have implications for the establishment of healthy workplaces, recruitment and retention. A questionnaire survey of nurses was organized by generation. Analyses of variance contrasted the scores on burnout, turnover intention, physical symptoms, supervisor incivility, coworker incivility and team civility. The results confirmed the hypotheses of Generation X nurses reporting more negative experiences than did Baby Boomer nurses on all measures. The negative quality of social encounters at work contributes to nurses' experience of distress and suggest conflicts of values with the dominant culture of their workplaces. Proactive initiatives to enhance the quality of collegiality can contribute to retention strategies. Building collegiality across generations can be especially useful. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

  1. Respiratory Distress Syndrome in Curacao - Conventional versus surfactant treatment

    NARCIS (Netherlands)

    Verhagen, AAE; van der Meulen, GN; Wiersma, HE; Keli, SO

    2002-01-01

    The aim of this study was to determine the incidence of Respiratory Distress Syndrome (RDS) and to evaluate the efficacy of surfactant treatment at the Neonatal Intensive Care Unit (NICU) at the St Elisabeth Hospital, Curaqao, Netherlands, Antilles, This was a retrospective cohort study of 86 infant

  2. [Shock in pregnancy: foetal distress may be the first symptom

    NARCIS (Netherlands)

    Vergeldt, T.F.; Kortenhorst, M.S.Q.; Hasaart, T.H.M.; Wijnberger, L.D.

    2014-01-01

    Shock may be difficult to recognize in pregnant women due to the physiological changes that take place in the cardiovascular system. The first symptom of shock may be foetal distress. We present two patients to illustrate this condition. The first patient had an uncomplicated pregnancy until she awo

  3. Unemployment and psychological distress among graduates: A longitudinal study

    NARCIS (Netherlands)

    Schaufeli, Wilmar B.; Van Yperen, Nico W.

    1992-01-01

    A longitudinal study which addresses the relationship between unemployment and psychological distress in Dutch technical college graduates is presented. Two samples were studied: sample 1 (N = 635) consisted of students leaving technical college and sample 2 (N = 487) consisted of technical college

  4. Accuracy of the Danish version of the 'distress thermometer'

    DEFF Research Database (Denmark)

    Bidstrup, Pernille Envold; Mertz, Birgitte; Dalton, Susanne Oksbjerg

    2012-01-01

    Objective: Short screening instruments have been suggested to improve the detection of psychological symptoms. We examined the accuracy of the Danish version of the 'Distress Thermometer'. Methods: Between October 2008 and October 2009, 426 women with newly diagnosed primary breast cancer who wer...... © 2011 John Wiley & Sons, Ltd....

  5. Loss and the Experience of Emotional Distress in Childhood

    Science.gov (United States)

    Taylor, Leslie K.; Weems, Carl F.; Costa, Natalie M.; Carrion, Victor G.

    2009-01-01

    The objective of this study was to investigate loss and the experience of emotional distress through a series of three studies. In Study 1, results indicated that when controlling for the total number of traumas experienced, children with loss traumas did not differ significantly from children with other types of traumas in terms of the level of…

  6. Maternal Distress during Pregnancy and Offspring Childhood Overweight

    DEFF Research Database (Denmark)

    Ingstrup, Katja Glejsted; Schou Andersen, Camilla; Ajslev, Teresa Adeltoft

    2012-01-01

    Background. Maternal distress during pregnancy increases the intrauterine level of glucocorticoids, which may have long-term health consequences for the child. Objective. To examine if distress as a combined measure of anxiety, depression, and stress of the mother during pregnancy was associated......, or stressed. The 95 percentile for body mass index in an international reference defined childhood overweight at any given age. Logistic regression was used for the analyses. Results. The prevalence of overweight children at 7 years of age was 9.9%. Prenatal exposure to maternal distress during pregnancy...... was not associated with childhood overweight at 7 years of age (adjusted OR 1.06 (95% CI 0.96; 1.18)). In analyses stratified on sex, a small tendency of overweight was seen in boys (OR 1.15 (0.99; 1.33)), but not in girls (OR 0.98 (0.85; 1.13)). Conclusions. Maternal distress during pregnancy appeared to have...

  7. Cannabis, alcohol use, psychological distress, and decision-making style.

    Science.gov (United States)

    Phillips, James G; Ogeil, Rowan P

    2017-09-01

    There have been suggestions of hypofrontality in cannabis users. To understand cannabis-related differences in decisional processes, Janis and Mann's conflict model of decision making was applied to recreational cannabis smokers who varied in their alcohol use and level of psychological distress. An online sample of recreational substance users (114 male, 119 female) completed the Melbourne Decision Making Questionnaire, the Alcohol Use Disorders Identification Test (AUDIT), Kessler's Psychological Distress Scale (K10), and the Severity of Dependence Scale (SDS) for cannabis. Multivariate analysis of variance examined self-reported decision-making styles as a function of gender, recent cannabis use, risky alcohol consumption, and levels of psychological distress. Psychological distress was associated with lower decisional self-esteem and higher levels of procrastination and buck-passing. There were gender differences associated with cannabis use. Female cannabis users reported higher levels of hypervigilance, while male cannabis users reported lower levels of buck-passing. Although there was little indication of an avoidant decisional style in cannabis users, the results suggest that cannabis affects decisional processes, contributing to panic in females and impulsivity in males.

  8. Understanding tinnitus distress: introducing the concepts of moderators and mediators.

    Science.gov (United States)

    Andersson, Gerhard; Westin, Vendela

    2008-11-01

    We focus this theoretical paper on a neglected distinction in tinnitus research between moderators and mediators of tinnitus distress. A moderator variable is one that influences the strength of a relationship between two other variables. In the paper we propose that several variables might act as moderators of tinnitus distress. Degree of hearing loss, arousal, insomnia, characteristics of tinnitus, noise sensitivity, and a range of psychological factors such as personality and perceived control are discussed as potential moderators. We then move on to mediator variables. A mediator variable is one that explains the relationship between the two other variables, and must by definition be caused by a predictor, and then mediate between the predictor and the dependent variable. We propose that stress levels (caused by tinnitus), classical conditioning, selective attention towards tinnitus, and psychological acceptance of tinnitus (versus experiential avoidance) might be mediators of distress. We encourage more research on moderators and mediators of tinnitus distress, as these will help illuminate treatment protocols and how they might work.

  9. Distress in the City: Racism, Fundamentalism and a Democratic Education

    Science.gov (United States)

    West, Linden

    2016-01-01

    Every day brings news about so-called Islamic State and its seduction of young people in the West. The radicalization of young Muslims causes alarm; even the desirability of multiculturalism is questioned in troubled cities where racism and Islamophobia are on the rise. This book is a case study of one distressed post-industrial city struggling…

  10. Culture, Context, and the Internalizing Distress of Mexican American Youth

    Science.gov (United States)

    Polo, Antonio J.; Lopez, Steven R.

    2009-01-01

    Latino youth appear to be at higher risk for depression relative to youth from other ethnic groups. This study assessed the relationship between nativity and several forms of internalizing distress among Mexican American middle school students as well as sociocultural factors that may help explain this relationship. Immigrant Mexican American…

  11. 29 CFR 4041.45 - Distress termination notice.

    Science.gov (United States)

    2010-07-01

    ..., Single-Employer Plan Termination, with Schedule EA-D, Distress Termination Enrolled Actuary Certification... guaranteed benefits. Unless the enrolled actuary certifies, in the Schedule EA-D filed in accordance with... benefits or benefit liabilities. If the enrolled actuary certifies that the plan is sufficient either...

  12. Seeking Help for Psychological Distress in Urban China

    Science.gov (United States)

    Chen, Juan

    2012-01-01

    Based on data gathered through a household survey of 1,474 urban residents in Beijing, this study examines Chinese help-seeking behaviors in times of psychological distress and perceived barriers to seeking professional help. The results demonstrate that most respondents rely on informal means of seeking help whereas mental health and medical…

  13. Pregnancy Loss and Distress among U.S. Women

    Science.gov (United States)

    Shreffler, Karina M.; Greil, Arthur L.; McQuillan, Julia

    2011-01-01

    Although pregnancy loss--especially miscarriage--is a relatively common experience among reproductive-aged women, much of our understanding about the experience has come from small clinic-based or other nonrepresentative samples. We compared fertility-specific distress among a national sample of 1,284 women who have ever experienced a stillbirth…

  14. Diabetes distress and related factors in South African adults with ...

    African Journals Online (AJOL)

    Keywords: adults, depression, diabetes-related distress, glycaemic index, South Africa, type 2 ... patient's concerns about the self-management of diabetes, ... for association between categorical variables. .... Notes: OR = odds ratio; CI = confidence interval. ... psychological well-being in a cohort of South African adults with.

  15. War and bereavement: consequences for mental and physical distress

    NARCIS (Netherlands)

    Morina, N.; von Lersner, U.; Prigerson, H.G.

    2011-01-01

    BACKGROUND: Little is known about the long-term impact of the killing of a parent in childhood or adolescence during war on distress and disability in young adulthood. This study assessed current prevalence rates of mental disorders and levels of dysfunction among young adults who had lost their fat

  16. Predicting Depression from Marital Distress and Attributional Processes.

    Science.gov (United States)

    Heim, Susan Creekmore; Snyder, Douglas K.

    1991-01-01

    Examined the interaction between marital distress and spouses' attributions and expectancies regarding the marital relationship in predicting depressive symptoms in a mixed sample of 59 clinic and nonclinic couples. Best predictor of depression for both sexes was measure of disaffection, reflecting emotional distance and alienation in the…

  17. Psychological Distress in Refugee Children: A Systematic Review

    Science.gov (United States)

    Bronstein, Israel; Montgomery, Paul

    2011-01-01

    Nearly one-quarter of the refugees worldwide are children. There have been numerous studies reporting their levels of psychological distress. The aim of this paper is to review systematically and synthesize the epidemiological research concerning the mental health of refugee children residing in Western countries. A Cochrane Collaboration style…

  18. Seeking Help for Psychological Distress in Urban China

    Science.gov (United States)

    Chen, Juan

    2012-01-01

    Based on data gathered through a household survey of 1,474 urban residents in Beijing, this study examines Chinese help-seeking behaviors in times of psychological distress and perceived barriers to seeking professional help. The results demonstrate that most respondents rely on informal means of seeking help whereas mental health and medical…

  19. The Effect of Reappraising Social Exclusion on Emotional Distress

    Science.gov (United States)

    Kitchens, Michael B.; Gohm, Carol L.

    2010-01-01

    The purpose of this investigation was to examine whether reappraisal, which is a strategy where the personal meaning of an event is reevaluated, would influence participants' emotional reactions to social exclusion feedback. It was expected that reappraising this event would reduce the emotional distress that accompanies social exclusion, but…

  20. PENGUKURAN TINGKAT KESEHATAN DAN GEJALA FINANCIAL DISTRESS BANK UMUM SYARIAH

    Directory of Open Access Journals (Sweden)

    Muhamad Nadratuzzaman Hosen

    2013-10-01

    Full Text Available Abstrak: Pengukuran Tingkat Kesehatan dan Gejala Financial Distress Bank Umum Syariah. Penelitian ini bertujuan untuk mengukur, menganalisis serta membandingkan tingkat kesehatan Bank Umum Syariah (BUS dengan menggunakan metode CAMELS dan metode Multiple ECR. Faktor asset terdiri dari rasio KAP dan NPF, faktor earning mencakup rasio NOM, ROA, ROE dan REO serta faktor terakhir liquidity mencakup rasio STM dan STMP. Sedangkan pada Multiple Discriminant Analysis (MDA Altman Z-score. Berdasarkan hasil analisis dengan CAMEL ditemukan bahwa ketiga bank syariah yang diteliti tergolong sehat, namun demikian hasil MDA menyatakan ketiga bank tersebut dalam kondisi bankrut. Temuan yang bertentangan tersebut menunjukkan bahwa metode MDA ternyata tidak tepat untuk diterapkan pada perbankan karena karakteristik perbankan sebagai financial intermediatory jauh berbeda dengan karakteristik perusahaan.   Kata kunci: kesehatan bank, CAMELS, financial distress Abstract: Measurement of Financial Soundness and Financial Distress Symptom of Commercial Bank. This study aims to measure, analyze and compare the level of Islamic Banks (BUS soundness using the CAMELS and the Multiple ECR method. The results of the CAMEL analysis show that the three Islamic banks studied are healthy. However, the results of the MDA analysis suggest that those three banks are categorized bankrupt. This conflicting finding indicates that MDA method is not appropriate to assess commercial banks. This is because the natures of commercial bank as a financial intermediary are much different from those of the company. Keywords:  Bank Soundness, CAMELS, financial distress

  1. Blastomyces gilchristii as Cause of Fatal Acute Respiratory Distress Syndrome.

    Science.gov (United States)

    Dalcin, Daniel; Rothstein, Aaron; Spinato, Joanna; Escott, Nicholas; Kus, Julianne V

    2016-02-01

    Since the 2013 description of Blastomyces gilchristii, research describing the virulence or clinical outcome of B. gilchristii infection has been lacking. We report molecular evidence of B. gilchristii as an etiologic agent of fatal acute respiratory distress syndrome. B. gilchristii infection was confirmed by PCR and sequence analysis.

  2. Oxytocin reduces separation distress in piglets when given intranasally

    Science.gov (United States)

    Oxytocin (OT) is one of the neurobiological foundations of sociality. It acts as a neuropeptide in numerous social processes, from ultra-social to anti-social behaviors. Evidence supports a role for OT in social support, possibly by attenuating separation distress. Nonetheless, research on OT is lac...

  3. Psychological Distress in Refugee Children: A Systematic Review

    Science.gov (United States)

    Bronstein, Israel; Montgomery, Paul

    2011-01-01

    Nearly one-quarter of the refugees worldwide are children. There have been numerous studies reporting their levels of psychological distress. The aim of this paper is to review systematically and synthesize the epidemiological research concerning the mental health of refugee children residing in Western countries. A Cochrane Collaboration style…

  4. Dual Minority Stress and Asian American Gay Men's Psychological Distress

    Science.gov (United States)

    Chen, Yung-Chi; Tryon, Georgiana Shick

    2012-01-01

    The present study investigated the direct and additive effects of racial minority stress and sexual minority stress on the psychological well-being among a community sample of 139 Asian American gay men. Self-esteem was tested to see whether it moderated or mediated the effects of perceived dual minority stress on psychological distress. Results…

  5. Acute respiratory distress syndrome in an alpaca cria

    Science.gov (United States)

    Simpson, Katharine M.; Streeter, Robert N.; Genova, Suzanne G.

    2011-01-01

    A 7-hour-old alpaca was presented for lethargy and depression. The cria responded favorably to initial treatment but developed acute-onset dyspnea 48 hours later. Acute respiratory distress syndrome was diagnosed by thoracic imaging and blood gas analysis. The cria was successfully treated with corticosteroids and discharged from the hospital. PMID:22210945

  6. Domains of distress among people with sexual orientation obsessions.

    Science.gov (United States)

    Williams, Monnica T; Wetterneck, Chad; Tellawi, Ghazel; Duque, Gerardo

    2015-04-01

    Although sexual obsessions in obsessive-compulsive disorder (OCD) are not uncommon, obsessions about sexual orientation have not been well studied. These obsessions focus on issues such as the fear of being or becoming gay, fear of being perceived by others as gay, and unwanted mental images involving homosexual acts. Sexual orientation obsessions in OCD are particularly distressing due to the ego-dystonic nature of the obsessions and, often, stigma surrounding a same-sex orientation. The purpose of this study was to better understand distress in people suffering from sexual orientation obsessions in OCD. Data were collected online (n = 1,176) and subjects were 74.6% male, 72.0% heterosexual, and 26.4% with an OCD diagnosis from a professional. The survey consisted of 70 novel questions that were assessed using a principal components analysis and the items separated into six components. These components were then correlated to distress among those with a prior OCD diagnosis and sexual orientation obsessions. Results indicated that sexual orientation obsessions in OCD were related to severe distress, including suicidal ideation. Implications of these findings and future directions for research are discussed.

  7. Social class and cause of death.

    Science.gov (United States)

    Erikson, Robert; Torssander, Jenny

    2008-10-01

    Previous studies have shown that causes of death differ in their relationship to social class, but we lack a more comprehensive description of this variation. The present study provides a detailed and extensive list of social class differences for a large number of specific causes of death. All deaths between 1991 and 2003 in Sweden were linked with information on household social class from 1990. Relative death risks and excess mortality in groups of causes according to the European shortlist were estimated separately for men and women in eight classes using Cox Regression. A clear mortality gradient among employees was found for the majority of causes, from low-relative death risks among higher managerial and professional occupations to relatively high risks for the unskilled working class. There is considerable variation in the strength of the association, from causes such as malignant melanoma, breast cancer and transport accidents among women, where no clear class differences were found. At the other extreme, mental and behavioural disorders, endocrine, nutritional and metabolic diseases and diseases of the respiratory system all show steep slopes for both men and women. Circulatory diseases and cancer together account for 15-20% of excess mortality. Exceptions to the general pattern--causes of death in which higher social classes are exposed to greater death risks or in which there is no mortality gradient--are practically non-existent. There is nevertheless significant variation in the strength of the class differences in specific causes.

  8. Precipitation extremes under climate change

    CERN Document Server

    O'Gorman, Paul A

    2015-01-01

    The response of precipitation extremes to climate change is considered using results from theory, modeling, and observations, with a focus on the physical factors that control the response. Observations and simulations with climate models show that precipitation extremes intensify in response to a warming climate. However, the sensitivity of precipitation extremes to warming remains uncertain when convection is important, and it may be higher in the tropics than the extratropics. Several physical contributions govern the response of precipitation extremes. The thermodynamic contribution is robust and well understood, but theoretical understanding of the microphysical and dynamical contributions is still being developed. Orographic precipitation extremes and snowfall extremes respond differently from other precipitation extremes and require particular attention. Outstanding research challenges include the influence of mesoscale convective organization, the dependence on the duration considered, and the need to...

  9. Respiratory Distress in Neonatal Intensive Care Unit: A Retrospective Evaluation

    Directory of Open Access Journals (Sweden)

    Ali Annagur

    2012-04-01

    Full Text Available Purpose: To determine the demographic characteristics of the newborns with respiratory difficulties, frequency of neonatal disease, analyze of the prognostic factors and effectiveness of treatment who were hospitalized in neonatal intensive care unit (NICU. Methods: In this study, file records of the newborns who were hospitalized in NICU of Meram Medical School were analyzed retrospectively. Results: Of the 771 newborns, 225 who admitted due to respiratory distress in 2008 and of the 692 newborns, 282 who admitted due to respiratory distress in 2009. Mean birth weight was 1954±972 gr in 2008, and 2140±1009 gr in 2009. Mean pregnancy weeks were 32,4±5,0 in 2008 and 33,4±4,9 in 2009. Diagnosis of patients were sepsis (77,8%, respiratory distress syndrome (RDS (40,4%, pneumothorax (20,9%, patent ductus arteriosus (PDA (12,4%, meconium aspiration syndrome (MAS (6,2%, intraventricular hemorrhage (IVH (5,3%, pneumonia (3,6%, retinopathy of prematurely (ROP (3,1%, bronchopulmonary dysplasia (BPD (2,7% and transient tachypne of newborn (TTN (2,2% in 2008. In 2009, percentage of the diagnosis was 69,5% sepsis, 33,3% RDS, 17,0% PDA, 16,0% pneumothorax, 10,3% pneumonia, 8,2% IVH, 6% TTN, 5,3% BPD, 3,2% MAS and 3,2% ROP. 33.7% of the patients were died in 2009 and 43,6% of them in 2008. Conclusion: The newborns with respiratory distress who admitted to the hospital must be evaluated according to the pregnancy week, way of birth and accompanying problems during first examination and convenient transportation of the ones who need to be cared in advanced center where an intensive care support can be applied to decrease mortality and morbidity of newborns distress. [Cukurova Med J 2012; 37(2.000: 90-97

  10. Psychometric evaluation of the HIV symptom distress scale

    Science.gov (United States)

    Marc, Linda G.; Wang, Ming-Mei; Testa, Marcia A.

    2012-01-01

    The objective of this paper is to psychometrically validate the HIV Symptom Distress Scale (SDS), an instrument that can be used to measure overall HIV symptom distress or clinically relevant groups of HIV symptoms. A secondary data analysis was conducted using the Collaborations in HIV Outcomes Research U.S. Cohort (CHORUS). Inclusion criteria required study participants (N=5,521) to have a valid baseline measure of the AIDS Clinical Trial Group Symptom Distress Module, with an SF-12 or SF-36 completed on the same day. Psychometric testing assessed unidimensionality, internal consistency and factor structure using exploratory and confirmatory factor analysis, and structural equation modeling (SEM). Construct validity examined whether the new measure discriminates across clinical significance (CD4 and HIV viral load). Findings show that the SDS has high reliability (α=0.92), and SEM supports a correlated second-order factor model (physical and mental distress) with acceptable fit (GFI=0.88, AGFI=0.85, NFI=0.99, NNFI=0.99; RMSEA=0.06, [90% CI 0.06 – 0.06]; Satorra Bentler Scaled, C2 =3274.20; p=0.0). Construct validity shows significant differences across categories for HIV-1 viral load (p< 0.001) and CD4 (p< 0.001). Differences in mean SDS scores exist across gender (p< 0.001), race/ethnicity (p< 0.05) and educational attainment (p < 0.001). Hence, the HIV Symptom Distress Scale is a reliable and valid instrument, which measures overall HIV symptoms or clinically relevant groups of symptoms. PMID:22409246

  11. The HSE indicator tool, psychological distress and work ability.

    Science.gov (United States)

    Guidi, S; Bagnara, S; Fichera, G P

    2012-04-01

    The Health and Safety Executive (HSE) indicator tool is one of the most commonly used tools for assessing the risk of work-related stress. Few studies, however, have investigated whether and how its scales are related to psychological distress or other work-related health outcomes. To investigate the relationship between the HSE indicator tool, psychological distress, as measured by the General Health Questionnaire (GHQ)-12, and work ability, assessed by the Work Ability Index (WAI). All the employees of a mid-sized bank in Italy were asked to fill in an anonymous cross-sectional questionnaire. The questionnaire was structured in four sections: the first one comprised socio-demographic questions and the other three corresponded, respectively, to the Italian translations of the GHQ-12, the HSE and the WAI questionnaires. Four hundred and thirteen employees completed the questionnaire. The response rate was 99%. Controlling for age and gender, the indicator subscales were negatively associated with the adopted measures of psychological distress and work ability. The GHQ score was also highly correlated with the WAI score and able to explain ≈ 47% of its variance. The only subscale that was still significantly associated with the WAI after removing the effect of psychological distress was 'control'. The study presents new evidence for the validity of the HSE indicator tool to estimate the risk of work-related stress and suggests that most but not all the effects of psychosocial conditions on work ability might be mediated by the level of psychological distress induced by these conditions.

  12. Psychological distress and lifestyle of students: implications for health promotion.

    Science.gov (United States)

    Deasy, Christine; Coughlan, Barry; Pironom, Julie; Jourdan, Didier; Mcnamara, Patricia Mannix

    2015-03-01

    Poor diet, physical inactivity, tobacco smoking and alcohol consumption are major risk factors for chronic disease and premature mortality. These behaviours are of concern among higher education students and may be linked to psychological distress which is problematic particularly for students on programmes with practicum components such as nursing and teaching. Understanding how risk behaviours aggregate and relate to psychological distress and coping among this population is important for health promotion. This research examined, via a comprehensive survey undergraduate nursing/midwifery and teacher education students' (n = 1557) lifestyle behaviour (Lifestyle Behaviour Questionnaire), self-reported psychological distress (General Health Questionnaire) and coping processes (Ways of Coping Questionnaire). The results showed that health- risk behaviours were common, including alcohol consumption (93.2%), unhealthy diet (26.3%), physical inactivity (26%), tobacco smoking (17%), cannabis use (11.6%) and high levels of stress (41.9%). Students tended to cluster into two groups: those with risk behaviours (n = 733) and those with positive health behaviours (n = 379). The group with risk behaviours had high psychological distress and used mostly passive coping strategies such as escape avoidance. The potential impact on student health and academic achievement is of concern and suggests the need for comprehensive health promotion programmes to tackle multiple behaviours. As these students are the nurses and teachers of the future, their risk behaviours, elevated psychological distress and poor coping also raise concerns regarding their roles as future health educators/promoters. Attention to promotion of health and well-being among this population is essential.

  13. "Triangular" extremal dilatonic dyons

    CERN Document Server

    Gal'tsov, Dmitri; Orlov, Dmitri

    2014-01-01

    Explicit dyonic dilaton black holes of the four-dimensional Einstein-Maxwell-dilaton theory are known only for two particular values of the dilaton coupling constant $a =1,\\sqrt{3}$, while for other $a$ numerical evidence was presented earlier about existence of extremal dyons in theories with the discrete sequence of dilaton couplings $a=\\sqrt{n(n+1)/2}$ with integer $n$. Apart from the lower members $n=1,\\,2$, this family of theories does not have motivation from supersymmetry or higher dimensions, and so far the above quantization rule has not been derived analytically. We fill this gap showing that this rule follows from analyticity of the dilaton at the $AdS_2\\times S^2$ event horizon with $n$ being the leading dilaton power in the series expansion. We also present generalization for asymptotically anti-de Sitter dyonic black holes with spherical, plane and hyperbolic topology of the horizon.

  14. Pulsars and Extreme Physics

    Science.gov (United States)

    Bell-Burnell, Jocelyn

    2004-10-01

    Pulsars were discovered 35 years ago. What do we know about them now, and what have they taught us about the extremes of physics? With an average density comparable to that of the nucleus, magnetic fields around 108 T and speeds close to c these objects have stretched our understanding of the behaviour of matter. They serve as extrememly accurate clocks with which to carry out precision experiments in relativity. Created in cataclysmic explosions, pulsars are a (stellar) form of life after death. After half a billion revolutions most pulsars finally die, but amazingly some are born again to yet another, even weirder, afterlife. Pulsar research continues lively, delivering exciting, startling and almost unbelievable results!

  15. A Comparison of High- and Low-Distress Marriages that End in Divorce

    Science.gov (United States)

    Amato, Paul R.; Hohmann-Marriott, Bryndl

    2007-01-01

    We used data from Waves 1 and 2 of the National Survey of Families and Households to study high- and low-distress marriages that end in divorce. A cluster analysis of 509 couples who divorced between waves revealed that about half were in high-distress relationships and the rest in low-distress relationships. These 2 groups were not artifacts of…

  16. Differences in Psychological Distress and Esteem Based on Sexual Identity Development

    Science.gov (United States)

    Shepler, Dustin; Perrone-McGovern, Kristin

    2016-01-01

    A sample of 791 college students between the ages of 18 and 25 years were administered a series of measures to determine their sexual identity development status, global self-esteem, global psychological distress, sexual-esteem and sexual distress. As hypothesized, results indicated no significant difference in terms of psychological distress,…

  17. Understanding Women's Differing Experiences of Distress after Colposcopy: A Qualitative Interview Study.

    LENUS (Irish Health Repository)

    O'Connor, Mairead

    2015-01-01

    Women who have an abnormal cervical cytology test may be referred for a colposcopy. Accumulating evidence suggests some women may experience distress after colposcopy. This exploratory study examined women\\'s differing experiences of post-colposcopy distress with the aim of identifying factors that are predictive of, or protective against, distress.

  18. Immigration distress and associated factors among Vietnamese women in transnational marriages in Taiwan.

    Science.gov (United States)

    Yang, Yung-Mei; Wang, Hsiu-Hung; Anderson, Debra

    2010-12-01

    The purpose of this study was to explore the types and predictors of immigration distress among Vietnamese women in transnational marriages in Taiwan. A cross-sectional survey with face-to-face interviews was conducted for data collection. A convenient sample of 203 Vietnamese women in transnational marriages in southern Taiwan was recruited. The Demographic Inventory measured the participants' age, education, employment status, religion, length of residency and number of children, as well as their spouse's age, education, employment status and religion. The Demand of Immigration Specific Distress scale measured the level of distress and had six subscales: loss, novelty, occupational adjustment, language accommodation, discrimination and alienation. Among the 203 participants, 6.4% had a high level of immigration distress; 91.1% had moderate distress; and 2.5% had minor distress. Higher mean scores were found for the loss, novelty and language accommodation subscales of the Demand of Immigration Specific Distress scale. Participant's (r = 0.321, p immigration distress. Length of residency in Taiwan (r = 0.576, p immigration distress. It indicated that the participants who had stayed fewer years in Taiwan had a higher level of immigrant distress. Health care professionals need to be aware that the female newcomers in transnational marriages are highly susceptible to immigration distress. The study suggests that healthcare professionals need to provide a comprehensive assessment of immigration distress to detect health problems early and administer culturally appropriate healthcare for immigrant women in transnational marriages.

  19. Exposure to Maternal Distress in Childhood and Cortisol Activity in Young Adulthood

    Science.gov (United States)

    Mahrer, Nicole E.; Luecken, Linda J.; Wolchik, Sharlene A.; Tein, Jenn-Yun; Sandler, Irwin N.

    2014-01-01

    Dysregulated cortisol is a risk factor for poor health outcomes. Children of distressed mothers exhibit dysregulated cortisol, yet it is unclear whether maternal distress predicts cortisol activity in later developmental stages. This longitudinal study examined the prospective relation between maternal distress during late childhood (9-12 years)…

  20. Psychological Distress among Nursing, Physiotherapy and Occupational Therapy Students: A Longitudinal and Predictive Study

    Science.gov (United States)

    Nerdrum, Per; Rustoen, Tone; Helge Ronnestad, Michael

    2009-01-01

    In this study, we present longitudinal data on changes in psychological distress among 232 Norwegian undergraduate students of nursing, physiotherapy, and occupational therapy. Psychological distress was assessed by applying the 12-item version of the General Health Questionnaire. Nursing students became substantially more distressed during the…

  1. Determinants of moral distress in daily nursing practice: a cross sectional correlational questionnaire survey.

    NARCIS (Netherlands)

    Veer, A.J.E. de; Francke, A.L.; Struijs, A.; Willems, D.L.

    2013-01-01

    Background: Moral distress is associated with job dissatisfaction, turnover and early retirement. Because of these negative consequences moral distress should be reduced. Little research has been done on what job factors contribute to whether or not a situation causes moral distress. Objective: To i

  2. Problem-Solving Skills in Happy and Distressed Couples: Effects of Videotape and Verbal Feedback.

    Science.gov (United States)

    Fichten, Catherine S.; Wright, John

    1983-01-01

    Investigated communication in happy and distressed married couples (N=58) in two studies. Problem-solving behaviors were evaluated by the spouses and observers. Half of the distressed couples received written feedback. Results indicated both happy and distressed wives engaged in more negative behaviors than husbands, and videotape and written…

  3. Exposure to Maternal Distress in Childhood and Cortisol Activity in Young Adulthood

    Science.gov (United States)

    Mahrer, Nicole E.; Luecken, Linda J.; Wolchik, Sharlene A.; Tein, Jenn-Yun; Sandler, Irwin N.

    2014-01-01

    Dysregulated cortisol is a risk factor for poor health outcomes. Children of distressed mothers exhibit dysregulated cortisol, yet it is unclear whether maternal distress predicts cortisol activity in later developmental stages. This longitudinal study examined the prospective relation between maternal distress during late childhood (9-12 years)…

  4. Psychological Distress among Nursing, Physiotherapy and Occupational Therapy Students: A Longitudinal and Predictive Study

    Science.gov (United States)

    Nerdrum, Per; Rustoen, Tone; Helge Ronnestad, Michael

    2009-01-01

    In this study, we present longitudinal data on changes in psychological distress among 232 Norwegian undergraduate students of nursing, physiotherapy, and occupational therapy. Psychological distress was assessed by applying the 12-item version of the General Health Questionnaire. Nursing students became substantially more distressed during the…

  5. The Relationship of Stress Arousal and Stress Prone Personality Traits to Menstrual Distress.

    Science.gov (United States)

    Marini, David C.

    The various relationships of stress arousal and stress-prone personality traits to menstrual distress were investigated in order to quantify psychophysiological arousal differences between high and low menstrual distress symptom reporters and examine differences in stress-prone personality traits between high and low menstrual distress symptom…

  6. The Impact of Multiple Roles on Psychological Distress among Japanese Workers

    Directory of Open Access Journals (Sweden)

    Ayumi Honda

    2015-06-01

    Conclusion: The present study demonstrated that participants who had only an employment role had an increased risk of psychological distress. The degree of psychological distress was not determined solely by the number of roles. It is important to have balance between work and family life to reduce role conflict and/or role submersion, which in turn may reduce the risk of psychological distress.

  7. Determinants of moral distress in daily nursing practice: a cross sectional correlational questionnaire survey.

    NARCIS (Netherlands)

    Veer, A.J.E. de; Francke, A.L.; Struijs, A.; Willems, D.L.

    2013-01-01

    Background: Moral distress is associated with job dissatisfaction, turnover and early retirement. Because of these negative consequences moral distress should be reduced. Little research has been done on what job factors contribute to whether or not a situation causes moral distress. Objective: To i

  8. Determinants of moral distress in daily nursing practice: a cross sectional correlational questionnaire survey.

    NARCIS (Netherlands)

    Veer, A.J.E. de; Francke, A.L.; Struijs, A.; Willems, D.L.

    2013-01-01

    Background: Moral distress is associated with job dissatisfaction, turnover and early retirement. Because of these negative consequences moral distress should be reduced. Little research has been done on what job factors contribute to whether or not a situation causes moral distress. Objective: To

  9. Magnetotactic Bacteria from Extreme Environments

    Directory of Open Access Journals (Sweden)

    Christopher T. Lefèvre

    2013-03-01

    Full Text Available Magnetotactic bacteria (MTB represent a diverse collection of motile prokaryotes that biomineralize intracellular, membrane-bounded, tens-of-nanometer-sized crystals of a magnetic mineral called magnetosomes. Magnetosome minerals consist of either magnetite (Fe3O4 or greigite (Fe3S4 and cause cells to align along the Earth’s geomagnetic field lines as they swim, a trait called magnetotaxis. MTB are known to mainly inhabit the oxic–anoxic interface (OAI in water columns or sediments of aquatic habitats and it is currently thought that magnetosomes function as a means of making chemotaxis more efficient in locating and maintaining an optimal position for growth and survival at the OAI. Known cultured and uncultured MTB are phylogenetically associated with the Alpha-, Gamma- and Deltaproteobacteria classes of the phylum Proteobacteria, the Nitrospirae phylum and the candidate division OP3, part of the Planctomycetes-Verrucomicrobia-Chlamydiae (PVC bacterial superphylum. MTB are generally thought to be ubiquitous in aquatic environments as they are cosmopolitan in distribution and have been found in every continent although for years MTB were thought to be restricted to habitats with pH values near neutral and at ambient temperature. Recently, however, moderate thermophilic and alkaliphilic MTB have been described including: an uncultured, moderately thermophilic magnetotactic bacterium present in hot springs in northern Nevada with a probable upper growth limit of about 63 °C; and several strains of obligately alkaliphilic MTB isolated in pure culture from different aquatic habitats in California, including the hypersaline, extremely alkaline Mono Lake, with an optimal growth pH of >9.0.

  10. Loosely coupled class families

    DEFF Research Database (Denmark)

    Ernst, Erik

    2001-01-01

    are expressed using virtual classes seem to be very tightly coupled internally. While clients have achieved the freedom to dynamically use one or the other family, it seems that any given family contains a xed set of classes and we will need to create an entire family of its own just in order to replace one......Families of mutually dependent classes that may be accessed polymor- phically provide an advanced tool for separation of concerns, in that it enables client code to use a group of instances of related classes safely without depending on the exact classes involved. However, class families which...... of the members with another class. This paper shows how to express class families in such a manner that the classes in these families can be used in many dierent combinations, still enabling family polymorphism and ensuring type safety....

  11. Diabetes-Related distress, depression and Distress-Depression among adults with type 2 diabetes mellitus in Malaysia

    NARCIS (Netherlands)

    Chew, Boon How; Vos, Rimke; Mohd-Sidik, Sherina; Rutten, Guy E H M

    2016-01-01

    Type 2 diabetes mellitus (T2DM) brings about an increasing psychosocial problem in adult patients. Prevalence data on and associated factors of diabetes related distress (DRD) and depression have been lacking in Asia. This study aimed to examine the prevalence of DRD and depression, and their

  12. The distressed (Type D) personality mediates the relationship between remembered parenting and psychological distress in cardiac patients.

    NARCIS (Netherlands)

    Damen, N.L.; Versteeg, H.; Helmondt, S.J. van; Jaegere, P.P. de; Geuns, R.J.M. van; Meine, M.M.; Domburg, R.T. van; Pedersen, S.S.

    2014-01-01

    Objective: Both the distressed (Type D) personality (i.e. the combination of negative affectivity and social inhibition traits) and dysfunctional parenting styles are associated with anxiety and depression. As parenting styles have been related to personality development, dysfunctional parenting sty

  13. Diabetes-Related distress, depression and Distress-Depression among adults with type 2 diabetes mellitus in Malaysia

    NARCIS (Netherlands)

    Chew, Boon How; Vos, Rimke; Mohd-Sidik, Sherina; Rutten, Guy E H M

    2016-01-01

    Type 2 diabetes mellitus (T2DM) brings about an increasing psychosocial problem in adult patients. Prevalence data on and associated factors of diabetes related distress (DRD) and depression have been lacking in Asia. This study aimed to examine the prevalence of DRD and depression, and their associ

  14. The distressed (Type D) personality mediates the relationship between remembered parenting and psychological distress in cardiac patients.

    NARCIS (Netherlands)

    Damen, N.L.; Versteeg, H.; Helmondt, S.J. van; Jaegere, P.P. de; Geuns, R.J.M. van; Meine, M.M.; Domburg, R.T. van; Pedersen, S.S.

    2014-01-01

    Objective: Both the distressed (Type D) personality (i.e. the combination of negative affectivity and social inhibition traits) and dysfunctional parenting styles are associated with anxiety and depression. As parenting styles have been related to personality development, dysfunctional parenting sty

  15. Hyaline membrane disease or respiratory distress syndrome? A new approach for an old disease

    Directory of Open Access Journals (Sweden)

    Lidia Grappone

    2014-06-01

    Full Text Available The term “hyaline membrane disease” refers to the histological aspect of the most frequent pulmonary pathology in preterm newborn patients. The lung of the preterm baby is morphologically and functionally immature. Surfactant deficiency in the immature lungs causes alveolar instability and collapse, capillary edema and the formation of hyaline membrane. Thus, the hyaline membranes are epiphenomena and are not the cause of respiratory failure in infants with immature lungs. This definition is presently used to indicate surfactant deficit alone and should not be used for other causes of respiratory distress. Clinicians prefer to talk of “respiratory distress syndrome” (RDS. Improvement in neonatal treatment has changed the natural course of the illness, its clinical and radiological features and has enabled extremely low birth weight newborns (ELBW to survive. Alveoli paucity and pulmonary interstitial thickness in ELBW impair gas exchange and may necessitate prolonged ventilation treatment, increasing the risk of ventilator-induced lung injury (VILI and bronchopulmonary dysplasia (BPD. RDS, therefore, is a complex illness where pulmonary immaturity and surfactant deficit play a role together with other pathological conditions that determine the course of the illness and both short and long-term results. Proceedings of the International Course on Perinatal Pathology (part of the 10th International Workshop on Neonatology · October 22nd-25th, 2014 · Cagliari (Italy · October 25th, 2014 · The role of the clinical pathological dialogue in problem solving Guest Editors: Gavino Faa, Vassilios Fanos, Peter Van Eyken

  16. Outcome of neonates with idiopathic respiratory distress syndrome; where do we go wrong?

    Directory of Open Access Journals (Sweden)

    MBKC Dayasiri

    2014-03-01

    Full Text Available Background This study focuses on assessing the modifiable risk factors, which are aetiologic in IRDS and the outcome of children who were treated with surfactant therapy. Methods All neonates received by the neonatal intensive care of Anuradhapura teaching hospital with early onset respiratory distress leading to surfactant therapy and among whom chest roentgenograms were supportive of a diagnosis of IRDS, were recruited to study. Appropriate information regarding antenatal and perinatal care, NICU management, complications, and outcomes were collected using a structured questionnaire by the investigators prospectively for one year from January 2012 and retrospectively for the calendar year 2011. Results Seventy one neonates were treated for two year study period and 45(63.4% were males. Antenatal problems included poor antenatal follow up 5(7% and bad obstetric history 3(4.2% with only 52 (73.2% mothers receiving antenatal steroids. Perinatal problems included eclampsia 8 (11.3%, abruption 5(7% and fetal distress 2(2.8% with 23(32.4% children needing resuscitation at birth. The proportion of pulmonary haemorrhage following surfactant was 14/71(19.7%. Twenty three children (32.4% were discharged lively and successfully, while 48 children (67.6% succumbed secondary to extreme prematurity (maturity < 28 weeks and IRDS 34(70.8%, pulmonary haemorrage 8(17%, septicaemia 8(17%, and severe birth asphyxia 2(4.1%. Conclusion Antenatal glucocorticoids to preterm deliveries, management of maternal medical problems, and control of sepsis in NICU need further improvement to optimize care and to bring down neonatal mortality following IRDS. As pulmonary heamorrhage following surfactant therapy remains a significant factor in increasing neonatal mortality and reducing the weight of the recognized beneficial effects of surfactant, effectiveness of these low cost interventions should be further evaluated.

  17. Comparing the meanings of living with advanced breast cancer between women resilient to distress and women with persistent distress: a qualitative study.

    Science.gov (United States)

    Lam, W W T; Yoon, S W; Sze, W K; Ng, A W Y; Soong, I; Kwong, A; Suen, D; Tsang, J; Yeo, W; Wong, K Y; Fielding, R

    2017-02-01

    Most women with advanced breast cancer (ABC) show little distress, but about one in ten show persistent distress over time. It remains unclear if meanings ascribed by patients to ABC differentiate these distress trajectories. This qualitative study (a) compared illness meanings of ABC between women with persistent psychological distress and those with low/transient distress, and (b) examined how illness meanings might influence coping strategies. The sample was drawn from a prior quantitative study exploring psychological distress trajectories following ABC diagnosis. Overall, 42 Cantonese- or Mandarin-speaking Chinese women diagnosed with locally advanced or metastatic ABC were recruited based on their distress trajectory status (low-stable, transient, or persistent distress). Interviews were recorded, transcribed, and analyzed following grounded theory approach using simultaneous analysis. Women with persistent distress viewed their diagnosis as another blow in life, the illness was global, permeating every aspect of their life. Maladaptive rumination and thought suppression were common responses to illness demands. These women had poor social support. A sense of demoralization stood out in their narratives. In contrast, women with transient/low-stable distress encapsulated the illness, with minimum impacts of their life. They did not evidence dysfunctional repetitive thoughts. Living in a supportive environment, they were able to accept and/or live in the present-moment. Rumination, thought suppression, social constraints, and pre-existing exposure to life stress may be potential risks for chronic distress in response to advanced breast cancer. Persistent and transient distress responses to cancer may have different underpinnings. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  18. Adolescent Friendships in the Context of Dual Risk: The Roles of Low Adolescent Distress Tolerance and Harsh Parental Response to Adolescent Distress

    Science.gov (United States)

    Ehrlich, Katherine B.; Cassidy, Jude; Gorka, Stephanie M.; Lejuez, C. W.; Daughters, Stacey B.

    2014-01-01

    Given extensive evidence of the importance of relationships with friends during development, a large body of research has examined the correlates of these significant social experiences. Most of this research, however, has examined either individual characteristics (e.g., behavior, personality) or contextual factors (e.g., family), and most of the work has studied relationships during childhood. The present study extended previous research by examining how both an individual factor (adolescent distress tolerance) and a contextual factor (parental response to adolescent distress) are linked to adolescents’ friendships. Adolescents (n = 161) completed two behavioral measures of distress tolerance and parents reported about their responses to adolescent distress. Although distress tolerance and parental responses to distress were not directly associated with adolescents’ positive or negative friendship experiences, for adolescents with low distress tolerance, harsh parental responses were negatively associated with adolescents’ positive friendship quality. Further, for adolescents whose parents used harsh responses to distress, distress tolerance was negatively associated with adolescents’ positive friendship quality. Results highlight the importance of studying both individual and familial factors related to adolescents’ social functioning. PMID:23795594

  19. Women in extreme poverty.

    Science.gov (United States)

    1994-01-01

    Population is estimated to increase from 5.5 billion in 1990 to 10 billion by 2050; the poverty level is expected to increase from 1 billion to 2-3 billion people. Women in development has been promoted throughout the UN and development system, but women in poverty who perform work in the informal sector are still uncounted, and solutions are elusive. The issue of extreme poverty can not be approached as just another natural disaster with immediate emergency relief. Many people live in precarious economic circumstances throughout their lives. Recent research reveals a greater understanding of the underlying causes and the need for inclusion of poor women in sustainable development. Sanitation, water, housing, health facilities need to be improved. Women must have access to education, opportunities for trading, and loans on reasonable terms. UNESCO makes available a book on survival strategies for poor women in the informal sector. The profile shows common problems of illiteracy, broken marriages, and full time involvement in provision of subsistence level existence. Existence is a fragile balance. Jeanne Vickers' "Women and the World" offers simple, low cost interventions for aiding extremely poor women. The 1992 Commission on the Status of Women was held in Vienna. Excerpts from several speeches are provided. The emphasis is on some global responses and an analysis of solutions. The recommendation is for attention to the gender dimension of poverty. Women's dual role contributes to greater disadvantages. Women are affected differently by macroeconomic factors, and that there is intergenerational transfer of poverty. Social services should be viewed as investments and directed to easing the burdens on time and energy. Public programs must be equipped to deal with poverty and to bring about social and economic change. Programs must be aware of the different distribution of resources within households. Women must be recognized as principal economic providers within

  20. Extreme winds in Denmark

    Energy Technology Data Exchange (ETDEWEB)

    Kristensen, L.; Rathmann, O.; Hansen, S.O.

    1999-02-01

    Wind-speed data from four sites in Denmark have been analyzed in order to obtain estimates of the basic wind velocity which is defined as the 50-year wind speed under standard conditions, i.e. ten-minute averages at the height 10 m over a uniform terrain with the roughness length 0.05 m. The sites are, from west, Skjern (15 years), Kegnaes (7 years), Sprogoe (20 years), and Tystofte (15 years). The data are ten minute averages of wind speed, wind direction, temperature and pressure. The last two quantities are used to determine the air density {rho}. The data are cleaned for terrain effects by means of a slightly modified WASP technique where the sector speed-up factors and roughness lengths are linearly smoothed with a direction resolution of one degree. Assuming geotropic balance, all the wind-velocity data are transformed to friction velocity u{sub *} and direction at standard conditions by means of the geotropic drag law for neutral stratification. The basic wind velocity in 30 deg. sectors are obtained through ranking of the largest values of the friction velocity pressure 1/2{rho}u{sub *}{sup 2} taken both one every two months and once every year. The main conclusion is that the basic wind velocity is significantly larger at Skjern, close to the west coast of Jutland, than at any of the other sites. Irrespective of direction, the present standard estimates of 50-year wind are 25 {+-} 1 m/s at Skern and 22 {+-} 1 m/s at the other three sites. These results are in agreement with those obtained by Jensen and Franck (1970) and Abild (1994) and supports the conclusion that the wind climate at the west coast of Jutland is more extreme than in any other part of the country. Simple procedures to translate in a particular direction sector the standard basic wind velocity to conditions with a different roughness length and height are presented. It is shown that a simple scheme makes it possible to calculate the total 50-year extreme load on a general structure without

  1. Psychological distress among dancers seeking outpatient treatment for musculoskeletal injury.

    Science.gov (United States)

    Air, Mary Elizabeth

    2013-09-01

    The purpose of this study was to investigate the incidence and magnitude of clinically significant psychological symptoms among outpatient injured dancers presenting for musculoskeletal issues and to identify features of "at risk" dancer-patients who might require additional psychological support when injured. The Brief Symptom Inventory® (BSI), a highly reliable and valid screening tool for psychological distress, was administered to first- and last-visit injured dancers at an orthopedic clinic in the Netherlands from February to May 2008. In all, 153 BSI surveys were completed, including 82 among first-visit patients and 71 among end-treatment patients. Scores were examined for the influence of age, gender, dance level, style, pain, perceived level of artistic compromise, and anatomic location of injury. Dancers' scores were compared to normative values for adult non-psychiatric patient community members. Ninety-two dancers (60.1%) met requirements for clinical referral to a psychologist or psychiatrist, having scored two or more standard deviations (SD) above the norm in at least one of nine psychopathological symptoms. Across first- and last-visit groups, dancers met referral criteria for an average of four psychopathological symptoms. First-visit dancers demonstrated higher distress than the general population on 90% of BSI dimensional symptoms and last-visit dancers on 50%. On the Global Symptom Index, a summary score for overall distress and the best measure of psychological discomfort, 46.6% of dancers demonstrated "above average" distress (≥ 1 SD) compared to the general population, and 19.6% demonstrated "high" (≥ 2 SD) or "very high" (≥ 2.5 SD) distress. Compared to academy level pre-professional students, professionals showed reduction in BSI scores on somatic, cognitive, interpersonal sensitivity, anxious, hostile, phobic, and global scores following resolution of injury, particularly among those greater than 25 years of age. Students and

  2. PRCR Classes and Activities

    Data.gov (United States)

    Town of Cary, North Carolina — This data is specific to Parks and Recreation classes, workshops, and activities within the course catalog. It contains an entry for upcoming classes.*This data set...

  3. Class 1 Areas

    Data.gov (United States)

    U.S. Environmental Protection Agency — A "Class 1" area is a geographic area recognized by the EPA as being of the highest environmental quality and requiring maximum protection. Class I areas are areas...

  4. Doodling in Math Class

    National Research Council Canada - National Science Library

    Arkenberg, Rebecca

    2013-01-01

      Arkenberg reviews Doodling in Math Class, an Internet resource available at www.youtube.com. Both math and art teachers have recommended the series of YouTube videos "Doodling in Math Class with Vihart...

  5. Extremity fractures in children: a hospital based study in Tehran

    Institute of Scientific and Technical Information of China (English)

    Ali Khaji; Mousa Zargar; Mojgan Karbakhsh

    2010-01-01

    Objective: Although long bone fracture in children is not life-threatening, it may cause major disability, loss of working days and severe psychological distress. We conducted this study to determine the pattern of extremity fracture due to trauma in children.Methods: During one year in six general hospitals in Tehran, trauma patients who were hospitalized for more than 24 hours and sustained injuries within seven days before admission were included in the study. The records of children (≤16 years old) hospitalized in six general hospitals in Tehran due to trauma were reviewed prospectively.Results: During the study period, 1274 children had sustained extremity fractures. Male to female ratio was 3.6/1, with the mean age of (10.3±4.2) years. Falls and traffic crashes were the main causes of injuries, with the percentages of 57.3% and 37.1%, respectively. Simple fall (falling on the ground) consisted 60% of patients that sustained fall-related injuries. Pedestrians and bicycle riders comprised most of the cases that were injured due to traffic crashes. Of our cases, 56.8% sustained fractures in the upper extremities and 43.2% in the lower extremities. Forearm was the most common fracture site (34.1%). Comparing our results in preschool and school-age children, falls were the main cause of injuries in both groups, but fractures of lower extremities were significantly more common in preschool children.Conclusions:Improvement of physical condition of sidewalks and crossings in roads will be necessary for prevention of injuries. More attention to safety of home environment should be paid for control of preschools' injury at home. Education of children and adults is necessary to reduce injuries resulting from road traffic crashes.

  6. Changes in psychosocial distress in outpatients with heart failure with implantable cardioverter defibrillators.

    Science.gov (United States)

    Thomas, Sue A; Friedmann, Erika; Gottlieb, Stephen S; Liu, Fang; Morton, Patricia G; Chapa, Deborah W; Lee, Hyeon-Joo; Nahm, Eun-Shim

    2009-01-01

    Patients given implantable cardioverter defibrillators (ICDs) after arrhythmic events or sudden cardiac arrest (SCA) experience psychosocial distress. ICDs now are inserted for the primary prevention of SCA in patients with heart failure; the psychosocial impact of ICDs on patients with heart failure is unknown. Changes in psychosocial status in these ICD recipients were examined. ICD recipients (n = 57) completed depression, anxiety, and social support inventories every 6 months for up to 2 years. Initially, 35% of recipients were depressed and 45% of recipients were anxious. In linear mixed models, depression decreased over time overall but increased in those who experienced ICD shocks. Anxiety decreased in New York Heart Association class III ICD recipients but not in class II ICD recipients. Decreases in social support were related to age: the younger the patient the greater the decrease. A significant proportion of ICD recipients were depressed or anxious, or had diminished social support even after 2 years. Investigation of strategies to improve ICD recipients' psychosocial status is warranted.

  7. Stacked Extreme Learning Machines.

    Science.gov (United States)

    Zhou, Hongming; Huang, Guang-Bin; Lin, Zhiping; Wang, Han; Soh, Yeng Chai

    2015-09-01

    Extreme learning machine (ELM) has recently attracted many researchers' interest due to its very fast learning speed, good generalization ability, and ease of implementation. It provides a unified solution that can be used directly to solve regression, binary, and multiclass classification problems. In this paper, we propose a stacked ELMs (S-ELMs) that is specially designed for solving large and complex data problems. The S-ELMs divides a single large ELM network into multiple stacked small ELMs which are serially connected. The S-ELMs can approximate a very large ELM network with small memory requirement. To further improve the testing accuracy on big data problems, the ELM autoencoder can be implemented during each iteration of the S-ELMs algorithm. The simulation results show that the S-ELMs even with random hidden nodes can achieve similar testing accuracy to support vector machine (SVM) while having low memory requirements. With the help of ELM autoencoder, the S-ELMs can achieve much better testing accuracy than SVM and slightly better accuracy than deep belief network (DBN) with much faster training speed.

  8. Solar extreme events

    CERN Document Server

    Hudson, Hugh S

    2015-01-01

    Solar flares and CMEs have a broad range of magnitudes. This review discusses the possibility of "extreme events," defined as those with magnitudes greater than have been seen in the existing historical record. For most quantitative measures, this direct information does not extend more than a century and a half into the recent past. The magnitude distributions (occurrence frequencies) of solar events (flares/CMEs) typically decrease with the parameter measured or inferred (peak flux, mass, energy etc. Flare radiation fluxes tend to follow a power law slightly flatter than $S^{-2}$, where S represents a peak flux; solar particle events (SPEs) follow a still flatter power law up to a limiting magnitude, and then appear to roll over to a steeper distribution, which may take an exponential form or follow a broken power law. This inference comes from the terrestrial $^{14}$C record and from the depth dependence of various radioisotope proxies in the lunar regolith and in meteorites. Recently major new observation...

  9. Detectors in Extreme Conditions

    Energy Technology Data Exchange (ETDEWEB)

    Blaj, G. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Carini, G. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Carron, S. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Haller, G. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Hart, P. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Hasi, J. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Herrmann, S. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Kenney, C. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Segal, J. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Tomada, A. [SLAC National Accelerator Lab., Menlo Park, CA (United States)

    2015-08-06

    Free Electron Lasers opened a new window on imaging the motion of atoms and molecules. At SLAC, FEL experiments are performed at LCLS using 120Hz pulses with 1012 - 1013 photons in 10 femtoseconds (billions of times brighter than the most powerful synchrotrons). This extreme detection environment raises unique challenges, from obvious to surprising. Radiation damage is a constant threat due to accidental exposure to insufficiently attenuated beam, focused beam and formation of ice crystals reflecting the beam onto the detector. Often high power optical lasers are also used (e.g., 25TW), increasing the risk of damage or impeding data acquisition through electromagnetic pulses (EMP). The sample can contaminate the detector surface or even produce shrapnel damage. Some experiments require ultra high vacuum (UHV) with strict design, surface contamination and cooling requirements - also for detectors. The setup is often changed between or during experiments with short turnaround times, risking mechanical and ESD damage, requiring work planning, training of operators and sometimes continuous participation of the LCLS Detector Group in the experiments. The detectors used most often at LCLS are CSPAD cameras for hard x-rays and pnCCDs for soft x-rays.

  10. Upper extremity amputations and prosthetics.

    Science.gov (United States)

    Ovadia, Steven A; Askari, Morad

    2015-02-01

    Upper extremity amputations are most frequently indicated by severe traumatic injuries. The location of the injury will determine the level of amputation. Preservation of extremity length is often a goal. The amputation site will have important implications on the functional status of the patient and options for prosthetic reconstruction. Advances in amputation techniques and prosthetic reconstructions promote improved quality of life. In this article, the authors review the principles of upper extremity amputation, including techniques, amputation sites, and prosthetic reconstructions.

  11. Whole lot of parts: stress in extreme environments.

    Science.gov (United States)

    Steel, G Daniel

    2005-06-01

    Stress has been a central interest for researchers of human behavior in extreme and unusual environments and also for those who are responsible for planning and carrying out expeditions involving such environments. This paper compares the actuarial and case study methods for predicting reactions to stress. Actuarial studies are useful, but do not tap enough variables to allow us to predict how a specific individual will cope with the rigors of an individual mission. Case histories provide a wealth of detail, but few investigators understand the challenges of properly applying this method. This study reviews some of the strengths and weaknesses of the actuarial and case history methods, and presents a four celled taxonomy of stress based on method (actuarial and case history) and effects (distress and eustress). For both research and operational purposes, the person, the setting, and time should not be considered independently; rather, it is an amalgam of these variables that provides the proper basis of analysis.

  12. Longitudinal study of the protective effect of hope on reducing body image distress in cancer patients.

    Science.gov (United States)

    Liu, Jianlin; Griva, Konstadina; Lim, Haikel A; Tan, Joyce Y S; Mahendran, Rathi

    2017-01-01

    Body image distress is well-documented in patients with cancer, but little is known about the course of body image distress over time and the role of psychosocial resources such as hope. This prospective study sought to explore the dynamics between trajectories of body image distress and hope across time. Cancer patients receiving outpatient treatment at a cancer center completed self-reported measures of body image distress (Body Image Scale) and hope (Adult Hope Scale) at baseline (within three months of their cancer diagnosis) and follow-up (six months post-baseline; N = 111). Trajectories of intra-individual change (improved, stable, and declined) for body image distress were calculated based on the minimal clinically important difference (±0.5 baseline SD). There was a significant increase in body image distress at follow-up (p image distress trajectory groups and time on hope, suggesting that patients experiencing improvements in body image distress reported higher levels of hope than those who had stable or deteriorating levels of body image distress F(2,108) = 3.25, p image distress across time in a sample of cancer patients, although the mechanisms of interaction require further examination. Supportive care could lend greater focus to improving patients' hope to alleviating body image distress.

  13. EXISTENCE OF EXTREME SOLUTION TO FIRST-ORDER IMPULSIVE DIFFERENTIAL EQUATIONS WITH NONLINEAR BOUNDARY CONDITIONS

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    This paper is concerned with the existence of extreme solutions to three-point boundary value problems with nonlinear boundary conditions for a class of first order impulsive differential equations. We obtain suficient conditions for the existence of extreme solutions by the upper and lower solutions method coupled with a monotone iterative technique.

  14. A Virtual Class Calculus

    DEFF Research Database (Denmark)

    Ernst, Erik; Ostermann, Klaus; Cook, William Randall

    2006-01-01

    model for virtual classes has been a long-standing open question. This paper presents a virtual class calculus, vc, that captures the essence of virtual classes in these full-fledged programming languages. The key contributions of the paper are a formalization of the dynamic and static semantics of vc...

  15. Education and Class.

    Science.gov (United States)

    Van Galen, Jane A.

    2000-01-01

    The working class is nearly invisible in multicultural education literature. Examines the possibilities of a more careful foregrounding of the complexities of social class in shaping life chances, focusing on the educational experiences of working class students and discussing the poor in order to promote understanding of the potential of teacher…

  16. Likelihood estimators for multivariate extremes

    KAUST Repository

    Huser, Raphaël

    2015-11-17

    The main approach to inference for multivariate extremes consists in approximating the joint upper tail of the observations by a parametric family arising in the limit for extreme events. The latter may be expressed in terms of componentwise maxima, high threshold exceedances or point processes, yielding different but related asymptotic characterizations and estimators. The present paper clarifies the connections between the main likelihood estimators, and assesses their practical performance. We investigate their ability to estimate the extremal dependence structure and to predict future extremes, using exact calculations and simulation, in the case of the logistic model.

  17. Metaphors of Distress: Photo-Elicitation Enhances a Discourse Analysis of Parents' Accounts.

    Science.gov (United States)

    Kantrowitz-Gordon, Ira; Vandermause, Roxanne

    2016-07-01

    In research on sensitive topics, photo-elicitation can be a profound aid to data collection and interpretation processes. Photo-elicitation methods were used in this manner in a discourse analysis of parents' distress at least 6 months after preterm birth. After an initial interview, participants were asked to take digital photographs representing their distress and to return for a second interview to discuss the photographs. The elicited photo representations supported participants' engagement with their current or past distress and generated new meanings from the reappraisal of old photographs. Photo-elicitation demonstrated the embodiment of parents' distress in the child and the placement of distress in specific locations. Photographs of documents showed the power of the written word in generating and maintaining distress. Participants used existing photographs from their child's photo history to generate rich metaphors for their distress as parents. These findings have implications for enhancing interpretive health research by incorporating photo-elicitation methods.

  18. NEW AND EMERGING PROFESSIONALS: Does Race Moderate Social Support and Psychological Distress Among Rural Older Adults?

    Science.gov (United States)

    Hyams, Adriana V; Wayde, Ernest N; Crowther, Martha R; Scogin, Forrest R

    Greater social support is associated with decreased psychological distress among older adults. Researchers have found racial differences in psychological distress. Might race moderate social support and psychological distress? The authors hypothesized African American collectivistic values could increase the importance of social support. Participants were rural adults aged 60 and older (N = 100). Multiple regression analyses controlled for health, income, education, and sex. Race moderated satisfaction with social support and psychological distress. However, greater satisfaction predicted less psychological distress among Caucasians while it was not associated with African Americans' distress in this sample. Achieving satisfaction with social support may be particularly important for Caucasians receiving therapy. Interventions may also address strategies to improve physical health, emotional support, and quality of social support, which significantly predicted psychological distress for both groups.

  19. Psychometric properties of the Trauma and Distress Scale, TADS, in an adult community sample in Finland

    Directory of Open Access Journals (Sweden)

    Raimo K. R. Salokangas

    2016-03-01

    Full Text Available Background: There is increasing evidence that a history of childhood abuse and neglect is not uncommon among individuals who experience mental disorder and that childhood trauma experiences are associated with adult psychopathology. Although several interview and self-report instruments for retrospective trauma assessment have been developed, many focus on sexual abuse (SexAb rather than on multiple types of trauma or adversity. Methods: Within the European Prediction of Psychosis Study, the Trauma and Distress Scale (TADS was developed as a new self-report assessment of multiple types of childhood trauma and distressing experiences. The TADS includes 43 items and, following previous measures including the Childhood Trauma Questionnaire, focuses on five core domains: emotional neglect (EmoNeg, emotional abuse (EmoAb, physical neglect (PhyNeg, physical abuse (PhyAb, and SexAb.This study explores the psychometric properties of the TADS (internal consistency and concurrent validity in 692 participants drawn from the general population who completed a mailed questionnaire, including the TADS, a depression self-report and questions on help-seeking for mental health problems. Inter-method reliability was examined in a random sample of 100 responders who were reassessed in telephone interviews. Results: After minor revisions of PhyNeg and PhyAb, internal consistencies were good for TADS totals and the domain raw score sums. Intra-class coefficients for TADS total score and the five revised core domains were all good to excellent when compared to the interviewed TADS as a gold standard. In the concurrent validity analyses, the total TADS and its all core domains were significantly associated with depression and help-seeking for mental problems as proxy measures for traumatisation. In addition, robust cutoffs for the total TADS and its domains were calculated. Conclusions: Our results suggest the TADS as a valid, reliable, and clinically useful

  20. Diabetes Technology: Uptake, Outcomes, Barriers, and the Intersection With Distress.

    Science.gov (United States)

    Naranjo, Diana; Tanenbaum, Molly L; Iturralde, Esti; Hood, Korey K

    2016-07-01

    Patients managing type 1 diabetes have access to new technologies to assist in management. This manuscript has two aims: 1) to briefly review the literature on diabetes technology use and how this relates to psychological factors and 2) to present an example of human factors research using our data to examine psychological factors associated with technology use. Device/technology uptake and use has increased over the years and at present day is a common clinical practice. There are mixed results in terms of health and psychosocial outcomes, with specific subgroups doing better than others with technology. Our data demonstrated that patients have moderately elevated diabetes distress across differing types of technology used, from low-tech to high-tech options, possibly meaning that technology does not add or take away distress. In addition, users on multiple daily injections compared to all other technology groups have less positive attitudes about technology. Finally, we discuss implications for clinical practice and future research.

  1. Web-Based Distress Management for Implantable Cardioverter Defibrillator Patients

    DEFF Research Database (Denmark)

    Habibović, Mirela; Denollet, Johan; Cuijpers, Pim

    2017-01-01

    distress post-ICD implantation. The WEB-based distress management program for ICD patients (WEBCARE) was developed to mitigate anxiety and depression and enhance health-related quality of life in ICD patients. This study investigates the 6- and 12-months outcomes. METHOD: A total of 289 consecutive ICD...... patients from 6 referral hospitals in the Netherlands were randomized to either the WEBCARE (n = 146) or usual care (n = 143) group. Patients in the WEBCARE group received an online, 12-weeks fixed, 6 lesson behavioral treatment based on problem solving therapy. Patients in the usual care group receive...... care as usual. RESULTS: Current findings show no significant difference on anxiety, depression or quality of life between the WEBCARE and Usual Care group at 6- and 12-months postimplantation. CONCLUSIONS: In this clinical trial of a Web-based behavioral intervention for ICD patients, the Web...

  2. [Acute respiratory distress syndrome after near-drowning (author's transl)].

    Science.gov (United States)

    Tempel, G; Jelen, S; Forster, B; Gullotta, U; Daum, S

    1977-08-01

    After successful rescue from drowning there may develop a situation which is called secondary drowning, resulting in acute respiratory distress characterized by interstitial pulmonary oedema, hypoxaemia, hypercapnia and acidosis during drowning, direct alteration of the alveolar membrane by aspirated water and particulate matters and a volume overloading by adsorption and--not seldom--inept therapy. This situation requires mechanical ventilation and forced diuresis, combined with high doses of steroids, antibiotics and digitalis. We present the case of an eleven year old patient whose clinical course demonstrate the necessity of exact clinical observation after rescue from drowning. After development of acute respiratory distress only the immediate utilization of the therapeutic modalities of an intensive care may result in a satisfactory outcome. Four months later our patient had normal pulmonary function except for a moderate reduction of compliance.

  3. Motivation for change and psychological distress in homeless substance abusers.

    Science.gov (United States)

    Velasquez, M M; Crouch, C; von Sternberg, K; Grosdanis, I

    2000-12-01

    This study explores the treatment needs of homeless individuals participating in a large urban day shelter program. Alcohol and drug use, psychological distress, and stage of change were assessed in 100 participants presenting for services. The associations among substance use, risk perception, and readiness to change were examined for alcohol and drugs separately. Participants had high levels of psychological distress compared to "non-patient" samples. Eighty percent had used alcohol in the past 6 months, with 65% of those drinking at higher-risk levels; 60% had used drugs, with 82% in the higher-risk levels. While the majority felt that they drank and/or used drugs "too much", most were in precontemplation or contemplation stages of change. Intervention efforts for this population should focus on motivation, facilitation through the stages, and the associations between psychiatric symptoms and substance use.

  4. Flashbulb memories of menarche and adult menstrual distress.

    Science.gov (United States)

    Pillemer, D B; Koff, E; Rhinehart, E D; Rierdan, J

    1987-06-01

    Ninety-nine female college students completed a questionnaire in which they recounted their memories of menarche, described menarcheal circumstances, and completed the Menstrual Distress Questionnaire (MDQ). Consistent with previous research, inadequate emotional preparation for menstruation was associated with negative feelings at menarche. However, menarcheal circumstances were not strongly predictive of adult MDQ scores. Consistent with memory theory, the amount of information in memories of menarche was negatively related to adequacy of prior knowledge about menstruation: Women who reported feeling less knowledgeable at menarche provided more information about the first episode. While memories of menarche contain information that is relevant to subsequent menstrual experiences, the relationship between menarcheal events and adult menstrual distress appears to be minor.

  5. Acute Respiratory Distress Syndrome Complicating Strongyloides stercoralis Hyperinfection

    Directory of Open Access Journals (Sweden)

    Ming-Ju Tsai

    2011-03-01

    Full Text Available Strongyloidiasis is endemic in tropic and subtropic areas, but is currently seldom encountered in developed area like Taiwan. We present an elder man with acute respiratory distress syndrome complicating Strongyloides stercoralis hyperinfection. There was no significant clue initially for diagnosing this patient as having S. stercoralis hyperinfection. Neither peripheral eosinophilia nor significant hemoptysis was noted. Bronchoscopy played a critical role to define the unexpected cause of his progressive pulmonary infiltrates. The correct diagnosis was soon made by recognition of the worm in bronchioloalveolar lavage cytology, and specific treatment was initiated promptly. For a septic patient with progressive pulmonary infiltrates, bronchoscopic studies including cytology may be necessary for defining the cause. Hyperinfection strongyloidiasis should be considered as a cause of acute respiratory distress syndrome in immunocompromised patient, especially with the presence of chronic gastrointestinal symptoms.

  6. Stressors, recovery processes, and manifestations of training distress in dance.

    Science.gov (United States)

    Grove, J Robert; Main, Luana C; Sharp, Lucinda

    2013-01-01

    Dancers are expected to maintain consistently high levels of performance capability and to perform on demand. To meet these expectations, they subject their bodies to long hours of intensive physical training. Such training regimens are often combined with tight rehearsal and performance schedules, which over time can lead to persistent fatigue, psychological distress, performance decrements, and injury. A similar process has been observed as a consequence of high-intensity training in many different sports, and considerable sport-related research has been devoted to identifying the antecedents, the symptoms that are experienced, and the most cost-effective ways of monitoring symptom development. This paper presents a general heuristic framework for understanding this "training distress process" and discusses the framework with specific reference to dance.

  7. Lux in obscuro: photon orbits of extremal black holes revisited

    Science.gov (United States)

    Scen Khoo, Fech; Ong, Yen Chin

    2016-12-01

    It has been shown in the literature that the event horizon of an asymptotically flat extremal Reissner-Nordström black hole is also a stable photon sphere. We further clarify this statement and give a general proof that this holds for a large class of static spherically symmetric black hole spacetimes with an extremal horizon. In contrast, in the Doran frame, an asymptotically flat extremal Kerr black hole has an unstable photon orbit on the equatorial plane of its horizon. In addition, we show that an asymptotically flat extremal Kerr-Newman black hole exhibits two equatorial photon orbits if a\\lt M/2, one of which is on the extremal horizon in the Doran frame and is stable, whereas the second one outside the horizon is unstable. For a\\gt M/2, there is only one equatorial photon orbit, located on the extremal horizon, and it is unstable. There can be no photon orbit on the horizon of a non-extremal Kerr-Newman black hole.

  8. Moral distress among healthcare professionals: report of an institution-wide survey.

    Science.gov (United States)

    Whitehead, Phyllis B; Herbertson, Robert K; Hamric, Ann B; Epstein, Elizabeth G; Fisher, Joan M

    2015-03-01

    Moral distress is a phenomenon affecting many professionals across healthcare settings. Few studies have used a standard measure of moral distress to assess and compare differences among professions and settings. A descriptive, comparative design was used to study moral distress among all healthcare professionals and all settings at one large healthcare system in January 2011. Data were gathered via a web-based survey of demographics, the Moral Distress Scale-Revised (MDS-R), and a shortened version of Olson's Hospital Ethical Climate Scale (HECS-S). Five hundred ninety-two (592) clinicians completed usable surveys (22%). Moral distress was present in all professional groups. Nurses and other professionals involved in direct patient care had significantly higher moral distress than physicians (p = .001) and other indirect care professionals (p Moral distress was negatively correlated with ethical workplace climate (r = -0.516; p moral distress for all professional groups, but the groups varied in other identified sources. Providers working in adult or intensive care unit (ICU) settings had higher levels of moral distress than did clinicians in pediatric or non-ICU settings (p moral distress levels than those who never considered leaving (p moral distress than those without this training (p = .005). Although there may be differences in perspectives and experiences, moral distress is a common experience for clinicians, regardless of profession. Moral distress is associated with burnout and intention to leave a position. By understanding its root causes, interventions can be tailored to minimize moral distress with the ultimate goal of enhancing patient care, staff satisfaction, and retention. © 2014 Sigma Theta Tau International.

  9. Discrimination and Psychological Distress: Gender Differences among Arab Americans.

    Science.gov (United States)

    Assari, Shervin; Lankarani, Maryam Moghani

    2017-01-01

    Despite the existing knowledge on the association between discrimination and poor mental health, very few studies have explored gender differences in this association in Arab Americans. The current study aimed to investigate whether gender moderates the association between the experience of discrimination and psychological distress in a representative sample of Arab Americans in Michigan. Using data from the Detroit Arab American Study (DAAS), 2003, this study recruited Arab Americans (337 males, 385 females) living in Michigan, United States. The main independent variable was discrimination. The main outcome was psychological distress. Covariates included demographic factors (age), socioeconomic status (education, employment, and income), and immigration characteristics (nativity and years living in United States). Gender was the focal moderator. We used multivariable regression with and without discrimination × gender interaction term. In the pooled sample, discrimination was positively associated with psychological distress [B = 0.62, 95% confidence interval (CI) = 0.22-1.03, p = 0.003]. We found a significant gender × discrimination interaction in the pooled sample (B = 0.79, 95% CI = 0.01-1.59, p = 0.050), suggesting a stronger association in males than females. In our gender-specific model, higher discrimination was associated with higher psychological distress among male (B = 0.87, 95% CI = 0.33-1.42, p = 0.002) but not female (B = 0.18, 95% CI = -0.43 to 0.78, p = 0.567) Arab Americans. While discrimination is associated with poor mental health, a stronger link between discrimination and psychological symptoms may exist in male compared to female Arab Americans. While efforts should be made to universally reduce discrimination, screening for discrimination may be a more salient component of mental health care for male than female Arab Americans.

  10. Aortic mass in a newborn infant with respiratory distress

    Directory of Open Access Journals (Sweden)

    Michelle J. Vaz

    2017-10-01

    Full Text Available Thrombotic disease is rare in neonates. Many of the cases reported in literature are attributed to the placement of central catheters. We report on a case of aortic thrombosis in a newborn infant with significant respiratory distress due to meconium aspiration, necessitating intubation and placement of central catheters. Due to the location and size of the thrombus in our case, various subspecialties were involved, which ultimately guided therapy to anti-coagulate the patient.

  11. Prognostic Factors for Distress After Genetic Testing for Hereditary Cancer.

    Science.gov (United States)

    Voorwinden, Jan S; Jaspers, Jan P C

    2016-06-01

    The psychological impact of an unfavorable genetic test result for counselees at risk for hereditary cancer seems to be limited: only 10-20 % of counselees have psychological problems after testing positive for a known familial mutation. The objective of this study was to find prognostic factors that can predict which counselees are most likely to develop psychological problems after presymptomatic genetic testing. Counselees with a 50 % risk of BRCA1/2 or Lynch syndrome completed questionnaires at three time-points: after receiving a written invitation for a genetic counseling intake (T1), 2-3 days after receiving their DNA test result (T2), and 4-6 weeks later (T3). The psychological impact of the genetic test result was examined shortly and 4-6 weeks after learning their test result. Subsequently, the influence of various potentially prognostic factors on psychological impact were examined in the whole group. Data from 165 counselees were analyzed. Counselees with an unfavorable outcome did not have more emotional distress, but showed significantly more cancer worries 4-6 weeks after learning their test result. Prognostic factors for cancer worries after genetic testing were pre-existing cancer worries, being single, a high risk perception of getting cancer, and an unfavorable test result. Emotional distress was best predicted by pre-existing cancer worries and pre-existing emotional distress. The psychological impact of an unfavorable genetic test result appears considerable if it is measured as "worries about cancer." Genetic counselors should provide additional guidance to counselees with many cancer worries, emotional distress, a high risk perception or a weak social network.

  12. The Role of Surfactant in Respiratory Distress Syndrome

    OpenAIRE

    2012-01-01

    The key feature of respiratory distress syndrome (RDS) is the insufficient production of surfactant in the lungs of preterm infants. As a result, researchers have looked into the possibility of surfactant replacement therapy as a means of preventing and treating RDS. We sought to identify the role of surfactant in the prevention and management of RDS, comparing the various types, doses, and modes of administration, and the recent development. A PubMed search was carried out up to March 2012 u...

  13. Maternal trait anxiety, emotional distress, and salivary cortisol in pregnancy

    OpenAIRE

    Pluess, M; Bolten, M. *; Pirke, K. M.; Hellhammer, D. (Dirk)

    2010-01-01

    Animal models suggest that stress-induced hormonal changes in the mother during pregnancy lead to enduring changes in the fetus and empirical links between prenatal maternal stress and negative child development have been discerned repeatedly in human studies. But the role of heritable personality traits has received little attention in the latter work. The goal of the current study was to investigate the relationship between maternal personality, psychological measures of maternal distress a...

  14. Mothers’ Unresolved Trauma Blunts Amygdala Response to Infant Distress

    OpenAIRE

    Kim, S.; Fonagy, P; Allen, J.; Strathearn, L.

    2014-01-01

    While the neurobiology of post-traumatic stress disorder has been extensively researched, much less attention has been paid to the neural mechanisms underlying more covert but pervasive types of trauma (e.g., those involving disrupted relationships and insecure attachment). Here, we report on a neurobiological study documenting that mothers' attachment-related trauma, when unresolved, undermines her optimal brain response to her infant's distress. We examined the amygdala blood oxygenation le...

  15. Cortico-limbic morphology separates tinnitus from tinnitus distress

    Directory of Open Access Journals (Sweden)

    Amber M Leaver

    2012-04-01

    Full Text Available Tinnitus is a common auditory disorder characterized by a chronic ringing or buzzing in the ear. Despite the auditory-perceptual nature of this disorder, a growing number of studies have reported neuroanatomical differences in tinnitus patients outside the auditory-perceptual system. Some have used this evidence to characterize chronic tinnitus as dysregulation of the auditory system, either resulting from inefficient inhibitory control or through the formation of aversive associations with tinnitus. It remains unclear, however, whether these non-auditory anatomical markers of tinnitus are related to the tinnitus signal itself, or merely to negative emotional reactions to tinnitus (i.e., tinnitus distress. In the current study, we used anatomical MRI to identify neural markers of tinnitus, and measured their relationship to a variety of tinnitus characteristics and other factors often linked to tinnitus, such as hearing loss, depression, anxiety, and noise sensitivity. In a new cohort of participants, we confirmed that people with chronic tinnitus exhibit reduced grey matter in ventromedial prefrontal cortex (vmPFC compared to controls matched for age and hearing loss. This effect was driven by reduced cortical surface area, and was not related to tinnitus distress, symptoms of depression or anxiety, noise sensitivity, or other factors. Instead, tinnitus distress was positively correlated with cortical thickness in the anterior insula in tinnitus patients, while symptoms of anxiety and depression were negatively correlated with cortical thickness in subcallosal anterior cingulate cortex (scACC across all groups. Tinnitus patients also exhibited increased gyrification of dorsomedial prefrontal cortex (dmPFC, which was more severe in those patients with constant (vs. intermittent tinnitus. Our data suggest that the neural systems associated with chronic tinnitus are different from those involved in aversive or distressed reactions to tinnitus.

  16. Estimating Net Realizable Value for Distressed Real Estate

    OpenAIRE

    James D. Shilling; John D. Benjamin; Sirmans, C. F.

    1990-01-01

    This paper provides a framework for adjusting distressed real estate properties for liquidating discounts. We estimate the probability of receiving an offer on a property in any particular short interval of time. Our empirical evidence allows us to predict the average rate at which offers will occur in any particular interval of time. Further, it allows us to arrive at an estimate of net realizable value, adjusted for selling expenses.

  17. Alternatives to Pyrotechnic Distress Signals; Laboratory and Field Studies

    Science.gov (United States)

    2015-03-01

    evaluating the relative effectiveness of various colors under low light (about 0.25 foot candle ) conditions. Quoting Smith, “When the colors included in the...evaluating color , flash pattern, and intensity for an LED distress signal, conspicuous against certain lighting conditions, at six nautical miles, in...characteristic, effective intensity, color , flash pattern, response time, conspicuity 18. Distribution Statement Distribution Statement A: Approved

  18. Patterns of Gender Equality at Workplaces and Psychological Distress

    OpenAIRE

    Sofia Elwér; Lisa Harryson; Malin Bolin; Anne Hammarström

    2013-01-01

    Research in the field of occupational health often uses a risk factor approach which has been criticized by feminist researchers for not considering the combination of many different variables that are at play simultaneously. To overcome this shortcoming this study aims to identify patterns of gender equality at workplaces and to investigate how these patterns are associated with psychological distress. Questionnaire data from the Northern Swedish Cohort (n = 715) have been analysed and suppl...

  19. War and bereavement: consequences for mental and physical distress.

    Directory of Open Access Journals (Sweden)

    Nexhmedin Morina

    Full Text Available BACKGROUND: Little is known about the long-term impact of the killing of a parent in childhood or adolescence during war on distress and disability in young adulthood. This study assessed current prevalence rates of mental disorders and levels of dysfunction among young adults who had lost their father due to war-related violence in childhood or adolescence. METHODS: 179 bereaved young adults and 175 non-bereaved young adults were interviewed a decade after experiencing the war in Kosovo. Prevalence rates of Major Depressive Episode (MDE, anxiety, and substance use disorders, and current suicide risk were assessed using the Mini-International Neuropsychiatric Interview. The syndrome of Prolonged Grief Disorder (PGD was assessed with the Prolonged Grief Disorder Interview (PG-13. Somatic symptoms were measured with the Patient Health Questionnaire. General health distress was assessed with the General Health Questionnaire. FINDINGS: Bereaved participants were significantly more likely to suffer from either MDE or any anxiety disorder than non-bereaved participants (58.7% vs. 40%. Among bereaved participants, 39.7% met criteria for Post-Traumatic Stress Disorder, 34.6% for PGD, and 22.3% for MDE. Bereaved participants with PGD were more likely to suffer from MDE, any anxiety disorder, or current suicide risk than bereaved participants without PGD. Furthermore, these participants reported significantly greater physical distress than bereaved participants without PGD. CONCLUSION: War-related loss during middle childhood and adolescence presents significant risk for adverse mental health and dysfunction in young adulthood in addition to exposure to other war-related traumatic events. Furthermore, the syndrome of PGD can help to identify those with the greatest degree of distress and dysfunction.

  20. Emotional distress and parenting among community and clinic parents

    OpenAIRE

    Rimehaug, Tormod

    2012-01-01

    Background: The purpose of this thesis was to investigate the distribution of and the change in parental emotional distress and parenting dimensions by combining samples of community parents, non-parents and clinic parents. Clinic parents were involved in intensive inpatient family treatment related to their children’s psychiatric problems. Research questions: The focal themes of the three research questions were as follows: 1) Anxiety and depression among community parent and non-parent subg...

  1. Essays on leveraged buyouts and distressed asset pricing

    OpenAIRE

    Ayash, Brian

    2014-01-01

    This dissertation consists of three chapters that concern leveraged buyouts and the risk- return relationship of distressed stocks. The first chapter uses hand collected cash flow statements to present the origin, ownership and use of cash in leveraged buyouts of large publicly traded U.S. firms by private equity funds between 1980 and 2006. I find suggestive evidence that target firms exhibit inefficient investment in the form of empire building pre-acquisition. Once controlled by private eq...

  2. Neurological distress in Togolese newborn: Prevalence, causes and clinical features

    Directory of Open Access Journals (Sweden)

    Balaka Bahoura

    2013-01-01

    Full Text Available Background: The transition from fetal to neonatal life during birth is difficult for all babies. We aim to analyze the demography, clinical presentation, causes, and outcome of neurologically distressed newborns. Materials and Methods: We reviewed a total of 615 newborns files admitted with life threatening condition. Amongst them, 453 had presented neurological distress syndrome. Only cases with severe neurological impairment (Apgar Score System [ASS] ≤6 with no other associated injury were included in the study group. The study covered a period from January to December 2011 and located in pediatric intensive care unit. The information regarding clinical presentation, condition of birth, causes of distress, and outcome were analyzed. Neonate examination had been conducted by neonatologist and pediatric neurologist. Results: The sample included 272/453 (60.04% males and 181/453 (39.96% females. Newborns were aged from 1 to 14 days. The incidence of neurological distress amongst all admissions was 453/615 (73.65%. Clinical signs were weakness of primary reflexes (86.70%, non reactivity (78.19%, flaccid muscle tone (59.49% and impaired consciousness (32.29%. On Apgar score, 73 (20.68% had a score from 0 to 3; 234 (66.29% had a score 4-6 in the first minute of life. A total of 307 (86.97% newborns had been resuscitated at birth during the first five minutes. Death rate was 35.69%. Asphyxia (51.27% and neonatal infection (43.34% were the most common causes of death. Conclusion: These results show that much effort remains to be done in obstetric care, resuscitation management and improvement in neonatal infection care.

  3. Consequences of psychological distress in adolescents with acne.

    Science.gov (United States)

    Misery, Laurent

    2011-02-01

    Acne may cause psychological distress that is associated with many psychiatric disorders. In this issue, Halvorsen et al. report suicidal ideation, mental health problems, and affective isolation to be relatively frequent in adolescents with acne. This report suggests that adverse events that have been attributed to therapies for acne, including suicidal ideation and depression, may reflect the burden of substantial acne rather than the effect of medications.

  4. Acute respiratory distress syndrome associated with severe ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Shiho; Sagara; Yasuo; Horie; Yumiko; Anezaki; Hideaki; Miyazawa; Masahiro; Iizuka

    2010-01-01

    Various extraintestinal manifestations including pulmonary abnormalities have been reported in patients with ulcerative colitis. Acute respiratory distress syndrome (ARDS) is a serious and fatal pulmonary manifestation. We have experienced a 67-year-old male patient with ARDS associated with a severe type of ulcerative colitis (UC). Severe dyspnea symptoms occurred during the treatment of UC in a previous hospital and the patient was transferred to our hospital on June 27, 2007. Both blood and sputa culture...

  5. Tropical pyomyositis presenting as sepsis with acute respiratory distress syndrome

    Institute of Scientific and Technical Information of China (English)

    Siddalingana Gouda TG; H Manjunath Hande; Weena Stanley; Ragini Bargur

    2011-01-01

    Tropical pyomyositis is an underdiagnosed condition. We reported a35 year old male farmer, who presented with septicemia and acute respiratory distress syndrome due to pyomyositis involving the paraspinal muscles. Culture of the pus grew methicillin sensitiveStaphylococcus aureus, and the patient recovered after surgical drainage and antibiotic treatment. Diagnostic delays can be avoided if tropical pyomyositis is considered as a differential diagnosis in patients with septicemia.

  6. Persian Preposition Classes

    Directory of Open Access Journals (Sweden)

    Marina Pantcheva

    2007-01-01

    Full Text Available In this paper I present the prepositional system in Persian. I show that Persian prepositions can be divided into three classes (Class 1, Class 2a and Class 2b which exhibit distinct syntactic behavior. Then I examine the question of the categorial status of Class 2 prepositions and demonstrate that they are not to be regarded as nouns. Finally I present the extended PP projection of Persian spatial prepositions and argue for a feature-based analysis of the properties they manifest.

  7. Class, Culture and Politics

    DEFF Research Database (Denmark)

    Harrits, Gitte Sommer

    2013-01-01

    Even though contemporary discussions of class have moved forward towards recognizing a multidimensional concept of class, empirical analyses tend to focus on cultural practices in a rather narrow sense, that is, as practices of cultural consumption or practices of education. As a result......, discussions within political sociology have not yet utilized the merits of a multidimensional conception of class. In light of this, the article suggests a comprehensive Bourdieusian framework for class analysis, integrating culture as both a structural phenomenon co-constitutive of class and as symbolic...

  8. Local fiscal distress and investment efficiency of local SOEs

    Institute of Scientific and Technical Information of China (English)

    Xinxin; Liao; Yunguo; Liu

    2014-01-01

    In this paper, we use A-share listed firms between 2002 and 2010 to investigate the relationship between local fiscal distress and the investment efficiency of local SOEs, along with the effect of corporate tax payments on this relationship. We find a positive relationship between the extent of local SOEs’ overinvestment and the fiscal distress of the corresponding local government where the enterprise and this relationship become stronger for firms that pay fewer taxes. The pattern of underinvestment among local SOEs was in contrast,and these relationships do not exist for non-SOEs or central SOEs. Moreover,we find that expanding a firm’s investment scale leads to an increase in total taxes paid, including income and turnover taxes, which further result in more local fiscal revenue. Overall, we conclude that local governments have an incentive to increase fiscal revenue when faced with fiscal distress by raising the investment scale of local SOEs and that the incentives and effects of such interventions appear to be stronger among firms that contribute less to local fiscal revenue.ó 2013 Production and hosting by Elsevier B.V. on behalf of China Journal of Accounting Research. Founded by Sun Yat-sen University and City University of Hong Kong.

  9. Respiratory Therapy for Acute Respiratory Distress Syndrome in Cardiosurgical Patients

    Directory of Open Access Journals (Sweden)

    T. V. Zagorodnyaya

    2005-01-01

    Full Text Available The purpose of the present investigation was to improve the outcomes of intensive care in patients with acute respiratory distress syndrome after cardiac surgery under extracorporeal circulation.Materials and methods. Respiratory therapy was analyzed in 43 patients with acute respiratory distress syndrome after surgery under extracorporeal circulation. According to the procedure of artificial ventilation (AV, the patients were divided into 2 groups: 1 those who had undergone routine tracheal intubation (n=23 AND 2 THOSE who had received noninvasive intubation through a nasal mask (n=20. The respiratory parameters, blood gas composition, central hemodynamic parameters, respiratory support time, and the pattern of complications were analyzed.Results. Noninvasive artificial ventilation permits one to make the patients active in earlier periods and take a spontaneous breath, recovers the respiratory index earlier, reduces the level of positive end-expiratory pressure, the frequency of infectious complications of the tracheobronchial tree, and length of stay in an intensive care unit as compared with endotracheal AV.Conclusion. The findings suggest that noninvasive AV is highly effective and yields better results of treatment in patients with acute respiratory distress syndrome.

  10. Psychological Distress and Life Satisfaction among University Students

    Directory of Open Access Journals (Sweden)

    Haresh Kumar

    2016-02-01

    Full Text Available The objective of the present study is to determine the relationship between psychological distress and life satisfaction among university students. The sample of the present research consisted of 398 university students from three faculties (Medical sciences n=133 Social science n=133 and Engineering n=132. Data was collected from different organizations following the purposive sampling technique. After taking the consent from the participants, the depression Anxiety stress scale (DASS and life satisfaction scale were administered. To obtain the results of descriptive statistics, Pearson Product Moment co-efficient of correlation and linear-regressions were calculated. Results showed that there was significant (P <.05 correlation between Psychological distress and life satisfaction among university students. Further analysis considering the field of education, in engineering student’s depression was present 25%, anxiety 32% and stress 20%.In social science students, 21% depression, 30% anxiety and 17% stress. Medical students have 25% depression, 34% anxiety and 23% stress. Overall medical students experience relatively more psychological distress as compare to engineering and social science students.

  11. Local fiscal distress and investment efficiency of local SOEs

    Directory of Open Access Journals (Sweden)

    Xinxin Liao

    2014-06-01

    Full Text Available In this paper, we use A-share listed firms between 2002 and 2010 to investigate the relationship between local fiscal distress and the investment efficiency of local SOEs, along with the effect of corporate tax payments on this relationship. We find a positive relationship between the extent of local SOEs’ overinvestment and the fiscal distress of the corresponding local government where the enterprise and this relationship become stronger for firms that pay fewer taxes. The pattern of underinvestment among local SOEs was in contrast, and these relationships do not exist for non-SOEs or central SOEs. Moreover, we find that expanding a firm’s investment scale leads to an increase in total taxes paid, including income and turnover taxes, which further result in more local fiscal revenue. Overall, we conclude that local governments have an incentive to increase fiscal revenue when faced with fiscal distress by raising the investment scale of local SOEs and that the incentives and effects of such interventions appear to be stronger among firms that contribute less to local fiscal revenue.

  12. Break-even maturity as a guide to financial distress

    Directory of Open Access Journals (Sweden)

    Colin Ellis

    2014-12-01

    Full Text Available During the recent crisis, lags in the transmission mechanism of economic shocks, together with monetary and fiscal policy, made it difficult to assess the evolving dynamics of creditworthiness. As such, developments in financial markets became a key guide for investors and policymakers in determining the degree of financial distress that borrowers faced, providing a real-time update of market participants’ views. However, simple measures of borrowing costs such as secondary market yields typically ignore differences in debt maturities and hence refinancing risks. This paper describes a new indicator of financial distress – the break-even maturity – that combines these factors. Using financial market data for euro area countries, the break-even maturity is shown to provide an alternative perspective on the absolute and relative risks associated with different borrowers that is distinct from the standard metrics gleaned from bond yields or credit-default swaps. As such, while break-even maturities are ultimately theoretical constructs, they can offer a valuable alternative perspective on how the financing pressures facing distressed borrowers are evolving in real-time.

  13. Road rage in Sri Lanka: prevalence and psychiatric distress.

    Science.gov (United States)

    Rodrigo, A; Perera, D; Eranga, V P; Peris, M U; Pathmeswaran, A

    2015-09-01

    Road traffic accidents are a major public health concern in Sri Lanka. Aggressive and reckless driving is an important contributor to the high rate of road traffic accidents. We studied prevalence, nature, determinants and associated psychiatric morbidity of road rage among motorists in Sri Lanka. Methods Data were gathered from 238 randomly selected motorists in Sri Lanka using a modified questionnaire regarding road rage and the 6-item version of Kessler's psychological distress scale. While 98.7% participants reported being victims of road rage, 85.3% were involved in offending behaviour. However actual physical assault (0.8%) and damage to vehicles (2.5%) were rare. Male gender, young age, increased traffic density and driving a three-wheeler or bus were associated with daily road rage victimisation and perpetration. Psychiatric distress was associated with being a victim of road rage. High prevalence of road rage in Sri Lanka and significant psychiatric distress associated with it indicate the necessity of interventions at least for target groups.

  14. The Effects of Bank Distress on the Nigerian Economy

    Directory of Open Access Journals (Sweden)

    Ademola Felix Adeyefa

    2015-09-01

    Full Text Available Bank distress poses threats to financial intermediation process with serious detrimental effect on the economy. Despite all attempts made by the supervisory authorities, the problem appears to defy already established approach and the menace still continues to resurface. Hence, the need to investigate the effects of bank distress on the Nigerian economy. The cointegration and error correction mechanism were used to test the data which covers a period of thirty-one  (31 years from 1982 to 2012. The research findings revealed that the ratio of non-performing loans to total loans, and total loans and advances have significant negative effect on economic growth with p-values of 0.0240 and 0.0445 respectively. Also, total bank deposit and cash reserve ratio have significant positive effect on economic growth with p-values of 0.0020 and 0.0374 respectively. The implication of this result is that the Nigerian economy is significantly affected by bank distress. The paper suggests that careful evaluation of loan proposals should always be carried out by banks to determine the viability of the projects and the repayment of the principal sum and its interest ensured to prevent weak asset quality. 

  15. Exploring the ambiguities of masculinity in accounts of emotional distress in the military among young ex-servicemen.

    Science.gov (United States)

    Green, Gill; Emslie, Carol; O'Neill, Dan; Hunt, Kate; Walker, Steven

    2010-10-01

    This paper examines the experiences and perspectives of ex-military servicemen in the UK. It focuses specifically on the complex links between emotional distress and various constructions of 'masculinity' in a military context. Aspects of military culture that exacerbate vulnerability and also those that are protective to mental health are identified and discussed with reference to the theoretical constructs relating to hegemonic masculinity. A qualitative research design using semi-structured interviews provided in-depth accounts of the experiences of 20 ex-servicemen aged 23-44, all but one of whom were in the Army. We found that in a military setting hegemonic masculinity is embedded in the construction of a soldier identity and expression of emotion may be seen as inappropriate. As a result soldiers often lack a language with which to express distress (in a context in which they may witness extremely distressing events), which may result in delays in recognising and treating mental health problems. However, constructions of masculinity in this setting to some degree also promote a caring, sharing ethos based on strong inter-dependent bonds. A young soldier who can cope with the stresses of military life 'becomes a man', adopts a masculine/soldier identity and is well-placed to benefit from these protective factors, notably the camaraderie that is part of service life. In this manner a caring ethos in which some admissions of weakness may be permissible is situated within hegemonic masculinity. This seeming paradox between hyper masculinity and caring masculinities appears to be embedded within military culture, perhaps reflecting the flexibility and ambiguity inherent in constructions of hegemonic masculinity. Copyright © 2010 Elsevier Ltd. All rights reserved.

  16. Attitude extremity, consensus and diagnosticity

    NARCIS (Netherlands)

    van der Pligt, J.; Ester, P.; van der Linden, J.

    1983-01-01

    Studied the effects of attitude extremity on perceived consensus and willingness to ascribe trait terms to others with either pro- or antinuclear attitudes. 611 Ss rated their attitudes toward nuclear energy on a 5-point scale. Results show that attitude extremity affected consensus estimates. Trait

  17. Gender, Education, Extremism and Security

    Science.gov (United States)

    Davies, Lynn

    2008-01-01

    This paper examines the complex relationships between gender, education, extremism and security. After defining extremism and fundamentalism, it looks first at the relationship of gender to violence generally, before looking specifically at how this plays out in more extremist violence and terrorism. Religious fundamentalism is also shown to have…

  18. Grassland responses to precipitation extremes

    Science.gov (United States)

    Grassland ecosystems are naturally subjected to periods of prolonged drought and sequences of wet years. Climate change is expected to enhance the magnitude and frequency of extreme events at the intraannual and multiyear scales. Are grassland responses to extreme precipitation simply a response to ...

  19. Diabetes-Related Distress, Depression and Distress-Depression among Adults with Type 2 Diabetes Mellitus in Malaysia.

    Science.gov (United States)

    Chew, Boon-How; Vos, Rimke; Mohd-Sidik, Sherina; Rutten, Guy E H M

    2016-01-01

    Type 2 diabetes mellitus (T2DM) brings about an increasing psychosocial problem in adult patients. Prevalence data on and associated factors of diabetes related distress (DRD) and depression have been lacking in Asia. This study aimed to examine the prevalence of DRD and depression, and their associated factors in Asian adult T2DM patients. This study was conducted in three public health clinics measuring DRD (Diabetes Distress Scale, DDS), and depression (Patient Health Questionnaire, PHQ). Patients who were at least 30 years of age, had T2DM for more than one year, with regular follow-up and recent laboratory results ( 130/80 mmHg (OR 0.53, 95% CI 0.32 to 0.89) were less likely to experience both DRD and depression. DRD and depression were common and correlated in Asian adults with T2DM at primary care level. Socio-demographic more than clinical characteristics were related to DRD and depression.

  20. Modeling extreme risks in ecology.

    Science.gov (United States)

    Burgman, Mark; Franklin, James; Hayes, Keith R; Hosack, Geoffrey R; Peters, Gareth W; Sisson, Scott A

    2012-11-01

    Extreme risks in ecology are typified by circumstances in which data are sporadic or unavailable, understanding is poor, and decisions are urgently needed. Expert judgments are pervasive and disagreements among experts are commonplace. We outline approaches to evaluating extreme risks in ecology that rely on stochastic simulation, with a particular focus on methods to evaluate the likelihood of extinction and quasi-extinction of threatened species, and the likelihood of establishment and spread of invasive pests. We evaluate the importance of assumptions in these assessments and the potential of some new approaches to account for these uncertainties, including hierarchical estimation procedures and generalized extreme value distributions. We conclude by examining the treatment of consequences in extreme risk analysis in ecology and how expert judgment may better be harnessed to evaluate extreme risks.