Sample records for extreme distress class

  1. A new Class of Extremal Composites

    DEFF Research Database (Denmark)

    Sigmund, Ole


    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......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...

  2. A Latent Class Regression Analysis of Men's Conformity to Masculine Norms and Psychological Distress (United States)

    Wong, Y. Joel; Owen, Jesse; Shea, Munyi


    How are specific dimensions of masculinity related to psychological distress in specific groups of men? To address this question, the authors used latent class regression to assess the optimal number of latent classes that explained differential relationships between conformity to masculine norms and psychological distress in a racially diverse…

  3. Social class, income, education, area of residence and psychological distress: does social class have an independent effect on psychological distress in Antalya, Turkey? (United States)

    Belek, I


    The aim of this study is to determine the separate effects of social class, income, education and area of residence on psychological distress. The study also assesses whether the association between prevalence of high score on the 12-item General Health Questionnaire (GHQ 12) and social class is independent of other variables. Psychological distress was assessed by means of the GHQ 12. The study covered 1,092 adults aged 15 years or more living in two different quarters of Antalya. Social class status was defined by occupational position, with income, education and area of residence treated as confounders. Chi-square and logistic regression analyses were used to evaluate the data. Large inequalities in psychological distress by all variables were observed. Psychological distress was significantly associated with class status, after adjusting for income, education, area of residence and other potential confounders (age, sex and marital status). Class inequalities in psychological distress were observed between blue-collar workers/unqualified employees and bourgeoisie. These findings support the view that the recent widening of inequalities among social classes in Turkey pose a substantial threat to health.

  4. "Extreme Programming" in a Bioinformatics Class (United States)

    Kelley, Scott; Alger, Christianna; Deutschman, Douglas


    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).…

  5. Social class and mental distress in Greek urban communities during the period of economic recession. (United States)

    Zissi, Anastasia; Stalidis, George


    This study draws on old and well-established evidence that economic change, and especially recession, affects people's lives, behavior and mental health. Even though the literature is rich on the relationship between unemployment and mental distress, there is a renewed research interest on the link between socio-economic inequalities and psychological health. The study investigates the relationship of social class with mental distress during the hard times of persistent and severe economic crisis in Greece by conducting a comparative, community study in the country's second largest city, Thessaloniki. A face-to-face structured interview covering living conditions, life events, chronic stressors and coping strategies was employed to 300 residents of socio-economically contrasting neighborhood areas. Social class was operationalized by Erik Olin Wright's social class position typology, based on ownership and control over productive assets. The method of multiple correspondence analysis (MCA) was also applied to analyze the collected data. The results indicated that mental distress was significantly differentiated across social classes and in each residential area. Unemployed and unskilled workers were the most vulnerable groups in terms of psychological health. Chronic stress arose in this study as a risk factor for poor mental health outcomes and it was associated to low marital quality, intense economic burden and impoverished housing conditions. Those who face income loss, job loss and disability are at high risk for poverty and marginalization, suffering from greater psychological distress.

  6. Modeling spatial processes with unknown extremal dependence class

    KAUST Repository

    Huser, Raphaël G.


    Many environmental processes exhibit weakening spatial dependence as events become more extreme. Well-known limiting models, such as max-stable or generalized Pareto processes, cannot capture this, which can lead to a preference for models that exhibit a property known as asymptotic independence. However, weakening dependence does not automatically imply asymptotic independence, and whether the process is truly asymptotically (in)dependent is usually far from clear. The distinction is key as it can have a large impact upon extrapolation, i.e., the estimated probabilities of events more extreme than those observed. In this work, we present a single spatial model that is able to capture both dependence classes in a parsimonious manner, and with a smooth transition between the two cases. The model covers a wide range of possibilities from asymptotic independence through to complete dependence, and permits weakening dependence of extremes even under asymptotic dependence. Censored likelihood-based inference for the implied copula is feasible in moderate dimensions due to closed-form margins. The model is applied to oceanographic datasets with ambiguous true limiting dependence structure.

  7. Social class and gender patterning of insomnia symptoms and psychiatric distress: a 20-year prospective cohort study. (United States)

    Green, Michael J; Espie, Colin A; Benzeval, Michael


    Psychiatric distress and insomnia symptoms exhibit similar patterning by gender and socioeconomic position. Prospective evidence indicates a bi-directional relationship between psychiatric distress and insomnia symptoms so similarities in social patterning may not be coincidental. Treatment for insomnia can also improve distress outcomes. We investigate the extent to which the prospective patterning of distress over 20 years is associated with insomnia symptoms over that period. 999 respondents to the Twenty-07 Study had been followed for 20 years from approximately ages 36-57 (73.2% of the living baseline sample). Psychiatric distress was measured using the GHQ-12 at baseline and at 20-year follow-up. Gender and social class were ascertained at baseline. Insomnia symptoms were self-reported approximately every five years. Latent class analysis was used to classify patterns of insomnia symptoms over the 20 years. Structural Equation Models were used to assess how much of the social patterning of distress was associated with insomnia symptoms. Missing data was addressed with a combination of multiple-imputation and weighting. Patterns of insomnia symptoms over 20 years were classified as either healthy, episodic, developing or chronic. Respondents from a manual social class were more likely to experience episodic, developing or chronic patterns than those from non-manual occupations but this was mostly explained by baseline psychiatric distress. People in manual occupations experiencing psychiatric distress however were particularly likely to experience chronic patterns of insomnia symptoms. Women were more likely to experience a developing pattern than men, independent of baseline distress. Psychiatric distress was more persistent over the 20 years for those in manual social classes and this effect disappeared when adjusting for insomnia symptoms. Irrespective of baseline symptoms, women, and especially those in a manual social class, were more likely than men to

  8. A New Stress-Based Model of Political Extremism: Personal Exposure to Terrorism, Psychological Distress, and Exclusionist Political Attitudes (United States)

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


    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…

  9. Evidence for a New Class of Extreme Ultraviolet Sources (United States)

    Maoz, Dan; Ofek, Eran O.; Shemi, Amotz


    Most of the sources detected in the extreme ultraviolet (EUV; 100-600 A) by the ROSAT/WFC and EUVE all-sky surveys have been identified with active late-type stars and hot white dwarfs that are near enough to the Earth to escape absorption by interstellar gas. However, about 15 per cent of EUV sources are as yet unidentified with any optical counterparts. We examine whether the unidentified EUV sources may consist of the same population of late-type stars and white dwarfs. We present B and R photometry of stars in the fields of seven of the unidentified EUV sources. We detect in the optical the entire main-sequence and white dwarf population out to the greatest distances where they could still avoid absorption. We use color-magnitude diagrams to demonstrate that, in most of the fields, none of the observed stars has the colours and magnitudes of late-type dwarfs at distances less than 100 pc. Similarly, none of the observed stars is a white dwarf within 500 pc that is hot enough to be a EUV emitter. The unidentified EUV sources we study are not detected in X-rays, while cataclysmic variables, X-ray binaries, and active galactic nuclei generally are. We conclude that some of the EUV sources may be a new class of nearby objects, which are either very faint at optical bands or which mimic the colours and magnitudes of distant late-type stars or cool white dwarfs. One candidate for optically faint objects is isolated old neutron stars, slowly accreting interstellar matter. Such neutron stars are expected to be abundant in the Galaxy, and have not been unambiguously detected.

  10. Modeling spatial processes with unknown extremal dependence class

    KAUST Repository

    Huser, Raphaë l G.; Wadsworth, Jennifer L.


    Many environmental processes exhibit weakening spatial dependence as events become more extreme. Well-known limiting models, such as max-stable or generalized Pareto processes, cannot capture this, which can lead to a preference for models

  11. Prevention of postnatal distress or depression: an evaluation of an intervention at preparation for parenthood classes. (United States)

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


    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.

  12. Management of a severe Class III malocclusion with extreme dentoalveolar compensations. (United States)

    Nehra, Karan; Sharma, Vineet; Mitra, Rajat


    This case report describes the treatment of a 21-year-old woman with a severe Class III malocclusion, 9-mm anterior crossbite, extremely proclined maxillary anterior incisors associated with decreased buccolingual alveolar width, and a malformed supernumerary tooth. The treatment plan included fixed appliances to align and level the teeth, en masse retraction of maxillary anterior incisors after a labial and palatal corticotomy using temporary anchorage devices, high Le Fort I maxillary osteotomy for maxillary advancement, and bilateral sagittal split osteotomy for mandibular setback. Ideal overjet and overbite relationships were established, and the final esthetic result was pleasing. Occlusal stability was excellent in the 1-year follow-up.

  13. 454 sequencing reveals extreme complexity of the class II Major Histocompatibility Complex in the collared flycatcher

    Directory of Open Access Journals (Sweden)

    Gustafsson Lars


    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

  14. 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. (United States)

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


    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.

  15. The Role of Continuous Positive Airway Pressure Therapy in the Management of Respiratory Distress in Extremely Premature Infants


    Sekar, Kris


    The use of mechanical ventilation for the treatment of respiratory distress syndrome (RDS) in low birth weight infants may cause barotrauma, volutrauma, and chronic lung disease. Different continuous positive airway pressure (CPAP) delivery systems exist, each with its own practical and clinical advantages and disadvantages. CPAP can be used as either a primary or an adjunctive respiratory support for RDS. Research demonstrates that CPAP decreases the incidence of respiratory failure after ex...


    Energy Technology Data Exchange (ETDEWEB)

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


    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.

  17. Dealing with extreme response style in cross-cultural research: A restricted latent class factor approach

    NARCIS (Netherlands)

    Morren, M.H.; Gelissen, J.P.T.M.; Vermunt, J.K.


    Cross-cultural comparison of attitudes using rating scales may be seriously biased by response styles. This paper deals with statistical methods for detection of and correction for extreme response style (ERS), which is one of the well-documented response styles. After providing an overview of

  18. EEG classification for motor imagery and resting state in BCI applications using multi-class Adaboost extreme learning machine (United States)

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


    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.

  19. Bromine incorporation into five DBP classes upon chlorination of water with extremely low SUVA values. (United States)

    Hong, Huachang; Yan, Xiaoqing; Song, Xuhui; Qin, Yanyan; Sun, Hongjie; Lin, Hongjun; Chen, Jianrong; Liang, Yan


    The main objective of this study was to assess the effects of disinfection conditions on bromine incorporation into disinfection by-products (DBPs) during chlorination of water with low specific UV absorbance (SUVA). Five classes of DBPs were included: trihalomethanes (THMs), dihaloacetic acids (di-HAAs), trihaloacetic acids (tri-HAAs), dihaloacetonitriles (DHANs) and trihalonitromethanes (THNMs). Results showed that the bromine utilization in DBPs formation was positive related with reaction time, pH and temperature. On the other hand, the bromine substitution factors (BSFs) of DBPs were generally increased with pH (except tri-HAAs) and bromide concentration, but decreased with the reaction time, temperature and chlorine dose. Moreover, the BSFs values varied with DBP classes with the ranking being as following: THNMs≫DHANs≫tri-HAAs>THM≈di-HAAs. These results were mostly similar with the references, yet the pH effect on BSFs as well as the rank of BSFs for different DBP classes may differ with the specific UV absorbance of organic matter. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Optimization and Modeling of Extreme Freshwater Discharge from Japanese First-Class River Basins to Coastal Oceans (United States)

    Kuroki, R.; Yamashiki, Y. A.; Varlamov, S.; Miyazawa, Y.; Gupta, H. V.; Racault, M.; Troselj, J.


    We estimated the effects of extreme fluvial outflow events from river mouths on the salinity distribution in the Japanese coastal zones. Targeted extreme event was a typhoon from 06/09/2015 to 12/09/2015, and we generated a set of hourly simulated river outflow data of all Japanese first-class rivers from these basins to the Pacific Ocean and the Sea of Japan during the period by using our model "Cell Distributed Runoff Model Version 3.1.1 (CDRMV3.1.1)". The model simulated fresh water discharges for the case of the typhoon passage over Japan. We used these data with a coupled hydrological-oceanographic model JCOPE-T, developed by Japan Agency for Marine-earth Science and Technology (JAMSTEC), for estimation of the circulation and salinity distribution in Japanese coastal zones. By using the model, the coastal oceanic circulation was reproduced adequately, which was verified by satellite remote sensing. In addition to this, we have successfully optimized 5 parameters, soil roughness coefficient, river roughness coefficient, effective porosity, saturated hydraulic conductivity, and effective rainfall by using Shuffled Complex Evolution method developed by University of Arizona (SCE-UA method), that is one of the optimization method for hydrological model. Increasing accuracy of peak discharge prediction of extreme typhoon events on river mouths is essential for continental-oceanic mutual interaction.

  1. Extremely high-brightness kW-class fiber coupled diode lasers with wavelength stabilization (United States)

    Huang, Robin K.; Chann, Bien; Glenn, John D.


    TeraDiode has produced ultra-high brightness fiber-coupled direct diode lasers. A fiber-coupled direct diode laser with a power level of 1,040 W from a 200 μm core diameter, 0.18 numerical aperture (NA) output fiber at a single center wavelength was demonstrated. This was achieved with a novel beam combining and shaping technique using COTS diode lasers. The fiber-coupled output corresponds to a Beam Parameter Product (BPP) of 18 mm-mrad and is the lowest BPP kW-class direct diode laser yet reported. The laser has been used to demonstrate laser cutting and welding of steel sheet metal up to 6.65 mm thick. Higher brightness fiber-coupled diode lasers, including a module with 418 W of power coupled to a 100 μm, 0.15 NA fiber, have also been demonstrated.

  2. Kinetic turbulence simulations at extreme scale on leadership-class systems

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Bei [Princeton Univ., Princeton, NJ (United States); Ethier, Stephane [Princeton Plasma Physics Lab. (PPPL), Princeton, NJ (United States); Tang, William [Princeton Univ., Princeton, NJ (United States); Princeton Plasma Physics Lab. (PPPL), Princeton, NJ (United States); Williams, Timothy [Argonne National Lab. (ANL), Argonne, IL (United States); Ibrahim, Khaled Z. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Madduri, Kamesh [The Pennsylvania State Univ., University Park, PA (United States); Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Williams, Samuel [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Oliker, Leonid [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)


    Reliable predictive simulation capability addressing confinement properties in magnetically confined fusion plasmas is critically-important for ITER, a 20 billion dollar international burning plasma device under construction in France. The complex study of kinetic turbulence, which can severely limit the energy confinement and impact the economic viability of fusion systems, requires simulations at extreme scale for such an unprecedented device size. Our newly optimized, global, ab initio particle-in-cell code solving the nonlinear equations underlying gyrokinetic theory achieves excellent performance with respect to "time to solution" at the full capacity of the IBM Blue Gene/Q on 786,432 cores of Mira at ALCF and recently of the 1,572,864 cores of Sequoia at LLNL. Recent multithreading and domain decomposition optimizations in the new GTC-P code represent critically important software advances for modern, low memory per core systems by enabling routine simulations at unprecedented size (130 million grid points ITER-scale) and resolution (65 billion particles).

  3. A new class of photoactivatable and carbene generating reagents with extremely high specific radioactivity. Synthesis, characterization and applications

    International Nuclear Information System (INIS)

    Weber, T.


    The main objective of this work was the development of new photocrosslinking and labeling reagents which show favourable photochemical properties and can be synthesized in an extremely high specific radioactivity. A key compound in the synthesis of these reagents was 2-tributyltin-4-(3-trifluormethyl-3H-diazirin-3-yl)-benzyl alcohol. Esters of this alcohol can be easily radioiodinated at a specific radioactivity of >2000 Ci/mmol under mild conditions. By experiments with a model compound it was shown that 2-iodo-4-(3-trifluormethyl-3H-diazirin-3-yl)-benzyl esters, upon photolysis, generate highly reactive (singlet) carbenes capable of inserting into CH-bonds. Equally important, there is no indication of loss of iodine under the photolysis conditions applied. Therefore two key requirements for photolabeling reagents are fulfilled. Several photoactivatable radioiodinated phospholipids have been synthesized. Their properties have been evaluated by labeling of the the membranes of intact erythrocytes and influenza viruses. Currently these lipids are used to study the interaction of various proteins (shown are experiments with MARCKS) with membranes. Furthermore a new class of actual label transfer crosslinkers (two thiol specific and one amino specific) have been developed. The range of potentialities of these reagents is currently being investigated. Finally a photoactivatable radioiodinated ceramide analogue suitable as a photoaffinity crosslinker has been developed with the goal of identifying the putative receptor of this second messenger-like lipid. Preliminary studies towards this goal are described. We are convinced that the reagents and methods presented in this work are valuable tools, and that they will find widespread use in future cell-biological and biochemical research. (author) figs., tabs., refs

  4. Extremely high MHC class I variation in a population of a long-distance migrant, the Scarlet Rosefinch (Carpodacus erythrinus)

    Czech Academy of Sciences Publication Activity Database

    Promerová, Marta; Albrecht, Tomáš; Bryja, Josef


    Roč. 61, č. 6 (2009), s. 451-461 ISSN 0093-7711 R&D Projects: GA AV ČR IAA600930608; GA ČR GA206/06/0851; GA MŠk LC06073 Institutional research plan: CEZ:AV0Z60930519 Keywords : MHC class I * scarlet rosefinch * positive selection * recombination Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 2.988, year: 2009

  5. Geometric modeling of controlled third-class hinged mechanisms with a stand in one extreme position for cyclic automatic machines (United States)

    Khomchenko, V. G.; Varepo, L. G.; Glukhov, V. I.; Krivokhatko, E. A.


    The geometric model for the synthesis of third-class lever mechanisms is proposed, which allows, by changing the length of the auxiliary link and the position of its fixed hinge, to rearrange the movement of the working organ onto the cyclograms with different predetermined dwell times. It is noted that with the help of the proposed model, at the expense of the corresponding geometric constructions, the best uniform Chebyshev approximation can be achieved at the interval of the standstill.

  6. Neonatal respiratory distress syndrome (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 ...

  7. Idioms of Distress. (United States)

    Desai, Geetha; Chaturvedi, Santosh K


    The presentations of psychosocial distress and cultural conflicts are often bodily symptoms, especially in traditional societies and village backgrounds. These might not meet the criteria of the current psychiatric diagnostic systems. Sociocultural milieu contributes to the unique presentations of the stress in the form of idioms of distress. The latter are alternative modes of expressing distress and indicate manifestations of distress in relation to personal and cultural meaning. Health professionals often consider these as hysterical, functional or having functional overlays, and abnormal illness behaviors. Management of idioms of distress would need cultural competence and sensitivity. This article highlights the common idioms of distress in India with specific focus on bodily symptoms.

  8. Acute respiratory distress syndrome (United States)

    ... page: // Acute respiratory distress syndrome To use the sharing features on this page, please enable JavaScript. Acute respiratory distress syndrome (ARDS) is a life-threatening lung ...

  9. Performance of the THS4302 and the Class V Radiation-Tolerant THS4304-SP Silicon Germanium Wideband Amplifiers at Extreme Temperatures (United States)

    Patterson, Richard L.; Elbuluk, Malik; Hammoud, Ahmad; VanKeuls, Frederick W.


    This report discusses the performance of silicon germanium, wideband gain amplifiers under extreme temperatures. The investigated devices include Texas Instruments THS4304-SP and THS4302 amplifiers. Both chips are manufactured using the BiCom3 process based on silicon germanium technology along with silicon-on-insulator (SOI) buried oxide layers. The THS4304-SP device was chosen because it is a Class V radiation-tolerant (150 kRad, TID silicon), voltage-feedback operational amplifier designed for use in high-speed analog signal applications and is very desirable for NASA missions. It operates with a single 5 V power supply [1]. It comes in a 10-pin ceramic flatpack package, and it provides balanced inputs, low offset voltage and offset current, and high common mode rejection ratio. The fixed-gain THS4302 chip, which comes in a 16-pin leadless package, offers high bandwidth, high slew rate, low noise, and low distortion [2]. Such features have made the amplifier useful in a number of applications such as wideband signal processing, wireless transceivers, intermediate frequency (IF) amplifier, analog-to-digital converter (ADC) preamplifier, digital-to-analog converter (DAC) output buffer, measurement instrumentation, and medical and industrial imaging.

  10. Extreme MHC class I diversity in the sedge warbler (Acrocephalus schoenobaenus); selection patterns and allelic divergence suggest that different genes have different functions. (United States)

    Biedrzycka, Aleksandra; O'Connor, Emily; Sebastian, Alvaro; Migalska, Magdalena; Radwan, Jacek; Zając, Tadeusz; Bielański, Wojciech; Solarz, Wojciech; Ćmiel, Adam; Westerdahl, Helena


    Recent work suggests that gene duplications may play an important role in the evolution of immunity genes. Passerine birds, and in particular Sylvioidea warblers, have highly duplicated major histocompatibility complex (MHC) genes, which are key in immunity, compared to other vertebrates. However, reasons for this high MHC gene copy number are yet unclear. High-throughput sequencing (HTS) allows MHC genotyping even in individuals with extremely duplicated genes. This HTS data can reveal evidence of selection, which may help to unravel the putative functions of different gene copies, i.e. neofunctionalization. We performed exhaustive genotyping of MHC class I in a Sylvioidea warbler, the sedge warbler, Acrocephalus schoenobaenus, using the Illumina MiSeq technique on individuals from a wild study population. The MHC diversity in 863 genotyped individuals by far exceeds that of any other bird species described to date. A single individual could carry up to 65 different alleles, a large proportion of which are expressed (transcribed). The MHC alleles were of three different lengths differing in evidence of selection, diversity and divergence within our study population. Alleles without any deletions and alleles containing a 6 bp deletion showed characteristics of classical MHC genes, with evidence of multiple sites subject to positive selection and high sequence divergence. In contrast, alleles containing a 3 bp deletion had no sites subject to positive selection and had low divergence. Our results suggest that sedge warbler MHC alleles that either have no deletion, or contain a 6 bp deletion, encode classical antigen presenting MHC molecules. In contrast, MHC alleles containing a 3 bp deletion may encode molecules with a different function. This study demonstrates that highly duplicated MHC genes can be characterised with HTS and that selection patterns can be useful for revealing neofunctionalization. Importantly, our results highlight the need to consider the

  11. Impacts of Extreme Space Weather Events on Power Grid Infrastructure: Physics-Based Modelling of Geomagnetically-Induced Currents (GICs) During Carrington-Class Geomagnetic Storms (United States)

    Henderson, M. G.; Bent, R.; Chen, Y.; Delzanno, G. L.; Jeffery, C. A.; Jordanova, V. K.; Morley, S.; Rivera, M. K.; Toth, G.; Welling, D. T.; Woodroffe, J. R.; Engel, M.


    Large geomagnetic storms can have devastating effects on power grids. The largest geomagnetic storm ever recorded - called the Carrington Event - occurred in 1859 and produced Geomagnetically Induced Currents (GICs) strong enough to set fires in telegraph offices. It has been estimated that if such a storm occurred today, it would have devastating, long-lasting effects on the North American power transmission infrastructure. Acutely aware of this imminent threat, the North American Electric Reliability Corporation (NERC) was recently instructed to establish requirements for transmission system performance during geomagnetic disturbance (GMD) events and, although the benchmarks adopted were based on the best available data at the time, they suffer from a severely limited physical understanding of the behavior of GMDs and the resulting GICs for strong events. To rectify these deficiencies, we are developing a first-of-its-kind data-informed modelling capability that will provide transformational understanding of the underlying physical mechanisms responsible for the most harmful intense localized GMDs and their impacts on real power transmission networks. This work is being conducted in two separate modes of operation: (1) using historical, well-observed large storm intervals for which robust data-assimilation can be performed, and (2) extending the modelling into a predictive realm in order to assess impacts of poorly and/or never-before observed Carrington-class events. Results of this work are expected to include a potential replacement for the current NERC benchmarking methodology and the development of mitigation strategies in real power grid networks. We report on progress to date and show some preliminary results of modeling large (but not yet extreme) events.

  12. What Is Respiratory Distress Syndrome? (United States)

    ... Home / Respiratory Distress Syndrome Respiratory Distress Syndrome Also known as What Is Respiratory ... This condition is called apnea (AP-ne-ah). Respiratory Distress Syndrome Complications Depending on the severity of ...

  13. Differences in extreme low salinity timing and duration differentially affect eastern oyster (Crassostrea virginica) size class growth and mortality in Breton Sound, LA (United States)

    LaPeyre, Megan K.; Eberline, Benjamin S.; Soniat, Thomas M.; La Peyre, Jerome F.


    Understanding how different life history stages are impacted by extreme or stochastic environmental variation is critical for predicting and modeling organism population dynamics. This project examined recruitment, growth, and mortality of seed (25–75 mm) and market (>75 mm) sized oysters along a salinity gradient over two years in Breton Sound, LA. In April 2010, management responses to the Deepwater Horizon oil spill resulted in extreme low salinity (25 °C) significantly and negatively impacted oyster recruitment, survival and growth in 2010, while low salinity (25 °C). With increasing management of our freshwater inputs to estuaries combined with predicted climate changes, how extreme events affect different life history stages is key to understanding variation in population demographics of commercially important species and predicting future populations.


    Palamarchuk, V I; Odnorog, S I; Gvozdyak, M M; Vilgash, A M


    The experience of surgical treatment of 50 patients for varicose disease of lower extremities, complicated by trophic ulcers, in the presence of diabetes mellitus type II were analysed. During surgery in patients of the 1st group performed a combined phlebectomy, group 2--scleroobliteration and echoscleroobliteration. Using fleboscleroobliteration method helped reduce the frequency of early postoperative complications in (6.5 +/- 1.3) times.

  15. Navigating moral distress using the moral distress map. (United States)

    Dudzinski, Denise Marie


    The plethora of literature on moral distress has substantiated and refined the concept, provided data about clinicians' (especially nurses') experiences, and offered advice for coping. Fewer scholars have explored what makes moral distress moral If we acknowledge that patient care can be distressing in the best of ethical circumstances, then differentiating distress and moral distress may refine the array of actions that are likely to ameliorate it. This article builds upon scholarship exploring the normative and conceptual dimensions of moral distress and introduces a new tool to map moral distress from emotional source to corrective actions. The Moral Distress Map has proven useful in clinical teaching and ethics-related debriefings. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  16. ARDS (Acute Respiratory Distress Syndrome) (United States)

    ... Also known as What Is ARDS, or acute respiratory distress syndrome, is a lung condition that leads ... treat ARDS. Other Names Acute lung injury Adult respiratory distress syndrome Increased-permeability pulmonary edema Noncardiac pulmonary ...

  17. Adult respiratory distress syndrome

    International Nuclear Information System (INIS)

    Svendsen, J.; Jespersen, J.; Skjoedt, T.


    Our present-day knowledge concerning the clinico-chemical and radiological findings in adult respiratory distress syndrome are described. Three typical case histories have been selected to illustrate this condition; they were due to multiple trauma or sepsis. It is stressed that radiology is in a key position for making the diagnosis and for observing the course of the illness. (orig) [de

  18. Distress about mating rivals

    NARCIS (Netherlands)

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

    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 =

  19. The career distress scale

    DEFF Research Database (Denmark)

    Creed, Peter; Hood, Michelle; Praskova, Anna


    distress items for model fit, item bias, location dependency, dimensionality, reliability, suitability of response options, and construct validity. Three of the 12 items examined were removed from consideration as they did not fit the Rasch model or were not invariant across groups. The remaining 9 items...

  20. Girls in Distress in Israel. (United States)

    Steiner, Yosepha

    The typical girl in distress in Israel comes from a Jewish family of oriental origin. Her distress is partially due to the strains of immigrating to Israel from, in most cases, North Africa. Authority models in distressed girls' families feature either the role of the father as the commanding familial authority figure; the mother as the dominant…

  1. Characterizing the Energetics of the Youngest Protostars: FIFI-LS Spectroscopy of Herschel-Identified Extreme Class 0 objects in Orion (United States)

    Megeath, S.


    We propose FIFI-LS spectroscopy observations toward 3 of the youngest known Herschel- detected Class 0 protostars in the Orion molecular clouds. Characterization of the far-IR spectrum toward these PACS Bright Red Sources (PBRS) is imperative: this is the only observational means to characterize the complete energetics of the outflow in the earliest stages of the star formation process. We have already obtained Herschel-PACS spectroscopy for 8/14 PBRS; for these, the CO rotation temperatures are systematically lower than the larger samples of 'more typical' protostars observed. Furthermore, all of the Herschel-detected PBRS also have CARMA CO (J=1-0) outflow maps, enabling us to identify tentative trends between the detection and morphology (compact or extended) of the CO outflow and the presence or lack of far-infrared emission lines. Moreover, we only convincingly detect [OI] emission toward the source with the brightest outflow emission; thus, [OI] may not be universally present in protostellar outflows. However, due to the small-numbers with PACS spectroscopy, it is unclear if these trends are real and the three proposed PBRS have outflow maps of varying morphologies, but no far-infrared spectra. The results from this program will provide a firm observational footing for the presence or lack of such trends and will strengthen the connection of the far-IR emission lines to the outflow.

  2. Moral distress in emergency nurses. (United States)

    Fernandez-Parsons, Robin; Rodriguez, Lori; Goyal, Deepika


    For nurses, moral distress leads to burnout, attrition, compassion fatigue, and patient avoidance. Using a quantitative, cross-sectional, and descriptive design, we assessed the frequency, intensity, and type of moral distress in 51 emergency nurses in 1 community hospital using a 21-item, self-report, Likert-type questionnaire. Results showed a total mean moral distress level of 3.18, indicative of overall low moral distress. Situations with the highest levels of moral distress were related to the competency of health care providers and following family wishes to continue life support, also known as futile care. Moral distress was the reason given by 6.6% of registered nurses for leaving a previous position, 20% said that they had considered leaving a position but did not, and 13.3% stated that they are currently considering leaving their position because of moral distress. Copyright © 2013 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

  3. Narrating psychological distress

    DEFF Research Database (Denmark)

    Zinken, Jörg; Blakemore, Caroline; Zinken, Katarzyna


    Psychological research has emphasized the importance of narrative for a person's sense of self. Building a coherent narrative of past events is one objective of psychotherapy. However, in guided self-help therapy the patient has to develop this narrative autonomously. Identifying patients......' narrative skills in relation to psychological distress could provide useful information about their suitability for self-help. The aim of this study was to explore whether the syntactic integration of clauses into narrative in texts written by prospective psychotherapy patients was related to mild...... to moderate psychological distress. Cross-clausal syntax of texts by 97 people who had contacted a primary care mental health service was analyzed. Severity of symptoms associated with mental health difficulties was assessed by a standardized scale (Clinical Outcomes in Routine Evaluation outcome measure...

  4. The neonate in distress

    International Nuclear Information System (INIS)

    Ball, T.I. Jr.


    Respiratory distress is a very common and yet non-specific symptom in neonates and young infants. It may be manifested clinically in many ways, including tachypnea, apnea, periodic respiratory, grunting, retractions, nasal flaring, and cyanosis. In many instances, the chest radiograph is diagnostic or at least suggestive of the diagnosis. This fact is important in determining surgical or medical conditions that require emergency therapy. Even if the chest film is normal, valuable information can be gained. This initial normal radiograph can be used as a baseline film in the face of further developing symptoms which, likewise, may have developing radiographic findings. In any event, the chest radiograph gives the clinician ''direction'' in his or her search for the cause of the patient's respiratory distress

  5. Acute respiratory distress syndrome


    Confalonieri, Marco; Salton, Francesco; Fabiano, Francesco


    Since its first description, the acute respiratory distress syndrome (ARDS) has been acknowledged to be a major clinical problem in respiratory medicine. From July 2015 to July 2016 almost 300 indexed articles were published on ARDS. This review summarises only eight of them as an arbitrary overview of clinical relevance: definition and epidemiology, risk factors, prevention and treatment. A strict application of definition criteria is crucial, but the diverse resource-setting scenarios foste...

  6. Mandelbrot's Extremism

    NARCIS (Netherlands)

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


    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. Maternal psychological distress and child decision-making. (United States)

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


    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.

  8. Psychological distress among homeless adults. (United States)

    Gelberg, L; Linn, L S


    Recent studies have reported a high prevalence of mental illness among the homeless. As part of a community-based survey of 529 homeless adults, we developed and tested a model to increase our understanding of the factors related to their psychological distress. Using a previously validated and reliable scale of perceived psychological distress, we found that homeless adults were more likely to report psychological distress than the general population (80% vs. 49%). Distress levels were not associated with most demographic or homeless characteristics or general appearance. However, distress was related to unemployment, greater cigarette and alcohol use, worse physical health, fewer social supports, and perceived barriers to obtaining needed medical care. Since mental, physical, and social health are strongly related among homeless adults, alleviating distress among them may be most effectively done by implementing a broad-based health services package coupled with employment programs provided in an accessible service delivery setting.

  9. Moral distress in nursing personnel


    Barlem,Edison Luiz Devos; Lunardi,Valéria Lerch; Lunardi,Guilherme Lerch; Tomaschewski-Barlem,Jamila Geri; Silveira,Rosemary Silva da; Dalmolin,Graziele de Lima


    OBJECTIVE: to analyze the frequency and intensity of moral distress experienced by nursing personnel in southern Brazil, covering elements of their professional practice. METHOD: a survey was undertaken in two hospitals in Rio Grande do Sul, Brazil, with 247 nurses. Data was collected by means of the adapted Moral Distress Scale. RESULTS: the perception of situations that lead to moral distress is enhanced in nurses and in nursing staff working in institutions with greater openness to dialogu...

  10. Congenital rickets presenting as refractory respiratory distress at birth. (United States)

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


    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.

  11. Partner personality in distressed relationships

    NARCIS (Netherlands)

    Barelds, D.P.H.; Barelds-Dijkstra, P.


    The present study examines the personality characteristics of partners receiving marital therapy. On the basis of previous research, we expected partners in distressed relationships to be more neurotic and more introverted and to have lower self-esteem than partners in non-distressed relationships.

  12. 47 CFR 80.314 - Distress communications. (United States)


    ... radiotelephone distress call consists of: (1) The distress signal MAYDAY spoken three times; (2) The words THIS IS; (3) The call sign (or name, if no call sign assigned) of the mobile station in distress, spoken...

  13. Extreme cosmos

    CERN Document Server

    Gaensler, Bryan


    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

  14. Acute Respiratory Distress Syndrome

    Directory of Open Access Journals (Sweden)

    Carmen Sílvia Valente Barbas


    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.

  15. Adult respiratory distress syndrome

    International Nuclear Information System (INIS)

    Murphy, C.H.; Colvin, R.S.


    Due to improved emergency resuscitation procedures, and with advancing medical technology in the field of critical care, an increasing number of patients survive the acute phase of shock and catastrophic trauma. Patients who previously died of massive sepsis, hypovolemic or hypotensive shock, multiple fractures, aspiration, toxic inhalation, and massive embolism are now surviving long enough to develop previously unsuspected and unrecognized secondary effects. With increasing frequency, clinicians are recognizing the clinical and radiographic manifestations of pathologic changes in the lungs occurring secondary to various types of massive insult. This paper gives a list of diseases that have been shown to precipitate or predispose to diffuse lung damage. Various terms have been used to describe the lung damage and respiratory failure secondary to these conditions. The term adult respiratory distress syndrome (ARDS) is applied to several cases of sudden respiratory failure in patients with previously healthy lungs following various types of trauma or shock. Numerous investigations and experiments have studied the pathologic changes in ARDS, and, while there is still no clear indication of why it develops, there is now some correlation of the sequential pathologic developments with the clinical and radiographic changes

  16. Acute respiratory distress syndrome

    Directory of Open Access Journals (Sweden)

    Marco Confalonieri


    Full Text Available Since its first description, the acute respiratory distress syndrome (ARDS has been acknowledged to be a major clinical problem in respiratory medicine. From July 2015 to July 2016 almost 300 indexed articles were published on ARDS. This review summarises only eight of them as an arbitrary overview of clinical relevance: definition and epidemiology, risk factors, prevention and treatment. A strict application of definition criteria is crucial, but the diverse resource-setting scenarios foster geographic variability and contrasting outcome data. A large international multicentre prospective cohort study including 50 countries across five continents reported that ARDS is underdiagnosed, and there is potential for improvement in its management. Furthermore, epidemiological data from low-income countries suggest that a revision of the current definition of ARDS is needed in order to improve its recognition and global clinical outcome. In addition to the well-known risk-factors for ARDS, exposure to high ozone levels and low vitamin D plasma concentrations were found to be predisposing circumstances. Drug-based preventive strategies remain a major challenge, since two recent trials on aspirin and statins failed to reduce the incidence in at-risk patients. A new disease-modifying therapy is awaited: some recent studies promised to improve the prognosis of ARDS, but mortality and disabling complications are still high in survivors in intensive care.

  17. Distress During the Menopause Transition

    Directory of Open Access Journals (Sweden)

    Marcianna Nosek


    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.

  18. 47 CFR 80.1111 - Distress alerting. (United States)


    ... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Global Maritime Distress and Safety System (GMDSS) Operating Procedures for Distress and Safety Communications § 80.1111 Distress alerting. (a) The transmission of a distress alert indicates...

  19. Changes in the Occurrence, Severity, and Distress of Symptoms in Patients With Gastrointestinal Cancers Receiving Chemotherapy


    Tantoy, IY; Cooper, BA; Dhruva, A; Cataldo, J; Paul, SM; Conley, YP; Hammer, M; Wright, F; Dunn, LB; Levine, JD; Miaskowski, C


    Studies on multiple dimensions of the symptom experience of patients with gastrointestinal cancers are extremely limited.Purpose was to evaluate for changes over time in the occurrence, severity, and distress of seven common symptoms in these patients.Patients completed Memorial Symptom Assessment Scale, six times over two cycles of chemotherapy (CTX). Changes over time in occurrence, severity, and distress of pain, lack of energy, nausea, feeling drowsy, difficulty sleeping, and change in th...

  20. Coming out in Class (United States)

    McKinnon, Rachel


    This article shares how the author explained her trans status to her students. Everyone has been extremely supportive of her decision to come out in class and to completely mask the male secondary-sex characteristics, especially in the workplace. The department chair and the faculty in general have been willing to do whatever they can to assist…

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

    Directory of Open Access Journals (Sweden)

    Montserrat Manzaneque


    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.

  2. Understanding women's experiences of distress during pregnancy in Dar es Salaam, Tanzania. (United States)

    Kaaya, S F; Mbwambo, J K; Fawzi, M C Smith; Van Den Borne, H; Schaalma, H; Leshabari, M T


    Several studies show depression is common during pregnancy. However, there is limited information in Tanzania on the magnitude of perceived distress during pregnancy and meanings ascribed to such distress. A descriptive survey collected data using unstructured interviews from 12 traditional practitioners and 10 peri-urban women with previous pregnancy related mental health concerns identified using a depression vignette. The objectives were to describe the sources and characteristics of distress during pregnancy, and idioms of distress that could inform cultural adaptation of depression screening tools. Narrative analysis showed an emergent category of "problematic pregnancies" framed women's recollections of prolonged periods of sadness. This experience was qualified using various idioms of distress that were differentially emphasized depending on informant's perceived causes of health concern. The idiom kusononeka was consistently used to describe extreme sadness across causal categories and clustered with at least two typical features of major depression. This suggested existence of a construct with similarities to biomedical criteria for depression. "Thinking too much" emerged as a distinctive expression associated with prolonged sadness. Distinctive expressions of social functioning impairments were identified that can inform depression severity assessments. In conclusion, contextual inquiry into experiences of psychological distress showed distinct local idioms that clustered in patterns similar to symptoms of biomedical depressive episodes. Further studies to assess the utility of local idioms of distress and distress related functional impairment in depression assessment tools are warranted.

  3. Psychological Distress and Lifestyle of Malay Medical Students

    Directory of Open Access Journals (Sweden)

    Hani Ramli Zafirah


    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

  4. Dependent Classes

    DEFF Research Database (Denmark)

    Gasiunas, Vaidas; Mezini, Mira; Ostermann, Klaus


    of dependent classes and a machine-checked type soundness proof in Isabelle/HOL [29], the first of this kind for a language with virtual classes and path-dependent types. [29] T.Nipkow, L.C. Poulson, and M. Wenzel. Isabelle/HOL -- A Proof Assistant for Higher-Order Logic, volume 2283 of LNCS, Springer, 2002......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...

  5. Moral Distress, Workplace Health, and Intrinsic Harm. (United States)

    Weber, Elijah


    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.

  6. Maternal postpartum distress and childhood overweight

    DEFF Research Database (Denmark)

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


    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....

  7. Why Do Distressed Firms Acquire?

    NARCIS (Netherlands)

    Q. Zhang (Quxian)


    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

  8. Perfectionism, Procrastination, and Psychological Distress (United States)

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


    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…

  9. Development and psychometric testing of a new tool for detecting moral distress: the Moral Distress Thermometer. (United States)

    Wocial, Lucia D; Weaver, Michael T


    To report the development and psychometric testing of the Moral Distress Thermometer. The Moral Distress Thermometer is a new screening tool to measure moral distress in nurses who practise in the hospital setting. Moral distress occurs when one knows the ethically correct thing to do, but is prevented from acting on that perceived obligation. It is a well documented phenomenon with negative consequences that may be experienced by nurses. Creating an instrument to effectively and efficiently measure moral distress in a timely way has been identified as a priority for nursing. This study used a cross-sectional survey design. Data collection for this research occurred in 2009. Participants simultaneously completed either the adult or pediatric version of the Moral Distress Scale version 2009 and the Moral Distress Thermometer. A total of 529 participants from various clinical areas completed both tools. Coefficients alpha were adequate for both Adult (0·90) and Pediatric (0·92) Moral Distress Scale 2009 scales. Statistically significant Pearson correlations were found for the Moral Distress Thermometer with Adult Moral Distress Scale 2009 and Pediatric Moral Distress Scale 2009 and higher Moral Distress Thermometer, Adult Moral Distress Scale 2009 and Pediatric Moral Distress Scale 2009 means for participants who had left or who considered leaving a position because of moral distress. These findings provide support for the validity of the Moral Distress Thermometer. © 2012 Blackwell Publishing Ltd.

  10. Cutting Classes (United States)

    Hacker, Andrew


    Provides critical reviews of three books, "The Political Economy of Social Class", "Ethnicity: Theory and Experience," and "Ethnicity in the United States," focusing on the political economy of social class and ethnicity. (Author/AM)

  11. Industry specific financial distress modeling

    Directory of Open Access Journals (Sweden)

    Naz Sayari


    Full Text Available This study investigates uncertainty levels of various industries and tries to determine financial ratios having the greatest information content in determining the set of industry characteristics. It then uses these ratios to develop industry specific financial distress models. First, we employ factor analysis to determine the set of ratios that are most informative in specified industries. Second, we use a method based on the concept of entropy to measure the level of uncertainty in industries and also to single out the ratios that best reflect the uncertainty levels in specific industries. Finally, we conduct a logistic regression analysis and derive industry specific financial distress models which can be used to judge the predictive ability of selected financial ratios for each industry. The results show that financial ratios do indeed echo industry characteristics and that information content of specific ratios varies among different industries. Our findings show diverging impact of industry characteristics on companies; and thus the necessity of constructing industry specific financial distress models.

  12. Moderate and extreme maternal obesity.

    LENUS (Irish Health Repository)

    Abdelmaboud, M O


    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.

  13. Psychological distress and its correlates among dental students: a survey of 17 Colombian dental schools. (United States)

    Divaris, Kimon; Mafla, Ana Cristina; Villa-Torres, Laura; Sánchez-Molina, Marisol; Gallego-Gómez, Clara Liliana; Vélez-Jaramillo, Luis Fernando; Tamayo-Cardona, Julián Andrés; Pérez-Cepeda, David; Vergara-Mercado, Martha Ligia; Simancas-Pallares, Miguel Ángel; Polychronopoulou, Argy


    Links between the demanding nature of studies in the health sciences, students' personality traits and psychological distress have been well-established. While considerable amount of work has been done in medicine, evidence from the dental education arena is sparse and data from Latin America are lacking. The authors conducted a large-scale investigation of psychological distress among dental students in Colombia and sought to determine its curriculum and student-level correlates. The Spanish version of the Derogatis' Symptoms Checklist Revised (SCL-90-R) was administered to all students officially registered and attending classes or clinics in 17 dental schools in 4 geographic districts of Colombia between January and April 2012. Additional information was collected on participants' socio-demographic information and first career choice, as well as school's characteristics such as class size. The Global Severity Index (GSI) score, a measure of overall psychological distress, served as the primary analytical endpoint. Analyses relied on multilevel mixed-effects linear and log-binomial regression, accounting for study design and sample characteristics. A total of 5700 dental students completed the survey, a response rate of 67%. Pronounced gradients were noted in the association between socio-economic status and psychological distress, with students in higher strata reporting fewer problems. After adjustment for all important covariates, there was an evident pattern of increasing psychological distress corresponding to the transition from the didactic, to the preclinical and clinical phases of training, with few differences between male and female students. Independent of other factors, reliance on own funds for education and having dentistry as the first career choice were associated with lower psychological distress. Levels of psychological distress correlated with students' socio-economic and study-level characteristics. Above and beyond the influence of person

  14. Factors influencing psychological distress during a disease epidemic: Data from Australia's first outbreak of equine influenza

    Directory of Open Access Journals (Sweden)

    Stevens Garry J


    Full Text Available Abstract Background In 2007 Australia experienced its first outbreak of highly infectious equine influenza. Government disease control measures were put in place to control, contain, and eradicate the disease; these measures included movement restrictions and quarantining of properties. This study was conducted to assess the psycho-social impacts of this disease, and this paper reports the prevalence of, and factors influencing, psychological distress during this outbreak. Methods Data were collected using an online survey, with a link directed to the affected population via a number of industry groups. Psychological distress, as determined by the Kessler 10 Psychological Distress Scale, was the main outcome measure. Results In total, 2760 people participated in this study. Extremely high levels of non-specific psychological distress were reported by respondents in this study, with 34% reporting high psychological distress (K10 > 22, compared to levels of around 12% in the Australian general population. Analysis, using backward stepwise binary logistic regression analysis, revealed that those living in high risk infection (red zones (OR = 2.00; 95% CI: 1.57–2.55; p Conclusion Although, methodologically, this study had good internal validity, it has limited generalisability because it was not possible to identify, bound, or sample the target population accurately. However, this study is the first to collect psychological distress data from an affected population during such a disease outbreak and has potential to inform those involved in assessing the potential psychological impacts of human infectious diseases, such as pandemic influenza.

  15. Time-lagged relationships between leadership behaviors and psychological distress after a workplace terrorist attack. (United States)

    Birkeland, Marianne Skogbrott; Nielsen, Morten Birkeland; Knardahl, Stein; Heir, Trond


    The impact of leadership practices on employee health may be especially evident after extreme events that have physical, psychological, or material consequences for the members of an organization. In this prospective study, we aimed to examine the association between leadership behavior and psychological distress in employees who had experienced a workplace terror attack. Ten and 22 months after the 2011 Oslo bombing attack targeting their workplace, ministerial employees (n = 2272) responded to a questionnaire assessing fair, empowering, supportive, and laissez-faire leadership, as well as psychological distress. Cross-sectional and time-lagged associations between the constructs were tested using structural equation modeling. Cross-sectionally, higher levels of supportive leadership were associated with lower levels of psychological distress. Longitudinally, negative relationships were found between psychological distress and subsequent ratings of fair and empowering leadership. Supportive leadership was associated with employees' psychological health after trauma, but seems not to have long-term effects on subsequent psychological distress. Rather, psychological distress may lead the employees to perceive their leaders as more negative across time.

  16. Hunger, inhibitory control and distress-induced emotional eating. (United States)

    van Strien, Tatjana; Ouwens, Machteld A; Engel, Carmen; de Weerth, Carolina


    Self-reported emotional eating has been found to significantly moderate distress-induced food intake, with low emotional eaters eating less after a stress task than after a control task and high emotional eaters eating more. The aim of the present study was to explore possible underlying mechanisms by assessing possible associations with (1) ability to experience the typical post-stress reduction of hunger and (2) inhibitory control. We studied these effects in 54 female students who were preselected on the basis of extremely high or low scores on an emotional eating questionnaire. Using a within subject design we measured the difference of actual food or snack intake after a control or a stress task (Trier Social Stress Test). As expected, the moderator effect of emotional eating on distress-induced food intake was found to be only present in females with a failure to report the typical reduction of hunger immediately after a stress task (an a-typical hunger stress response). Contrary to our expectations, this moderator effect of emotional eating was also found to be only present in females with high ability to stop motor impulses (high inhibitory control). These findings suggest that an a-typical hunger stress response but not poor inhibitory control may underlie the moderator effect of emotional eating on distress-induced food intake. However, inhibitory control may play a role whether or not there is a moderator effect of self-reported emotional eating on distress-induced food intake. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Word classes

    DEFF Research Database (Denmark)

    Rijkhoff, Jan


    in grammatical descriptions of some 50 languages, which together constitute a representative sample of the world’s languages (Hengeveld et al. 2004: 529). It appears that there are both quantitative and qualitative differences between word class systems of individual languages. Whereas some languages employ...... 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...... – Adverb, because they have properties that are strongly associated with at least two of these four traditional word classes (e.g. Adjective and Adverb). Finally, this article discusses some of the ways in which word class distinctions interact with other grammatical domains, such as syntax and morphology....

  18. Attributional Models of Depression and Marital Distress. (United States)

    Horneffer, Karen J.; Fincham, Frank D.


    Compares attributional models presented in depression and marital literatures by examining simultaneously their prediction of depressive symptoms and marital distress with 150 married couples. Findings show that a model including paths from depressogenic and distress-maintaining marital attributions to both depressive symptoms and marital distress…

  19. Distress attributed to negative symptoms in schizophrenia

    NARCIS (Netherlands)

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


    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

  20. Screening for distress in cancer patients

    DEFF Research Database (Denmark)

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


    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...

  1. Extremely Preterm Birth (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 “ ...

  2. Marital Adjustment and Psychological Distress in Japan (United States)

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


    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. PMID:28082761

  3. Piracetam for fetal distress in labour. (United States)

    Hofmeyr, G Justus; Kulier, Regina


    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.

  4. 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...

  5. Liquidity Risk and Distressed Equity

    DEFF Research Database (Denmark)

    Medhat, Mamdouh

    I show theoretically and empirically that cash holdings can help rationalize the low returns to distressed equity. In my model, levered firms with financing constraints optimally choose their cash holdings to eliminate liquidity risk and optimally default when insolvent. Using data on solvency......, liquidity, and returns for US firms, I find evidence consistent with the model’s predictions: (1) In all solvency levels, the average firm holds enough liquid assets to cover its short-term liabilities; less solvent firms have (2) a higher fraction of their total assets in liquid assets and therefore (3......) lower conditional betas and (4) lower returns; (5) the profits of long-short solvency strategies are highest among firms with low liquidity; and (6) the profits of long-short liquidity strategies are highest among firms with low solvency....

  6. Idioms of distress: alternatives in the expression of psychosocial distress: a case study from South India. (United States)

    Nichter, M


    This paper focuses attention on alternative modes of expressing distress and the need to analyze particular manifestations of distress in relation to personal and cultural meaning complexes as well as the availability and social implications of coexisting idioms of expression. To illustrate this point the case of South Kanarese Havik Brahmin women is presented. These women are described as having a weak social support network and limited opportunities to ventilate feelings and seek counsel outside the household. Alternative means of expressing psychosocial distress resorted to by Havik women are discussed in relation to associated Brahminic values, norms and stereotypes. Somatization is focused upon as an important idiom through which distress is communicated. Idioms of distress more peripheral to the personal or cultural behavioral repertoire of Havik women are considered as adaptive responses in circumstances where other modes of expression fail to communicate distress adequately or provide appropriate coping strategies. The importance of an 'idioms of distress' approach to psychiatric evaluation is noted.

  7. Does education buffer the impact of disability on psychological distress? (United States)

    Mandemakers, Jornt J; Monden, Christiaan W S


    This paper investigates whether education buffers the impact of physical disability on psychological distress. It further investigates what makes education helpful, by examining whether cognitive ability and occupational class can explain the buffering effect of education. Two waves of the 1958 British National Child Development Study are used to test the hypothesis that the onset of a physical disability in early adulthood (age 23 to 33) has a smaller effect on psychological distress among higher educated people. In total 423 respondents (4.6%) experienced the onset of a physical disability between the ages of 23 and 33. We find that a higher educational level cushions the psychology impact of disability. Cognitive ability and occupational class protect against the effect of a disability too. The education buffer arises in part because individuals with a higher level of education have more cognitive abilities, but the better social position of those with higher levels of education appears to be of greater importance. Implications of these findings for the social gradient in health are discussed. Copyright 2010 Elsevier Ltd. All rights reserved.

  8. Psychological distress among children and adolescents. Do individual or contextual factors matter?

    DEFF Research Database (Denmark)

    Meilstrup, Charlotte; Ersbøll, Annette Kjær; Nielsen, Line

    Psychological distress among children and adolescents. Do individual or contextual factors matter? Authors Meilstrup C, Ersbøll AK, Nielsen L, Due P, Holstein BE Background A large minority of children and adolescents suffer from mental distress and it is important to identify contributing factors......% across schools. Individual level variables such as low socio-economic position and family composition explained much of the variation across schools. Still, class level variables also contributed to this variation. In classes where many students reported that the class-mates doesn´t like being together...... (compositional effects), this study suggest that contextual factors are important to take into account in the research on psychological complaints among children and adolescents. This analytical model presents a way for future studies about contextual influences on psychological complaints....

  9. Social Classes

    DEFF Research Database (Denmark)

    Aktor, Mikael


    . Although this social structure was ideal in nature and not equally confirmed in other genres of ancient and medieval literature, it has nevertheless had an immense impact on Indian society. The chapter presents an overview of the system with its three privileged classes, the Brahmins, the Kṣatriyas......The notions of class (varṇa) and caste (jāti) run through the dharmaśāstra literature (i.e. Hindu Law Books) on all levels. They regulate marriage, economic transactions, work, punishment, penance, entitlement to rituals, identity markers like the sacred thread, and social interaction in general...

  10. Female sexual distress in infertile Turkish women

    Directory of Open Access Journals (Sweden)

    Serdar Aydın


    Full Text Available Objective: To evaluate the effect of infertility on sexual distress in women attending the infertility clinic. 
 Materials and Methods: In a cross-sectional study we evaluated sexual distress among 88 women who attended the infertility clinic in our institute between January and June 2015. All women who were experiencing primary or secondary infertility during the study sampling were included in the sudy. Sexual distress was measured using the Female sexual distress scale-revised (FSDS-R, a cross-validated patient-reported outcomes measure. Correlations of FSDS-R with patient characteristics and laboratory measurements were calculated using Spearman’s rank correlation tests. Results: With the exceptions of the age of couples and serum anti-mullerian hormone (AMH levels, no predictor of high sexual distress was found in the univariate analysis when comparing groups with regard to the FSDS-R cut-off score. The mean age of the sexually distressed women (33.6±5.8 years vs. 29.3±5.1 years and their partners (35.4±4.8 years vs. 31.6±4.2 years was significantly higher than those of the non distressed women, according to a FSDS-R score over 11 (p<0.05. The serum level of AMH was significantly lower in infertile women with high total sexual distress scores (1.4 vs. 7.6 ng/mL (p<0.001. Conclusion: In infertile women, age of woman, age of partner, and serum AMH levels are related with the hope of women to have a child despite an association with sexual distress. Serum AMH, which is perceived as necessary for fertility, had a significant inverse correlation with levels of sexual stress.

  11. Distress intolerance and clinical functioning in persons with schizophrenia (United States)

    Nugent, Katie L.; Chiappelli, Joshua; Rowland, Laura M.; Daughters, Stacey B.; Hong, L. Elliot


    Impaired tolerance to distress may help explain part of the cognitive and functional impairments in schizophrenia. This project investigated distress intolerance in schizophrenia patients (SZ) as compared to controls, and whether distress intolerance represented an independent domain in relationship to symptoms, cognition, and functional capacity. Healthy controls (n=43) and SZ (n=65) completed a psychological distress challenge experiment and their levels of intolerance to distress were estimated. SZ showed increased distress intolerance such that they were significantly more likely to terminate the distress challenge session early compared to controls. Greater distress intolerance was associated with reduced functional capacity and worse cognitive performance in SZ. Mediation analyses suggested that distress intolerance had an independent effect on functional capacity, while some of this effect was mediated by cognitive performance. Our results suggest that distress intolerance is a promising domain for treatment research, and functional capacity may be improved by targeting treatments towards SZ patient’s ability to tolerate distress. PMID:25107316

  12. Birthing Classes (United States)

    ... management options. Breastfeeding basics. Caring for baby at home. Birthing classes are not just for new parents, though. ... midwife. Postpartum care. Caring for your baby at home, including baby first aid. Lamaze One of the most popular birthing techniques in the U.S., Lamaze has been around ...

  13. Who is Distressed Applying the Diabetes Related Distress Scale in a Diabetes Clinic (United States)


    59 MDW /SGVU SUBJECT: Professional Presentation Approval 7APR 2017 1. Your paper, entitled Who is Distressed? Applying the Diabetes -Related Distress...Scale in A Diabetes Clinic presented at/published to American Diabetes Association 2017 Meeting, San Francisco, CA (National Conference), 9-16 a publication/presentation, a new 59 MOW Form 3039 must be submitted for review and approval.) Using the Diabetes -Related Distress Scale in

  14. Financial distress prediction and operating leases

    NARCIS (Netherlands)

    Lückerath – Rovers, M.


    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

  15. Fibromyalgia: When Distress Becomes (Unsympathetic Pain

    Directory of Open Access Journals (Sweden)

    Manuel Martinez-Lavin


    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.

  16. Household Financial Distress and Initial Endowments

    DEFF Research Database (Denmark)

    Olafsson, Arna


    ( 4000 g). I also find evidence that the collapse reduced the sex ratio, indicating selection in utero due to maternal prenatal stress exposure. My results imply large welfare losses from financial distress that have hitherto been ignored...


    Directory of Open Access Journals (Sweden)

    M M Karambin


    Full Text Available "nThere is a lack of large, prospective epidemiologic studies concerning acute lung injury (ALI and acute respiratory distress syndrome (ARDS in pediatric population. To determine the different causes of respiratory distress in children, we prepared a retrospective study and included the whole 567 children with respiratory distress referred to 17-Shahrivar Hospital, Rasht, Guilan. Using their medical files, data including age, sex, and causes of respiratory distress were collected. SPSS 13.0 (statistical software applied for statistical analysis. Pneumonia, asthma, and croup were the major causes of ARDS in children with a rate of 38.4, 19.04, and 16.5 percent, respectively. It seems that infectious factors are at the top of the list of ARDS causing factors which can be helpful to approach and manage such patients. We suggest vaccinating these at risk groups against common infectious factors such as H. Influenza and RSV which can cause either pneumonia or inducing asthma.

  18. Adverse Life Experience and Psychological Distress in Adolescence: Moderating and Mediating Effects of Emotion Regulation and Rumination. (United States)

    Boyes, Mark E; Hasking, Penelope A; Martin, Graham


    The current study tested whether emotion regulation and rumination moderated and/or mediated the relationship between accumulated adverse life experience and psychological distress in adolescence. In class, Australian high school students (n = 2637, 12-18 years, 68% female) from 41 schools completed well-validated measures of adverse life experience, emotion regulation, rumination and psychological distress, and were followed up 1 year later (n = 1973, 75% retention rate). Adjusting for age, gender and baseline psychological distress, adverse life experience predicted psychological distress 1 year later. Expressive suppression and rumination were positively associated with psychological distress. Cognitive reappraisal was negatively associated with psychological distress and moderated the relationship between adverse life experience and psychological distress. This relationship was also partially mediated by cognitive reappraisal, expressive suppression and rumination. Promoting cognitive reappraisal and minimizing expressive suppression and rumination may be useful strategies to improve mental health for adolescents who have experienced adverse life events. Future research should examine whether adolescents who have experienced adverse life events can be trained in effective emotion regulation strategies and whether this training can prevent development of psychological maladjustment. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  19. Young Children Sympathize Less in Response to Unjustified Emotional Distress (United States)

    Hepach, Robert; Vaish, Amrisha; Tomasello, Michael


    Three-year-old children saw an adult displaying the exact same distress in 3 different conditions: (a) the adult's distress was appropriate to a genuine harm, (b) the adult's distress was an overreaction to a minor inconvenience, and (c) there was no apparent cause for the adult's distress. Children who witnessed the adult being appropriately…

  20. Coding Class

    DEFF Research Database (Denmark)

    Ejsing-Duun, Stine; Hansbøl, Mikala

    Denne rapport rummer evaluering og dokumentation af Coding Class projektet1. Coding Class projektet blev igangsat i skoleåret 2016/2017 af IT-Branchen i samarbejde med en række medlemsvirksomheder, Københavns kommune, Vejle Kommune, Styrelsen for IT- og Læring (STIL) og den frivillige forening...... Coding Pirates2. Rapporten er forfattet af Docent i digitale læringsressourcer og forskningskoordinator for forsknings- og udviklingsmiljøet Digitalisering i Skolen (DiS), Mikala Hansbøl, fra Institut for Skole og Læring ved Professionshøjskolen Metropol; og Lektor i læringsteknologi, interaktionsdesign......, design tænkning og design-pædagogik, Stine Ejsing-Duun fra Forskningslab: It og Læringsdesign (ILD-LAB) ved Institut for kommunikation og psykologi, Aalborg Universitet i København. Vi har fulgt og gennemført evaluering og dokumentation af Coding Class projektet i perioden november 2016 til maj 2017...

  1. Psychological distress among women with newly diagnosed breast cancer

    DEFF Research Database (Denmark)

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


    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......: With a cut-off of 3 on the distress thermometer, 77% of women with breast cancer reported distress, whereas when the cut-off was 7, 43% were distressed. The mean distress score was 5.4 (SD, 3.1). The most frequently reported problems were worry (77%) and nervousness (71%). Distress was significantly...

  2. Acute Respiratory Distress Syndrome (ARDS After Nitric Acid Inhalation

    Directory of Open Access Journals (Sweden)

    Gülay Kır


    Full Text Available Lung injury resulting from inhalation of chemical products continues to be associated with high morbidity and mortality. Concentrated nitric acids are also extremely corrosive fuming chemical liquids. Fumes of nitric acid (HNO3 and various oxides of nitrogen such as nitric oxide (NO and nitrogen dioxide (NO2 may cause fatal illnesses such as severe pulmonary edema and acute respiratory distress syndrome (ARDS when inhaled. Intensive respiratory management including mechanical ventilation with positive end expiratory pressure (PEEP, inverse ratio ventilation, replacement of surfactant and extracorporeal membrane oxygenation (ECMO, steroids and n-acetylcysteine (NAC may improve survival. In this case report we present the diagnosis and successful treatment of a 57 years old male patient who developed ARDS following pulmonary edema due to nitric acid fumes inhalation.

  3. Extreme environment electronics

    CERN Document Server

    Cressler, John D


    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

  4. Non-extremal D-instantons

    NARCIS (Netherlands)

    Bergshoeff, E; Collinucci, A; Gran, U; Roest, D; Vandoren, S


    We construct the most general non-extremal deformation of the D-instanton solution with maximal rotational symmetry. The general non-supersymmetric solution carries electric charges of the SL(2,R) symmetry, which correspond to each of the three conjugacy classes of SL (2, R). Our calculations

  5. Non-extremal D-instantons

    NARCIS (Netherlands)

    Bergshoeff, E.; Collinucci, A.; Gran, U.; Roest, D.; Vandoren, S.


    We construct the most general non-extremal deformation of the D-instanton solution with maximal rotational symmetry. The general non-supersymmetric solution carries electric charges of the SL(2,R) symmetry, which correspond to each of the three conjugacy classes of SL(2,R). Our calculations

  6. Extreme value distributions

    CERN Document Server

    Ahsanullah, Mohammad


    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.

  7. Psychological distress and in vitro fertilization outcome. (United States)

    Pasch, Lauri A; Gregorich, Steven E; Katz, Patricia K; Millstein, Susan G; Nachtigall, Robert D; Bleil, Maria E; Adler, Nancy E


    To examine whether psychological distress predicts IVF treatment outcome as well as whether IVF treatment outcome predicts subsequent psychological distress. Prospective cohort study over an 18-month period. Five community and academic fertility practices. Two hundred two women who initiated their first IVF cycle. Women completed interviews and questionnaires at baseline and at 4, 10, and 18 months' follow-up. IVF cycle outcome and psychological distress. In a binary logistic model including covariates (woman's age, ethnicity, income, education, parity, duration of infertility, and time interval), pretreatment depression and anxiety were not significant predictors of the outcome of the first IVF cycle. In linear regression models including covariates (woman's age, income, education, parity, duration of infertility, assessment point, time since last treatment cycle, and pre-IVF depression or anxiety), experiencing failed IVF was associated with higher post-IVF depression and anxiety. IVF failure predicts subsequent psychological distress, but pre-IVF psychological distress does not predict IVF failure. Instead of focusing efforts on psychological interventions specifically aimed at improving the chance of pregnancy, these findings suggest that attention be paid to helping patients prepare for and cope with treatment and treatment failure. Copyright © 2012 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  8. Medical student psychological distress and academic performance. (United States)

    Dendle, Claire; Baulch, Julie; Pellicano, Rebecca; Hay, Margaret; Lichtwark, Irene; Ayoub, Sally; Clarke, David M; Morand, Eric F; Kumar, Arunaz; Leech, Michelle; Horne, Kylie


    The impact of medical student psychological distress on academic performance has not been systematically examined. This study provided an opportunity to closely examine the potential impacts of workplace and study related stress factors on student's psychological distress and their academic performance during their first clinical year. This one-year prospective cohort study was performed at a tertiary hospital based medical school in Melbourne, Australia. Students completed a questionnaire at three time points during the year. The questionnaire included the validated Kessler psychological distress scale (K10) and the General Health Questionnaire-28 (GHQ-28), as well as items about sources of workplace stress. Academic outcome scores were aggregated and correlated with questionnaire results. One hundred and twenty six students participated; 126 (94.7%), 102 (76.7%), and 99 (74.4%) at time points one, two, and three, respectively. 33.1% reported psychological distress at time point one, increasing to 47.4% at time point three. There was no correlation between the K10 scores and academic performance. There was weak negative correlation between the GHQ-28 at time point three and academic performance. Keeping up to date with knowledge, need to do well and fear of negative feedback were the most common workplace stress factors. Poor correlation was noted between psychological distress and academic performance.

  9. Understanding psychological distress among pediatric cancer caregivers. (United States)

    Nam, Gina E; Warner, Echo L; Morreall, Deborah K; Kirchhoff, Anne C; Kinney, Anita Y; Fluchel, Mark


    Few studies have examined distress in caregivers of pediatric cancer patients. We evaluated the association of socioeconomic, demographic, and patient clinical factors on caregivers' self-reported psychological distress associated with having a child with cancer. N = 366 pediatric cancer caregivers completed a self-administered questionnaire from July 2010 to July 2012. The Impact of Event Scale (IES), along with two subscales "intrusion" and "avoidance" measured caregiver cancer-specific distress, with higher scores indicating greater distress. Multivariable linear regression models were used to calculate coefficients (β) and 95 % confidence intervals (95 % CI) of IES by socioeconomic, demographic, and clinical factors. Average caregiver IES score was 31.2 (standard deviation (SD) = 16.9, range 0-75). Mean intrusion score was 18.1 (SD 9.8, range 0-35) and avoidance score was 12.8 (SD 9.0, range 0-40). Caregivers with household incomes psychological distress for caregivers of pediatric oncology patients. These findings underscore the importance of developing and testing interventions aimed at evaluating and addressing the psychosocial needs for high-risk caregivers in addition to those of patients.

  10. Spirituality and distress in palliative care consultation. (United States)

    Hills, Judith; Paice, Judith A; Cameron, Jacqueline R; Shott, Susan


    One's spirituality or religious beliefs and practices may have a profound impact on how the individual copes with the suffering that so often accompanies advanced disease. Several previous studies suggest that negative religious coping can significantly affect health outcomes. The primary aim of this study was to explore the relationship between spirituality, religious coping, and symptoms of distress among a group of inpatients referred to the palliative care consult service. Pilot study. The study was conducted in a large academic medical center with a comprehensive Palliative Care and Home Hospice Program. (1) National Comprehensive Cancer Network Distress Management Assessment Tool; (2) Pargament Brief Religious Coping Scale (Brief RCOPE); (3) Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp); (4) Puchalski's FICA; and (5) Profile of Mood States-Short Form (POMS-SF). The 31 subjects surveyed experienced moderate distress (5.8 +/- 2.7), major physical and psychosocial symptom burden, along with reduced function and significant caregiving needs. The majority (87.2%) perceived themselves to be at least somewhat spiritual, with 77.4% admitting to being at least somewhat religious. Negative religious coping (i.e., statements regarding punishment or abandonment by God) was positively associated with distress, confusion, depression, and negatively associated with physical and emotional well-being, as well as quality of life. Palliative care clinicians should be alert to symptoms of spiritual distress and intervene accordingly. Future research is needed to identify optimal techniques to address negative religious coping.

  11. 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


    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.

  12. Extremely high major histocompatibility complex class IIb gene ...

    Indian Academy of Sciences (India)

    tial for the genetic management of the captive alligator; thus much research on this ..... protected; at the same time, we must strengthen the education about alligator ... Province, Zoology Practical Skills Training Center in Fuyang. Teachers ...

  13. Interaction effect of job insecurity and role ambiguity on psychological distress in Japanese employees: a cross-sectional study. (United States)

    Inoue, Akiomi; Kawakami, Norito; Eguchi, Hisashi; Tsutsumi, Akizumi


    We examined the interaction effect of job insecurity (JI) and role ambiguity (RA) on psychological distress in Japanese employees. Overall, 2184 male and 805 female employees from two factories of a manufacturing company in Japan completed a self-administered questionnaire comprising the scales measuring JI (Job Content Questionnaire), RA (National Institute for Occupational Safety and Health Generic Job Stress Questionnaire), psychological distress (K6 scale), and potential confounders (i.e., age, education, family size, occupational class, and work shift). Taking psychological distress as a dependent variable, hierarchical multiple regression analyses were conducted by gender and employment status (i.e., permanent and non-permanent employees). An interaction term of JI × RA was included in the model. After adjusting for potential confounders, the main effects of JI and RA on psychological distress were significant regardless of gender or employment status. Furthermore, the significant interaction effect of JI × RA on psychological distress was observed among permanent male employees (β = 0.053, p = 0.010). Post hoc simple slope analyses showed that the simple slope of JI was greater at higher levels of RA (i.e., one standard deviation [SD] above the mean) (β = 0.300, p female employees. The present study suggests that higher levels of RA strengthen the association of JI with psychological distress, at least among Japanese permanent male employees.

  14. Children’s pain and distress while undergoing an acute radiographic examination

    International Nuclear Information System (INIS)

    Björkman, B.; Nilsson, S.; Sigstedt, B.; Enskär, K.


    Pain has been highlighted as a main concern for children in conjunction with an acute radiographic examination. The aim of this study was to further investigate children’s pain and distress while undergoing an acute radiographic examination. The study comprised 29 participants with an age range of 5–15 years who were injured and submitted to an acute radiographic examination of the upper or lower extremity when the question at issue was fracture. The Coloured Analogue Scale (CAS) and the Facial Affective Scale (FAS) were used as self-reporting scales to measure the children’s pain and distress. The Face, Legs, Activity, Cry and Consolability Behavioural scale (FLACC) was used as an observation tool to assess behaviours associated with pain in children. Descriptive statistics were used when analysing the scores, and the results showed that children experience pain and distress in conjunction with a radiographic examination after an injury. Spearman’s correlation was used to compare variables, and significant correlations were obtained between the self-reported pain and the observed pain behaviour. Fischer’s Exact test was used to compare groups, and when using the cut-off 3.0 on the self-reporting scale no significant correlation was found concerning the pain reported by children diagnosed with and without a fracture. No significant correlations were found concerning the self-reported distress and pain either, regardless of whether it was a first-time visit and whether a parent was near during the examination.

  15. How extreme is extreme hourly precipitation? (United States)

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


    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.

  16. Optimization with Extremal Dynamics

    International Nuclear Information System (INIS)

    Boettcher, Stefan; Percus, Allon G.


    We explore a new general-purpose heuristic for finding high-quality solutions to hard discrete optimization problems. The method, called extremal optimization, is inspired by self-organized criticality, a concept introduced to describe emergent complexity in physical systems. Extremal optimization successively updates extremely undesirable variables of a single suboptimal solution, assigning them new, random values. Large fluctuations ensue, efficiently exploring many local optima. We use extremal optimization to elucidate the phase transition in the 3-coloring problem, and we provide independent confirmation of previously reported extrapolations for the ground-state energy of ±J spin glasses in d=3 and 4

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

    African Journals Online (AJOL)

    aDepartment of Behavioural Medicine, School of Nursing and Public Health, College of ... Keywords: adults, depression, diabetes-related distress, glycaemic index, South Africa ... self-care and glycaemic control.7,8 Diabetes-related distress is.

  18. Levels of Distress in Women at Risk for Ovarian Cancer

    National Research Council Canada - National Science Library

    Kash, Kathryn M


    The overall goal of this study was to determine the levels of distress in women with a family history of ovarian cancer and to identify the mediating factors between risk of developing ovarian cancer and distress...

  19. Psychological distress in patients with morphea and eosinophilic fasciitis.

    NARCIS (Netherlands)

    Kroft, Ilse; Jong, E.M.G.J. de; Evers, A.W.M.


    OBJECTIVE: To examine the level of psychological distress and factors contributing to distress in patients with morphea or eosinophilic fasciitis. DESIGN: Cross-sectional study. SETTING: Dermatology outpatient clinic of a university hospital. PARTICIPANTS: Of 120 patients with morphea or

  20. Psychological Distress and Emotional Expression on Facebook. (United States)

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


    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.

  1. Diabetes distress among type 2 diabetic patients

    African Journals Online (AJOL)


    Key words: Diabetes mellitus, diabetes distress, HbA1c, glycaemic status ... [3] The management of diabetes mellitus and the ... morbidity and mortality risks associated with ... appropriate policy for prevention, control and ..... Mellitus and its Association Risk Indicators in a ... collaborative Research on Internal Medicine and.

  2. Disordered Eating and Psychological Distress among Adults (United States)

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


    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.…

  3. Distress classification measures in the banking sector

    Directory of Open Access Journals (Sweden)

    Maria Carapeto


    Full Text Available This paper investigates distress classification measures in the banking sector. The power of ten different accounting measures is tested using media coverage as the benchmark for a sample of 1,175 banks which participated in merger and acquisitions or divestiture deals over the past 22 calendar years. According to the results of the study, a bank should be defined as distressed if the ratio of its non-performing loans to total loans is in the two highest deciles of the industry, using a three-year moving average. This measure is typically favored by practitioners, who maintain that other common measures, e.g., those involving provisions for loan losses, are not as accurate as they express only a managerial forecast. Interestingly, measures that capture capital adequacy too often depict the bank as healthy even if it is de facto distressed, while measures of asset quality, though highly correlated with each other, tend to overestimate the number of distressed banks.

  4. Women's Feminist Consciousness, Anger, and Psychological Distress (United States)

    Fischer, Ann R.; Good, Glenn E.


    The goal of this study was to bring together several lines of research and theory on women's feminist consciousness from psychology, sociology, and philosophy. Past literatures had suggested bivariate links between feminist identity development and psychological distress, feminist identity and anger, feminist identity and interpersonal conflict,…

  5. 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.

  6. Religion and Psychological Distress in Japan (United States)

    Roemer, Michael K.


    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…

  7. Psychological distress and intelligence in young men

    DEFF Research Database (Denmark)

    Teasdale, T. W.; Antal, K.


    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...

  8. Psychological distress amongst undergraduate students of a ...

    African Journals Online (AJOL)

    Background: Mental health among university students represents an important public health concern and the health of university students has been the subject of increasing focus in recent years. Available evidence suggests that there are significantly more students experiencing high levels of distress compared with the ...

  9. Psychological distress and symptoms among patients attending ...

    African Journals Online (AJOL)

    Background: The study was carried out to investigate the manifestations of psychological distress and symptoms among individuals receiving treatment for sexually transmitted diseases and to compare them with individuals who were not suffering from sexually transmitted diseases. Methods: Patients attending the sexually ...

  10. Assessment of Body perception, Psychological Distress, and ...

    African Journals Online (AJOL)

    Background: Obesity can lead to psychological, social, and medical problems that may negatively affect the quality of life Aim: In our study, we aimed to evaluate the body perception, psychological distress, and subjective quality of life of obese subjects in comparison with normal weighted ones. Methods: A total of 494 ...

  11. Assessment of Body perception, Psychological Distress, and ...

    African Journals Online (AJOL)


    Feb 7, 2018 ... (MBSRQ), Zung Depression Rating Scale, and Zung Anxiety Rating Scale were applied to ... psychological distress, and subjective quality of life among obese and ... kg/m2, not receiving any medication, no special training .... Emotional role ..... Questionnaire (MBSRQ) showed positive improvement.

  12. Family caregiving in schizophrenia: domains and distress

    NARCIS (Netherlands)

    Schene, A. H.; van Wijngaarden, B.; Koeter, M. W.


    This article focuses on (1) the dimensionality of the caregiving concept; (2) the relation between the identified caregiving dimensions and characteristics of the patient, the caregiver, and their relationship; and (3) the relation between caregiving dimensions and caregiver distress. Findings are

  13. Infertility, psychological distress, and coping strategies among ...

    African Journals Online (AJOL)

    Relatively little is known about infertility and its consequences in Mali, West Africa where the context and culture are different from those of previously studied settings. This study therefore aimed to specifically examine infertility induced psychological distress and coping strategies among women in Mali. A convergent ...

  14. How Does Distress Acquisition Incentivized by Government Purchases of Distressed Loans Affect Bank Default Risk?

    Directory of Open Access Journals (Sweden)

    Jyh-Jiuan Lin


    Full Text Available The topic of bank default risk in connection with government bailouts has recently attracted a great deal of attention. In this paper, the question of how a bank’s default risk is affected by a distress acquisition is investigated. Specifically, the government provides a bailout program of distressed loan purchases for a strong bank to acquire a bank in distress. The acquirer bank may likely refuse the acquisition with a bailout when the amount of distressed loan purchases is large or the knock-out value of the acquired bank is high. When the acquirer bank realizes acquisition gains, the default risk in the consolidated bank’s equity return is negatively related to loan purchases, but positively to the knock-out value of the acquired bank. The government bailout, as such, in large part contributes to banking stability.

  15. The Indirect Costs of Financial Distress in Indonesia


    Wijantini, Wijantini


    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 opera...

  16. Frameworks for visualization at the extreme scale

    International Nuclear Information System (INIS)

    Joy, Kenneth I; Miller, Mark; Childs, Hank; Bethel, E Wes; Clyne, John; Ostrouchov, George; Ahern, Sean


    The challenges of visualization at the extreme scale involve issues of scale, complexity, temporal exploration and uncertainty. The Visualization and Analytics Center for Enabling Technologies (VACET) focuses on leveraging scientific visualization and analytics software technology as an enabling technology to increased scientific discovery and insight. In this paper, we introduce new uses of visualization frameworks through the introduction of Equivalence Class Functions (ECFs). These functions give a new class of derived quantities designed to greatly expand the ability of the end user to explore and visualize data. ECFs are defined over equivalence classes (i.e., groupings) of elements from an original mesh, and produce summary values for the classes as output. ECFs can be used in the visualization process to directly analyze data, or can be used to synthesize new derived quantities on the original mesh. The design of ECFs enable a parallel implementation that allows the use of these techniques on massive data sets that require parallel processing

  17. Classifying Returns as Extreme

    DEFF Research Database (Denmark)

    Christiansen, Charlotte


    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...

  18. Llaki and ñakary: idioms of distress and suffering among the highland Quechua in the Peruvian Andes. (United States)

    Pedersen, Duncan; Kienzler, Hanna; Gamarra, Jeffrey


    This article examines some of the long-term health outcomes of extreme adversities and the ways in which social inequalities and idioms of distress are historically and socially produced in the Peruvian context. We describe how the highland Quechua of northern Ayacucho construct and experience expressions of distress and suffering such as pinsamientuwan (worrying thoughts, worries), ñakary (suffering) and llaki (sorrow, sadness), in a context of persistent social inequalities, social exclusion and a recent history of political violence. It is concluded that the multiple expressions of distress and suffering are closely related to past and current events, shaped by beliefs, core values and cultural norms and, in this process, transformed, recreated and invested with new meanings and attributions.

  19. Predictors of distress and anxiety during pregnancy | Roos | African ...

    African Journals Online (AJOL)

    Objective: There is a high incidence of distressing psychological symptoms including anxiety in pregnancy. Nevertheless, predictors of distress and anxiety during pregnancy have not been well characterized. We determined whether temperament and character, trait anxiety, resilience, and social support predicted distress ...

  20. A review on automated pavement distress detection methods

    NARCIS (Netherlands)

    Coenen, Tom B.J.; Golroo, Amir


    In recent years, extensive research has been conducted on pavement distress detection. A large part of these studies applied automated methods to capture different distresses. In this paper, a literature review on the distresses and related detection methods are presented. This review also includes

  1. 47 CFR 80.1114 - False distress alerts. (United States)


    ... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Global Maritime Distress and Safety System (GMDSS) Operating Procedures for Distress and Safety Communications § 80.1114 False distress alerts. The provisions of §§ 80.334 and 80.335 apply to...

  2. 47 CFR 80.1113 - Transmission of a distress alert. (United States)


    ... Section 80.1113 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Global Maritime Distress and Safety System (GMDSS) Operating Procedures for Distress and Safety Communications § 80.1113 Transmission of a distress alert. (a) The...

  3. Negative Emotions and Behaviors are Markers of Breakup Distress (United States)

    Field, Tiffany; Diego, Miguel; Pelaez, Martha; Deeds, Osvelia; Delgado, Jeanette


    Method: University students who experienced a recent romantic breakup were given several self-report measures and were then divided into high versus low breakup distress groups. Results: The high breakup distress versus the low breakup distress groups had higher scores on negative emotions scales including depression, anxiety and anger and…

  4. Maternal psychological distress after preterm birth: Disruptive or adaptive?

    NARCIS (Netherlands)

    Hall, Ruby A.s.; Hoffenkamp, Hannah N.; Braeken, Johan; Tooten, Anneke; Vingerhoets, A.J.J.M.; Van Bakel, Hedwig J.a.


    BACKGROUND: Maternal postpartum distress is often construed as a marker of vulnerability to poor parenting. Less is known, however, about the impact of postpartum distress on parenting an infant born prematurely. The present study investigated whether high distress levels, which are particularly

  5. Late Financial Distress Process Stages and Financial Ratios

    DEFF Research Database (Denmark)

    Sormunen, Nina; Laitinen, Teija


    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...... of these findings for auditors and every stakeholder of business firms are considered....

  6. 47 CFR 80.1115 - Transmission of a distress alert by a station not itself in distress. (United States)


    ... (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Global Maritime Distress and Safety System (GMDSS) Operating Procedures for Distress and Safety Communications § 80.1115 Transmission...

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

    Directory of Open Access Journals (Sweden)

    Martin Estelle


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

    Directory of Open Access Journals (Sweden)

    Anna Tarocco


    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.

  9. Price discovery in dual-class shares across multiple markets

    DEFF Research Database (Denmark)

    Fernandes, Marcelo; Scherrer, Cristina


    data to study price discovery in dual-class Brazilian stocks and their ADRs. We find that the foreign market is at least as informative as the home market and that shocks in the dual-class premium entail a permanent effect in normal times, but transitory in periods of financial distress......This paper proposes a new measure of price discovery that uses the spectral decomposition. The methodology is especially important in the context of large price systems, such as interest rate parities with spot and futures contracts or dual-class shares in multiple markets. We employ high frequency...

  10. A Virtual Class Calculus

    DEFF Research Database (Denmark)

    Ernst, Erik; Ostermann, Klaus; Cook, William Randall


    Virtual classes are class-valued attributes of objects. Like virtual methods, virtual classes are defined in an object's class and may be redefined within subclasses. They resemble inner classes, which are also defined within a class, but virtual classes are accessed through object instances...... 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...

  11. Prospect for extreme field science

    Energy Technology Data Exchange (ETDEWEB)

    Tajima, T. [Ludwig Maximilian Univ. and Max Planck Institute for Quantum Optics, Garching (Germany); Japan Atomic Energy Agency, Kyoto and KEK, Tsukuba (Japan)


    The kind of laser extreme light infrastructure (ELI) provides will usher in a class of experiments we have only dreamed of for years. The characteristics that ELI brings in include: the highest intensity ever, large fluence, and relatively high repetition rate. A personal view of the author on the prospect of harnessing this unprecedented opportunity for advancing science of extreme fields is presented. The first characteristic of ELI, its intensity, will allow us to access, as many have stressed already, extreme fields that hover around the Schwinger field or at the very least the neighboring fields in which vacuum begins to behave as a nonlinear medium. In this sense, we are seriously probing the 'material' property of vacuum and thus the property that theory of relativity itself described and will entail. We will probe both special theory and general theory of relativity in regimes that have been never tested so far. We may see a glimpse into the reach of relativity or even its breakdown in some extreme regimes. We will learn Einstein and may even go beyond Einstein, if our journey is led. Laser-driven acceleration both by the laser field itself and by the wakefield that is triggered in a plasma is huge. Energies, if not luminosity, we can access, may be unprecedented going far beyond TeV. The nice thing about ELI is that it has relatively high repetition rate and average fluence as compared with other extreme lasers. This high fluence can be a key element that leads to applications to high energy physics, such as gamma-gamma collider driver experiment, and some gamma ray experiments that may be relevant in the frontier of photo-nuclear physics, and atomic energy applications. Needless to say, high fluence is one of most important features that industrial and medical applications may need. If we are lucky, we may see a door opens at the frontier of novel physics that may not be available by any other means. (authors)

  12. Psychological distress: precursor or consequence of dating infidelity? (United States)

    Hall, Julie H; Fincham, Frank D


    Research on infidelity-related distress has focused on victims with little attention to perpetrators. Two studies therefore explore the psychological functioning of individuals who have engaged in dating infidelity. Study 1 showed that, compared to faithful partners, individuals who had engaged in infidelity showed more psychological distress. Study 2 investigated the interrelationships among infidelity, psychological distress, and relationship satisfaction over time. Results suggested that initial levels of psychological distress predicted later infidelity but infidelity did not predict subsequent psychological distress. Findings are interpreted in light of the broader infidelity literature, potential mechanisms are suggested, and avenues for future research are recommended.

  13. Extremal surface barriers

    International Nuclear Information System (INIS)

    Engelhardt, Netta; Wall, Aron C.


    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

  14. Psychological distress associated with cancer screening: A systematic review. (United States)

    Chad-Friedman, Emma; Coleman, Sarah; Traeger, Lara N; Pirl, William F; Goldman, Roberta; Atlas, Steven J; Park, Elyse R


    Current national cancer screening recommendations include the potential risk of psychological harm related to screening. However, data on the relation of psychological distress to cancer screening is limited. The authors conducted a systematic review to assess psychological distress associated with cancer screening procedures. Studies that administered measures of psychological distress between 2 weeks before and 1 month after the screening procedure were included. In total, 22 eligible studies met criteria for review, including 13 observational trials and 9 randomized controlled trials. Eligible studies used a broad range of validated and unvalidated measures. Anxiety was the most commonly assessed construct and was measured using the State Trait Anxiety Inventory. Studies included breast, colorectal, prostate, lung, and cervical screening procedures. Distress was low across procedures, with the exception of colorectal screening. Distress did not vary according to the time at which distress was measured. None of the studies were conducted exclusively with the intention of assessing distress at the time of screening. Evidence of low distress during the time of cancer screening suggests that distress might not be a widespread barrier to screening among adults who undergo screening. However, more studies are needed using validated measures of distress to further understand the extent to which screening may elicit psychological distress and impede adherence to national screening recommendations. Cancer 2017;123:3882-94. © 2017 American Cancer Society. © 2017 American Cancer Society.

  15. Moral distress and moral conflict in clinical ethics. (United States)

    Fourie, Carina


    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. © 2013 John Wiley & Sons Ltd.

  16. The cultural expression of spiritual distress in Israel. (United States)

    Schultz, Michael; Meged-Book, Tehilah; Mashiach, Tanya; Bar-Sela, Gil


    Although spiritual distress is present across cultures, the ways in which patients experience it vary between cultures. Our goal was to examine the cultural expression and key indicators of spiritual distress in Israel. We conducted a structured interview of 202 oncology outpatients in a cross-sectional study. Self-diagnosis of spiritual distress, which is a demonstrated gold standard for identifying its presence, was compared with the Facit-Sp-12 and a number of other items (from the Spiritual Injury Scale and newly developed Israeli items) hypothesized as Israeli cultural expressions of spiritual distress, demographic and medical data, and patient desire to receive spiritual care. Significant variation was found between Israeli cultural expression of spiritual distress and that found in studies from other countries. Key expressions of spiritual distress in this study included lack of inner peace, grief, and an inability to accept what is happening. Items related to faith were not significant, and loss of meaning showed mixed results. Patients requesting spiritual care were more likely to be in spiritual distress. No demographic or medical data correlated with spiritual distress. Specially designed interventions to reduce spiritual distress should address the expressions of the distress specific to that culture. Studies of the efficacy of spiritual care can examine the extent of spiritual distress in general or of its specific cultural expressions.

  17. 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


    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.

  18. Distress risk and leverage puzzles: Evidence from Taiwan

    Directory of Open Access Journals (Sweden)

    Kung-Cheng Ho


    Full Text Available Financial distress has been invoked in the asset pricing literature to explain the anomalous patterns in the cross-section of stock returns. The risk of financial distress can be measured using indexes. George and Hwang (2010 suggest that leverage can explain the distress risk puzzle and that firms with high costs choose low leverage to reduce distress intensities and earn high returns. This study investigates whether this relationship exists in the Taiwan market. When examined separately, distress intensity is found to be negatively related to stock returns, but leverage is found to not be significantly related to stock returns. The results are the same when distress intensity and leverage are examined simultaneously. After assessing the robustness by using O-scores, distress risk puzzle is found to exist in the Taiwan market, but the leverage puzzle is not

  19. The Indirect Costs of Financial Distress in Indonesia

    Directory of Open Access Journals (Sweden)

    Wijantini Wijantini


    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.

  20. Stressors, resources, and distress among homeless persons: a longitudinal analysis. (United States)

    Wong, Y L; Piliavin, I


    Relations among stressors, resources, and psychological distress were examined using two waves of data obtained from a probability sample of homeless persons (N = 430) residing in a large, demographically diverse county in North California. The focus of research was to examine whether and how social resources and housing resources directly affect distress and mediate the impact of stress factors on depressive symptoms. Path analysis results revealed that levels of psychological distress were responsive to change in objective housing circumstances, with the attainment of domicile status being associated with fewer distress symptoms. Our findings, however, indicated only modest effects of social resources on psychological distress through direct effects and mediating effects of life stressors on distress. Overall, the study suggests that the relationships among stressors, resources, and distress for homeless persons may be understood within the same analytical framework for the general population.

  1. Prevention of Respiratory Distress After Laparoscopic Cholecystectomy

    Directory of Open Access Journals (Sweden)

    O. A. Dolina


    Full Text Available The paper presents the results of a comparative study of different methods for preventing respiratory distress after laparoscopic cholecystectomy. It shows the advantages of use of noninvasive assisted ventilation that ensures excessive positive pressure in the respiratory contour, its impact on external respiratory function, arterial blood gases, oxygen transport and uptake. A scheme for the prevention of respiratory diseases applying noninvasive assisted ventilation is given.

  2. Statistics of Extremes

    KAUST Repository

    Davison, Anthony C.; Huser, Raphaë l


    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

  3. Analysis of extreme events

    CSIR Research Space (South Africa)

    Khuluse, S


    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...

  4. Acute lower extremity ischaemia

    African Journals Online (AJOL)

    Acute lower extremity ischaemia. Acute lower limb ischaemia is a surgical emergency. ... is ~1.5 cases per 10 000 persons per year. Acute ischaemia ... Table 2. Clinical features discriminating embolic from thrombotic ALEXI. Clinical features.

  5. Cumulative exposure to childhood stressors and subsequent psychological distress. An analysis of US panel data. (United States)

    Björkenstam, Emma; Burström, Bo; Brännström, Lars; Vinnerljung, Bo; Björkenstam, Charlotte; Pebley, Anne R


    Research has shown that childhood stress increases the risk of poor mental health later in life. We examined the effect of childhood stressors on psychological distress and self-reported depression in young adulthood. Data were obtained from the Child Development Supplement (CDS) to the national Panel Study of Income Dynamics (PSID), a survey of US families that incorporates data from parents and their children. In 2005 and 2007, the Panel Study of Income Dynamics was supplemented with two waves of Transition into Adulthood (TA) data drawn from a national sample of young adults, 18-23 years old. This study included data from participants in the CDS and the TA (n = 2128), children aged 4-13 at baseline. Data on current psychological distress was used as an outcome variable in logistic regressions, calculated as odds ratios (OR) with 95% confidence intervals (CI). Latent Class Analyses were used to identify clusters based on the different childhood stressors. Associations were observed between cumulative exposure to childhood stressors and both psychological distress and self-reported depression. Individuals being exposed to three or more stressors had the highest risk (crude OR for psychological distress: 2.49 (95% CI: 1.16-5.33), crude OR for self-reported depression: 2.07 (95% CI: 1.15-3.71). However, a large part was explained by adolescent depressive symptoms. Findings support the long-term negative impact of cumulative exposure to childhood stress on psychological distress. The important role of adolescent depression in this association also needs to be taken into consideration in future studies. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Intensity cut-points for the Respiratory Distress Observation Scale (United States)

    Campbell, Margaret L; Templin, Thomas N


    Background The Respiratory Distress Observation Scale© is an innovative solution to assessment when a dyspnea report cannot be elicited. The Respiratory Distress Observation Scale has acceptable reliability and validity psychometrics. Aim To identify distress-intensity cut-points of the Respiratory Distress Observation Scale. Design Receiver operating characteristic curve analysis was conducted with inpatients stratified by four levels of respiratory distress—none, mild, moderate, or severe. Patients provided three self-report measures of dyspnea: dichotomous (yes/no); a ranking of none, mild, moderate, or severe; and a numerical rating scale. Respiratory distress was assessed using the Respiratory Distress Observation Scale instrument. Setting/participants Participants were 136 adult inpatients, mean age 61.8 years (standard deviation = 13.18 years), 89.7% African American, and 56.6% female, who were recruited from an urban, tertiary care hospital in the Midwest of the United States. Results In all, 47% (n = 64) self-reported dyspnea (yes/no). Ranking was distributed as follows: none = 36, mild = 35, moderate = 40, and severe = 25. Numerical rating scale scores ranged from 0 to 10, mean = 4.99 (standard deviation = 2.9). Respiratory Distress Observation Scale scores ranged from 0 to 7, median (interquartile range) = 2 (1–3). Receiver operating characteristic curve analysis–determined Respiratory Distress Observation Scale score of 0–2 suggests little or no respiratory distress; score ≥3 signified moderate to severe distress. Conclusion A Respiratory Distress Observation Scale score ≥3 signifies a patient’s need for palliation of respiratory distress. An end-point for identifying responsiveness to treatment, in other words, respiratory comfort, is Respiratory Distress Observation Scale <3. Because patients with imminent respiratory failure, as typified by dying patients, were not represented yielding lower than expected Respiratory Distress

  7. Moral repugnance, moral distress, and organ sales. (United States)

    Taylor, James Stacey


    Many still oppose legalizing markets in human organs on the grounds that they are morally repugnant. I will argue in this paper that the repugnance felt by some persons towards sales of human organs is insufficient to justify their prohibition. Yet this rejection of the view that markets in human organs should be prohibited because some persons find them to be morally repugnant does not imply that persons' feelings of distress at the possibility of organ sales are irrational. Eduardo Rivera-Lopez argues that such instinctive distress is an appropriate response to the (rationally defensible) perception that certain kinds of arguments that are offered in favor of legalizing organ sales are "in an important sense, illegitimate." Having argued that repugnance should not ground the prohibition of markets in human organs, I will also argue that the moral distress that some feel towards certain arguments that favor such markets is not rationally defensible, either. © The Author 2015. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail:

  8. Pushing the Envelope of Extreme Space Weather (United States)

    Pesnell, W. D.


    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.

  9. Severe Acute Infection Due to Serratia marcescens Causing Respiratory Distress in An Immunocompetent Adult. (United States)

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


    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.

  10. Extreme Programming: Maestro Style (United States)

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


    "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

  11. RxClass (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....

  12. Existence for a class of discrete hyperbolic problems

    Directory of Open Access Journals (Sweden)

    Luca Rodica


    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. Scaling a Survey Course in Extreme Weather (United States)

    Samson, P. J.


    "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.

  14. Extreme meteorological conditions

    International Nuclear Information System (INIS)

    Altinger de Schwarzkopf, M.L.


    Different meteorological variables which may reach significant extreme values, such as the windspeed and, in particular, its occurrence through tornadoes and hurricanes that necesarily incide and wich must be taken into account at the time of nuclear power plants' installation, are analyzed. For this kind of study, it is necessary to determine the basic phenomenum of design. Two criteria are applied to define the basic values of design for extreme meteorological variables. The first one determines the expected extreme value: it is obtained from analyzing the recurence of the phenomenum in a convened period of time, wich may be generally of 50 years. The second one determines the extreme value of low probability, taking into account the nuclear power plant's operating life -f.ex. 25 years- and considering, during said lapse, the occurrence probabilities of extreme meteorological phenomena. The values may be determined either by the deterministic method, which is based on the acknowledgement of the fundamental physical characteristics of the phenomena or by the probabilistic method, that aims to the analysis of historical statistical data. Brief comments are made on the subject in relation to the Argentine Republic area. (R.J.S.) [es

  15. Acclimatization to extreme heat (United States)

    Warner, M. E.; Ganguly, A. R.; Bhatia, U.


    Heat extremes throughout the globe, as well as in the United States, are expected to increase. These heat extremes have been shown to impact human health, resulting in some of the highest levels of lives lost as compared with similar natural disasters. But in order to inform decision makers and best understand future mortality and morbidity, adaptation and mitigation must be considered. Defined as the ability for individuals or society to change behavior and/or adapt physiologically, acclimatization encompasses the gradual adaptation that occurs over time. Therefore, this research aims to account for acclimatization to extreme heat by using a hybrid methodology that incorporates future air conditioning use and installation patterns with future temperature-related time series data. While previous studies have not accounted for energy usage patterns and market saturation scenarios, we integrate such factors to compare the impact of air conditioning as a tool for acclimatization, with a particular emphasis on mortality within vulnerable communities.

  16. Extremely deformable structures

    CERN Document Server


    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 ...

  17. Statistics of Extremes

    KAUST Repository

    Davison, Anthony C.


    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.

  18. The relationship between reproductive work and sociodemographic and psychosocial factors in regard to psychological distress in men and women in Spain. (United States)

    Ruiz-Pérez, Isabel; Ricci-Cabello, Ignacio; Plazaola-Castaño, Juncal; Montero-Piñar, María Isabel; Escribá-Agüir, Vicenta


    Studies have shown that some sociodemographic factors, such as marital status, employment status or social class, can affect mental health in different ways for each gender. However, up until now, few research projects have tried to ascertain if the role that reproductive work or psychosocial factors play in mental health is different for men and women. The aim of this study is to assess the differences between men and women in terms of how reproductive work, sociodemographic and psychosocial factors are linked to psychological distress in Spain. A cross-sectional study of 29,478 male and female adults using data gathered for the Spanish National Health Survey 2006 was carried out. Psychological distress was measured using the GHQ-12. The independent variables analyzed were: sociodemographic, psychosocial (family functionality and functional social support) and those related to reproductive work (living with or being in charge of different types of people needing care and number of hours devoted to caregiver tasks). Different independent logistic regression models were developed for men and women. In general, with the exception of men who were more prone to psychological distress if they were signed off work for 3 months or more, no major differences were observed regarding the effect of sociodemographic and psychosocial characteristics on psychological distress. With regard to reproductive work, the likelihood of psychological distress doubles in both sexes when the person lives with someone who needs care. In women, a greater number of hours devoted to caring for another person is associated with an increase in distress. Men play a less frequent role in caregiving, but the impact on psychological distress is similar to that in women. Women experienced more psychological distress when they had to live with or be in charge of a disabled person or different types of persons needing care, while men were not affected by this. Major differences have been identified in

  19. Distinguishing Between Spiritual Distress, General Distress, Spiritual Well-Being, and Spiritual Pain Among Cancer Patients During Oncology Treatment. (United States)

    Schultz, Michael; Meged-Book, Tehilah; Mashiach, Tanya; Bar-Sela, Gil


    Spiritual distress is present in approximately 25% of oncology patients. We examined the extent to which this measure is identical to a variety of other measures, such as spiritual well-being, spiritual injury, spiritual pain, and general distress. Structured interview of oncology outpatients over 12 months, approached nonselectively. The presence or absence of spiritual distress was compared against spiritual pain and two spiritual well-being tools: Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being 12-Item Scale (FACIT-Sp-12) and the Spiritual Injury Scale (SIS). We also examined whether a general distress visual analogue scale sufficed to identify spiritual distress. Other questions concerned demographic and clinical data. Of 416 patients approached, 202 completed the interview, of whom 23% reported spiritual distress. All measures showed significant correlation (receiver operating characteristic, area under the curve: SIS 0.79; distress thermometer [DT] 0.68; FACIT-Sp-12 0.67), yet none were identical with spiritual distress (sensitivity/specificity: SIS 64%/79%; spiritual pain 72%/76%; DT 41%/76%; FACIT-Sp-12 57%/72%). Of the FACIT-Sp-12 subscales, only peace correlated with spiritual distress. A significant predictor of spiritual distress was patients' self-evaluation of grave clinical condition (odds ratio 3.3; 95% CI 1.1-9.5). Multivariable analysis of individual measure items suggests an alternative three-parameter model for spiritual distress: not feeling peaceful, feeling unable to accept that this is happening, and perceived severity of one's illness. The DT is not sufficient to identify spiritual distress. The peace subscale of FACIT-Sp-12 is a better match than the measure as a whole. The SIS is the best match for spiritual distress, although an imperfect one. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  20. Adventure and Extreme Sports. (United States)

    Gomez, Andrew Thomas; Rao, Ashwin


    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. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Extremal graph theory

    CERN Document Server

    Bollobas, Bela


    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

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

    Directory of Open Access Journals (Sweden)

    Per Nerdrum


    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.

  3. Psychological distress of adolescents exposed to Hurricane Hugo. (United States)

    Hardin, S B; Weinrich, M; Weinrich, S; Hardin, T L; Garrison, C


    To ascertain the effects of a natural disaster on adolescents, 1482 South Carolina high school students who were exposed to Hurricane Hugo were surveyed 1 year after the disaster. Subjects completed a self-administered questionnaire measuring Hugo exposure, nonviolent and violent life events, social support, self-efficacy, and psychological distress. Results showed that the students reported minimal exposure to the hurricane and psychological distress variables approximated national norms. As exposure increased, adolescents reported increased symptoms of psychological distress; i.e., anger, depression, anxiety, and global mental distress. Females and white students experienced higher levels of distress. In most cases, other stressful life events were at least as strong a predictor of psychological distress as was exposure to the hurricane. Self-efficacy and social support were protective.

  4. Factors associated with financial distress of nonprofit hospitals. (United States)

    Kim, Tae Hyun


    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.

  5. Perceptions of friendship among youth with distressed friends. (United States)

    Hill, Erin N; Swenson, Lance P


    This cross-sectional study examined the relationship between a friend's level of internalizing distress and the focal child's perceptions of friendship amongst 5th, 8th, and 11th grade youth. Participants completed the Youth Self-Report to assess internalizing distress and measures assessing perceptions of friendship quality, social support, and self-disclosure within reciprocal, same-sex friendship dyads. Results indicated that youth with friends experiencing low levels of internalizing distress reported poorer friendship quality and decreased levels of social support and self-disclosure within the friendship compared to youth with friends experiencing average or high internalizing distress. In a second set of analyses controlling for the focal child's own internalizing symptoms, gender, and age, friend's level of internalizing distress remained a significant, unique predictor of target participants' self-disclosure about their own problems within the friendship. The findings suggest that a mild degree of internalizing distress may enhance, rather than harm, friendships amongst youth.

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

    Directory of Open Access Journals (Sweden)

    Wendy Reich


    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.

  7. Resilience and Psychological Distress in Psychology and Medical Students. (United States)

    Bacchi, Stephen; Licinio, Julio


    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 Students supported 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.

  8. Conflict with less distress: promoting team effectiveness. (United States)

    Sessa, V I; Bennett, J A; Birdsall, C


    As nurses increasingly turn to teamwork as a viable option for accomplishing a myriad of duties and responsibilities, they are discovering that teamwork can also be a source of conflict and stress. This article suggests that conflict is both inevitable and necessary within a team. A model of conflict is presented that aims not at reducing conflict, but at making it less distressing and thus more effective. The authors trace the influence of pre-conflict conditions and perspective-taking on conflict and ultimately team effectiveness. Finally, to apply the conflict model to practice, two examples are presented demonstrating both an ineffective and an effective use of conflict.

  9. Psychological Distress in Acute Low Back Pain

    DEFF Research Database (Denmark)

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


    INFO, PubMed, Web of Science, AMED, and Academic Search Premier) for the period from January 1, 1966, to April 30, 2015, in English, Danish, Norwegian, and Swedish languages. STUDY SELECTION: Cross-sectional, case-control, cohort, or randomized controlled trials assessing psychological distress......-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...

  10. Intrathoracic lipoblastoma presenting with severe respiratory distress


    Joseph Motshedi Sekgololo; Risenga Frank Chauke; Peter Shere Ramoroko; Khondker Mofazzal Hossain


    Lipoblastoma is a rare benign tumour which originates from an adipose tissue. In this study we report the case of a three year old boy who presented with a large intrathoracic tumour occupying the whole of the left hemithorax. He presented in severe respiratory distress. A chest X-ray showed total opacity of the left hemithorax, and CT-scan showed a low attenuation mass inkeeping with fat in the left hemithorax. A complete resection of a tumour was undertaken, with histopathology report confi...

  11. Mental distress predicts divorce over 16 years: the HUNT study. (United States)

    Idstad, Mariann; Torvik, Fartein Ask; Borren, Ingrid; Rognmo, Kamilla; Røysamb, Espen; Tambs, Kristian


    The association between mental distress and divorce is well established in the literature. Explanations are commonly classified within two different frameworks; social selection (mentally distressed people are selected out of marriage) and social causation (divorce causes mental distress). Despite a relatively large body of literature on this subject, selection effects are somewhat less studied, and research based on data from both spouses is scarce. The purpose of the present study is to investigate selection effects both at the individual level and the couple level. The current study is based on couple-level data from a Norwegian representative sample including 20,233 couples. Long-term selection effects were tested for by means of Cox proportional hazard models, using mental distress in both partners at baseline as predictors of divorce the next 16 years. Three identical sets of analyses were run. The first included the total sample, whereas the second and third excluded couples who divorced within the first 4 or 8 years after baseline, respectively. An interaction term between mental distress in husband and in wife was specified and tested. Hazard of divorce was significantly higher in couples with one mentally distressed partner than in couples with no mental distress in all analyses. There was also a significant interaction effect showing that the hazard of divorce for couples with two mentally distressed partners was higher than for couples with one mentally distressed partner, but lower than what could be expected from the combined main effects of two mentally distressed partners. Our results suggest that mentally distressed individuals are selected out of marriage. We also found support for a couple-level effect in which spouse similarity in mental distress to a certain degree seems to protect against divorce.

  12. Spiritual well-being and moral distress among Iranian nurses. (United States)

    Soleimani, Mohammad Ali; Sharif, Saeed Pahlevan; Yaghoobzadeh, Ameneh; Sheikhi, Mohammad Reza; Panarello, Bianca; Win, Ma Thin Mar


    Moral distress is increasingly recognized as a problem affecting healthcare professionals, especially nurses. If not addressed, it may create job dissatisfaction, withdrawal from the moral dimensions of patient care, or even encourage one to leave the profession. Spiritual well-being is a concept which is considered when dealing with problems and stress relating to a variety of issues. This research aimed to examine the relationship between spiritual well-being and moral distress among a sample of Iranian nurses and also to study the determinant factors of moral distress and spiritual well-being in nurses. A cross-sectional, correlational design was employed to collect data from 193 nurses using the Spiritual Well-Being Scale and the Moral Distress Scale-Revised. This study was approved by the Regional Committee of Medical Research Ethics. The ethical principles of voluntary participation, anonymity, and confidentiality were considered. Mean scores of spiritual well-being and moral distress were 94.73 ± 15.89 and 109.56 ± 58.70, respectively. There was no significant correlation between spiritual well-being and moral distress (r = -.053, p = .462). Marital status and job satisfaction were found to be independent predictors of spiritual well-being. However, gender and educational levels were found to be independent predictors for moral distress. Age, working in rotation shifts, and a tendency to leave the current job also became significant after adjusting other factors for moral distress. This study could not support the relationship between spiritual well-being and moral distress. However, the results showed that moral distress is related to many elements including individual ideals and differences as well as organizational factors. Informing nurses about moral distress and its consequences, establishing periodic consultations, and making some organizational arrangement may play an important role in the identification and management of moral distress and

  13. Nurse moral distress: A survey identifying predictors and potential interventions. (United States)

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


    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

  14. Translating 'distress' and screening for emotional distress in multicultural cancer patients in Israel. (United States)

    Cohen, Miri; Gagin, Roni; Cinamon, Tali; Stein, Tamar; Moscovitz, Marian; Kuten, Abraham


    The adaptability of the distress thermometer (DT) to multicultural groups has rarely been assessed. To assess DT adaptability to the Israeli population as a multicultural society. Participants were 496 cancer patients. They were recruited for 3 days a week in 2009-2010 (97% response rate). Participants completed the DT, a problem list, Hospital Anxiety and Depression Scale (HADS), and the Brief Symptom Inventory (BSI-18). Receiver-operating characteristic (ROC) curve analyses of DT scores yielded area under the curve (AUC) of 0.63 as against HADS and of 0.78 as against BSI-18. ROC analysis revealed that the optimal cutoff score was ≥ 3. It yielded sensitivity and specificity of 0.74 and 0.65, as against the HADS, and 0.64 and 0.64, as against the BSI-18. The Jewish participants reported higher distress than the Arab participants, and the ROC properties were markedly higher for the Jewish subgroup alone. The adapted DT was moderately efficient for detecting emotional distress in cancer patients in Israel. Cultural aspects related to distress should be taken into account for administration of the DT in multicultural societies.

  15. 47 CFR 80.324 - Transmission of distress message by station not itself in distress. (United States)


    ... authorities who may be able to assist. (b) Transmission must be made on the international distress frequencies... radiotelegraphy is used: (i) The signal DDD SOS SOS SOS DDD: (ii) The word DE; (iii) The call sign of the... three times; (ii) The words THIS IS; (iii) The call sign or other identification of the transmitting...

  16. Questions never asked. Positive family outcomes of extremely premature childbirth

    DEFF Research Database (Denmark)

    Lou, Hanne; Pedersen, Birthe D; Hedegaard, Morten


    OBJECTIVE: To explore positive aspects of family life after extremely premature childbirth, thereby supplementing current literature on long-term family outcome. DESIGN: Semi-structured, qualitative research interviews were analysed according to the editing strategy described by Miller and Crabtree....... SETTING: Denmark, Europe. PARTICIPANTS: Nine fathers and 11 mothers of 14 children born before 28 completed weeks of gestation at a tertiary centre were interviewed when their children were 7-10 years old. RESULTS: Whereas developmental delay, functional limitations, family burden, and parental distress...

  17. Perceived organizational support and moral distress among nurses. (United States)

    Robaee, Navideh; Atashzadeh-Shoorideh, Foroozan; Ashktorab, Tahereh; Baghestani, Ahmadreza; Barkhordari-Sharifabad, Maasoumeh


    Moral distress is prevalent in the health care environment at different levels. Nurses in all roles and positions are exposed to ethically challenging conditions. Development of supportive climates in organizations may drive nurses towards coping moral distress and other related factors. This study aimed at determining the level of perceived organizational support and moral distress among nurses and investigating the relationship between the two variables. This was a correlational-descriptive study. A total of 120 nurses were selected using random quota sampling method. A demographic questionnaire, Survey of Perceived Organizational Support, and Moral Distress Scale were used to collect the data which were analyzed using descriptive and analytical tests in SPSS20. The mean perceived organizational support was low (2.63 ± 0.79). The mean moral distress was 2.19 ± 0.58, which shows a high level of moral distress. Moreover, Statistical analysis showed no significant relationship between perceived organizational support and moral distress ( r  = 0.01, p  = 0.86). Given the low level of perceived organizational support and high moral distress among nurses in this study, it is necessary to provide a supportive environment in hospitals and to consider strategies for diminishing moral distress.

  18. Psychological distress two years after diagnosis of breast cancer

    DEFF Research Database (Denmark)

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


    The present prospective study aimed at (1) investigating the frequency of high levels of psychological distress in women with early-stage breast cancer almost two years after diagnosis and (2) identifying characteristics associated with long-term distress. One hundred and seventy women participated...... of surgery). At the second measurement, subjective distress was assessed for a second time by means of the Impact of Events Scale (IES). Almost two years after diagnosis, 16% of the women reported a high level of psychological distress as measured by the Intrusion scale (IES). Best predictors of a high level...

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

    Directory of Open Access Journals (Sweden)

    Friborg Oddgeir


    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.

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

    Directory of Open Access Journals (Sweden)

    Thomas B


    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.

  1. Symptom distress in older adults following cancer surgery. (United States)

    Van Cleave, Janet H; Egleston, Brian L; Ercolano, Elizabeth; McCorkle, Ruth


    Symptom distress remains a significant health problem among older adults with cancer following surgery. Understanding factors influencing older adults' symptom distress may lead to early identification and interventions, decreasing morbidity and improving outcomes. We conducted this study to identify factors associated with symptom distress following surgery among 326 community-residing patients 65 years or older with a diagnosis of thoracic, digestive, gynecologic, and genitourinary cancers. This secondary analysis used combined subsets of data from 5 nurse-directed intervention clinical trials targeting patients after surgery at academic cancer centers in northwest and northeastern United States. Symptom distress was assessed by the Symptom Distress Scale at baseline and at 3 and 6 months. A multivariable analysis, using generalized estimating equations, showed that symptom distress was significantly less at 3 and 6 months (3 months: P psychological, treatment, and function covariates. Thoracic cancer, comorbidities, worse mental health, and decreased function were, on average, associated with increased symptom distress (all P cancer, comorbidities, mental health, and function may influence older adults' symptom distress following cancer surgery. Older adults generally experience decreasing symptom distress after thoracic, abdominal, or pelvic cancer surgery. Symptom management over time for those with thoracic cancer, comorbidities, those with worse mental health, those with decreased function, and those 75 years or older may prevent morbidity and improve outcomes of older adults following surgery.

  2. Stellar extreme ultraviolet astronomy

    International Nuclear Information System (INIS)

    Cash, W.C. Jr.


    The design, calibration, and launch of a rocket-borne imaging telescope for extreme ultraviolet astronomy are described. The telescope, which employed diamond-turned grazing incidence optics and a ranicon detector, was launched November 19, 1976, from the White Sands Missile Range. The telescope performed well and returned data on several potential stellar sources of extreme ultraviolet radiation. Upper limits ten to twenty times more sensitive than previously available were obtained for the extreme ultraviolet flux from the white dwarf Sirius B. These limits fall a factor of seven below the flux predicted for the star and demonstrate that the temperature of Sirius B is not 32,000 K as previously measured, but is below 30,000 K. The new upper limits also rule out the photosphere of the white dwarf as the source of the recently reported soft x-rays from Sirius. Two other white dwarf stars, Feige 24 and G191-B2B, were observed. Upper limits on the flux at 300 A were interpreted as lower limits on the interstellar hydrogen column densities to these stars. The lower limits indicate interstellar hydrogen densitites of greater than .02 cm -3 . Four nearby stars (Sirius, Procyon, Capella, and Mirzam) were observed in a search for intense low temperature coronae or extended chromospheres. No extreme ultraviolet radiation from these stars was detected, and upper limits to their coronal emisson measures are derived

  3. Extremity x-ray (United States)

    ... page: // Extremity x-ray To use the sharing features on this page, ... in the body Risks There is low-level radiation exposure. X-rays are monitored and regulated to provide the ...

  4. Extremity perfusion for sarcoma

    NARCIS (Netherlands)

    Hoekstra, Harald Joan


    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

  5. Statistics of Local Extremes

    DEFF Research Database (Denmark)

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


    . 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...

  6. Social affiliation in same-class and cross-class interactions. (United States)

    Côté, Stéphane; Kraus, Michael W; Carpenter, Nichelle C; Piff, Paul K; Beermann, Ursula; Keltner, Dacher


    Historically high levels of economic inequality likely have important consequences for relationships between people of the same and different social class backgrounds. Here, we test the prediction that social affiliation among same-class partners is stronger at the extremes of the class spectrum, given that these groups are highly distinctive and most separated from others by institutional and economic forces. An internal meta-analysis of 4 studies (N = 723) provided support for this hypothesis. Participant and partner social class were interactively, rather than additively, associated with social affiliation, indexed by affiliative behaviors and emotions during structured laboratory interactions and in daily life. Further, response surface analyses revealed that paired upper or lower class partners generally affiliated more than average-class pairs. Analyses with separate class indices suggested that these patterns are driven more by parental income and subjective social class than by parental education. The findings illuminate the dynamics of same- and cross-class interactions, revealing that not all same-class interactions feature the same degree of affiliation. They also reveal the importance of studying social class from an intergroup perspective. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  7. Class and compassion: socioeconomic factors predict responses to suffering. (United States)

    Stellar, Jennifer E; Manzo, Vida M; Kraus, Michael W; Keltner, Dacher


    Previous research indicates that lower-class individuals experience elevated negative emotions as compared with their upper-class counterparts. We examine how the environments of lower-class individuals can also promote greater compassionate responding-that is, concern for the suffering or well-being of others. In the present research, we investigate class-based differences in dispositional compassion and its activation in situations wherein others are suffering. Across studies, relative to their upper-class counterparts, lower-class individuals reported elevated dispositional compassion (Study 1), as well as greater self-reported compassion during a compassion-inducing video (Study 2) and for another person during a social interaction (Study 3). Lower-class individuals also exhibited heart rate deceleration-a physiological response associated with orienting to the social environment and engaging with others-during the compassion-inducing video (Study 2). We discuss a potential mechanism of class-based influences on compassion, whereby lower-class individuals' are more attuned to others' distress, relative to their upper-class counterparts.

  8. Routine cognitive errors: a trait-like predictor of individual differences in anxiety and distress. (United States)

    Fetterman, Adam K; Robinson, Michael D


    Five studies (N=361) sought to model a class of errors--namely, those in routine tasks--that several literatures have suggested may predispose individuals to higher levels of emotional distress. Individual differences in error frequency were assessed in choice reaction-time tasks of a routine cognitive type. In Study 1, it was found that tendencies toward error in such tasks exhibit trait-like stability over time. In Study 3, it was found that tendencies toward error exhibit trait-like consistency across different tasks. Higher error frequency, in turn, predicted higher levels of negative affect, general distress symptoms, displayed levels of negative emotion during an interview, and momentary experiences of negative emotion in daily life (Studies 2-5). In all cases, such predictive relations remained significant with individual differences in neuroticism controlled. The results thus converge on the idea that error frequency in simple cognitive tasks is a significant and consequential predictor of emotional distress in everyday life. The results are novel, but discussed within the context of the wider literatures that informed them. © 2010 Psychology Press, an imprint of the Taylor & Francis Group, an Informa business

  9. Management of Psychosocial Distress by Oncologists (United States)

    Muriel, Anna C.; Hwang, Vivian S.; Kornblith, Alice; Greer, Joseph; Greenberg, Donna B.; Temel, Jennifer; Schapira, Lidia; Pirl, William


    Objective Little is known about the nature of psychosocial care delivered by oncologists. The goal of this study was to survey oncologists about their management of psychosocial distress, referencing the National Comprehensive Cancer Network guidelines. Methods A random sample of 1,000 oncologists were sent an e-mail requesting their participation in an online survey; nonrespondents were sent the survey through postal mail. Regression analyses were conducted to identify independent predictors of care. Results Forty-six percent (448 of 965) of oncologists responded. Practice locations included: community (63%), cancer center (25%), and hospital (7%). Respondents estimated that over one-third of their patients (mean± SD=38%±22%) experience psychosocial distress warranting intervention, although only 225 of 447 (50%) indicated having mental health services affiliated with their practice. Nearly half (212 of 447, 47%) reported only initiating a referral for psychosocial services, and 214 of 447 (48%) reported both making a referral and starting psychiatric medications, mainly selective serotonin reuptake inhibitors and benzodiazepines. Conclusions Most oncologists delivered some level of psychosocial care, although only half had affiliated mental health services. PMID:19648204

  10. Estimation of Mental Distress from Photoplethysmography

    Directory of Open Access Journals (Sweden)

    Roberto Zangróniz


    Full Text Available This paper introduces the design of a new wearable photoplethysmography (PPG sensor and its assessment for mental distress estimation. In our design, a PPG sensor obtains blood volume information by means of an optical plethysmogram technique. A number of temporal, morphological and frequency markers are computed using time intervals between adjacent normal cardiac cycles to characterize pulse rate variability (PRV. In order to test the efficiency of the developed wearable for classifying distress versus calmness, the well-known International Affective Picture System has been used to induce different levels of arousal in forty-five healthy participants. The obtained results have shown that temporal features present a single discriminant power between emotional states of calm and stress, ranging from 67 to 72%. Moreover, a discriminant tree-based model is used to assess the possible underlying relationship among parameters. In this case, the combination of temporal parameters reaches 82.35% accuracy. Considering the low difficulty of metrics and methods used in this work, the algorithms are prepared to be embedded into a micro-controller device to work in real-time and in a long-term fashion.

  11. Extreme quantile estimation for dependent data with applications to finance


    Drees, Holger


    The asymptotic normality of a class of estimators for extreme quantiles is established under mild structural conditions on the observed stationary \\beta-mixing time series. Consistent estimators of the asymptotic variance are introduced, which render possible the construction of asymptotic confidence intervals for the extreme quantiles. Moreover, it is shown that many well-known time series models satisfy our conditions. Then the theory is applied to a time series of returns of a stock in...

  12. Assessment of work intensification by managers and psychological distressed and non-distressed employees: a multilevel comparison. (United States)

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


    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.

  13. Framing the issues: moral distress in health care. (United States)

    Pauly, Bernadette M; Varcoe, Colleen; Storch, Jan


    Moral distress in health care has been identified as a growing concern and a focus of research in nursing and health care for almost three decades. Researchers and theorists have argued that moral distress has both short and long-term consequences. Moral distress has implications for satisfaction, recruitment and retention of health care providers and implications for the delivery of safe and competent quality patient care. In over a decade of research on ethical practice, registered nurses and other health care practitioners have repeatedly identified moral distress as a concern and called for action. However, research and action on moral distress has been constrained by lack of conceptual clarity and theoretical confusion as to the meaning and underpinnings of moral distress. To further examine these issues and foster action on moral distress, three members of the University of Victoria/University of British Columbia (UVIC/UVIC) nursing ethics research team initiated the development and delivery of a multi-faceted and interdisciplinary symposium on Moral Distress with international experts, researchers, and practitioners. The goal of the symposium was to develop an agenda for action on moral distress in health care. We sought to develop a plan of action that would encompass recommendations for education, practice, research and policy. The papers in this special issue of HEC Forum arose from that symposium. In this first paper, we provide an introduction to moral distress; make explicit some of the challenges associated with theoretical and conceptual constructions of moral distress; and discuss the barriers to the development of research, education, and policy that could, if addressed, foster action on moral distress in health care practice. The following three papers were written by key international experts on moral distress, who explore in-depth the issues in three arenas: education, practice, research. In the fifth and last paper in the series, we highlight

  14. A philosophical taxonomy of ethically significant moral distress. (United States)

    Thomas, Tessy A; McCullough, Laurence B


    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:

  15. Extremes in nature

    CERN Document Server

    Salvadori, Gianfausto; Kottegoda, Nathabandu T


    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.

  16. Rhabdomyosarcoma of the extremity

    International Nuclear Information System (INIS)

    Rao, Bhaskar N


    Rhabdomyosarcoma is the most common soft tissue sarcoma accounting for almost 55%. These tumors arise from unsegmented mesoderm or primitive mesenchyma, which have the capacity to differentiate into muscle. Less than 5% occur in the first year of life. Extremity rhabdomyosarcoma are mainly seen in the adolescent years. The most common histologic subtype is the alveolar variant. Other characteristics of extremity rhabdomyosarcoma include a predilection for lymph node metastasis, a high local failure, and a relatively low survival rate. They often present as slow painless masses; however, lesions in the hand and foot often present as painful masses and imaging studies may show invasion of the bone. Initial diagnostic approaches include needle biopsy or incisional biopsy for larger lesions. Excisional biopsy is indicated preferably for lesions less than 2.5 cm. following this in most instances therapy is initiated with multi agent chemotherapy depending upon response, the next modality may be either surgery with intent to cure or radiation therapy. Amputation of an extremity for local control is not considered in most instances. Prognostic factors that have been determined over the years to be of significance by multi variant analysis have included age, tumor size, invasiveness, presence of either nodal or distant metastasis, and complete excision whenever feasible, with supplemental radiation therapy for local control

  17. Psychological Distress and Pain Reporting in Australian Coal Miners

    Directory of Open Access Journals (Sweden)

    Kristy N. Carlisle


    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.

  18. Examining Victimization and Psychological Distress in Transgender College Students (United States)

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


    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…

  19. Emotional distress and strain in relatives of patients with severe ...

    African Journals Online (AJOL)

    The levels of emotional distress and strain were examined in two groups of relatives of psychiatric patients using standard instruments. The dementia group had more GHQ - 30 cases than the schizophrenic group. Even though the schizophrenic relatives had higher distress and strain scores than the dementia relatives, ...

  20. Ethnic Differences in Adolescents' Mental Distress, Social Stress, and Resources (United States)

    Choi, Heeseung; Meininger, Janet C.; Roberts, Robert E.


    Limited data on ethnic group differences among young adolescents exist regarding the prevalence of mental distress, social stress, and resources. The aim of this cross-sectional study was to examine ethnic differences among African American (AA), European American (EA), Hispanic American (HA), and Asian American adolescents in mental distress,…

  1. Psychopathic traits, victim distress and aggression in children

    NARCIS (Netherlands)

    van Baardewijk, Y.; Stegge, G.T.M.; Bushman, B.J.; Vermeiren, R.R.J.M.


    Background: The relationship between psychopathic traits and aggression in children may be explained by their reduced sensitivity to signs of distress in others. Emotional cues such as fear and sadness function to make the perpetrator aware of the victim's distress and supposedly inhibit aggression.

  2. 47 CFR 80.1109 - Distress, urgency, and safety communications. (United States)


    ... 47 Telecommunication 5 2010-10-01 2010-10-01 false Distress, urgency, and safety communications. 80.1109 Section 80.1109 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Global Maritime Distress and Safety System (GMDSS...

  3. 47 CFR 80.313 - Frequencies for use in distress. (United States)


    ... 80.313 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Safety Watch Requirements and Procedures Distress, Alarm, Urgency and Safety Procedures § 80.313 Frequencies for use in distress. The frequencies specified in the...


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


    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.

  5. Psychological distress among adults admitted to medical and ...

    African Journals Online (AJOL)

    Background: Physical illness is commonly associated with psychological distress that may be a direct effect of the illness or an adjustment in coping with the physical illness or its treatment. Little is known about psychological distress of patients on general wards in developing countries. Objectives: This study aimed to ...

  6. Distressed Relationships : Lessons from the Norwegian Banking Crisis

    NARCIS (Netherlands)

    Ongena, S.; Smith, D.C.; Michalsen, D.


    This paper measures the economy-wide impact of bank distress on the loss of relationship benefits. We use the near-collapse of the Norwegian banking system during the period 1988 to 1991 to measure the impact of bank distress announcements on the stock prices of firms maintaining a relationship with

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

    NARCIS (Netherlands)

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


    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

  8. Low cerebral blood flow in hypotensive perinatal distress

    DEFF Research Database (Denmark)

    Lou, H C; Lassen, N A; Friis-Hansen, B


    was used for the cerebral blood flow measurements. The study confirmed that perinatal distress may be associated with low arterial blood pressure, and it was shown that cerebral blood flow is very low, 20 ml/100 g/min or less, in hypotensive perinatal distress. It is concluded that cerebral ischaemia plays...... a crucial role in the development of perinatal hypoxic brain injury....

  9. Impact of Relational Proximity on Distress from Infidelity

    NARCIS (Netherlands)

    Fisher, Maryanne; Geher, Glenn; Cox, Anthony; Tran, Ulrich S.; Hoben, Ashley; Arrabaca, Andrew; Chaize, Corinna; Dietrich, Robert; Voracek, Martin


    Men are generally more distressed by a partner's sexual infidelity whereas women are generally more distressed by a partner's emotional infidelity. The importance of the identity of the interloper, however, has been neglected. We explored the influence of relational proximity (i.e., the degree of

  10. 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

  11. Hearts and minds: Agency and discourse on distress. (United States)

    Kemp, Martin


    This paper is based on ethnographic fieldwork in south Bristol, United Kingdom, and on the south Atlantic island of St Helena. It addresses the relationship between the experience of psychosocial distress, the language used to express such distress and the socio-cultural constraints on both language and experience. Accounts of emotional distress were obtained from interviews with 36 informants in south Bristol and with 40 informants on St Helena. Informants in both settings shared a Euro-American discourse on the self in which emotional distress is conceived as a breakdown in human agency. This discourse is linked to narrative as a way of depicting and re-affirming individual agency. A prototypical concept of narrative is used in this paper to interpret accounts of emotional distress. This interpretation demonstrates the usefulness of the idea of narrative for understanding such experiences.

  12. Adolescent identity development and distress in a clinical sample. (United States)

    Wiley, Rachel E; Berman, Steven L


    The purpose of this study was to examine the relationships of identity development and identity distress to psychological adjustment within adolescents affected by psychological problems. Participants included 88 adolescents (43.2% female) ranging from 11 to 20 years of age who were receiving services from a community mental health center. A high proportion of the participants (22.7%) met the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Text Revision criteria for Identity Problem. Regression analyses found psychopathology symptom score was associated with identity distress, identity exploration, and identity commitment, while identity distress was only related to psychopathology symptom score and not the other two identity variables. Adolescents with a clinical diagnosis may report significant levels of identity distress. Given that the relationship between psychopathology and identity distress may be reciprocal, assessing for identity issues might be prudent when conducting clinical diagnostic interviews and useful in treatment planning. © 2013 Wiley Periodicals, Inc.

  13. Analysis and evaluation of the moral distress theory. (United States)

    Wilson, Melissa A


    Moral distress is a pervasive problem in nursing resulting in a detriment to patient care, providers, and organizations. Over a decade ago, the moral distress theory (MDT) was proposed and utilized in multiple research studies. This middle range theory explains and predicts the distress that occurs in a nurse because of moral conflict. The research findings born from this theory have been substantial. Since inception of this theory, moral distress has been extensively examined which has further elaborated its understanding. This paper provides an analysis and evaluation of the MDT according to applicable guidelines. Current understanding of the phenomenon indicates that a new theory may be warranted to better predict, treat, and manage moral distress. © 2017 Wiley Periodicals, Inc.

  14. Acute respiratory distress syndrome: evaluation and management. (United States)

    Cortés, I; Peñuelas, O; Esteban, A


    Acute respiratory distress syndrome (ARDS) is a life-threatening condition that affects patients admitted in the Intensive Care Units (ICUs) under mechanical ventilation. ARDS is a process of non-hydrostatic pulmonary edema and hypoxemia associated with a variety of conditions, resulting in a direct (e.g., pneumonia) or indirect (e.g., sepsis) lung injury and is associated with a significant morbidity and mortality. A large body of clinical and basic research has focused in ventilatory strategies and novel pharmacological therapies but, nowadays, treatment is mainly supportive. Mechanical ventilation is the hallmark of the management of these patients. In the last decades, the recognition that mechanical ventilation can contribute to harming the lung has changed the goals of this therapy and has driven research to focus in ventilatory strategies that mitigate lung injury. This review emphasizes clinical aspects in the evaluation and management of ARDS in the ICUs and updates the latest advances in these therapies.


    Directory of Open Access Journals (Sweden)

    Maura Gabriela FELEA


    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.

  16. Psychosocial distress and periodontitis in adolescents

    DEFF Research Database (Denmark)

    Lopez, Rodrigo; Ramírez, Valeria; Marró, Patricio


    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...

  17. Intrathoracic lipoblastoma presenting with severe respiratory distress

    Directory of Open Access Journals (Sweden)

    Joseph Motshedi Sekgololo


    Full Text Available Lipoblastoma is a rare benign tumour which originates from an adipose tissue. In this study we report the case of a three year old boy who presented with a large intrathoracic tumour occupying the whole of the left hemithorax. He presented in severe respiratory distress. A chest X-ray showed total opacity of the left hemithorax, and CT-scan showed a low attenuation mass inkeeping with fat in the left hemithorax. A complete resection of a tumour was undertaken, with histopathology report confirming the diagnosis of lipoblastoma. The relevant literature review was done. At three and six months follow up, there was no recurrent tumour on imaging and the child had started thriving well.

  18. Sharing, liking, commenting, and distressed? The pathway between Facebook interaction and psychological distress. (United States)

    Chen, Wenhong; Lee, Kye-Hyoung


    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.

  19. Oxidative Distress in Patients with Polytrauma

    Directory of Open Access Journals (Sweden)

    M. Sh. Khubutia


    Full Text Available Polytrauma is a serious threat to human life not only due to its direct damage to vital organs, but also to the development of significant oxidative distress that gives rise to multiple organ dysfunction. At the same time, the risk of lifethreatening infectious complications increases.Objective: to study oxidative distress over time and its association with early pulmonary infectious complications in patients with polytrauma.Subjects and methods. The authors examined 35 patients with polytrauma in the first 6—12 and 12—24 hours and 3, 5—7, and 10 days after injury and 25 healthy volunteers. Having regard to the development of pulmonary infectious complications, they formed two comparison groups of patients: 1 15 patients without pneumonia and 2 20 patients with pneumonia. The investigation used the antioxidant  index  (AOI  considering  the  activity  of  erythrocyte  enzymes  (superoxide  dismutase,  catalase,  glutathione peroxidase, and glutathione reductase and the degree of lipid peroxidation in the plasma (dienic conjugates and malonic dialdehyde to estimate the balance between oxidative lesions and the performance of the body's antioxidant systems.Results. In both groups, the AOI reflects the oxidative stress state, as substantiated by negative values for the AOI with its normal value equal to zero. However, with the virtually parallel nature of AOI changes after injury in the patients with pneumonia, the values of the index were significantly lower than in those without complications within the first 6—12 and 12—24 hours and 5—7 days (p<0.05.Conclusion. This investigation has indicated that the AOI is an early candidate biomarker for the risk of infectious complications and its values are of prognostic value just within the first hours after injury.

  20. Pathogenesis of Acute Respiratory Distress Syndrome

    Directory of Open Access Journals (Sweden)

    A. M. Golubev


    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

  1. Acute Respiratory Distress Syndrome in Obstetric Patients

    Directory of Open Access Journals (Sweden)

    S. V. Galushka


    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.

  2. Impact of ethical climate on moral distress revisited: multidimensional view. (United States)

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


    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

  3. Distress among young adult cancer survivors: a cohort study. (United States)

    Yanez, Betina; Garcia, Sofia F; Victorson, David; Salsman, John M


    Being diagnosed with cancer as a young adult can lead to significant psychological distress and impaired quality of life. Compared to children and older adults diagnosed with cancer, fewer studies have addressed psychological distress among young adult cancer survivors. This study sought to identify the prevalence of, and factors associated with, distress among young adult cancer survivors (ages 18-39). Young adult cancer survivors (N = 335, mean age = 31.8, women = 68.4%) were recruited from an online research panel and stratified by cohort (time postactive treatment: 0-12, 13-24, and 25-60 months). Participants completed measures assessing demographic and clinical characteristics, global impact of cancer, cancer-related education and work interruption, and cancer-specific distress using the impact of event scale (IES). The mean score on the IES (M = 31.0, range = 0-75) was above the cut point of 20, suggesting clinically elevated distress. Analysis of covariance revealed significant main effects for cohort, global impact and cancer-related education/work interruption, and an interaction between cohort and cancer-related education/work interruption on distress. Although there was no significant effect of education/work interruption on distress for those in the 0-12 month cohort (p = .88), survivors in the 13-24 and 25-60 month cohorts reporting education/work interruption were significantly more distressed than those not reporting education/work interruption in the respective cohorts (p cancer survivors face unique challenges. These data underscore the importance of attending to cancer-related distress beyond the completion of treatment and may help inform targeted interventions to prevent or reduce significant distress and related sequelae in this population.

  4. The effectiveness of bibliotherapy in alleviating tinnitus-related distress. (United States)

    Malouff, John M; Noble, William; Schutte, Nicola S; Bhullar, Navjot


    The present study examined the efficacy of bibliotherapy in assisting individuals experiencing distress related to tinnitus. One hundred sixty-two tinnitus sufferers from Australia participated in a study designed to examine the effectiveness of a cognitive-behaviorally based self-help book in reducing distress. To maximize the ecological validity of the findings, we excluded no individuals interested in treatment for tinnitus-related distress. The experimental condition lost 35% of participants at postassessment, compared to 10% in the control group. In an analysis of participants who completed postintervention assessment, those assigned to the intervention condition, who received a tinnitus self-help book, showed significantly less tinnitus-related distress and general distress 2 months later compared to those assigned to the waiting list control condition. The intervention group's reduction in tinnitus-related distress and general distress from preintervention to postintervention 2 months later was significant, and these participants maintained a significant reduction in distress on follow-up 4 months after they received the tinnitus self-help book. A long-term follow-up of all participants, who at that time had received the book at least a year previously, showed a significant reduction in tinnitus distress. Although these group differences and pre-post changes were significant, effect sizes were small. Intention-to-treat analyses showed no significant effect for between-groups analyses, but did show a significant effect for the 1-year follow-up pre-post analysis. Information on the effectiveness of using a self-help book, without therapist assistance, in alleviating distress is important, as bibliotherapy can provide inexpensive treatment that is not bound by time or place. Copyright 2010 Elsevier Inc. All rights reserved.

  5. Psychological distress through immigration: the two-phase temporal pattern? (United States)

    Ritsner, M; Ponizovsky, A


    A large community sample, cross-sectional and in part longitudinal design, and comparison groups was used to determine the timing of psychological distress among immigrants. A total of 2,378 adult immigrants from the former Soviet Union to Israel completed the self-administered questionnaire Talbieh Brief Distress Inventory. The aggregate levels of distress and six psychological symptoms--obsessiveness, hostility, interpersonal sensitivity, depression, anxiety, and paranoid ideation--were compared at 20 intervals covering 1 to 60 months after resettlement. The level of psychological distress was significantly higher in the immigrants than that of Israeli natives but not in the potential immigrant controls. A two-phase temporal pattern of development of psychological distress was revealed consisting of escalation and reduction phases. The escalation phase was characterized by an increase in distress levels until the 27th month after arrival (a peak) and the reduction phase led to a decline returning to normal levels. The 1-month prevalence rate was 15.6% for the total sample, and for highly distressed subjects it reached 24% at the 27th month after arrival, and it declined to 4% at the 44th month. The time pattern of distress shared males and females, married and divorced/widowed (but not singles), as well as subjects of all age groups (except for immigrants in their forties). The two-phase pattern of distress obtained according to cross-sectional data was indirectly confirmed through a longitudinal way. Claims of early euphoric or distress-free period followed by mental health crisis frequently referred to in the literature on migration was not supported by this study.

  6. Class 1 Areas (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...

  7. PRCR Classes and Activities (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...

  8. Class Notes for "Class-Y-News." (United States)

    Stuart, Judy L.


    A self-contained class of students with mild to moderate disabilities published a monthly newsletter which was distributed to students' families. Students became involved in writing, typing, drawing, folding, basic editing, and disseminating. (JDD)

  9. Classed identities in adolescence


    Jay, Sarah


    peer-reviewed The central argument of this thesis is that social class remains a persistent system of inequality in education, health, life chances and opportunities. Therefore class matters. But why is it that so little attention has been paid to class in the psychological literature? Three papers are presented here which draw together theoretical advances in psychological understandings of group processes and sociological understandings of the complexity of class. As western labour marke...

  10. European Extremely Large Telescope: progress report (United States)

    Tamai, R.; Spyromilio, J.


    The European Extremely Large Telescope is a project of the European Southern Observatory to build and operate a 40-m class optical near-infrared telescope. The telescope design effort is largely concluded and construction contracts are being placed with industry and academic/research institutes for the various components. The siting of the telescope in Northern Chile close to the Paranal site allows for an integrated operation of the facility providing significant economies. The progress of the project in various areas is presented in this paper and references to other papers at this SPIE meeting are made.

  11. Topological stability through extremely tame retractions

    DEFF Research Database (Denmark)

    Feragen, Aasa


    not know whether f will be topologically stable if we can find a pair of continuous retractions r and s. The class of extremely tame (E-tame) retractions, introduced by du Plessis and Wall, are defined by their nice geometric properties, which are sufficient to ensure that f is topologically stable....... In this article, we present the E-tame retractions and their relation with topological stability, survey recent results by the author concerning their construction, and illustrate the use of our techniques by constructing E-tame retractions for certain germs belonging to the E- and Z-series of singularities....

  12. Extreme Programming Pocket Guide

    CERN Document Server



    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

  13. Upper extremity golf injuries. (United States)

    Cohn, Michael A; Lee, Steven K; Strauss, Eric J


    Golf is a global sport enjoyed by an estimated 60 million people around the world. Despite the common misconception that the risk of injury during the play of golf is minimal, golfers are subject to a myriad of potential pathologies. While the majority of injuries in golf are attributable to overuse, acute traumatic injuries can also occur. As the body's direct link to the golf club, the upper extremities are especially prone to injury. A thorough appreciation of the risk factors and patterns of injury will afford accurate diagnosis, treatment, and prevention of further injury.

  14. Loosely coupled class families

    DEFF Research Database (Denmark)

    Ernst, Erik


    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...... 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....

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

    Directory of Open Access Journals (Sweden)

    Wen-Je Ko


    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.

  16. Metaphorical profile of distress in English media discourse

    Directory of Open Access Journals (Sweden)

    Verbytska Anna


    Full Text Available The current research is directed towards the transition of distress studies in the English speaking culture from the prototype towards the conceptual metaphor approach. It enables the enlightenment of mental images, which underlie distress language usage in modern mass communication. The analysis involves identification of conceptual distress metaphors and metonymies within the image-schematic structure. The study includes a cognitive semantic analysis of linguistic units of the distress lexicon retrieved from the GloWbE, BNC, COCA, English newspapers and media platforms. Figurative language reveals conventional beliefs about distress represented in English media discourse, such as strong associations of emotion with darkness and coldness. Metaphorical mappings contain views about the reasons for distress experience which lie in the loss of balance or inner equilibrium, loss of control, and convictions about the reaction characterizing a person as being weak and brittle. The findings of data analysis are summed up in a metaphorical profile of distress (MPD which discloses the behavioural patterns (communicative behaviour, adequacy/inadequacy of behaviour, ability to socialize and physical effects including health issues.

  17. Psychological distress in remote mining and construction workers in Australia. (United States)

    Bowers, Jennifer; Lo, Johnny; Miller, Peta; Mawren, Daveena; Jones, Brooklyn


    To assess the prevalence and correlates of psychological distress in a sample of remote mining and construction workers in Australia. Design, setting: A cross-sectional, anonymous Wellbeing and Lifestyle Survey at ten mining sites in South Australia and Western Australia, administered at meetings held during 2013-2015. 1124 employees at remote construction, and open cut and underground mining sites completed the survey. General psychological distress (Kessler Psychological Distress Scale, K10) and self-reported overall mental health status; work, lifestyle and family factors correlated with level of psychological distress. The final sample comprised 1124 workers; 93.5% were men, 63% were aged 25-44 years. 311 respondents (28%) had K10 scores indicating high/very high psychological distress, compared with 10.8% for Australia overall. The most frequently reported stressors were missing special events (86%), relationship problems with partners (68%), financial stress (62%), shift rosters (62%), and social isolation (60%). High psychological distress was significantly more likely in workers aged 25-34 years (v ≥ 55 years: odds ratio [OR], 3.2; P = 0.001) and workers on a 2 weeks on/1 week off roster (v 4 weeks on/1 week off: OR, 2.4; P mental health problems were at the greatest risk of high/very high psychological distress (v not stressed: OR, 23.5; P mental ill health in these workers need to be addressed, and the stigma associated with mental health problems reduced.

  18. Comparison of the models of financial distress prediction

    Directory of Open Access Journals (Sweden)

    Jiří Omelka


    Full Text Available Prediction of the financial distress is generally supposed as approximation if a business entity is closed on bankruptcy or at least on serious financial problems. Financial distress is defined as such a situation when a company is not able to satisfy its liabilities in any forms, or when its liabilities are higher than its assets. Classification of financial situation of business entities represents a multidisciplinary scientific issue that uses not only the economic theoretical bases but interacts to the statistical, respectively to econometric approaches as well.The first models of financial distress prediction have originated in the sixties of the 20th century. One of the most known is the Altman’s model followed by a range of others which are constructed on more or less conformable bases. In many existing models it is possible to find common elements which could be marked as elementary indicators of potential financial distress of a company. The objective of this article is, based on the comparison of existing models of prediction of financial distress, to define the set of basic indicators of company’s financial distress at conjoined identification of their critical aspects. The sample defined this way will be a background for future research focused on determination of one-dimensional model of financial distress prediction which would subsequently become a basis for construction of multi-dimensional prediction model.

  19. Partner relationship satisfaction and maternal emotional distress in early pregnancy

    Directory of Open Access Journals (Sweden)

    Eberhard-Gran Malin


    Full Text Available Abstract Background Recognition of maternal emotional distress during pregnancy and the identification of risk factors for this distress are of considerable clinical- and public health importance. The mental health of the mother is important both for herself, and for the physical and psychological health of her children and the welfare of the family. The first aim of the present study was to identify risk factors for maternal emotional distress during pregnancy with special focus on partner relationship satisfaction. The second aim was to assess interaction effects between relationship satisfaction and the main predictors. Methods Pregnant women enrolled in the Norwegian Mother and Child Cohort Study (n = 51,558 completed a questionnaire with questions about maternal emotional distress, relationship satisfaction, and other risk factors. Associations between 37 predictor variables and emotional distress were estimated by multiple linear regression analysis. Results Relationship dissatisfaction was the strongest predictor of maternal emotional distress (β = 0.25. Other predictors were dissatisfaction at work (β = 0.11, somatic disease (β = 0.11, work related stress (β = 0.10 and maternal alcohol problems in the preceding year (β = 0.09. Relationship satisfaction appeared to buffer the effects of frequent moving, somatic disease, maternal smoking, family income, irregular working hours, dissatisfaction at work, work stress, and mother's sick leave (P Conclusions Dissatisfaction with the partner relationship is a significant predictor of maternal emotional distress in pregnancy. A good partner relationship can have a protective effect against some stressors.

  20. Behavioral Assessment of the Negative Emotion Aspect of Distress Tolerance. (United States)

    Veilleux, Jennifer C; Pollert, Garrett A; Zielinski, Melissa J; Shaver, Jennifer A; Hill, Morgan A


    The current behavioral tasks assessing distress tolerance measure tolerance to frustration and tolerance to physical discomfort, but do not explicitly assess tolerance to negative emotion. We closely evaluated the conceptual distinctions between current behavioral tasks and self-report tasks assessing distress tolerance, and then developed a new behavioral distress tolerance task called the Emotional Image Tolerance (EIT) task. The EIT task retains elements of existing behavioral tasks (e.g., indices of persistence) while augmenting the reliability and content sufficiency of existing measures by including multiple trials, including a variety of negative affect stimuli, and separating overall task persistence from task persistence after onset of distress. In a series of three studies, we found that the EIT correlated with extant behavioral measures of distress tolerance, the computerized mirror-tracing task and a physical cold pressor task. Across all of the studies, we also evaluated whether the EIT correlated with self-report measures of distress tolerance and measures of psychopathology (e.g., depression, anxiety, and binge eating). Implications for the refinement of the distress tolerance construct are discussed.

  1. Extremal extensions for the sum of nonnegative selfadjoint relations

    NARCIS (Netherlands)

    Hassi, Seppo; Sandovici, Adrian; De Snoo, Henk; Winkler, Henrik


    The sum A + B of two nonnegative selfadjoint relations (multivalued operators) A and B is a nonnegative relation. The class of all extremal extensions of the sum A + B is characterized as products of relations via an auxiliary Hilbert space associated with A and B. The so-called form sum extension

  2. Diabetes-Related Distress Assessment among Type 2 Diabetes Patients. (United States)

    Aljuaid, Majed O; Almutairi, Abdulmajeed M; Assiri, Mohammed A; Almalki, Dhifallah M; Alswat, Khaled


    Diabetes is one of the most common chronic diseases; it is a debilitating and hard to live with. Diabetes-related distress (DRD) refers to the emotional and behavioral changes caused by diabetes. Our study aims to assess the prevalence of DRD among type 2 diabetes (T2D) patients using Diabetes Distress Scale-17 items (DDS-17) and its relation to complications and treatment modalities. A cross-sectional study of adult T2D patients with follow-up visits at the Diabetes and Endocrinology Center in Taif, Saudi Arabia, between January and July 2017. We excluded patients with other forms of diabetes, untreated hypothyroidism, and psychiatric illness. The total score of DDS-17 was calculated by summing the 17 items' results and then dividing the total by 17. If the total score was >2, then it was considered as clinically significant results (moderate distress), but if it is ≥3, then it is classified as a high distress. A total of 509 T2D patients with a mean age of 58 ± 14 years were included. The majority of participants were male, married, not college educated, and reported a sedentary lifestyle. We found 25% of the screened T2D patients have moderate to high DRD. Regarding the DRD components, emotional distress was the most prevalent followed by physician-related distress. HabA1c was significantly higher in those with high combined distress and high emotional distress compared to those with mild/moderate distress ( p = 0.015 and 0.030, resp.). Our study shows that DRD is a medically relevant issue that clinicians need to address. Despite observing a low prevalence of DRD compared to other studies, we found significant correlations between DRD scores and HabA1c, triglyceride levels, BMI, T2D duration, and interval between visits.

  3. Psychological and physical distress of cancer patients during radiotherapy

    International Nuclear Information System (INIS)

    Koenig, A.


    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 decreasing, while therapy-related symptoms are increasing in the course of radiotherapy. Even after the end of the therapy these symptoms keep on causing distress, sometimes in a higher amount than before. A correlation between sex, sort of cancer and curative or palliative treatment and the amount of distress was found. Conclusion: the results stress the importance of adequate emotional support for patients undergoing radiotherapy especially in the first week of treatment and after the treatment. There is a need for the development of a valid radiotherapy - questionnaire in order to be able to measure the distress of these patients. (author)

  4. Moral distress and professional freedom of speech among doctors. (United States)

    Førde, Reidun; Aasland, Olaf Gjerløw


    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.

  5. Alternative measures of risk of extreme events in decision trees

    International Nuclear Information System (INIS)

    Frohwein, H.I.; Lambert, J.H.; Haimes, Y.Y.


    A need for a methodology to control the extreme events, defined as low-probability, high-consequence incidents, in sequential decisions is identified. A variety of alternative and complementary measures of the risk of extreme events are examined for their usability as objective functions in sequential decisions, represented as single- or multiple-objective decision trees. Earlier work had addressed difficulties, related to non-separability, with the minimization of some measures of the risk of extreme events in sequential decisions. In an extension of these results, it is shown how some non-separable measures of the risk of extreme events can be interpreted in terms of separable constituents of risk, thereby enabling a wider class of measures of the risk of extreme events to be handled in a straightforward manner in a decision tree. Also for extreme events, results are given to enable minimax- and Hurwicz-criterion analyses in decision trees. An example demonstrates the incorporation of different measures of the risk of extreme events in a multi-objective decision tree. Conceptual formulations for optimizing non-separable measures of the risk of extreme events are identified as an important area for future investigation

  6. Magnetotactic Bacteria from Extreme Environments

    Directory of Open Access Journals (Sweden)

    Christopher T. Lefèvre


    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.

  7. Investigating NARCCAP Precipitation Extremes via Bivariate Extreme Value Theory (Invited) (United States)

    Weller, G. B.; Cooley, D. S.; Sain, S. R.; Bukovsky, M. S.; Mearns, L. O.


    We introduce methodology from statistical extreme value theory to examine the ability of reanalysis-drive regional climate models to simulate past daily precipitation extremes. Going beyond a comparison of summary statistics such as 20-year return values, we study whether the most extreme precipitation events produced by climate model simulations exhibit correspondence to the most extreme events seen in observational records. The extent of this correspondence is formulated via the statistical concept of tail dependence. We examine several case studies of extreme precipitation events simulated by the six models of the North American Regional Climate Change Assessment Program (NARCCAP) driven by NCEP reanalysis. It is found that the NARCCAP models generally reproduce daily winter precipitation extremes along the Pacific coast quite well; in contrast, simulation of past daily summer precipitation extremes in a central US region is poor. Some differences in the strength of extremal correspondence are seen in the central region between models which employ spectral nudging and those which do not. We demonstrate how these techniques may be used to draw a link between extreme precipitation events and large-scale atmospheric drivers, as well as to downscale extreme precipitation simulated by a future run of a regional climate model. Specifically, we examine potential future changes in the nature of extreme precipitation along the Pacific coast produced by the pineapple express (PE) phenomenon. A link between extreme precipitation events and a "PE Index" derived from North Pacific sea-surface pressure fields is found. This link is used to study PE-influenced extreme precipitation produced by a future-scenario climate model run.

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

    Directory of Open Access Journals (Sweden)

    E N Zamri

    Full Text Available 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.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.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.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.Self-reported LBP and NSP were common among secondary school teachers. Interventions targeting psychological distress and work-related psychosocial characteristics may reduce

  9. 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. (United States)

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


    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.


    Directory of Open Access Journals (Sweden)

    Samokhin Mikhail Vasilevich


    The author considers the problems concerning where B is either a unit sphere in the (D space or one of the classes , p>1. He shows the possibility of the results concerning the characteristic of extreme functions, their uniqueness, the possilble presentation of the functions from the classes and with the use of the Cauchy-Stieltjes integrals in the component of the D\\ suppµ set and the boundary behavior of an extreme function from the (D class. One should note that the given mathematical system can be implemented for making decisions in the field of construction engineering and structural analysis, it can provide research assistants and engineers with the background necessary for developing sound solutions and rational proposals.

  11. Psychological distress among adolescents victims of cyberbullying

    Directory of Open Access Journals (Sweden)

    Jessica Ortega-Barón


    Full Text Available The information and communication technologies have rapidly been incorporated and expanded in our society. The age in which children and adolescents get access to electronic devices is decreasing. These devices have big advantages, but they can also be inappropriately used to molest and intimidate other children and, as a result, to cause severe psychological problems to other children. Taking this into consideration, the main objective of this study has been to describe the psychological distress shown by adolescents suffering from cyberbullying. In order to do this, the following variables were registered: depressive symptomatology, perceived stressed, isolation and life satisfaction. The initial sample was formed by 1360 adolescents. From these, 194 from 11 to 18 years old (M = 14.22, SD = 1.81 were selected according to their scores in cybervictimization (43.8 % boys. Participants were divided into three groups according to how intense their cyberbullying victimization was. These were: mild, moderated and severe. Our findings show that there were statistically significant differences between mild and severe victims. Adolescents who were severe cyberbullying victims scored higher in depressive symptomatology and perceived stress, and lower in life satisfaction compared to mild cyberbullying victims. These results and their implications are discussed in order to propose future strategies to prevent cyberbullying.

  12. Integrals of the Ising class

    International Nuclear Information System (INIS)

    Bailey, D H; Borwein, J M; Crandall, R E


    From an experimental-mathematical perspective we analyse 'Ising-class' integrals. These are structurally related n-dimensional integrals we call C n , D n , E n , where D n is a magnetic susceptibility integral central to the Ising theory of solid-state physics. We first analyse C n := 4/(n factorial) ∫ 0 ∞ ... ∫ 0 ∞ 1/(Σ j=1 n (u j + 1/u j )) 2 du 1 /u 1 ... du n /u n . We had conjectured-on the basis of extreme-precision numerical quadrature-that C n has a finite large-n limit, namely C ∞ = 2 e -2γ , with γ being the Euler constant. On such a numerological clue we are able to prove the conjecture. We then show that integrals D n and E n both decay exponentially with n, in a certain rigorous sense. While C n , D n remain unresolved for n ≥ 5, we were able to conjecture a closed form for E 5 . Our experimental results involved extreme-precision, multidimensional quadrature on intricate integrands; thus, a highly parallel computation was required

  13. Models and Inference for Multivariate Spatial Extremes

    KAUST Repository

    Vettori, Sabrina


    The development of flexible and interpretable statistical methods is necessary in order to provide appropriate risk assessment measures for extreme events and natural disasters. In this thesis, we address this challenge by contributing to the developing research field of Extreme-Value Theory. We initially study the performance of existing parametric and non-parametric estimators of extremal dependence for multivariate maxima. As the dimensionality increases, non-parametric estimators are more flexible than parametric methods but present some loss in efficiency that we quantify under various scenarios. We introduce a statistical tool which imposes the required shape constraints on non-parametric estimators in high dimensions, significantly improving their performance. Furthermore, by embedding the tree-based max-stable nested logistic distribution in the Bayesian framework, we develop a statistical algorithm that identifies the most likely tree structures representing the data\\'s extremal dependence using the reversible jump Monte Carlo Markov Chain method. A mixture of these trees is then used for uncertainty assessment in prediction through Bayesian model averaging. The computational complexity of full likelihood inference is significantly decreased by deriving a recursive formula for the nested logistic model likelihood. The algorithm performance is verified through simulation experiments which also compare different likelihood procedures. Finally, we extend the nested logistic representation to the spatial framework in order to jointly model multivariate variables collected across a spatial region. This situation emerges often in environmental applications but is not often considered in the current literature. Simulation experiments show that the new class of multivariate max-stable processes is able to detect both the cross and inner spatial dependence of a number of extreme variables at a relatively low computational cost, thanks to its Bayesian hierarchical

  14. Class, Culture and Politics

    DEFF Research Database (Denmark)

    Harrits, Gitte Sommer


    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...... practice. Further, the article explores this theoretical framework in a multiple correspondence analysis of a Danish survey, demonstrating how class and political practices are indeed homologous. However, the analysis also points at several elements of field autonomy, and the concluding discussion...

  15. Class network routing (United States)

    Bhanot, Gyan [Princeton, NJ; Blumrich, Matthias A [Ridgefield, CT; Chen, Dong [Croton On Hudson, NY; Coteus, Paul W [Yorktown Heights, NY; Gara, Alan G [Mount Kisco, NY; Giampapa, Mark E [Irvington, NY; Heidelberger, Philip [Cortlandt Manor, NY; Steinmacher-Burow, Burkhard D [Mount Kisco, NY; Takken, Todd E [Mount Kisco, NY; Vranas, Pavlos M [Bedford Hills, NY


    Class network routing is implemented in a network such as a computer network comprising a plurality of parallel compute processors at nodes thereof. Class network routing allows a compute processor to broadcast a message to a range (one or more) of other compute processors in the computer network, such as processors in a column or a row. Normally this type of operation requires a separate message to be sent to each processor. With class network routing pursuant to the invention, a single message is sufficient, which generally reduces the total number of messages in the network as well as the latency to do a broadcast. Class network routing is also applied to dense matrix inversion algorithms on distributed memory parallel supercomputers with hardware class function (multicast) capability. This is achieved by exploiting the fact that the communication patterns of dense matrix inversion can be served by hardware class functions, which results in faster execution times.

  16. Culture and social class. (United States)

    Miyamoto, Yuri


    A large body of research in Western cultures has demonstrated the psychological and health effects of social class. This review outlines a cultural psychological approach to social stratification by comparing psychological and health manifestations of social class across Western and East Asian cultures. These comparisons suggest that cultural meaning systems shape how people make meaning and respond to material/structural conditions associated with social class, thereby leading to culturally divergent manifestations of social class. Specifically, unlike their counterparts in Western cultures, individuals of high social class in East Asian cultures tend to show high conformity and other-orientated psychological attributes. In addition, cultures differ in how social class impacts health (i.e. on which bases, through which pathways, and to what extent). Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. The Class Initiatives of Intelligence Rhetoric: Implications of Racism for Scientific Inquiry. (United States)

    Hall, Ronald E.


    Asserts that in a society that is not totalitarian, class disparities are enabled institutionally by science. A capital driven nation that associates intelligence with class and race can determine overall quality of life. Thus, perception of intelligence is an extremely powerful tool for reinforcing class. Suggests that in order to be better…

  18. Semantic Analysis of Virtual Classes and Nested Classes

    DEFF Research Database (Denmark)

    Madsen, Ole Lehrmann


    Virtual classes and nested classes are distinguishing features of BETA. Nested classes originated from Simula, but until recently they have not been part of main stream object- oriented languages. C++ has a restricted form of nested classes and they were included in Java 1.1. Virtual classes...... classes and parameterized classes have been made. Although virtual classes and nested classes have been used in BETA for more than a decade, their implementation has not been published. The purpose of this paper is to contribute to the understanding of virtual classes and nested classes by presenting...

  19. Class in disguise

    DEFF Research Database (Denmark)

    Faber, Stine Thidemann; Prieur, Annick

    This paper asks how class can have importance in one of the worlds’ most equal societies: Denmark. The answer is that class here appears in disguised forms. The field under study is a city, Aalborg, in the midst of transition from a stronghold of industrialism to a post industrial economy. The pa....... The paper also raises questions about how sociological discourses may contribute to the veiling of class....

  20. Emergency distress call system for automobiles in Lagos state, Nigeria

    African Journals Online (AJOL)

    Emergency distress call system for automobiles in Lagos state, Nigeria. ... PROMOTING ACCESS TO AFRICAN RESEARCH ... and communications technology capabilities to transportation and the medical care system in order to save lives, ...


    Directory of Open Access Journals (Sweden)

    Sukirno Sukirno


    Full Text Available This paper examines the usefulness of financial statements to predict financial distress in thecooperative. The financial distress is a condition before the bankruptcy that can be seen inthe financial statements. Furthermore, the financial statements are being analyzed using ratioanalysis. The ratio analysis  used as a predictor variable are current ratio, quick ratio, currentassets to total assets ratio, current liabilities to total assets, net profit margin ratio and net SHUto total assets ratio. While the research object is a cooperative financial statements reported on2012. There are 63 cooperatives used as the sample with purposive sampling approach. Thehypothesis is analysed using logistic regression. The results found that three variables can be used to predict financial distress of the cooperative. Those variables are ratio of current assets to total assets, current liabilities to total assets and net SHU to total assets. This implies theusefulnes of financial ratio to predict financial distress in the cooperative.

  2. Distress modeling for DARWin-ME : final report. (United States)


    Distress prediction models, or transfer functions, are key components of the Pavement M-E Design and relevant analysis. The accuracy of such models depends on a successful process of calibration and subsequent validation of model coefficients in the ...

  3. [Resilience, spirituality, distress and tactics for battered women's conflict resolution]. (United States)

    Jaramillo-Vélez, Diva E; Ospina-Muñoz, Doris E; Cabarcas-Iglesias, Germán; Humphreys, Janice


    Determining the relationship of resilience and spirituality in battered women to distress, the frequency and intensity of mistreatment and the severity of injury. A sample was taken of 199 women who consulted Comisarías de Familia de Medellín, Colombia (family police/counselling stations). Resilience scales (RS), spiritual perspective (SPS), SCL-90R and conflict tactics (CTS) were used. Internal consistency, correlation and main exploratory components were measured. The scales revealed internal consistency. Resilience was positively correlated to spirituality (r = 0.22; p = 0.0015) and negatively correlated to total positive distress symptoms (PST) (r = -0.39; p spirituality, a lower number of positive distress symptoms and less distress.

  4. Psychological distress, cortisol stress response and subclinical coronary calcification

    NARCIS (Netherlands)

    Seldenrijk, A.; Hamer, M.; Lahiri, A.; Penninx, B.W.J.H.; Steptoe, A.


    Objectives: Poor mental health has been associated with coronary heart disease (CHD). One hypothesized underlying mechanism is hypothalamus pituitary adrenal axis dysfunction. We examined the associations between psychological distress, cortisol response to laboratory-induced mental stress and

  5. Ethical dilemma and moral distress: proposed new NANDA diagnoses. (United States)

    Kopala, Beverly; Burkhart, Lisa


    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.

  6. Impact of Relational Proximity on Distress from Infidelity

    Directory of Open Access Journals (Sweden)

    Maryanne Fisher


    Full Text Available Men are generally more distressed by a partner's sexual infidelity whereas women are generally more distressed by a partner's emotional infidelity. The importance of the identity of the interloper, however, has been neglected. We explored the influence of relational proximity (i.e., the degree of genetic relatedness on distress about infidelity. In Study 1, participants were most distressed when the imagined infidelity occurred between their current mate and close kin. In Study 2, relational proximity mattered more than the type of sexual behavior, the likelihood of contracting a sexually transmitted disease, and the likelihood of the infidelity leading to a damaged reputation. Together, the results indicate that identity matters, especially if the interloper is someone with whom we have familial bonds.

  7. An approach to the child in respiratory distress

    African Journals Online (AJOL)

    ... global under-five mortality rates between 1990 and 2015), only about one in five health caregivers knows the danger ... The principle features of the respiratory distress syndrome (RDS) are: ... These conditions include primary or secondary.

  8. 'Moral distress'--time to abandon a flawed nursing construct? (United States)

    Johnstone, Megan-Jane; Hutchinson, Alison


    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.

  9. Prospective relationships between workplace sexual harassment and psychological distress. (United States)

    Nielsen, M B; Einarsen, S


    Exposure to workplace sexual harassment (SH) has been associated with impaired mental health, but longitudinal studies confirming the relationship are lacking. To examine gender differences in prospective associations between SH and psychological distress. Baseline questionnaire survey data were collected in 2005 in a representative sample of Norwegian employees. Follow-up data were collected in 2007. SH was measured with the Bergen Sexual Harassment Scale. Psychological distress was measured with the 25 item Hopkins Symptom Checklist (HSCL-25) with cases of psychological distress defined as having a mean score of Workplace measures against SH would be expected to lead to a reduction in mental disorders. The finding that psychological distress predicts SH among men may indicate either a vulnerability factor or a negative perception mechanism.

  10. Ordered LOGIT Model approach for the determination of financial distress. (United States)

    Kinay, B


    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.

  11. Multiple health-risk behaviour and psychological distress in adolescence. (United States)

    Arbour-Nicitopoulos, Kelly P; Faulkner, Guy E; Irving, Hyacinth M


    To examine the prevalence and correlates of psychological distress in a school-based sample of Canadian adolescents. Self-reported data of demographics, weight status, physical activity, screen-time, diet, substance use, and psychological distress were derived from a representative sample of 2935 students in grades 9 to 12 (M(age) = 15.9 years) from the 2009 Ontario Student Drug Use and Health Survey. Overall prevalence of psychological distress was 35.1%. Significant associations were shown between psychological distress and the following: being female, tobacco use, not meeting physical activity and screen-time recommendations, and inadequate consumption of breakfast and vegetables. These findings highlight the need for targeting greater physical health promotion for adolescents at risk of mental health problems.

  12. Features of residency training and psychological distress among ...

    African Journals Online (AJOL)

    Features of residency training and psychological distress among residents in a Nigerian teaching hospital. O Esan, A Adeoye, P Onakoya, O Opeodu, K Owonikoko, D Olulana, M Bello, A Adeyemo, L Onigbogi, O Idowu, T Akute ...

  13. Distress tolerance as a predictor of risky and aggressive driving. (United States)

    Beck, Kenneth H; Ali, Bina; Daughters, Stacey B


    The purpose of this investigation was to determine the relationship between distress tolerance and risky and aggressive driving. Distress tolerance, defined as an individual's capability to experience and endure negative emotional states, was hypothesized to be related negatively to aggressive driving and risky driving. An anonymous, web-based survey of 769 college students was conducted at a large East Coast university. After controlling for age, gender, race, ethnicity, year in school, grade point average, and driving frequency, distress tolerance was significantly inversely related to reported risky driving and aggressive driving. College drivers who have a diminished capacity to endure frustration without experiencing negative emotional states (i.e., low distress tolerance) tend to drive aggressively and in a risky manner. Traditional deterrence-based approaches to highway safety may benefit from inclusion of a wider array of prevention strategies that focus on emotion regulation while driving.

  14. Non-pharmacological approaches to alleviate distress in dementia care. (United States)

    Mitchell, Gary; Agnelli, Joanne


    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.

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

    Directory of Open Access Journals (Sweden)

    William W. Dressler


    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.

  16. 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...... was retrieved from the Danish Health and Medicines Authority on a weekly basis during 2012. All newly registered patients were requested by letter to pass on an enclosed baseline questionnaire to their closest relative. Responding caregivers bereaved within six months received a follow-up questionnaire six...

  17. Nurse middle manager ethical dilemmas and moral distress. (United States)

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


    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.

  18. Distinguishing Fear Versus Distress Symptomatology in Pediatric OCD. (United States)

    Rozenman, Michelle; Peris, Tara; Bergman, R Lindsey; Chang, Susanna; O'Neill, Joseph; McCracken, James T; Piacentini, John


    Prior research has identified OCD subtypes or "clusters" of symptoms that differentially relate to clinical features of the disorder. Given the high comorbidity between OCD and anxiety, OCD symptom clusters may more broadly associate with fear and/or distress internalizing constructs. This study examines fear and distress dimensions, including physical concerns (fear), separation anxiety (fear), perfectionism (distress), and anxious coping (distress), as predictors of previously empirically-derived OCD symptom clusters in a sample of 215 youth diagnosed with primary OCD (ages 7-17, mean age = 12.25). Self-reported separation fears predicted membership in Cluster 1 (aggressive, sexual, religious, somatic obsessions, and checking compulsions) while somatic/autonomic fears predicted membership in Cluster 2 (symmetry obsessions and ordering, counting, repeating compulsions). Results highlight the diversity of pediatric OCD symptoms and their differential association with fear, suggesting the need to carefully assess both OCD and global fear constructs that might be directly targeted in treatment.

  19. Improved Extreme Learning Machine and Its Application in Image Quality Assessment


    Mao, Li; Zhang, Lidong; Liu, Xingyang; Li, Chaofeng; Yang, Hong


    Extreme learning machine (ELM) is a new class of single-hidden layer feedforward neural network (SLFN), which is simple in theory and fast in implementation. Zong et al. propose a weighted extreme learning machine for learning data with imbalanced class distribution, which maintains the advantages from original ELM. However, the current reported ELM and its improved version are only based on the empirical risk minimization principle, which may suffer from overfitting. To solve the overfitting...

  20. Shift work, mental distress and job satisfaction among Palestinian nurses. (United States)

    Jaradat, Y M; Nielsen, M B; Kristensen, P; Bast-Pettersen, R


    Associations between shift work (SW) schedules, mental distress and job satisfaction have never been completely described. To examine gender-specific associations of SW with mental distress and job satisfaction in nurses in Hebron District, Palestine, in 2012. Detailed information on work schedules (day versus shift), socio-demographic status, mental distress (General Health Questionnaire, GHQ-30) and job satisfaction (Generic Job Satisfaction Scale) in nurses employed in Hebron District, Palestine, was obtained through a questionnaire survey. Associations of SW and outcomes were examined by linear regression analysis. Of 372 nurses eligible for the study, 309 and 338 completed surveys regarding mental distress and job satisfaction, respectively. The sample comprised 62% women and 38% men. After adjusting for covariates, women working shifts reported significantly higher levels of mean mental distress [β coefficient 3.6; 95% confidence interval (CI) 0.3-7.0] compared with women working regular day shifts. Men working shifts reported significantly lower levels of job satisfaction (-3.3; 95% CI -6.2 to -0.5) than men working regular day shifts. Women reported higher levels of mental distress than men, but this was unrelated to work schedule. In this study, nurses working shifts reported higher levels of mental distress and lower levels of job satisfaction, although these associations were weaker when adjusted for potential covariates. There was no evidence of a gender differential in the association between SW and mental distress and job satisfaction. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine.

  1. Memprediksi Financial Distress dengan Binary Logit Regression Perusahaan Telekomunikasi


    antikasari, tiara widya; Djuminah, Djuminah


    In this globalization era, sub–sector telecommunication industry has rapid development as time goes by with the number of customers’ growth. However, its growth is not balanced with operational revenue development. Therefore, it is important to analyze the financial distress in telecommunication companies in order to avoid bankruptcy. This research aimed to investigate the effect of financial ratios to predict probability of financial distress. Financial ratios indicator used profitability ra...

  2. Fibromyalgia: When Distress Becomes (Un)sympathetic Pain


    Martinez-Lavin, Manuel


    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...



    Sukirno Sukirno; Haryadi Haryadi; Laeli Budiarti


    This paper examines the usefulness of financial statements to predict financial distress in thecooperative. The financial distress is a condition before the bankruptcy that can be seen inthe financial statements. Furthermore, the financial statements are being analyzed using ratioanalysis. The ratio analysis  used as a predictor variable are current ratio, quick ratio, currentassets to total assets ratio, current liabilities to total assets, net profit margin ratio and net SHUto total assets ...

  4. Prediksi Financial Distress Pada Koperasi Di Kabupaten Pemalang


    Sukirno, Sukirno; Haryadi, Haryadi; Budiarti, Laeli


    This paper examines the usefulness of financial statements to predict financial distress in thecooperative. The financial distress is a condition before the bankruptcy that can be seen inthe financial statements. Furthermore, the financial statements are being analyzed using ratioanalysis. The ratio analysis used as a predictor variable are current ratio, quick ratio, currentassets to total assets ratio, current liabilities to total assets, net profit margin ratio and net SHUto total assets ...

  5. Predicting parental distress among children newly diagnosed with craniopharyngioma. (United States)

    Peterson, Rachel K; Ashford, Jason M; Scott, Sarah M; Wang, Fang; Zhang, Hui; Bradley, Julie A; Merchant, Thomas E; Conklin, Heather M


    Childhood brain tumor diagnoses are stressful for families. Children diagnosed with craniopharyngioma (Cp) present with particularly challenging medical and cognitive problems due to tumor location and associated biophysiologic comorbidities. This study examined parental distress in a sample of families of patients with Cp treated with proton beam therapy to identify factors for targeting psychological intervention. Prior to (n = 96) and 1 year after (n = 73) proton therapy, parents of children diagnosed with Cp (9.81 ± 4.42 years at baseline; 49% male) completed a self-report measure of distress, the Brief Symptom Inventory (BSI). Children completed cognitive assessment measures at baseline; medical variables were extracted from the study database. At baseline, t-tests revealed parents reported higher levels of distress than normative expectations on Anxiety, Depression, Global Severity, and Positive Symptom Distress BSI scales (P < 0.05). Linear mixed effects models revealed parent report measures of child executive dysfunction and behavioral issues were more predictive of parental distress than patients' cognitive performance or medical status (P < 0.05). Models also revealed a significant reduction only in Anxiety over time (t = -2.19, P < 0.05). Extensive hypothalamic involvement at baseline predicted this reduction (P < 0.05). Parents experience significant distress before their child begins adjuvant therapy for Cp, though parental distress appears largely unrelated to medical complications and more related to parent perceptions of child cognitive difficulties (vs. child performance). Importantly, this may be explained by a negative parent reporting style among distressed parents. Knowledge of socio-emotional functioning in parents related to patient characteristics is important for optimization of psychological intervention. © 2018 Wiley Periodicals, Inc.

  6. Researching moral distress among New Zealand nurses: a national survey. (United States)

    Woods, Martin; Rodgers, Vivien; Towers, Andy; La Grow, Steven


    Moral distress has been described as a major problem for the nursing profession, and in recent years, a considerable amount of research has been undertaken to examine its causes and effects. However, few research projects have been performed that examined the moral distress of an entire nation's nurses, as this particular study does. The purpose of this study was to determine the frequency and intensity of moral distress experienced by registered nurses in New Zealand. The research involved the use of a mainly quantitative approach supported by a slightly modified version of a survey based on the Moral Distress Scale-Revised. In total, 1500 questionnaires were sent out at random to nurses working in general areas around New Zealand and 412 were returned, giving an adequate response rate of 27%. The project was evaluated and judged to be low risk and recorded as such on 22 February 2011 via the auspices of the Massey University Human Ethics Committee. Results indicate that the most frequent situations to cause nursing distress were (a) having to provide less than optimal care due to management decisions, (b) seeing patient care suffer due to lack of provider continuity and (c) working with others who are less than competent. The most distressing experiences resulted from (a) working with others who are unsafe or incompetent, (b) witnessing diminished care due to poor communication and (c) watching patients suffer due to a lack of provider continuity. Of the respondents, 48% reported having considered leaving their position due to the moral distress. The results imply that moral distress in nursing remains a highly significant and pertinent issue that requires greater consideration by health service managers, policymakers and nurse educators. © The Author(s) 2014.

  7. Predicting Financial Distress and Closure in Rural Hospitals. (United States)

    Holmes, George M; Kaufman, Brystana G; Pink, George H


    Annual rates of rural hospital closure have been increasing since 2010, and hospitals that close have poor financial performance relative to those that remain open. This study develops and validates a latent index of financial distress to forecast the probability of financial distress and closure within 2 years for rural hospitals. Hospital and community characteristics are used to predict the risk of financial distress 2 years in the future. Financial and community data were drawn for 2,466 rural hospitals from 2000 through 2013. We tested and validated a model predicting a latent index of financial distress (FDI), measured by unprofitability, equity decline, insolvency, and closure. Using the predicted FDI score, hospitals are assigned to high, medium-high, medium-low, and low risk of financial distress for use by practitioners. The FDI forecasts 8.01% of rural hospitals to be at high risk of financial distress in 2015, 16.3% as mid-high, 46.8% as mid-low, and 28.9% as low risk. The rate of closure for hospitals in the high-risk category is 4 times the rate in the mid-high category and 28 times that in the mid-low category. The ability of the FDI to discriminate hospitals experiencing financial distress is supported by a c-statistic of .74 in a validation sample. This methodology offers improved specificity and predictive power relative to existing measures of financial distress applied to rural hospitals. This risk assessment tool may inform programs at the federal, state, and local levels that provide funding or support to rural hospitals. © 2016 National Rural Health Association.

  8. Distress, sexual dysfunctions, and DSM: Dialogue at cross purposes?


    Hendrickx, Lies; Gijs, Luk; Enzlin, Paul


    Introduction. A distress criterion was added to the diagnostic criteria of sexual dysfunctions in Diagnostic and Statistical Manual of Mental Disorders, 4th Edition DSM-IV; 1994). This decision was neither based on empirical evidence, nor on an open, academic, or public debate about its necessity. As a result, this decision has been disputed ever since the publication of DSM-IV. Aim. In this article, the necessity to include or exclude the distress criterion from the diagnostic criteria of...

  9. The use and misuse of moral distress in neonatology. (United States)

    Prentice, Trisha M; Gillam, Lynn; Davis, Peter G; Janvier, Annie


    The neonatal intensive care unit is recognized as a stressful environment; the nature of caring for sick babies with uncertain outcomes and the need to make difficult decisions results in a work place where moral distress is prevalent. According to the prevailing definition, moral distress occurs when the provider believes that what is "done" is not the right course of action, with an element of constraint: the provider has no choice but to act this way. This can lead to adverse outcomes, including burnout and a change of career. Traditionally, moral distress was considered to represent a misuse of power that forced nurses (typically) to provide burdensome treatments they believed not in the patient's best interests. Today, with shared decision-making, it is rare for physicians to act in a purely paternalistic fashion and impose management strategies on a team and parents. However, in the grey zones, it is not unusual for individuals with different values to disagree on a course of treatment. Healthcare professionals across all disciplines may feel constrained despite there being no identified misuse of power. We argue for a broader understanding of moral distress and an awareness that maladaptive responses to moral distress may result in "transference" of moral distress on to other healthcare professionals and even on to the families of babies for whom we have a duty of care. Strategies for dealing with moral distress exist. An appreciation of these dynamics will enable providers to reduce the negative impacts of moral distress while also using it as a vehicle for constructive discussion and progressive thought that will better serve our patients and our colleagues. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Does tinnitus distress depend on age of onset?


    Schlee, Winfried; Kleinjung, Tobias; Hiller, Wolfgang; Goebel, Gerhard; Kolassa, Iris; Langguth, Berthold


    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 studiesindicate that the amount of tinnitus distress is associated with many factors including comorbid anxiety, comorbid depre...

  11. Tei index in neonatal respiratory distress and perinatal asphyxia


    Ahmed Anwer Attia Khattab


    Cardiovascular compromise is a common complication of neonatal respiratory distress and perinatal asphyxia. Tei index is a Doppler-derived index for the assessment of overall left ventricular function that combines systolic and diastolic time intervals. Aim: Assess the role of MPI versus cardiac troponin I as early indicator of hypoxic cardiac damage in neonates with respiratory distress or perinatal asphyxia. The present work was conducted on forty neonates, 15 with neonatal respiratory dist...

  12. Effects of Screening for Psychological Distress on Patient Outcomes in Cancer: a Systematic Review (United States)

    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 identified as distressed; and (2) effects of screening for distress on distress outcomes. Methods CINAHL, Cochrane, EMBASE, ISI, MEDLINE, PsycINFO, and SCOPUS databases were searched through April 6, 2011 with manual searches of 45 relevant journals, reference list review, citation tracking of included articles, and trial registry reviews through June 30, 2012. Articles in any language on cancer patients were included if they (1) compared treatment for patients with psychological distress to placebo or usual care in a randomized controlled trial (RCT); or (2) assessed the effect of screening on psychological distress in a RCT. Results There were 14 eligible RCTs for treatment of distress, and 1 RCT on the effects of screening on patient distress. Pharmacological, psychotherapy and collaborative care interventions generally reduced distress with small to moderate effects. One study investigated effects of screening for distress on psychological outcomes, and it found no improvement. Conclusion Treatment studies reported modest improvement in distress symptoms, but only a single eligible study was found on the effects of screening cancer patients for distress, and distress did not improve in screened patients versus those receiving usual care. Because of the lack of evidence of beneficial effects of screening cancer patients for distress, it is premature to recommend or mandate implementation of routine screening. PMID:23751231

  13. Asian elephants (Elephas maximus reassure others in distress

    Directory of Open Access Journals (Sweden)

    Joshua M. Plotnik


    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.

  14. Idioms of distress among trauma survivors: subtypes and clinical utility. (United States)

    Hinton, Devon E; Lewis-Fernández, Roberto


    In this introduction to the Special Issue on Trauma and Idioms of Distress, we provide an overview of the concept and typology of "idioms of distress," focusing particularly on their clinical utility. This includes the role of idioms as indicators of trauma exposure, of various types of psychopathology and of levels of distress, risk and functioning. It likewise includes the fact that idioms of distress may profoundly influence the personal meaning of having a trauma-related disorder, may shape the interpersonal course of the disorder and may pattern help-seeking and self-treatment. Finally, it illustrates the fact that idioms may also help clinicians understand sufferers' views of the causes of their distress, constitute key therapeutic targets and help increase therapeutic empathy and treatment adherence. This special issue focuses on the role played by idioms of distress in the local trauma ontology, the associations between the idioms and psychiatric disorders occurring in the context of trauma and the mechanisms by which the idioms profoundly influence the personal and interpersonal course of trauma-related disorders.

  15. Screening for psychological distress in cancer: renewing the research agenda. (United States)

    Salmon, Peter; Clark, Louise; McGrath, Elly; Fisher, Peter


    Although health policy for cancer care promotes screening of patients for emotional distress, the utility and validity of screening have been questioned. Continued research to refine detection of distress or to evaluate outcomes of screening programmes is unlikely to end this controversy. Instead, we need to identify more fundamental research questions that address the validity or utility of screening in this context. We critically and selectively review research and policy literature on psychological screening in cancer care, drawing also from research literature about the nature of psychological needs in cancer care and from relevant literature on psychological screening in mental health. We identify three broad research questions: (i) Apart from intensity of distress, what further information should screening seek about the context of distress, psychological processes that promote distress and patients' own perspective on their needs? (ii) What are the implications of the contextual dependence of disclosure of emotional feelings, given that screening questions can be asked in contexts ranging from an impersonal questionnaire to dialogue with a trusted practitioner? (iii) How should a screen be responded to, given the inherent uncertainty associated with screening results and given that distress in a cancer context can indicate instrumental as well as psychological needs? Examining these questions will mean exchanging a diagnostic framework for screening, in which health need is indicated by the presence of a psychological disorder, for a public health framework, in which health need is identified from multiple perspectives. Copyright © 2014 John Wiley & Sons, Ltd.

  16. Authenticity, life satisfaction, and distress: a longitudinal analysis. (United States)

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


    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. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  17. Prevalence and etiology of respiratory distress in newborns

    International Nuclear Information System (INIS)

    Zaman, S.; Goheer, L.; Riaz, H.


    Objective: To determine the prevalence and etiology of respiratory distress in the newborns delivered over the period of one year from 1st January 2008 to 31st Dec 2008. Study Design: A descriptive study Place and Duration of Study: The study was conducted in Armed Forces Hospital Sharurah Kingdom of Saudi Arabia over a period of one year from January 2008 to Dec 2008 Patients and methods: All live newborns delivered at Armed Forces Hospital Sharurah during the study period were included and observed for development of respiratory distress. Results: All newborns (n=659), delivered at this hospital over the period of 12 months, were observed for respiratory distress. The overall prevalence of respiratory distress (RD) was 4.24%. Prevalence was 19.7% in preterm and 2.3% in full term. Transient tachypnea of newborn(TTN) was found to be the commonest 35.7% cause of Respiratory Distress (RD) followed by Hyaline membrane disease (HMD) 25%, meconium aspiration syndrome (MAS) 17.9%, congenital pneumonia 7.1% and other congenital anomalies 14.3%. TTN was found to be common among both term and preterm babies, while hyaline membrane disease was seen among preterm, and meconium aspiration syndrome among term and post term babies. Conclusion: Respiratory distress is a common neonatal problem with significant morbidity and mortality. Majority of cases are due to TTN followed by hyaline membrane disease and meconium aspiration syndrome. (author)

  18. Distress vocalization sequences broadcasted by bats carry redundant information. (United States)

    Hechavarría, Julio C; Beetz, M Jerome; Macias, Silvio; Kössl, Manfred


    Distress vocalizations (also known as alarm or screams) are an important component of the vocal repertoire of a number of animal species, including bats, humans, monkeys and birds, among others. Although the behavioral relevance of distress vocalizations is undeniable, at present, little is known about the rules that govern vocalization production when in alarmful situations. In this article, we show that when distressed, bats of the species Carollia perspicillata produce repetitive vocalization sequences in which consecutive syllables are likely to be similar to one another regarding their physical attributes. The uttered distress syllables are broadband (12-73 kHz) with most of their energy focussing at 23 kHz. Distress syllables are short (~4 ms), their average sound pressure level is close to 70 dB SPL, and they are produced at high repetition rates (every 14 ms). We discuss that, because of their physical attributes, bat distress vocalizations could serve a dual purpose: (1) advertising threatful situations to conspecifics, and (2) informing the threatener that the bats are ready to defend themselves. We also discuss possible advantages of advertising danger/discomfort using repetitive utterances, a calling strategy that appears to be ubiquitous across the animal kingdom.

  19. 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.

  20. Does tinnitus distress depend on age of onset? (United States)

    Schlee, Winfried; Kleinjung, Tobias; Hiller, Wolfgang; Goebel, Gerhard; Kolassa, Iris-Tatjana; Langguth, Berthold


    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. 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. 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. We argue that a decline of compensatory brain plasticity in older age accounts for this age-dependent tinnitus decompensation.

  1. Does Tinnitus Distress Depend on Age of Onset? (United States)

    Schlee, Winfried; Kleinjung, Tobias; Hiller, Wolfgang; Goebel, Gerhard; Kolassa, Iris-Tatjana; Langguth, Berthold


    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. PMID:22125612

  2. Psychological distress and coping in military cadre candidates. (United States)

    Nakkas, Can; Annen, Hubert; Brand, Serge


    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. 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. 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. 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.

  3. Plasma cytokine levels fall in preterm newborn infants on nasal CPAP with early respiratory distress. (United States)

    Carvalho, Clarissa Gutierrez; Silveira, Rita de Cassia; Neto, Eurico Camargo; Procianoy, Renato Soibelmann


    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.

  4. 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.

  5. Mental distress in treatment seeking young adults (18-25 years) with severe obesity compared with population controls of different body mass index levels: cohort study. (United States)

    Dreber, H; Reynisdottir, S; Angelin, B; Tynelius, P; Rasmussen, F; Hemmingsson, E


    Young adults (18-25) with severe obesity constitute a challenging patient group, and there is limited evidence about their mental health status compared to population controls. Mental distress in treatment seeking young adults with severe obesity (n = 121, mean body mass index [BMI] = 39.8 kg m -2 ) was compared with matched (1:3 for age, gender and socioeconomic status) population controls of normal weight (n = 363, mean BMI = 22.4 kg m -2 ), as well as unmatched population controls with class I obesity (n = 105, mean BMI = 32.1 kg m -2 ) or severe obesity (n = 41, mean BMI = 39.7 kg m -2 ). Mental distress was measured by the General Health Questionnaire-12 (GHQ-12), and we quantified physician-diagnosed depression, present anxiety and suicide attempts. Poisson regression and linear regression analysis were used for analysing differences in mental distress between groups. Treatment seekers experienced more mental distress than normal weight controls as measured by continuous (adjusted mean: 3.9 vs. 2.2 points, P obesity (adjusted mean: 2.3 points) or severe obesity (adjusted mean: 2.1; both, P Young adult treatment seekers with severe obesity constitute a risk group for mental distress compared to population controls of different BMI levels. © 2017 World Obesity Federation.

  6. 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.


    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

  7. Are BALQSOs extreme accretors? (United States)

    Yuan, M. J.; Wills, B. J.


    Broad Absorption Line (BAL) QSOs are QSOs with massive absorbing outflows up to 0.2c. Two hypothesis have been suggested in the past about the nature of BALQSOs: Every QSO might have BAL outflow with some covering factor. BALQSOs are those which happen to have outflow along our line of sight. BALQSOs have intrinsically different physical properties than non-BALQSOs. Based on BALQSO's optical emission properties and a large set of correlations linking many general QSO emission line and continuum properties, it has been suggested that BALQSOs might accrete at near Eddington limit with abundant of fuel supplies. With new BALQSO Hβ region spectroscopic observation conducted at UKIRT and re-analysis of literature data for low and high redshift non-BALQSOs, We confirm that BALQSOs have extreme Fe II and [O III] emission line properties. Using results derived from the latest QSO Hβ region reverberation mapping, we calculated Eddington ratios (˙ {M}/˙ {M}Edd) for our BAL and non-BALQSOs. The Fe II and [O III] strengths are strongly correlated with Eddington ratios. Those correlations link Eddington ratio to a large set of general QSO properties through the Boroson & Green Eigenvector 1. We find that BALQSOs have Eddington ratios close to 1. However, all high redshift, high luminosity QSOs have rather high Eddington ratios. We argue that this is a side effect from selecting the brightest objects. In fact, our high redshift sample might constitute BALQSO's high Eddington ratio orientation parent population.

  8. Prevalence and related factors of psychological distress among cancer inpatients using routine Distress Thermometer and Chinese Health Questionnaire screening

    Directory of Open Access Journals (Sweden)

    Chiou YJ


    Full Text Available Yu-Jie Chiou,1 Nien-Mu Chiu,1 Liang-Jen Wang,2 Shau-Hsuan Li,3 Chun-Yi Lee,1 Ming-Kung Wu,1 Chien-Chih Chen,1 Yi-Shan Wu,1 Yu Lee1 1Department of Psychiatry, 2Department of Child and Adolescent Psychiatry, 3Department of Hematology-Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China Background: Clinical practice guidelines suggest routine screening for distress among cancer patients for immediate early psychiatric care. However, previous studies focusing on routine screening for psychological distress among cancer inpatients in Taiwan are scant. Thus, the aim of this study was to evaluate the prevalence and related factors of psychological distress and mental illness among cancer inpatients in Taiwan. Patients and methods: This study was conducted as a retrospective chart review in a general hospital in southern Taiwan. Cancer inpatients were regularly screened by nursing staff using the Distress Thermometer and the 12-item Chinese Health Questionnaire. Positive screening results on either instrument were followed by a non-commanded referral to psychiatrists for clinical psychiatric diagnosis and treatment. Results: Of the 810 participants in this study, 179 (22.1% were recognized as having psychological distress. Younger age (odds ratio [OR] =1.82, having head and neck cancer (OR =2.43, and having not received chemotherapy (OR =1.58 were significantly related to psychological distress. Among the 56 patients (31.3% with psychological distress who were referred to psychiatrists, the most common mental illness was adjustment disorder (n=22, 39.2%, followed by major depressive disorder (n=13, 23.2%, depressive disorder not otherwise specified (n=6, 10.7%, and anxiety disorder not otherwise specified (n=4, 7.1%. Conclusion: Our study indicated that cancer inpatients with psychological distress were more likely to be younger in age, have head and neck cancer, and have not

  9. Decreased cerebral blood flow after administration of sodium bicarbonate in the distressed newborn infant

    DEFF Research Database (Denmark)

    Lou, H C; Lassen, N A; Fris-Hansen, B


    In the course of our studies on cerebral blood flow in newborn infants, we have observed a striking depressing effect of sodium bicarbonate infusion on cerebral blood flow which in some cases may severely aggravate cerebral ischemia. We measured cerebral blood flow before and after the treatment...... with 1 to 8 meqs of sodium bicarbonate in seven distressed newborn infants. The 133 Xe clearance technique was used. The results showed in six of the seven cases a decrease in cerebral blood flow, which in most cases was reduced to 14 to 22 ml/100 g/min, which is about half the value prior...... to the bicarbonate infusion. In one case an extreme reduction occurred: cerebral blood flow was reduced to 3 ml/100 g/min, well below the level compatible with tissue survival. The results are discussed with regard to the optimal treatment of the acidotic newborn....

  10. Extreme boundary of space semi-additive functionals on finite set

    Directory of Open Access Journals (Sweden)

    Gayratbay F. Djabbarov


    Full Text Available The present paper is devoted to study of the extreme boundary of the convexcompact set of all semi-additive functionals on a finite-point compactum. We shall find some classes of extreme points of the space semi-additive functionals OS (n .

  11. Teaching Social Class (United States)

    Tablante, Courtney B.; Fiske, Susan T.


    Discussing socioeconomic status in college classes can be challenging. Both teachers and students feel uncomfortable, yet social class matters more than ever. This is especially true, given increased income inequality in the United States and indications that higher education does not reduce this inequality as much as many people hope. Resources…

  12. Generalized Fourier transforms classes

    DEFF Research Database (Denmark)

    Berntsen, Svend; Møller, Steen


    The Fourier class of integral transforms with kernels $B(\\omega r)$ has by definition inverse transforms with kernel $B(-\\omega r)$. The space of such transforms is explicitly constructed. A slightly more general class of generalized Fourier transforms are introduced. From the general theory...

  13. Cutting Class Harms Grades (United States)

    Taylor, Lewis A., III


    An accessible business school population of undergraduate students was investigated in three independent, but related studies to determine effects on grades due to cutting class and failing to take advantage of optional reviews and study quizzes. It was hypothesized that cutting classes harms exam scores, attending preexam reviews helps exam…

  14. A note on extreme sets

    Directory of Open Access Journals (Sweden)

    Radosław Cymer


    Full Text Available In decomposition theory, extreme sets have been studied extensively due to its connection to perfect matchings in a graph. In this paper, we first define extreme sets with respect to degree-matchings and next investigate some of their properties. In particular, we prove the generalized Decomposition Theorem and give a characterization for the set of all extreme vertices in a graph.

  15. Classes of modules

    CERN Document Server

    Dauns, John


    Because traditional ring theory places restrictive hypotheses on all submodules of a module, its results apply only to small classes of already well understood examples. Often, modules with infinite Goldie dimension have finite-type dimension, making them amenable to use with type dimension, but not Goldie dimension. By working with natural classes and type submodules (TS), Classes of Modules develops the foundations and tools for the next generation of ring and module theory. It shows how to achieve positive results by placing restrictive hypotheses on a small subset of the complement submodules, Furthermore, it explains the existence of various direct sum decompositions merely as special cases of type direct sum decompositions. Carefully developing the foundations of the subject, the authors begin by providing background on the terminology and introducing the different module classes. The modules classes consist of torsion, torsion-free, s[M], natural, and prenatural. They expand the discussion by exploring...

  16. Likelihood estimators for multivariate extremes

    KAUST Repository

    Huser, Raphaë l; Davison, Anthony C.; Genton, Marc G.


    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. Likelihood estimators for multivariate extremes

    KAUST Repository

    Huser, Raphaël


    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.

  18. The ethics of distress: toward a framework for determining the ethical acceptability of distressing health promotion advertising. (United States)

    Brown, Stephen L; Whiting, Demian


    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. © 2013 International Union of Psychological Science.

  19. Further outlooks: extremely uncomfortable; Die weiteren Aussichten: extrem ungemuetlich

    Energy Technology Data Exchange (ETDEWEB)

    Resenhoeft, T.


    Climate is changing extremely in the last decades. Scientists dealing with extreme weather, should not only stare at computer simulations. They have also to turn towards psyche, seriously personal experiences, knowing statistics, relativise supposed sensational reports and last not least collecting more data. (GL)

  20. Assessing Climate Variability using Extreme Rainfall and ...

    African Journals Online (AJOL)


    extreme frequency); the average intensity of rainfall from extreme events ... frequency and extreme intensity indices, suggesting that extreme events are more frequent and intense during years with high rainfall. The proportion of total rainfall from ...

  1. On the entropy of four-dimensional near-extremal N = 2 black holes with R2-terms

    International Nuclear Information System (INIS)

    Gruss, Eyal; Oz, Yaron


    We consider the entropy of four-dimensional near-extremal N = 2 black holes. The Bekenstein-Hawking entropy formula has the structure of the extremal black holes entropy with a shift of the charges depending on the non-extremality parameter and the moduli at infinity. We construct a class of near-extremal horizon solutions with R 2 -terms, and show that the generalized Wald entropy formula exhibits the same property

  2. 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......) for psychological distress was 1.36 (95% CI 1.25-1.48) in the medium FAS-group and 2.07 (95% CI 1.78-2.40) in the low FAS-group. The association appeared in all countries although only significant in Iceland and Sweden (girls only). OSC: The Odds Ratio (OR) for psychological distress was 1.01 (95% CI 0.......89-1.15) in the medium OSC-group, 1.37 (1.24-1.52) in the low OSC-group and 1.66 (95% CI 1.49-1.85) in the unclassifiable OSC-group. For girls this finding was robust and significant across all countries except Sweden. For boys the association was graded but not significant. Implications A socioeconomic gradient...

  3. Development and content validation of a questionnaire to assess moral distress among social workers in long-term care facilities. (United States)

    Lev, Sagit; Ayalon, Liat


    Despite the significance of ethical issues faced by social workers, research on moral distress among social workers has been extremely limited. The aim of the current study is to describe the development and content validation of a unique questionnaire to measure moral distress among social workers in long-term care facilities for older adults in Israel. The construction of the questionnaire was based on a secondary analysis of a qualitative study that addressed the moral dilemma of social workers in nursing homes in Israel. A content validation included review and evaluation by two experts, a cognitive interview with a nursing home social worker, and three focus groups of experts and the target population. The initial questionnaire consisted of 25 items. After the content validation process the questionnaire in its final version, consisted of 17 items and included two scales, measuring the frequency of morally loaded events and the intensity of distress that followed them. We believe that the questionnaire can contribute by broadening and deepening ethics discourse and research, with regard to social workers' obligation dilemmas and conflicts.

  4. Moral distress in undergraduate nursing students: A systematic review. (United States)

    Sasso, Loredana; Bagnasco, Annamaria; Bianchi, Monica; Bressan, Valentina; Carnevale, Franco


    Nurses and nursing students appear vulnerable to moral distress when faced with ethical dilemmas or decision-making in clinical practice. As a result, they may experience professional dissatisfaction and their relationships with patients, families, and colleagues may be compromised. The impact of moral distress may manifest as anger, feelings of guilt and frustration, a desire to give up the profession, loss of self-esteem, depression, and anxiety. The purpose of this review was to describe how dilemmas and environmental, relational, and organizational factors contribute to moral distress in undergraduate student nurses during their clinical experience and professional education. The research design was a systematic literature review. The search produced a total of 157 articles published between 2004 and 2014. These were screened with the assessment sheet designed by Hawker and colleagues. Four articles matched the search criteria (one quantitative study and three qualitative), and these were separately read and analyzed by the researchers. The process of review and analysis of the data was supervised by a colleague experienced in moral distress who provided an independent quality check. Since this was a systematic review, no ethical approval was required. From the analysis, it emerged that inequalities and healthcare disparities, the relationship with the mentor, and students' individual characteristics can all impact negatively on the decisions taken and the nursing care provided, generating moral distress. All these factors condition both the clinical experience and learning process, in addition to the professional development and the possible care choices of future nurses. Few studies dealt with moral distress in the setting of nurse education, and there is a knowledge gap related to this phenomenon. The results of this review underline the need for further research regarding interventions that can minimize moral distress in undergraduate nursing students.

  5. Moral sensitivity and moral distress in Iranian critical care nurses. (United States)

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


    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.

  6. Patterns of electronic cigarette use and level of psychological distress.

    Directory of Open Access Journals (Sweden)

    Su Hyun Park

    Full Text Available Psychological distress has been correlated with higher levels of nicotine dependence. To date, the possible association between individuals' levels of psychological distress and e-cigarette use has not been investigated, despite the dramatic growth of e-cigarette use in the US. We examined this possible association using a nationally representative sample of US adults.A total of 36,697 adults from the 2014 National Health Interview Survey (NHIS were included. The Kessler 6 scale was used to measure psychological distress. Multivariate logistic regression analysis was conducted to assess the association between level of psychological distress and e-cigarette use.Both e-cigarette and cigarette use varied according to level of psychological distress as well as multiple socio-demographic characteristics. In a multivariate model, psychological distress was significantly associated with the following groups: (a exclusive e-cigarette ever-use (aOR = 3.7; 95% CI = 1.6, 8.6, (b current dual use of e-cigarettes and cigarettes (aOR = 4.6; 95% CI = 3.1, 6.7, (c former cigarette use and ever use of e-cigarette (aOR = 3.2; 95% CI = 2.2, 4.8 and (d current use of cigarettes only (aOR = 2.1; 95% CI = 1.7, 2.6.These are the first data to demonstrate that, as is true for cigarettes, e-cigarette use is associated with increased levels of psychological distress. Further large-scale, longitudinal studies are needed to determine the direction of this relationship and to evaluate the long-term positive and negative consequences of such use.

  7. Mortality in patients with respiratory distress syndrome. (United States)

    Lopez Saubidet, I; Maskin, L P; Rodríguez, P O; Bonelli, I; Setten, M; Valentini, R


    Mortality in Acute Respiratory Distress Syndrome (ARDS) is decreasing, although its prognosis after hospital discharge and the prognostic accuracy of Berlin's new ARDS stratification are uncertain. We did a restrospective analysis of hospital and 6 month mortality of patients with ARDS admitted to the Intensive Care Unit of a Univeristy Hospital in Buenos Aires, between January 2008 and June 2011. ARDS was defined by PaO2/FiO2 lower than 200 mmHg under ventilation with at least 10 cm H2O of PEEP and a FiO2 higher or equal than 0.5. and the presence of bilateral infiltrates in chest radiography, in the absence of cardiogenic acute pulmonary edema, during the first 72 hs of mechanical ventilation. Mortality associated risk factors, the use of rescue therapies and Berlin's stratification for moderate and severe ARDS patients were considered. Ninety eight patients were included; mean age was 59±19 years old, 42,9% had mayor co-morbidities; APACHE II at admission was 22±7; SOFA at day 1 was 8±3. Prone position ventilation was applied in 20,4% and rescue measures in 12,2% (12 patients with nitric oxide and 1 with extracorporeal membrane oxygenation). Hospital and 6 months mortality were 37.7 and 43.8% respectively. After logistic regression analysis, only age, the presence of septic shock at admission, Ppl >30 cmH2O, and major co-morbidities were independently associated with hospital outcome. There was no difference between moderate and severe groups (41,2 and 36,8% respectively; p=0,25). In this cohort, including patients with severe hypoxemia and high percentage of mayor co-morbidities, ARDS associated mortality was lower than some previous studies. There was no increase in mortality after hospital discharge. There was no difference in mortality between moderate and severe groups according to Berlin's definition. Copyright © 2015 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  8. Acute respiratory distress syndrome: the Berlin Definition. (United States)

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


    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 < PaO2/FIO2 ≤ 300 mm Hg), moderate (100 mm Hg < PaO2/FIO2 ≤ 200 mm Hg), and severe (PaO2/FIO2 ≤ 100 mm Hg) and 4 ancillary variables for severe ARDS: radiographic severity, respiratory system compliance (≤40 mL/cm H2O), positive end-expiratory pressure (≥10 cm H2O), and corrected expired volume per minute (≥10 L/min). The draft Berlin 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 < .001) and increased median duration of mechanical ventilation in survivors (5 days; interquartile [IQR], 2-11; 7 days; IQR, 4-14; and 9 days; IQR, 5-17, respectively; P < .001). Compared with the AECC 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

  9. Metalloproteinase inhibition prevents acute respiratory distress syndrome. (United States)

    Carney, D E; McCann, U G; Schiller, H J; Gatto, L A; Steinberg, J; Picone, A L; Nieman, G F


    The acute respiratory distress syndrome (ARDS) occurs in patients with clearly identifiable risk factors, and its treatment remains merely supportive. We postulated that patients at risk for ARDS can be protected against lung injury by a prophylactic treatment strategy that targets neutrophil-derived proteases. We hypothesized that a chemically modified tetracycline 3 (COL-3), a potent inhibitor of neutrophil matrix metalloproteinases (MMPs) and neutrophil elastase (NE) with minimal toxicity, would prevent ARDS in our porcine endotoxin-induced ARDS model. Yorkshire pigs were anesthetized, intubated, surgically instrumented for hemodynamic monitoring, and randomized into three groups: (1) control (n = 4), surgical instrumentation only; (2) lipopolysaccharide (LPS) (n = 4), infusion of Escherichia coli lipopolysaccharide at 100 microg/kg; and (3) COL-3 + LPS (n = 5), ingestion of COL-3 (100 mg/kg) 12 h before LPS infusion. All animals were monitored for 6 h following LPS or sham LPS infusion. Serial bronchoalveolar lavage (BAL) samples were analyzed for MMP concentration by gelatin zymography. Lung tissue was fixed for morphometric assessment at necropsy. LPS infusion was marked by significant (P decrement in arterial oxygen partial pressure (P(a)O(2)) (LPS = 66 +/- 15 mm Hg, Control = 263 +/- 25 mm Hg) 6 h following LPS or sham LPS infusion, respectively. Pretreatment with COL-3 reduced the above pathophysiological changes 6 h following LPS infusion (P(plat) = 18.5 +/- 1.7 mm Hg, P(a)O(2) = 199 +/- 35 mm Hg; P = NS vs control). MMP-9 and MMP-2 concentration in BAL fluid was significantly increased between 2 and 4 h post-LPS infusion; COL-3 reduced the increase in MMP-9 and MMP-2 concentration at all time periods. Morphometrically LPS caused a significant sequestration of neutrophils and monocytes into pulmonary tissue. Pretreatment with COL-3 ameliorated this response. The wet/dry lung weight ratio was significantly greater (P single prophylactic treatment with COL

  10. Management of the mangled extremity

    NARCIS (Netherlands)

    Prasarn, Mark L.; Helfet, David L.; Kloen, Peter


    The management of a mangled extremity continues to be a matter of debate. With modern advances in trauma resuscitation, microvascular tissue transfer, and fracture fixation, severe traumatic extremity injuries that would historically have been amputated are often salvaged. Even if preserving a

  11. A decade of weather extremes

    NARCIS (Netherlands)

    Coumou, Dim; Rahmstorf, Stefan

    The ostensibly large number of recent extreme weather events has triggered intensive discussions, both in- and outside the scientific community, on whether they are related to global warming. Here, we review the evidence and argue that for some types of extreme - notably heatwaves, but also

  12. Attitude extremity, consensus and diagnosticity

    NARCIS (Netherlands)

    van der Pligt, J.; Ester, P.; van der Linden, J.


    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

  13. Social Class Dialogues and the Fostering of Class Consciousness (United States)

    Madden, Meredith


    How do critical pedagogies promote undergraduate students' awareness of social class, social class identity, and social class inequalities in education? How do undergraduate students experience class consciousness-raising in the intergroup dialogue classroom? This qualitative study explores undergraduate students' class consciousness-raising in an…

  14. Unhealthy behaviour modification, psychological distress, and 1-year survival in cardiac rehabilitation. (United States)

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


    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

  15. Diabetes Distress Among Persons With Type 1 Diabetes. (United States)

    Powers, Margaret A; Richter, Sara A; Ackard, Diann M; Craft, Cheryl


    Purpose The purpose of this study is to evaluate associations between diabetes distress and a range of psychological health behaviors and concerns among persons with type 1 diabetes for the benefit of enhancing early identification and intervention of at-risk individuals. Methods Persons with type 1 diabetes (n = 268; 57.1% female, 91.0% white, 76.8% satisfaction with life, self-esteem, self-efficacy, depression, perfectionism, body image satisfaction, dietary restraint and eating, and shape and weight concerns. Each subscale score was compared within age groups (depression scores and eating, and shape and weight concerns than those with low or moderate distress. For patients satisfaction with life, self-esteem, and self-efficacy and higher on dietary restraint and several areas of perfectionism than those with low or moderate distress. Conclusions Individuals with type 1 diabetes who have high diabetes distress also report higher A1C values and poorer psychological health concerns. A brief diabetes distress questionnaire can help to identify those who need additional screening, education and support, and treatment for overall health and well-being.

  16. Using lexical analysis to identify emotional distress in psychometric schizotypy. (United States)

    Abplanalp, Samuel J; Buck, Benjamin; Gonzenbach, Virgilio; Janela, Carlos; Lysaker, Paul H; Minor, Kyle S


    Through the use of lexical analysis software, researchers have demonstrated a greater frequency of negative affect word use in those with schizophrenia and schizotypy compared to the general population. In addition, those with schizotypy endorse greater emotional distress than healthy controls. In this study, our aim was to expand on previous findings in schizotypy to determine whether negative affect word use could be linked to emotional distress. Schizotypy (n=33) and non-schizotypy groups (n=33) completed an open-ended, semi-structured interview and negative affect word use was analyzed using a validated lexical analysis instrument. Emotional distress was assessed using subjective questionnaires of depression and psychological quality of life (QOL). When groups were compared, those with schizotypy used significantly more negative affect words; endorsed greater depression; and reported lower QOL. Within schizotypy, a trend level association between depression and negative affect word use was observed; QOL and negative affect word use showed a significant inverse association. Our findings offer preliminary evidence of the potential effectiveness of lexical analysis as an objective, behavior-based method for identifying emotional distress throughout the schizophrenia-spectrum. Utilizing lexical analysis in schizotypy offers promise for providing researchers with an assessment capable of objectively detecting emotional distress. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  17. Emotional distress in women presenting for breast imaging

    International Nuclear Information System (INIS)

    Gupta, R.; Roy, S.; Nayak, Madhabika B.; Khoursheed, M.


    The aim of this study was to assess anxiety and depression in a sample of women presenting for imaging of breast following a clinical referral. Emotional distress in the women was also assessed in relation to demographic factors, reason for referral, presence for breast symptoms, type of imaging procedure performed and self-reported pain and discomfort during imaging. The study comprised 167 patients. The Hopkins Symptom Checklist-25 (HSCL-25) and a discomfort rating scale were used to assess emotional distress and discomfort or pain experienced during the imaging. While less than 10% of all subjects scored above psychiatric cut-off points for anxiety and depression, 25% and 20% reported significant distress associated with anxiety and depression symptoms respectively. Education alone was associated with higher anxiety scores, while the presence of breast symptoms significantly increased depression scores and reports of specific nonsomatic symptoms of depression. Higher anxiety and depression scores were also associated with pain experienced during the imaging procedure. Emotional distress may negatively impact women's experience of breast imaging. Screening for emotional distress is important within the context of breast imaging. (author)

  18. Terrorism, distress, and drinking: vulnerability and protective factors. (United States)

    Richman, Judith A; Rospenda, Kathleen M; Cloninger, Lea


    Research has demonstrated effects of 9/11 on distress and drinking outcomes in individuals directly affected and indirectly affected across the United States. Fewer studies have addressed vulnerability and protective factors shown to moderate the effects of stress exposure. We report findings from a Midwestern workplace cohort study. Respondents to a 6 wave longitudinal mail survey completed questionnaires prior to September 11, 2001 and again in 2003 and 2005. Regression analyses encompassed measures of terrorism-related beliefs and fears, workplace stressors (sexual harassment, generalized abuse and low decision latitude), marital and parental status, and perceived social support in 2003, and distress and deleterious drinking outcomes in 2005. Analyses showed that terrorism-related fears significantly interacted with workplace stressors and interpersonal social relationships in predicting distress, drinking or both, controlling for pre-9/11 distress and drinking. Gender differences were also found. This article suggests that certain individuals may be at heightened risk for distressful reactions to and/or deleterious drinking resulting from terrorism-related issues and fears due to additional risk factors involving workplace stressors and inadequate interpersonal bonds. However, limitations of the study were noted and future research was recommended.

  19. Experiences and psychological distress of fertility treatment and employment. (United States)

    Payne, Nicola; Seenan, Susan; van den Akker, Olga


    This study examined experiences and psychological distress about fertility treatment in people combining work and treatment. Five hundred and sixty-three participants in the UK completed an online survey asking about difficulties in combining work and treatment; workplace disclosure, support, absence and policy; and psychological distress about treatment. Absence from work and perceptions that treatment has an impact on work and career prospects were reported by the majority of participants and this was related to the psychological distress of treatment. Around three quarters of participants disclosed to their employer and colleagues. The key reason for disclosure was needing to ask for absence from work and the main reason for non-disclosure was privacy. Workplace policy relating to managing fertility treatment and support from colleagues and their employer was related to reduced psychological distress but workplace policy was reported by less than one quarter of participants. Difficulties experienced in combining work and treatment suggest that support is needed. Specific workplace policy, guidance for supervisors and flexibility in fertility clinic times should help support employees during treatment and reduce psychological distress, thereby potentially influencing physical health and treatment outcomes.

  20. Toward interventions to address moral distress: navigating structure and agency. (United States)

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


    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.

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

    Directory of Open Access Journals (Sweden)

    Moradi Mahdi


    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.

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

    Directory of Open Access Journals (Sweden)

    Mubaraki Muhammad


    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.

  3. Executive Summary: Transforming Moral Distress into Moral Resilience in Nursing. (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

  4. Narcissistic personality disorder: relations with distress and functional impairment. (United States)

    Miller, Joshua D; Campbell, W Keith; Pilkonis, Paul A


    This study examined the construct validity of narcissistic personality disorder (NPD) by examining the relations between NPD and measures of psychologic distress and functional impairment both concurrently and prospectively across 2 samples. In particular, the goal was to address whether NPD typically "meets" criterion C of the DSM-IV definition of Personality Disorder, which requires that the symptoms lead to clinically significant distress or impairment in functioning. Sample 1 (n = 152) was composed of individuals receiving psychiatric treatment, whereas sample 2 (n = 151) was composed of both psychiatric patients (46%) and individuals from the community. Narcissistic personality disorder was linked to ratings of depression, anxiety, and several measures of impairment both concurrently and at 6-month follow-up. However, the relations between NPD and psychologic distress were (a) small, especially in concurrent measurements, and (b) largely mediated by impaired functioning. Narcissistic personality disorder was most strongly related to causing pain and suffering to others, and this relationship was significant even when other Cluster B personality disorders were controlled. These findings suggest that NPD is a maladaptive personality style which primarily causes dysfunction and distress in interpersonal domains. The behavior of narcissistic individuals ultimately leads to problems and distress for the narcissistic individuals and for those with whom they interact.

  5. Diffusion of a Distress Management Guideline into practice. (United States)

    Tavernier, Susan S; Beck, Susan L; Dudley, William N


    The purpose of this study was to explore system and clinician-related barriers, and predictors for the adoption of the National Comprehensive Cancer Network Distress Management Guideline (DMG) into oncology outpatient practice. This descriptive, correlational study surveyed a national sample of oncology nurses working in an outpatient setting who completed the survey electronically or by mail. Study respondents (n = 409) were predominantly certified nurses (84%) yet largely unfamiliar with the DMG; 17% of respondents were using the DMG. Time, staff uncertainties and ambiguous accountability were the largest barriers to not assessing distress. Compared with those not using any assessment tool, those using the DMG were more comfortable discussing distress, worked as an oncology nurse longer, scored colleagues higher on valuing distress screening and had more organizational processes in place to support evidence-based practices. Significant predictors of DMG use included higher familiarity with the DMG (OR 3.81, p DMG, which are amenable to interventions. DMG adoption may be augmented by interventions, which increase familiarity with the guideline. Additionally, adoption of the DMG may improve through explicit articulation of the responsibilities oncology team members have in cancer-related distress screening and management. Further studies are needed to evaluate the efficacy of such interventions and their impact on patient care outcomes. Copyright © 2013 John Wiley & Sons, Ltd.

  6. A framework for understanding moral distress among palliative care clinicians. (United States)

    Rushton, Cynda H; Kaszniak, Alfred W; Halifax, Joan S


    Palliative care clinicians confront suffering as they care for people living with life-limiting conditions. When the degree of suffering becomes unjustified, moral distress can ensue. Promising work from neuroscience and social psychology has yet to be applied to clinical practice. Our objective was to expand a social psychology model focusing on empathy and compassion in response to suffering to include an ethical dimension and to examine how the interrelationships of its proposed components can assist clinicians in understanding their responses to morally distressing situations. In the clinical context, responses to distressing events are thought to include four dimensions: empathy (emotional attunement), perspective taking (cognitive attunement), memory (personal experience), and moral sensitivity (ethical attunement). These dynamically intertwined dimensions create the preconditions for how clinicians respond to a triggering event instigated by an ethical conflict or dilemma. We postulate that if the four dimensions are highly aligned, the intensity and valence of emotional arousal will influence ethical appraisal and discernment by engaging a robust view of the ethical issues, conflicts, and possible solutions and cultivating compassionate action and resilience. In contrast, if they are not, ethical appraisal and discernment will be deficient, creating emotional disregulation and potentially leading to personal and moral distress, self-focused behaviors, unregulated moral outrage, burnout, and secondary stress. The adaptation and expansion of a conceptual framework offers a promising approach to designing interventions that help clinicians mitigate the detrimental consequences of unregulated moral distress and to build the resilience necessary to sustain themselves in clinical service.

  7. Optimizing UML Class Diagrams

    Directory of Open Access Journals (Sweden)

    Sergievskiy Maxim


    Full Text Available Most of object-oriented development technologies rely on the use of the universal modeling language UML; class diagrams play a very important role in the design process play, used to build a software system model. Modern CASE tools, which are the basic tools for object-oriented development, can’t be used to optimize UML diagrams. In this manuscript we will explain how, based on the use of design patterns and anti-patterns, class diagrams could be verified and optimized. Certain transformations can be carried out automatically; in other cases, potential inefficiencies will be indicated and recommendations given. This study also discusses additional CASE tools for validating and optimizing of UML class diagrams. For this purpose, a plugin has been developed that analyzes an XMI file containing a description of class diagrams.

  8. Classes of Heart Failure (United States)

    ... Introduction Types of Heart Failure Classes of Heart Failure Heart Failure in Children Advanced Heart Failure • Causes and ... and Advanced HF • Tools and Resources • Personal Stories Heart Failure Questions to Ask Your Doctor Use these questions ...

  9. Generalized Fourier transforms classes

    DEFF Research Database (Denmark)

    Berntsen, Svend; Møller, Steen


    The Fourier class of integral transforms with kernels $B(\\omega r)$ has by definition inverse transforms with kernel $B(-\\omega r)$. The space of such transforms is explicitly constructed. A slightly more general class of generalized Fourier transforms are introduced. From the general theory foll...... follows that integral transform with kernels which are products of a Bessel and a Hankel function or which is of a certain general hypergeometric type have inverse transforms of the same structure....

  10. Nordic Walking Classes

    CERN Multimedia

    Fitness Club


    Four classes of one hour each are held on Tuesdays. RDV barracks parking at Entrance A, 10 minutes before class time. Spring Course 2015: 05.05/12.05/19.05/26.05 Prices 40 CHF per session + 10 CHF club membership 5 CHF/hour pole rental Check out our schedule and enroll at: Hope to see you among us!

  11. It could have been me: vicarious victims and disaster-focused distress. (United States)

    Wayment, Heidi A


    College students who had experienced no personal bereavement in the September 11 terrorist attacks completed questionnaires between 3 and 5 weeks after the attacks and 5 months later. Cross-sectional and longitudinal structural equation model (SEM) analyses revealed that general distress and disaster-focused distress are discernable reactions following a collective loss. Both types of distress were higher among women and by those reporting social strain. General distress was associated with previous stressful events and mental health issues. Perceived similarity to the victims predicted disaster-focused distress and mediated the relationship between attending to media accounts of victims and disaster-focused distress. Only the disaster-focused distress reactions of survivor guilt and grief were associated with collective helping behaviors after the attacks and, for women, these behaviors were associated with greater reductions in these distress reactions over time. Discussion focuses on the importance of examining disaster-focused distress reactions following collective loss.

  12. Refinement of the distress management problem list as the basis for a holistic therapeutic conversation among UK patients with cancer. (United States)

    Brennan, James; Gingell, Polly; Brant, Heather; Hollingworth, William


    Originally devised in the USA, the Distress Thermometer is being deployed in many cancer settings in the UK. It is commonly used with a Problem List (PL), which has never been validated with a UK population. This study aimed to refine the PL items based upon the concerns of a sample of UK patients attending a regional cancer centre. Existing versions of the PL were scrutinised by a focus group comprising five ex-patients, six health care staff and two academics. This group considered the intelligibility, ambiguity and redundancy of items, sometimes making alternative suggestions or pooling items. The resulting 46 candidate items were sent to 735 patients with mixed cancer, asking them to endorse items that had been 'a source of concern or distress' during their recently finished treatment. We used multivariate logistic regression to evaluate the association between the prevalence of problems and patient characteristics. In this study, 395 (53%) people responded. 'Fatigue, exhaustion or extreme tiredness' (70%), 'worry, fear or anxiety' (45%) and 'sleep problems' (38%) were the most frequently endorsed items. Items not appearing on the original PL were commonly endorsed such as 'memory or concentration' (30%) and 'loneliness or isolation' (15%), suggesting that they should be routinely included in the Distress Thermometer Problem List. The current study offers a more comprehensive PL, on the basis of actual patients' concerns, using words that are understood by UK patients. The reluctance of some patients to volunteer their concerns suggests that screening for distress should be undertaken within the context of a structured conversation. Copyright © 2011 John Wiley & Sons, Ltd.

  13. Spatial dependence of extreme rainfall (United States)

    Radi, Noor Fadhilah Ahmad; Zakaria, Roslinazairimah; Satari, Siti Zanariah; Azman, Muhammad Az-zuhri


    This study aims to model the spatial extreme daily rainfall process using the max-stable model. The max-stable model is used to capture the dependence structure of spatial properties of extreme rainfall. Three models from max-stable are considered namely Smith, Schlather and Brown-Resnick models. The methods are applied on 12 selected rainfall stations in Kelantan, Malaysia. Most of the extreme rainfall data occur during wet season from October to December of 1971 to 2012. This period is chosen to assure the available data is enough to satisfy the assumption of stationarity. The dependence parameters including the range and smoothness, are estimated using composite likelihood approach. Then, the bootstrap approach is applied to generate synthetic extreme rainfall data for all models using the estimated dependence parameters. The goodness of fit between the observed extreme rainfall and the synthetic data is assessed using the composite likelihood information criterion (CLIC). Results show that Schlather model is the best followed by Brown-Resnick and Smith models based on the smallest CLIC's value. Thus, the max-stable model is suitable to be used to model extreme rainfall in Kelantan. The study on spatial dependence in extreme rainfall modelling is important to reduce the uncertainties of the point estimates for the tail index. If the spatial dependency is estimated individually, the uncertainties will be large. Furthermore, in the case of joint return level is of interest, taking into accounts the spatial dependence properties will improve the estimation process.

  14. Evolution caused by extreme events. (United States)

    Grant, Peter R; Grant, B Rosemary; Huey, Raymond B; Johnson, Marc T J; Knoll, Andrew H; Schmitt, Johanna


    Extreme events can be a major driver of evolutionary change over geological and contemporary timescales. Outstanding examples are evolutionary diversification following mass extinctions caused by extreme volcanism or asteroid impact. The evolution of organisms in contemporary time is typically viewed as a gradual and incremental process that results from genetic change, environmental perturbation or both. However, contemporary environments occasionally experience strong perturbations such as heat waves, floods, hurricanes, droughts and pest outbreaks. These extreme events set up strong selection pressures on organisms, and are small-scale analogues of the dramatic changes documented in the fossil record. Because extreme events are rare, almost by definition, they are difficult to study. So far most attention has been given to their ecological rather than to their evolutionary consequences. We review several case studies of contemporary evolution in response to two types of extreme environmental perturbations, episodic (pulse) or prolonged (press). Evolution is most likely to occur when extreme events alter community composition. We encourage investigators to be prepared for evolutionary change in response to rare events during long-term field studies.This article is part of the themed issue 'Behavioural, ecological and evolutionary responses to extreme climatic events'. © 2017 The Author(s).

  15. Maternal Distress during Pregnancy and Offspring Childhood Overweight

    DEFF Research Database (Denmark)

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


    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...... with offspring childhood overweight at age 7. Methods. We performed a cohort study using prospective data from 37,764 women and child dyads from the Danish National Birth Cohort (1996-2002). At a telephone interview at approximately 30 weeks gestation, the women reported whether they felt anxious, depressed......, 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...

  16. Discrimination and psychological distress among recently released male prisoners. (United States)

    Turney, Kristin; Lee, Hedwig; Comfort, Megan


    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 article, data from a sample of men recently released from prison to Oakland or San Francisco, California (N = 172), are used to consider how criminal record discrimination and racial/ethnic discrimination are independently and cumulatively associated with psychological distress. Results indicate that (a) the frequency of criminal record discrimination and racial/ethnic discrimination are similar; (b) both forms of discrimination are independently, negatively associated with psychological distress; and (c) 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.

  17. Understanding mental distress in film and media: a new agenda? (United States)

    Harper, Stephen


    This paper surveys some recent developments in media criticism and recent developments in film and media representations of mental distress. Focusing on a representations drawn from various forms of media, the paper argues that media and film images of mental distress are in many cases 'positive' and sympathetic, although they can also contain sexist, racist and other problematic elements that are not commonly identified by anti-stigma campaigners. It also suggests that while still valid in many ways, existing anti-stigma criticism tends to focus on a rather undifferentiated notion of 'violence to others' as the sole criterion against which media images are judged. Finally, the paper proposes that critics and campaigners pay closer attention to how the particular form or genre of any media text influences its treatment of psychological distress.

  18. The distress thermometer in survivors of gynaecological cancer

    DEFF Research Database (Denmark)

    Olesen, Mette L.; Hansen, Merete K.; Hansson, Helena


    Purpose: Unrecognised psychological distress among cancer survivors may be identified using short screening tools. We validated the accuracy of the distress thermometer (DT) to detect psychological distress on the Hospital Anxiety and Depression Scale (HADS) among early stage gynaecological cancer...... survivors and whether the women’s DT and HADS scores were associated with the need of an individualised supportive intervention. Methods: One hundred sixty-five gynaecological cancer survivors answered DT and HADS before randomisation in a trial testing a nurse-led, person-centred intervention using...... supportive conversations. The number of conversations was decided in the woman-nurse dyad based on the woman’s perceived need. Nurses were unaware of the women’s DT and HADS scores. We validated DT’s accuracy for screening using HADS as gold standard and receiver operating characteristic curves. Associations...

  19. Workplace distress and ethical dilemmas in neuroscience nursing. (United States)

    Silén, Marit; Tang, Ping Fen; Wadensten, Barbro; Ahlström, Gerd


    This study concerns Swedish nurses' experiences of workplace stress and the occurrence of ethical dilemmas in a neurological setting. Qualitative interviews were conducted with 21 nurses. The interview results were subjected to qualitative latent content analysis and sorted into 4 content areas: workplace distress, ethical dilemmas, managing distress and ethical dilemmas, and quality of nursing. Common workplace stressors were high workload and lack of influence. These were perceived to have negative consequences for the quality of nursing. Ethical dilemmas mainly concerned decision making on initiation or withdrawal of treatment, which was experienced as a troublesome situation where conflicts could arise. The nurses managed the distress and ethical dilemmas by accepting and adjusting to the situation and seeking support from colleagues. They also endeavored to gain new strength in their private lives.

  20. Nurses' workplace distress and ethical dilemmas in Tanzanian health care. (United States)

    Häggström, Elisabeth; Mbusa, Ester; Wadensten, Barbro


    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.

  1. Acute respiratory distress syndrome: epidemiology and management approaches

    Directory of Open Access Journals (Sweden)

    Walkey AJ


    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

  2. Assessment of sexually related personal distress accompanying premenopausal sexual dysfunction with an Arabic version of the Female Sexual Distress Scale. (United States)

    Ahmed, Magdy R; Shaaban, Mohamed M; Meky, Heba K


    To assess sexually related personal distress among premenopausal women with female sexual dysfunction (FSD) via a validated Arabic version of the Female Sexual Distress Scale (FSDS). A cross-sectional study was conducted among women attending Suez Canal University Hospital, Egypt, between May 2015 and July 2016. In a pilot study to evaluate test-retest reliability and internal consistency, 42 sexually active premenopausal women (aged ≥20 years) completed the Arabic FSDS at recruitment and 2 weeks later. Subsequently, premenopausal sexually active women (aged 20-45 years) were asked to complete the female sexual function index (FSFI) questionnaire; those with FSD (FSFI score ≤26.55) were invited to return to complete the validated version of the Arabic FSDS. The Arabic FSDS showed good test-retest reliability (Pearson correlation coefficient 0.93-0.98) and internal consistency (Cronbach α 0.83-0.92). Overall, 140 (58.1%) of 241 women who completed the FSFI had sexual dysfunction, of whom 51 (36.4%) had sexually related personal distress. Marriage duration was significantly increased among women with FSD (P<0.001). All FSFI sexual domains except lubrication were negatively correlated with FSDS. FSD and sexually related personal distress were highly interrelated and prevalent. An Arabic version of the FSDS was found to be valid and reliable for evaluation of sexually related personal distress. © 2017 International Federation of Gynecology and Obstetrics.

  3. Psychological distress and coping in military cadre candidates

    Directory of Open Access Journals (Sweden)

    Nakkas C


    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

  4. Assessing and addressing moral distress and ethical climate, part 1. (United States)

    Sauerland, Jeanie; Marotta, Kathleen; Peinemann, Mary Anne; Berndt, Andrea; Robichaux, Catherine


    There is minimal research exploring moral distress and its relationship to ethical climate among nurses working in acute care settings. Objectives of the study were to explore moral distress, moral residue, and perception of ethical climate among registered nurses working in an academic medical center and develop interventions to address study findings. A mixed-methods design was used. Two versions of Corley and colleagues' Moral Distress Scale, adult and pediatric/neonatal, were used in addition to Olson's Hospital Ethical Climate Survey. Participants were invited to respond to 2 open-ended questions. This article reports the results for those nurses working in adult acute and critical care units. The sample (N = 225) was predominantly female (80%); half held a bachelor of science in nursing or higher, were aged 30 to 49 years, and staff nurses (77.3%). The mean item score for moral distress intensity ranged from 3.79 (SD, 2.21) to 2.14 (SD, 2.42) with mean item score frequency ranging from 2.86 (SD, 1.88) to 0.23 (SD, 0.93). The mean score for total Hospital Ethical Climate Survey was 94.39 (SD, 18.3) ranging from 23 to 130. Qualitative comments described bullying, lateral violence, and retribution. Inadequate staffing and perceived incompetent coworkers were the most distressing items. Almost 22% left a previous position because of moral distress and perceived the current climate to be less ethical compared with other participants. Findings may potentially impact nurse retention and recruitment and negatively affect the quality and safety of patient care. Interventions developed focus on the individual nurse, including ethics education and coping skills, intraprofessional/interprofessional approaches, and administrative/policy strategies.

  5. Palliative sedation and moral distress: A qualitative study of nurses. (United States)

    Lokker, M E; Swart, S J; Rietjens, J A C; van Zuylen, L; Perez, R S G M; van der Heide, A


    Clinical nursing practice may involve moral distress, which has been reported to occur frequently when nurses care for dying patients. Palliative sedation is a practice that is used to alleviate unbearable and refractory suffering in the last phase of life and has been linked to distress in nurses. The aim of this study was to explore nurses' reports on the practice of palliative sedation focusing on their experiences with pressure, dilemmas and morally distressing situations. In-depth interviews with 36 nurses working in hospital, nursing home or primary care. Several nurses described situations in which they felt that administration of palliative sedation was in the patient's best interest, but where they were constrained from taking action. Nurses also reported on situations where they experienced pressure to be actively involved in the provision of palliative sedation, while they felt this was not in the patient's best interest. The latter situation related to (1) starting palliative sedation when the nurse felt not all options to relieve suffering had been explored yet; (2) family requesting an increase of the sedation level where the nurse felt that this may involve unjustified hastening of death; (3) a decision by the physician to start palliative sedation where the patient had previously expressed an explicit wish for euthanasia. Nurses experienced moral distress in situations where they were not able to act in what they believed is the patient's best interest. Situations involving moral distress require nurses to be well informed and able to adequately communicate with suffering patients, distressed family and physicians. Copyright © 2018 Elsevier Inc. All rights reserved.

  6. Patterns of Gender Equality at Workplaces and Psychological Distress (United States)

    Bolin, Malin; Hammarström, Anne


    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

  7. Psychological distress and prejudice following terror attacks in France. (United States)

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


    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. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Psychological distress in Japanese men with localized prostate cancer

    International Nuclear Information System (INIS)

    Namiki, Shunichi; Saito, Seiichi; Arai, Yoichi; Tochigi, Tatsuo; Numata, Isao; Ioritani, Naomasa


    The objective of this study was to investigate: the level of psychological distress; and the relationships between the level of psychological distress and general or disease-specific HRQOL of Japanese men with localized prostate cancer following surgery or radiotherapy. The study was a retrospective cross-sectional survey of 253 men with localized prostate cancer treated with radical prostatectomy and 87 with external beam radiotherapy were collected. The measures used four questionnaires including: the Medical Outcomes Study 36-Item Health Survey; The University of California, Los Angeles Prostate Cancer Index; International Prostate Symptom Score; and Hospital Anxiety and Depression Scale (HADS). Mean anxiety and depression scores were 4.0 and 4.7, respectively (standard deviation, 3.3 and 3.7). On the anxiety section of HADS, 291 patients (85%) scored 7 points or less; and on the depression scale, 183 (54%) patients scored 4 points or less. Those 'cases' (HADS total, >10) with psychological distress scored lower in all domains of the general and disease related health-related quality of life (HRQOL) than the 'non-cases' (HADS total, ≤10) except for sexual domains. Logistic regression modeling suggested that the men who tended to experience moderate to high distress suffered from worse urinary and bowel symptoms. Most patients who underwent radical prostatectomy or external beam radiotherapy for localized prostate cancer experienced low levels of psychological distress after treatment. However, men who were experiencing urinary and bowel symptoms tended to suffer from moderate to higher distress compared with men reporting no or fewer such symptoms. (author)

  9. Negotiating Gender Norms to Support Men in Psychological Distress. (United States)

    Keohane, Aisling; Richardson, Noel


    Underpinning a general pattern of higher suicide rates in men is the assumption that men do not ask for help or utilize the health-care system during times of psychological distress. There has been a failure to grapple with the dynamic of when, how and from whom men might ask for help during times of psychological distress, and what key barriers or enabling factors are likely to influence potential help-givers' capacity or willingness to offer help to men in psychological distress. The aim of this study was to investigate how masculine norms impact men's help-seeking as well as care givers' behaviors and willingness to support men in need of psychological help or perceived to be at risk of suicide. Focus groups ( n = 13) were used with "high-risk suicide" groups of men and community gatekeepers. The principles of grounded theory were used for data analysis. Three themes emerged: "negotiating ways to ask for, offer and accept help without compromising masculinity"; "making and sustaining contact with men in psychological distress"; and "navigating roles responsibilities and boundaries to support men in psychological distress." Approaches to suicide prevention need to take account of how masculine norms shape men's willingness to ask for and accept help during times of psychological distress as well as care givers willingness to offer help. The findings address a gap in the literature by looking beyond men's help-seeking as a passive, one dimensional construct, to a more dynamic triad of help-seeking/giving/taking behaviors that are embedded in the sociocultural context of men's lives.

  10. Predicting financial distress in publicly-traded companies

    Directory of Open Access Journals (Sweden)

    Felipe Fontaine Rezende


    Full Text Available ABSTRACT Several models for forecasting bankruptcy have been developed over the years, one of the reasons for which is the important part it plays in decision-making. However, forecasting a company’s bankruptcy leaves a very short time for stakeholders to change the situation. It is in this context that this paper arises in order to develop a model for predicting financial distress, which is identified as a step prior to bankruptcy. The predictive model uses the logistic regression technique with panel data and a sample of Brazilian publicly-traded companies with shares listed on the São Paulo Stock, Commodities, and Futures Exchange between 2001 and 2014. As well as financial variables, the final model includes market expectations (macroeconomic and sector variables. These variables are statistically tested and the hypothesis is confirmed that they improve the accuracy of the model. The research identified the existence of financial distress in 96% of the companies that went bankrupt. In addition, the relationship between the phenomena of bankruptcy and financial distress is verified, using financial and macroeconomic explanatory variables. The results demonstrate that most (83% of the explanatory variables in the model for predicting bankruptcy are also present in the model for predicting the phenomenon of financial distress. The expected gross domestic product variables and the quick ratio, asset turnover, and net equity over total liabilities financial variables are statistically significant in predicting both phenomena. With this evidence, the study suggests the use of the concept of financial distress as a stage prior to bankruptcy and provides a model for predicting financial distress with 89% accuracy when applied to publicly-traded companies in Brazil in the period examined.

  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. Public hospitals in financial distress: Is privatization a strategic choice? (United States)

    Ramamonjiarivelo, Zo; Weech-Maldonado, Robert; Hearld, Larry; Menachemi, Nir; Epané, Josué Patien; O'Connor, Stephen


    As safety net providers, public hospitals operate in more challenging environments than private hospitals. Such environments put public hospitals at greater risk of financial distress, which may result in privatization and deterioration of the safety net. The purpose of this study was to investigate whether financial distress is associated with privatization among public hospitals. We used panel data merged from the American Hospital Association Annual Survey, Medicare Cost Reports, Area Resource File, and Local Area Unemployment Statistics. Our study population consisted of all U.S. nonfederal acute care public hospitals in 1997 tracked through 2009, resulting in 6,426 hospital-year observations. The dependent variable "privatization" was defined as conversion from public status to either private not-for-profit or private for-profit status. The main independent variable, "financial distress," was based on the Altman Z-score methodology. Control variables included market and organizational factors. Two random-effects logistic regression models with state and year fixed-effects were constructed. The independent and control variables were lagged by 1 year and 2 years for Models 1 and 2, respectively. Public hospitals in financial distress had greater odds of being privatized than public hospitals not in financial distress: (OR = 4.53, p resources and may provide financial relief to government entities from the burden of continuously funding a hospital operating at a loss, which in turn may help keep the hospital open and preserve access to care for the community. Privatizing a financially distressed public hospital may be a better strategic alternative than closure. The Altman Z-score could be used as a managerial tool to monitor hospitals' financial condition and take corrective actions.

  13. Patterns of gender equality at workplaces and psychological distress. (United States)

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


    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

  14. Safety class methodology

    International Nuclear Information System (INIS)

    Donner, E.B.; Low, J.M.; Lux, C.R.


    DOE Order 6430.1A, General Design Criteria (GDC), requires that DOE facilities be evaluated with respect to ''safety class items.'' Although the GDC defines safety class items, it does not provide a methodology for selecting safety class items. The methodology described in this paper was developed to assure that Safety Class Items at the Savannah River Site (SRS) are selected in a consistent and technically defensible manner. Safety class items are those in the highest of four categories determined to be of special importance to nuclear safety and, merit appropriately higher-quality design, fabrication, and industrial test standards and codes. The identification of safety class items is approached using a cascading strategy that begins at the 'safety function' level (i.e., a cooling function, ventilation function, etc.) and proceeds down to the system, component, or structure level. Thus, the items that are required to support a safety function are SCls. The basic steps in this procedure apply to the determination of SCls for both new project activities, and for operating facilities. The GDC lists six characteristics of SCls to be considered as a starting point for safety item classification. They are as follows: 1. Those items whose failure would produce exposure consequences that would exceed the guidelines in Section 1300-1.4, ''Guidance on Limiting Exposure of the Public,'' at the site boundary or nearest point of public access 2. Those items required to maintain operating parameters within the safety limits specified in the Operational Safety Requirements during normal operations and anticipated operational occurrences. 3. Those items required for nuclear criticality safety. 4. Those items required to monitor the release of radioactive material to the environment during and after a Design Basis Accident. Those items required to achieve, and maintain the facility in a safe shutdown condition 6. Those items that control Safety Class Item listed above

  15. Language barriers in Hispanic patients: relation to upper-extremity disability. (United States)

    Menendez, Mariano E; Eberlin, Kyle R; Mudgal, Chaitanya S; Ring, David


    Although upper-extremity disability has been shown to correlate highly with various psychosocial aspects of illness (e.g., self-efficacy, depression, kinesiophobia, and pain catastrophizing), the role of language in musculoskeletal health status is less certain. In an English-speaking outpatient hand surgery office setting, we sought to determine (1) whether a patient's primary native language (English or Spanish) is an independent predictor of upper-extremity disability and (2) whether there are any differences in the contribution of measures of psychological distress to disability between native English- and Spanish-speaking patients. A total of 122 patients (61 native English speakers and 61 Spanish speakers) presenting to an orthopaedic hand clinic completed sociodemographic information and three Patient-Reported Outcomes Measurement Information System (PROMIS)-based computerized adaptive testing questionnaires: PROMIS Pain Interference, PROMIS Depression, and PROMIS Upper-Extremity Physical Function. Bivariate and multivariable linear regression modeling were performed. Spanish-speaking patients reported greater upper-extremity disability, pain interference, and symptoms of depression than English-speaking patients. After adjusting for sociodemographic covariates and measures of psychological distress using multivariable regression modeling, the patient's primary language was not retained as an independent predictor of disability. PROMIS Depression showed a medium correlation (r = -0.35; p Spanish-speaking patients. PROMIS Pain Interference had a large correlation with disability in both patient cohorts (Spanish-speaking: r = -0.66; p immigration to the USA did not correlate with disability among Spanish speakers. Primary language has less influence on symptom intensity and magnitude of disability than psychological distress and ineffective coping strategies. Interventions to optimize mood and to reduce pain interference should be considered in

  16. I-Love-Q to the extreme (United States)

    Silva, Hector O.; Yunes, Nicolás


    Certain bulk properties of neutron stars, in particular their moment of inertia, rotational quadrupole moment and tidal Love number, when properly normalized, are related to one another in a nearly equation of state independent way. The goal of this paper is to test these relations with extreme equations of state at supranuclear densities constrained to satisfy only a handful of generic, physically sensible conditions. By requiring that the equation of state be (i) barotropic and (ii) its associated speed of sound be real, we construct a piecewise function that matches a tabulated equation of state at low densities, while matching a stiff equation of state parametrized by its sound speed in the high-density region. We show that the I-Love-Q relations hold to 1 percent with this class of equations of state, even in the extreme case where the speed of sound becomes superluminal and independently of the transition density. We also find further support for the interpretation of the I-Love-Q relations as an emergent symmetry due to the nearly constant eccentricity of isodensity contours inside the star. These results reinforce the robustness of the I-Love-Q relations against our current incomplete picture of physics at supranuclear densities, while strengthening our confidence in the applicability of these relations in neutron star astrophysics.

  17. Web-Based Distress Management for Implantable Cardioverter Defibrillator Patients

    DEFF Research Database (Denmark)

    Habibović, Mirela; Denollet, Johan; Cuijpers, Pim


    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...... 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...

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

    DEFF Research Database (Denmark)

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


    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 were...... operated at the Breast Surgery Clinic of the Rigshospitalet, Copenhagen, were eligible for this study. Of these, 357 participated (84%) and 333 completed a questionnaire. The distress thermometer was evaluated against the 'hospital anxiety and depression scale' (HADS). We also examined the women's wish...

  19. Turnaround distressed physician practices. 20 tips for success. (United States)

    Wolper, L F


    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.

  20. [The Life Style Index: correlations with psychological distress and hostility]. (United States)

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


    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


    Directory of Open Access Journals (Sweden)

    Riesanti Edie Wijaya


    Full Text Available Voluntary disclosure meant giving information to public either about fi nancial or non-fi -nancial regarding the fi rm’s operations without any legal requirement (Fishman and Hagerty, 1997.Giving information about voluntary disclosure enables all the concerned parties obtaining more relevantinformation about the strategies and critical elements of the fi rms. In this study, we examinedthe impact of corporate governance and fi nancial distress condition on the level of voluntary informationdisclosure. This research used a sample of manufacture fi rms listed in Indonesian stockexchange. Based on data processing using sample above, we found that corporate governance andfi nancial distress could be associated with the voluntary disclosure level.

  2. XDGMM: eXtreme Deconvolution Gaussian Mixture Modeling (United States)

    Holoien, Thomas W.-S.; Marshall, Philip J.; Wechsler, Risa H.


    XDGMM uses Gaussian mixtures to do density estimation of noisy, heterogenous, and incomplete data using extreme deconvolution (XD) algorithms which is compatible with the scikit-learn machine learning methods. It implements both the astroML and Bovy et al. (2011) algorithms, and extends the BaseEstimator class from scikit-learn so that cross-validation methods work. It allows the user to produce a conditioned model if values of some parameters are known.

  3. Statistical Model of Extreme Shear

    DEFF Research Database (Denmark)

    Larsen, Gunner Chr.; Hansen, Kurt Schaldemose


    In order to continue cost-optimisation of modern large wind turbines, it is important to continously increase the knowledge on wind field parameters relevant to design loads. This paper presents a general statistical model that offers site-specific prediction of the probability density function...... by a model that, on a statistically consistent basis, describe the most likely spatial shape of an extreme wind shear event. Predictions from the model have been compared with results from an extreme value data analysis, based on a large number of high-sampled full-scale time series measurements...... are consistent, given the inevitabel uncertainties associated with model as well as with the extreme value data analysis. Keywords: Statistical model, extreme wind conditions, statistical analysis, turbulence, wind loading, statistical analysis, turbulence, wind loading, wind shear, wind turbines....

  4. Racial Extremism in the Army

    National Research Council Canada - National Science Library

    Hudson, Walter M


    ... modem phenomenon of "skinheads." I then discuss the history of white supremacist extremism in the Army, culminating in the December, 1995 murders of two black civilians by soldiers assigned to the 82d Airborne Division at Fort Bragg, North Carolina...

  5. Sexual Distress and Sexual Problems During Pregnancy: Associations With Sexual and Relationship Satisfaction. (United States)

    Vannier, Sarah A; Rosen, Natalie O


    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 sexual problem), sexual distress (Female Sexual Distress Scale; score ≥ 15 indicates clinically significant distress), sexual satisfaction (Global Measure of Sexual Satisfaction), and 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.

  6. Legacies from extreme drought increase ecosystem sensitivity to future extremes (United States)

    Smith, M. D.; Knapp, A.; Hoover, D. L.; Avolio, M. L.; Felton, A. J.; Wilcox, K. R.


    Climate extremes, such as drought, are increasing in frequency and intensity, and the ecological consequences of these extreme events can be substantial and widespread. Although there is still much to be learned about how ecosystems will respond to an intensification of drought, even less is known about the factors that determine post-drought recovery of ecosystem function. Such knowledge is particularly important because post-drought recovery periods can be protracted depending on the extent to which key plant populations, community structure and biogeochemical processes are affected. These drought legacies may alter ecosystem function for many years post-drought and may impact future sensitivity to climate extremes. We experimentally imposed two extreme growing season droughts in a central US grassland to assess the impacts of repeated droughts on ecosystem resistance (response) and resilience (recovery). We found that this grassland was not resistant to the first extreme drought due to reduced productivity and differential sensitivity of the co-dominant C4 grass (Andropogon gerardii) and C3 forb (Solidago canadensis) species. This differential sensitivity led to a reordering of species abundances within the plant community. Yet, despite this large shift in plant community composition, which persisted post-drought, the grassland was highly resilient post-drought, due to increased abundance of the dominant C4 grass. Because of this shift to increased C4 grass dominance, we expected that previously-droughted grassland would be more resistant to a second extreme drought. However, contrary to these expectations, previously droughted grassland was more sensitive to drought than grassland that had not experienced drought. Thus, our result suggest that legacies of drought (shift in community composition) may increase ecosystem sensitivity to future extreme events.

  7. Construction and preliminary validation of a dictionary for cognitive rigidity: linguistic markers of overconfidence and overgeneralization and their concomitant psychological distress. (United States)

    Cohen, Shuki J


    Fanaticism and extremism are increasingly recognized as seminal to psychopathology and distress, especially considering the increase in political unrest and violence over the last decade. In the psychopathological literature, however, the cognitive style associated with extremism and overgeneralization has long been recognized as a risk factor for emotional distress, leading to both externalizing behavior (e.g. aggression) and internalizing pathology (e.g. depression). Despite its recognized importance, however, virtually no standardized measures of this cognitive style exist. Since direct inquiry about a respondent's Cognitive Rigidity, is likely to be biased, a text-analytical measure of extremism in spontaneous autobiographical narratives is proposed. In contrast to self-reports, naturally occurring speech often suggests cognitive proclivities towards overgeneralization, overconfidence or extremization. In this study, spoken autobiographical narratives were elicited from 483 participants, and contrasted with extensive mental health information using a hierarchical concordanced-keyword technique. The resulting corpus-based dictionary is context-sensitive, and exhibits significant correlations with measures of negative emotionality, with minimal association with response bias measures.

  8. Global predictability of temperature extremes (United States)

    Coughlan de Perez, Erin; van Aalst, Maarten; Bischiniotis, Konstantinos; Mason, Simon; Nissan, Hannah; Pappenberger, Florian; Stephens, Elisabeth; Zsoter, Ervin; van den Hurk, Bart


    Extreme temperatures are one of the leading causes of death and disease in both developed and developing countries, and heat extremes are projected to rise in many regions. To reduce risk, heatwave plans and cold weather plans have been effectively implemented around the world. However, much of the world’s population is not yet protected by such systems, including many data-scarce but also highly vulnerable regions. In this study, we assess at a global level where such systems have the potential to be effective at reducing risk from temperature extremes, characterizing (1) long-term average occurrence of heatwaves and coldwaves, (2) seasonality of these extremes, and (3) short-term predictability of these extreme events three to ten days in advance. Using both the NOAA and ECMWF weather forecast models, we develop global maps indicating a first approximation of the locations that are likely to benefit from the development of seasonal preparedness plans and/or short-term early warning systems for extreme temperature. The extratropics generally show both short-term skill as well as strong seasonality; in the tropics, most locations do also demonstrate one or both. In fact, almost 5 billion people live in regions that have seasonality and predictability of heatwaves and/or coldwaves. Climate adaptation investments in these regions can take advantage of seasonality and predictability to reduce risks to vulnerable populations.

  9. Translation in ESL Classes

    Directory of Open Access Journals (Sweden)

    Nagy Imola Katalin


    Full Text Available The problem of translation in foreign language classes cannot be dealt with unless we attempt to make an overview of what translation meant for language teaching in different periods of language pedagogy. From the translation-oriented grammar-translation method through the complete ban on translation and mother tongue during the times of the audio-lingual approaches, we have come today to reconsider the role and status of translation in ESL classes. This article attempts to advocate for translation as a useful ESL class activity, which can completely fulfil the requirements of communicativeness. We also attempt to identify some activities and games, which rely on translation in some books published in the 1990s and the 2000s.

  10. Extremal black hole/CFT correspondence in (gauged) supergravities

    International Nuclear Information System (INIS)

    Chow, David D. K.; Cvetic, M.; Lue, H.; Pope, C. N.


    We extend the investigation of the recently proposed Kerr/conformal field theory correspondence to large classes of rotating black hole solutions in gauged and ungauged supergravities. The correspondence, proposed originally for four-dimensional Kerr black holes, asserts that the quantum states in the near-horizon region of an extremal rotating black hole are holographically dual to a two-dimensional chiral theory whose Virasoro algebra arises as an asymptotic symmetry of the near-horizon geometry. In fact, in dimension D there are [(D-1)/2] commuting Virasoro algebras. We consider a general canonical class of near-horizon geometries in arbitrary dimension D, and show that in any such metric the [(D-1)/2] central charges each imply, via the Cardy formula, a microscopic entropy that agrees with the Bekenstein-Hawking entropy of the associated extremal black hole. In the remainder of the paper we show for most of the known rotating black hole solutions of gauged supergravity, and for the ungauged supergravity solutions with four charges in D=4 and three charges in D=5, that their extremal near-horizon geometries indeed lie within the canonical form. This establishes that, in all these examples, the microscopic entropies of the dual conformal field theories agree with the Bekenstein-Hawking entropies of the extremal rotating black holes.



    Dr. K. Sravana Kumar


    The middle class is placed between labour and capital. It neither directly awns the means of production that pumps out the surplus generated by wage labour power, nor does it, by its own labour, produce the surplus which has use and exchange value. Broadly speaking, this class consists of the petty bourgeoisie and the white-collar workers. The former are either self-employed or involved in the distribution of commodities and the latter are non-manual office workers, supervisors and profession...

  12. Talking Class in Tehroon

    DEFF Research Database (Denmark)

    Elling, Rasmus Christian; Rezakhani, Khodadad


    Persian, like any other language, is laced with references to class, both blatant and subtle. With idioms and metaphors, Iranians can identify and situate others, and thus themselves, within hierarchies of social status and privilege, both real and imagined. Some class-related terms can be traced...... back to medieval times, whereas others are of modern vintage, the linguistic legacy of television shows, pop songs, social media memes or street vernacular. Every day, it seems, an infectious set of phrases appears that make yesterday’s seem embarrassingly antiquated....

  13. Lung recruitability is better estimated according to the Berlin definition of acute respiratory distress syndrome at standard 5 cm H2O rather than higher positive end-expiratory pressure: a retrospective cohort study. (United States)

    Caironi, Pietro; Carlesso, Eleonora; Cressoni, Massimo; Chiumello, Davide; Moerer, Onner; Chiurazzi, Chiara; Brioni, Matteo; Bottino, Nicola; Lazzerini, Marco; Bugedo, Guillermo; Quintel, Michael; Ranieri, V Marco; Gattinoni, Luciano


    The Berlin definition of acute respiratory distress syndrome has introduced three classes of severity according to PaO2/FIO2 thresholds. The level of positive end-expiratory pressure applied may greatly affect PaO2/FIO2, thereby masking acute respiratory distress syndrome severity, which should reflect the underlying lung injury (lung edema and recruitability). We hypothesized that the assessment of acute respiratory distress syndrome severity at standardized low positive end-expiratory pressure may improve the association between the underlying lung injury, as detected by CT, and PaO2/FIO2-derived severity. Retrospective analysis. Four university hospitals (Italy, Germany, and Chile). One hundred forty-eight patients with acute lung injury or acute respiratory distress syndrome according to the American-European Consensus Conference criteria. Patients underwent a three-step ventilator protocol (at clinical, 5 cm H2O, or 15 cm H2O positive end-expiratory pressure). Whole-lung CT scans were obtained at 5 and 45 cm H2O airway pressure. Nine patients did not fulfill acute respiratory distress syndrome criteria of the novel Berlin definition. Patients were then classified according to PaO2/FIO2 assessed at clinical, 5 cm H2O, or 15 cm H2O positive end-expiratory pressure. At clinical positive end-expiratory pressure (11±3 cm H2O), patients with severe acute respiratory distress syndrome had a greater lung tissue weight and recruitability than patients with mild or moderate acute respiratory distress syndrome (pBerlin definition of acute respiratory distress syndrome assessed at 5 cm H2O allows a better evaluation of lung recruitability and edema than at higher positive end-expiratory pressure clinically set.

  14. The YouTube Makeup Class (United States)

    Haase, David G.


    When a college instructor goes out of town and must miss a lecture, the standard options are to cancel the class meeting or to enlist a colleague to fill in. In the former case a teaching opportunity is lost; in the latter the substitute may not lead the class in the same way as the instructor. Some students routinely skip lectures by a guest instructor, in the belief that the material in the substitute lecture will not be covered on the exam. There are other makeup options such as a directed study assignment. For instance, a missed class is sometimes a good opportunity to require students to investigate web-based simulations such as Physlets® that illustrate the class topics. These are most effective if the students are given a clear structure and if there are questions that the students must answer from their investigations with the Physlets. But many students are more comfortable with the audio and visual communication that occurs in the classroom. Web 2.0 technology, e.g., YouTube (, makes it convenient for faculty to upload videos of lectures and demonstrations that can be used for makeup classes. College students already use YouTube for entertainment, and the YouTube format is simple to view on any web-connected computer. Although some universities have highly developed media delivery systems, YouTube is extremely convenient and accessible by anyone. This paper discusses how a YouTube makeup class can be efficiently produced and structured to be an effective learning experience.

  15. Correlates of psychological distress, burnout, and resilience among Chinese female nurses (United States)

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


    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

  16. 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.

    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

  17. Cleaved caspase-3 in lung epithelium of children who died with acute respiratory distress syndrome

    NARCIS (Netherlands)

    Bem, Reinout A.; van der Loos, Chris M.; van Woensel, Job B. M.; Bos, Albert P.


    OBJECTIVE: To investigate the extent of cleaved caspase-3 immunostaining in lung epithelial cells in children with acute respiratory distress syndrome. DESIGN: Observational study in sixteen children who died with acute respiratory distress syndrome and diffuse alveolar damage. SETTING: Pediatric

  18. 47 CFR 80.319 - Radiotelegraph distress call and message transmission procedure. (United States)


    ...) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Safety Watch Requirements and Procedures Distress, Alarm, Urgency and Safety Procedures § 80.319 Radiotelegraph distress call and message...

  19. Levels of Distress in Women With a Family History of Ovarian Cancer

    National Research Council Canada - National Science Library

    Kash, Kathryn


    The overall goal of this study is to determine the levels of distress in women with a family history of ovarian cancer and to identify the mediating factors between risk of developing ovarian cancer and distress...

  20. Psychological distress and mortality in systolic heart failure

    DEFF Research Database (Denmark)

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


    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...

  1. Damsel in distress : de werk-zorg spagaat

    NARCIS (Netherlands)

    Nossent, S.; Blijswijk, M. van; Steentjes, A.


    Een grote opdracht, een zoontje met een gebroken been en een medewerkster met een hoog ziekteverzuim. Hoe kan een vrouwelijke ondernemer die hier mee te maken krijgt, een goede balans tussen zorg en werk behouden? Over de dilemma's van deze 'damsel in distress' (=belaagde jonkvrouw) buigen zich: een

  2. Emotional distress among caregivers of patients with epilepsy in ...

    African Journals Online (AJOL)

    Objective: Caregivers of patients with epilepsy experience considerable emotional distress. The study aimed to assess the magnitude of the problem in a developing country. Method: A total 166 patients-caregivers were enrolled for the study. They were interviewed using a socio-demographic data collecting sheet and the ...

  3. Post partum emotional distress in mothers of preterm infants: a ...

    African Journals Online (AJOL)

    More mothers of preterm neonates(27.3%) had GHQ-30 scores which categorised them as having significant emotional distress than mothers of full term normal infants(3.7%). Similarly more mothers of preterm neonates(15.1%) were more depressed than mothers of full term normal infants(3.7%). These differences were ...

  4. Commonly used stimulants: Sleep problems, dependence and psychological distress. (United States)

    Ogeil, Rowan P; Phillips, James G


    Caffeine and nicotine are commonly used stimulants that enhance alertness and mood. Discontinuation of both stimulants is associated with withdrawal symptoms including sleep and mood disturbances, which may differ in males and females. The present study examines changes in sleep quality, daytime sleepiness and psychological distress associated with use and dependence on caffeine and nicotine. An online survey comprising validated tools to assess sleep quality, excessive daytime sleepiness and psychological distress was completed by 166 participants (74 males, 96 females) with a mean age of 28 years. Participants completed the study in their own time, and were not offered any inducements to participate. Sleep quality was poorer in those dependent upon caffeine or nicotine, and there were also significant interaction effects with gender whereby females reported poorer sleep despite males reporting higher use of both stimulants. Caffeine dependence was associated with poorer sleep quality, increased daytime dysfunction, and increased levels of night time disturbance, while nicotine dependence was associated with poorer sleep quality and increased use of sleep medication and sleep disturbances. There were strong links between poor sleep and diminished affect, with psychological distress found to co-occur in the context of disturbed sleep. Stimulants are widely used to promote vigilance and mood; however, dependence on commonly used drugs including caffeine and nicotine is associated with decrements in sleep quality and increased psychological distress, which may be compounded in female dependent users. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  5. Life-course pathways to psychological distress: a cohort study. (United States)

    von Stumm, Sophie; Deary, Ian J; Hagger-Johnson, Gareth


    Early life factors, like intelligence and socioeconomic status (SES), are associated with health outcomes in adulthood. Fitting comprehensive life-course models, we tested (1) the effect of childhood intelligence and SES, education and adulthood SES on psychological distress at midlife, and (2) compared alternative measurement specifications (reflective and formative) of SES. Prospective cohort study (the Aberdeen Children of the 1950s). Aberdeen, Scotland. 12 500 live-births (6282 boys) between 1950 and 1956, who were followed up in the years 2001-2003 at age 46-51 with a postal questionnaire achieving a response rate of 64% (7183). Psychological distress at age 46-51 (questionnaire). Childhood intelligence and SES and education had indirect effects on psychological distress at midlife, mediated by adult SES. Adult SES was the only variable to have a significant direct effect on psychological distress at midlife; the effect was stronger in men than in women. Alternative measurement specifications of SES (reflective and formative) resulted in greatly different model parameters and fits. Even though formative operationalisations of SES are theoretically appropriate, SES is better specified as reflective than as a formative latent variable in the context of life-course modelling.

  6. Effect of Social Intolerance on Psychological Distress in Cardiac Patients

    International Nuclear Information System (INIS)

    Zonash, R.; Arouj, K.


    Background: The patients with diverse cardiac issues and physical illness experience different levels of social intolerance, depression, anxiety and stress. Objectives: To explore the relationship between social intolerance and psychological distress among cardiac patients and investigate the effect of different type of cardiac illness, its duration and physical symptoms on social intolerance and psychological distress. Study design, settings and duration: Cross-sectional study, conducted at Benazir Bhutto Hospital (BBH), Rawalpindi Institute of Cardiology (RIC), Hearts International Hospital (HIH) and Pakistan Institute of Medical Sciences (PIMS) from September-December, 2014. Patients and Methods: The sample size of 180 adult cardiac patients was collected. These patients were selected from the cardiac units of 4 hospitals of Rawalpindi using purposive sampling. Social intolerance was assessed using Frustration Discomfort Scale (FDS), distress was assessed using depression anxiety and stress scale (DASS) Results: Out of 180 patients, 53.3 percent were males and 46.7 percent females. Their ages ranged from 20 to 60 years. Results revealed significant discomfort intolerance, (p < 0.01) entitlement (p < 0.05) and emotional intolerance (p < 0.01) in these patients. There was 45 percent variance in depression, while discomfort intolerance (p < 0.01) and achievement frustration (p< 0.01) showed 35 percent variance in anxiety. Conclusion: Cardiac patients suffer from major emotional distress.(author)

  7. Maternal distress and parenting in the context of cumulative disadvantage. (United States)

    Arditti, Joyce; Burton, Linda; Neeves-Botelho, Sara


    This article presents an emergent conceptual model of the features and links between cumulative disadvantage, maternal distress, and parenting practices in low-income families in which parental incarceration has occurred. The model emerged from the integration of extant conceptual and empirical research with grounded theory analysis of longitudinal ethnographic data from Welfare, Children, and Families: A Three-City Study. Fourteen exemplar family cases were used in the analysis. Results indicated that mothers in these families experienced life in the context of cumulative disadvantage, reporting a cascade of difficulties characterized by neighborhood worries, provider concerns, bureaucratic difficulties, violent intimate relationships, and the inability to meet children's needs. Mothers, however, also had an intense desire to protect their children, and to make up for past mistakes. Although, in response to high levels of maternal distress and disadvantage, most mothers exhibited harsh discipline of their children, some mothers transformed their distress by advocating for their children under difficult circumstances. Women's use of harsh discipline and advocacy was not necessarily an "either/or" phenomenon as half of the mothers included in our analysis exhibited both harsh discipline and care/advocacy behaviors. Maternal distress characterized by substance use, while connected to harsh disciplinary behavior, did not preclude mothers engaging in positive parenting behaviors.

  8. Bank distress, consolidation and economic development in Nigeria ...

    African Journals Online (AJOL)

    The role of the banking sector in the economic development of any country cannot be over emphasized. Inter alia, the ... This paper takes an overview of the phenomenon of bank distress coupled with its attendant causes as well as the recent banking consolidation initiative spear-headed by the Central Bank of Nigeria.

  9. Pregnancy Loss and Distress among U.S. Women (United States)

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


    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…


    Directory of Open Access Journals (Sweden)

    Isnalita Isnalita


    Full Text Available This research aim to determine the effect of independent commissioner and institutional ownershipto financial distress banks in Indonesia. The existence of the banking crisis occurred in 1997/1998resulted the collapse of public confidence in banking industry. In 2008, the scale, pattern, anda different scope, we face the reality that seems similar to the condition of the banks in the endof 1997. Financial distress experienced is not only caused by external factors stemming fromthe bank but also can be caused by internal factors. On the other hand, the financial distress inthe banking sector can be caused by governance are not good in running the bank’s operations.This study used a quantitative approach. The unit of analysis is the banks in Indonesia with dataobtained from directory of Bank Indonesia in 2008-2009. The research sampling techniques use saturated sampling or census. Research design use multiple logistic regression with the cross section. The result from this study indicated that independent commissioners and institutionalownership cannot prevent the financial distress in 2008 and 2009.

  11. A study of personality And psychological distress among delusional ...

    African Journals Online (AJOL)

    An assessment of personality and psychological distress of people living with delusional halitosis attending Oral Wellness Centre (OWC) at the University of Benin Teaching Hospital, Benin City over a six-month period was undertaken. Five (5) patients with age range of 18-30 years and a mean age of 24 years (SD = 4.47) ...

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

    NARCIS (Netherlands)

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


    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


    Directory of Open Access Journals (Sweden)

    Tiara Widya Antikasari


    Full Text Available In this globalization era, sub–sector telecommunication industry has rapid development as time goes by with the number of customers’ growth. However, its growth is not balanced with operational revenue development. Therefore, it is important to analyze the financial distress in telecommunication companies in order to avoid bankruptcy. This research aimed to investigate the effect of financial ratios to predict probability of financial distress. Financial ratios indicator used profitability ratio, liquidity ratio, activity ratio, and leverage ratio. The population in this research was telecommunication companies listed in the Indonesia Stock Exchange periods 2009-2016. Based on purposive sampling method, the criteria of financial distress in this study was measured by using net operation negative two years, while statistic analysis used was logistic regression with a significance level of 10%. The result was that liquidity ratio (current ratio and activity ratio (total asset turnover ratio had a negative significant value, and profitability ratio(return on asset and leverage ratio (debt to total asset had positive significant value to predict financial distress.

  14. Adolescent Mental Health: Neighborhood Stress and Emotional Distress (United States)

    Snedker, Karen A.; Herting, Jerald R.


    The purpose of this article is to explore the role of neighborhood characteristics, specifically economic disadvantage/advantage, residential instability, and racial/ethnic heterogeneity on emotional distress (depressed affect, anxiety, hopelessness) among youth. Using a regional sample of adolescents and matching their data to census tracts, we…

  15. Distress Behavior in Children With Leukemia Undergoing Medical Procedures. (United States)

    Katz, Ernest R.

    Improving prognosis for many forms of childhood cancer has resulted in increased attention on the quality-of-life experience. Conditioned anxiety and pain associated with recurrent diagnostic and treatment procedures have been identified as major sources of distress in children with malignant disease. To evaluate the efficacy of various…

  16. Children's Memories for Painful Cancer Treatment Procedures: Implications for Distress. (United States)

    Chen, Edith; Zeltzer, Lonnie K.; Craske, Michelle G.; Katz, Ernest R.


    Examined memory of 3- to 18-year-olds with leukemia regarding lumbar punctures (LP). Found that children displayed considerable accuracy for event details, with accuracy increasing with age. Use of Versed (anxiolytic medication described as a "memory blocker") was not related to recall. Higher distress predicted greater exaggerations in…

  17. Social Isolation, Depression, and Psychological Distress Among Older Adults. (United States)

    Taylor, Harry Owen; Taylor, Robert Joseph; Nguyen, Ann W; Chatters, Linda


    To investigate the impact of objective and subjective social isolation from extended family members and friends on depressive symptoms and psychological distress among a national sample of older adults. Data for older adults (55 years and above) from the National Survey of American Life ( N = 1,439) were used to assess level of objective social isolation and subjective social isolation and to test regression models examining their impact on depressive symptoms (Center for Epidemiologic Studies Depression [CES-D] Scale) and psychological distress (Kessler 6 [K6] Scale). The majority of respondents were not socially isolated from family or friends; 5% were objectively isolated from family and friends, and less than 1% were subjectively isolated from family and friends. Regression analyses using both social isolation measures indicated that objective social isolation was unrelated to depressive symptoms and psychological distress. However, subjective social isolation from both family and friends and from friends only was associated with more depressive symptoms, and subjective social isolation from friends only was associated with higher levels of psychological distress. Assessments of social isolation among older populations should account for both subjective and objective dimensions, as well as both family and friend social networks. Social isolation from friends is an important, but understudied, issue that has significant consequences for older adult mental health.

  18. Slow dissolving of emotional distress contributes to hyperarousal. (United States)

    Wassing, Rick; Benjamins, Jeroen S; Dekker, Kim; Moens, Sarah; Spiegelhalder, Kai; Feige, Bernd; Riemann, Dieter; van der Sluis, Sophie; Van Der Werf, Ysbrand D; Talamini, Lucia M; Walker, Matthew P; Schalkwijk, Frans; Van Someren, Eus J W


    The mechanisms underlying hyperarousal, the key symptom of insomnia, have remained elusive, hampering cause-targeted treatment. Recently, restless rapid-eye-movement (REM) sleep emerged as a robust signature of sleep in insomnia. Given the role of REM sleep in emotion regulation, we hypothesized that restless REM sleep could interfere with the overnight resolution of emotional distress, thus contributing to accumulation of arousal. Participants (n = 1,199) completed questionnaires on insomnia severity, hyperarousal, self-conscious emotional distress, and thought-like nocturnal mentation that was validated to be a specific proxy for restless REM sleep (selective fragmentation: R = 0.57, P insomnia severity (β = 0.29, P Insomnia severity was associated with hyperarousal (β = 0.47, P insomnia was mediated specifically by reduced overnight resolution of emotional distress. The model outperformed all alternative mediation pathways. The findings suggest that restless REM sleep reflects a process that interferes with the overnight resolution of distress. Its accumulation may promote the development of chronic hyperarousal, giving clinical relevance to the role of REM sleep in emotion regulation in insomnia, depression, and posttraumatic stress disorder.

  19. Psychological Distress in Refugee Children: A Systematic Review (United States)

    Bronstein, Israel; Montgomery, Paul


    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…

  20. 29 CFR 4041.45 - Distress termination notice. (United States)


    ..., 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 for...

  1. Emotional distress in Angolan patients with several types of ...

    African Journals Online (AJOL)

    Married subjects, a diagnosis of extra-pulmonary TB and multidrug resistant TB were related to ... Female gender and cases of extra-pulmonary TB presented a 1.5 times risk for emotional distress. ..... and perceptions in the US-Mexico border.

  2. Post partum emotional distress in mothers of preterm infants: a ...

    African Journals Online (AJOL)

    Objectives: To investigate whether mothers of preterm infants experience more psychological distress than mothers of normal full term infants in the immediate postpartum period. Design: Cross sectional prospective study of postpartal women using the Beck Depression Inventory(BDI) and the GHQ-30. Setting: Neonatal ...

  3. Khat Chewing and Mental Distress: A Community Based Study, in ...

    African Journals Online (AJOL)

    BACKGROUND: Khat (Catha edulis) contains a psychoactive substance, cathinone, which produces central nervous system stimulation analogous to amphetamine. It is believed that ... Using cut-off point 7 out of 20 on the Self Reporting Questionnaire-20, 25.8% of the study population was found to have mental distress.

  4. Generational differences in distress, attitudes and incivility among nurses. (United States)

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


    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.


    Directory of Open Access Journals (Sweden)

    Triani Pujiastuti


    Full Text Available Based on theory and previous research, some factors which influenced probability of corporate financialdistress were found. This research was done for testing the consistency of research result with different researchperiod that would strengthen the related empirical research finding. The purpose of this research was to test theimpact of profitability ratio (Return on Assets, working capital policy, capital structure, size, current ratioand firm age toward the probability of financial distress of manufacturing firms at Indonesian Stock Exchange.The method used in this research was purposive sampling, which was taking data with certain criteria.The criteria was that the companies or firms used were those which issued bond and were listed in IndonesianStock Exchange between 2007 until 2012 and had data completion needed in this research. The research resultsusing Logistic Regression were 1 test of profitability ratio, working capital policy ratio, capital structure, size,and firm age had significant influence to the probability of financial distress manufacturing firms in Indonesia,2 partially only profitability ratio that had negative significant influence to the probability of financialdistress manufacturing firms in Indonesia while working capital ratio, capital structure, size, and age firm didnot have significant influence to financial distress manufacturing firms in Indonesia. This research producedprediction model of financial distress.

  6. Dual Minority Stress and Asian American Gay Men's Psychological Distress (United States)

    Chen, Yung-Chi; Tryon, Georgiana Shick


    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…

  7. Ideologies and Discourses: Extreme Narratives in Extreme Metal Music

    Directory of Open Access Journals (Sweden)

    Bojana Radovanović


    Full Text Available Historically speaking, metal music has always been about provoking a strong reaction. Depending on the characteristics of different sub-genres, one can focus on the sound, technique, visual appearance, and furthermore, the ideologies and ideas that are the foundation for each of the sub-genres. Although the majority of the metal community rejects accusations of being racially intolerant, some ideologies of extreme sub-genres (such as black metal are in fact formed around the ideas of self-conscious elitism expressed through interest in pagan mythology, racism, Nazism and fascism. There has been much interest in the Nazi era within the extreme metal scene thus influencing other sub-genres and artists. The aim of this paper is to examine various appearances of extreme narratives such as Nazism and racism in  different sub-genres of metal, bearing in mind variations dependent on geographical, political, and other factors.

  8. Ethnic heterogeneity, social capital and psychological distress in Sweden. (United States)

    Johnson-Singh, Charisse M; Rostila, Mikael; Ponce de Leon, Antonio; Forsell, Yvonne; Engström, Karin


    Ethnic heterogeneity has been linked to both protective and detrimental effects on mental health. Few studies have investigated the role of social capital in this relationship and none have found that it has an explanatory role. The aim of this study is to investigate the relationship between two measures of ethnic heterogeneity and psychological distress in Stockholm County, as well as the explanatory role of social capital for individuals with Swedish-background, foreign-background and those who are foreign-born. This study used data collected from respondents aged 18-64 to the 2002, 2006, 2010 baseline questionnaires of the Stockholm Public Health Cohort and was linked with individual and area-level register information. Ethnic heterogeneity was the main exposure, measured by: 1) ethnic density, defined as the proportion of first and second generation immigrants with 2 foreign-born parents; and 2) ethnic diversity, using the fragmentation index. Social capital measures of individual and contextual-level social support and horizontal trust were the main explanatory factors of interest. The outcome, psychological distress, was assessed using the General Health Questionnaire-12 with a 2/3 cut-off. Prevalence ratios with 95% confidence intervals were estimated using multi-level poisson regression with robust variances. Age and sex adjusted analyses for the whole study population demonstrated that a 10% increase in ethnic density or diversity was associated with a 1.06 (1.05-1.07) times higher prevalence of psychological distress. In the stratified analyses, both foreign-born respondents and those with Swedish-background showed increasing prevalence of psychological distress with increasing ethnic heterogeneity. However, this trend was entirely explained by socioeconomic factors in the Swedish-background respondents and by additional adjustments for individual and contextual social support and horizontal trust for the foreign-born. Further adjustment for contextual

  9. Depression, psychological distress, and quality of life in patients with cardioverter defibrillator with or without cardiac resynchronization therapy. (United States)

    Knackstedt, Christian; Arndt, Marlies; Mischke, Karl; Marx, Nikolaus; Nieman, Fred; Kunert, Hanns Jürgen; Schauerte, Patrick; Norra, Christine


    Congestive heart failure is frequent and leads to reduced exercise capacity, reduced quality of life (QoL), and depression in many patients. Cardiac resynchronization therapy (CRT) and implantable cardioverter defibrillators (ICD) offer therapeutic options and may have an impact on QoL and depression. This study was performed to evaluate physical and mental health in patients undergoing ICD or combined CRT/ICD-implantation (CRT-D). Echocardiography, spiroergometry, and psychometric questionnaires [Beck Depression Inventory, General World Health Organization Five Well-being Index (WHO-5), Brief Symptom Inventory and 36-item Short Form (SF-36)] were obtained in 39 patients (ICD: 17, CRT-D: 22) at baseline and 6-month follow-up (FU) after device implantation. CRT-D patients had a higher NYHA class and broader left bundle branch block than ICD patients at baseline. At FU, ejection fraction (EF), peak oxygen uptake, and NYHA class improved significantly in CRT-D patients but remained unchanged in ICD patients. Patients with CRT-D implantation showed higher levels of depressive symptoms, psychological distress, and impairment in QoL at baseline and FU compared to ICD patients. These impairments remained mostly unchanged in all patients after 6 months. Overall, these findings imply that there is a need for careful assessment and treatment of psychological distress and depression in ICD and CRT-D patients in the course of device implantation as psychological burden seems to persist irrespective of physical improvement.

  10. Assessment of health-related quality of life, mental health status and psychological distress based on the type of pharmacotherapy used among patients with depression. (United States)

    Shah, Drishti; Vaidya, Varun; Patel, Amit; Borovicka, Mary; Goodman, Monica-Holiday


    Effectiveness of antidepressants is generally comparable between and within classes. However, real-world studies on antidepressant treatment and its consequences on the overall quality of life and mental health of individuals are limited. The purpose of this study was to examine the association of specific class of antidepressants with the health-related quality of life, psychological distress and self-reported mental health of individuals suffering from depression who are on monotherapy. This retrospective, longitudinal study included individuals with depression who were on antidepressant monotherapy, using data from 2008 to 2011 Medical Expenditure Panel Survey (MEPS). Changes in health-related quality of life, self-reported mental health and psychological distress over a year's time were observed. A multinomial logistic regression model was built to examine the association between the class of antidepressant medications and the dependent variables. A total of 688 adults met the study inclusion criteria. No significant difference was observed in the change in Physical Component Summary (PCS), self-reported mental health and psychological distress based on the class of antidepressants. However, individuals on serotonin-norepinephrine reuptake inhibitors (SNRIs) (OR 0.337, 95 % CI 0.155-0.730) were significantly less likely to show improvement on Mental Component Summary (MCS) scores as compared to those on selective serotonin reuptake inhibitors (SSRIs). The study findings suggest that practitioners should be aware of the differences in the health-related quality of life of those taking SSRIs versus other classes of antidepressants. Further research needs to be done to determine the reason for SSRIs to show greater improvement on mental health as compared to SNRIs.


    International Nuclear Information System (INIS)

    Norris, John E.; Yong, David; Gilmore, Gerard; Wyse, Rosemary F. G.; Frebel, Anna


    We report the analysis of high-resolution, high signal-to-noise ratio, spectra of an extremely metal-poor, extremely C-rich red giant, Seg 1-7, in Segue 1-described in the literature alternatively as an unusually extended globular cluster or an ultra-faint dwarf galaxy. The radial velocity of Seg 1-7 coincides precisely with the systemic velocity of Segue 1, and its chemical abundance signature of [Fe/H] = -3.52, [C/Fe] = +2.3, [N/Fe] = +0.8, [Na/Fe] = +0.53, [Mg/Fe] = +0.94, [Al/Fe] = +0.23, and [Ba/Fe] < -1.0 is similar to that of the rare and enigmatic class of Galactic halo objects designated CEMP-no (carbon-rich, extremely metal-poor with no enhancement (over solar ratios) of heavy neutron-capture elements). This is the first star in a Milky Way 'satellite' that unambiguously lies on the metal-poor, C-rich branch of the Aoki et al. bimodal distribution of field halo stars in the ([C/Fe], [Fe/H])-plane. Available data permit us only to identify Seg 1-7 as a member of an ultra-faint dwarf galaxy or as debris from the Sgr dwarf spheroidal galaxy. In either case, this demonstrates that at extremely low abundance, [Fe/H ] <-3.0, star formation and associated chemical evolution proceeded similarly in the progenitors of both the field halo and satellite systems. By extension, this is consistent with other recent suggestions that the most metal-poor dwarf spheroidal and ultra-faint dwarf satellites were the building blocks of the Galaxy's outer halo.

  12. Modelling of extreme minimum rainfall using generalised extreme value distribution for Zimbabwe

    Directory of Open Access Journals (Sweden)

    Delson Chikobvu


    Full Text Available We modelled the mean annual rainfall for data recorded in Zimbabwe from 1901 to 2009. Extreme value theory was used to estimate the probabilities of meteorological droughts. Droughts can be viewed as extreme events which go beyond and/or below normal rainfall occurrences, such as exceptionally low mean annual rainfall. The duality between the distribution of the minima and maxima was exploited and used to fit the generalised extreme value distribution (GEVD to the data and hence find probabilities of extreme low levels of mean annual rainfall. The augmented Dickey Fuller test confirmed that rainfall data were stationary, while the normal quantile-quantile plot indicated that rainfall data deviated from the normality assumption at both ends of the tails of the distribution. The maximum likelihood estimation method and the Bayesian approach were used to find the parameters of the GEVD. The Kolmogorov-Smirnov and Anderson-Darling goodnessof- fit tests showed that the Weibull class of distributions was a good fit to the minima mean annual rainfall using the maximum likelihood estimation method. The mean return period estimate of a meteorological drought using the threshold value of mean annual rainfall of 473 mm was 8 years. This implies that if in the year there is a meteorological drought then another drought of the same intensity or greater is expected after 8 years. It is expected that the use of Bayesian inference may better quantify the level of uncertainty associated with the GEVD parameter estimates than with the maximum likelihood estimation method. The Markov chain Monte Carlo algorithm for the GEVD was applied to construct the model parameter estimates using the Bayesian approach. These findings are significant because results based on non-informative priors (Bayesian method and the maximum likelihood method approach are expected to be similar.

  13. Second class weak currents

    International Nuclear Information System (INIS)

    Delorme, J.


    The definition and general properties of weak second class currents are recalled and various detection possibilities briefly reviewed. It is shown that the existing data on nuclear beta decay can be consistently analysed in terms of a phenomenological model. Their implication on the fundamental structure of weak interactions is discussed [fr

  14. World Class Teachers. (United States)

    Mitchell, Rosalita


    School communities are challenged to find ways to identify good teachers and give other teachers a chance to learn from them. The New Mexico World Class Teacher Project is encouraging teachers to pursue certification by the National Board for Professional Teaching Standards. This process sharpens teachers' student assessment skills and encourages…

  15. EPA Web Training Classes (United States)

    Scheduled webinars can help you better manage EPA web content. Class topics include Drupal basics, creating different types of pages in the WebCMS such as document pages and forms, using Google Analytics, and best practices for metadata and accessibility.

  16. Class Actions in Denmark

    DEFF Research Database (Denmark)

    Werlauff, Erik


    The article deals with the relatively new Danish Act on Class Action (Danish: gruppesøgsmål) which was suggested by The Permanent Council on Civil procedure (Retsplejerådet) of which the article's author is a member. The operability of the new provisions is illustrated through some wellknown Danish...

  17. Working Together in Class

    Directory of Open Access Journals (Sweden)

    Pateşan Marioara


    Full Text Available The scores obtained by the military students are very important as a lot of opportunities depend on them: the choice of the branch, selection for different in and off-campus activities, the appointment to the workplace and so on. A qualifier, regardless of its form of effective expression, can make a difference in a given context of issuing a value judgment, in relation to the student's performance assessment. In our research we tried to find out what motives students, what determines them to get actively involved in the tasks they are given and the ways we can improve their participation in classes and assignments. In order to have an educated generation we need to have not only well prepared teachers but ones that are open-minded, flexible and in pace with the methodological novelties that can improve the teaching learning process in class. Along the years we have noticed that in classes where students constituted a cohesive group with an increasing degree of interaction between members, the results were better than in a group that did not appreciate team-work. In this article we want to highlight the fact that a teacher can bring to class the appropriate methods and procedures can contribute decisively to the strengthening of the group cohesion and high scores.

  18. Adeus à classe trabalhadora?

    Directory of Open Access Journals (Sweden)

    Geoff Eley


    Full Text Available No início da década de 1980, a política centrada em classes da tradição socialista estava em crise, e comentadores importantes adotaram tons apocalípticos. No final da década, a esquerda permanecia profundamente dividida entre os advogados da mudança e os defensores da fé. Em meados dos anos 1990, os primeiros tinham, de modo geral, ganhado a batalha. O artigo busca apresentar essa mudança contemporânea não como a 'morte da classe', mas como o desa­parecimento de um tipo particular de ­sociedade de classes, marcado pelo ­processo de formação da classe trabalhadora entre os anos 1880 e 1940 e pelo alinhamento político daí resultante, atingindo seu apogeu na construção social-democrata do acordo do pós-guerra. Quando mudanças de longo prazo na economia se combinaram com o ataque ao keynesianismo na política de recessão a partir de meados da década de 1970, a unidade da classe trabalhadora deixou de estar disponível da forma antiga e bastante utilizada, como o terreno natural da política de esquerda. Enquanto uma coletividade dominante da classe trabalhadora entrou em declínio, outra se corporificou de modo lento e desigual para tomar o lugar daquela. Mas a unidade operacional dessa nova agregação da classe trabalhadora ainda está, em grande parte, em formação. Para recuperar a eficácia política da tradição socialista, alguma nova visão de agência política coletiva será necessária, uma visão imaginativamente ajustada às condições emergentes da produção e acumulação capitalista no início do século XXI.

  19. Future doctors : Mental distress during medical education: cross-sectional and longitudinal studies


    Dahlin, Marie


    Medical education is long and stressful and medical students may suffer from mental distress. The aims of this dissertation are threefold; to investigate levels of distress in medical students at one Swedish medical school, to examine gender differences in such distress and to study individual and environmental determinants of distress. Major outcome measures were self-rated depression, burnout and interviewer-rated psychiatric morbidity. The thesis consists of two cross-sec...

  20. Genetics Home Reference: paroxysmal extreme pain disorder (United States)

    ... include changes in temperature (such as a cold wind) and emotional distress as well as eating spicy ... find a genetics professional in my area? Other Names for This Condition familial rectal pain PEPD PEXPD ...

  1. Psychometric evaluation of the HIV symptom distress scale (United States)

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


    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

  2. Unemployment and psychological distress one year after childbirth in France. (United States)

    Saurel-Cubizolles, M J; Romito, P; Ancel, P Y; Lelong, N


    To analyse the relation between unemployment and the psychological distress of mothers one year after childbirth. Multicentric survey concerning births occurring between September 1993 and July 1994. In France: two maternity units in the Parisian area and one in Champagne-Ardennes, in the east of France, comprising both urban and rural areas. Primipara and secondipara women were interviewed three times: at birth by a face to face interview, five months and 12 months after the birth, by postal questionnaires, with a 83% response rate for the two postal questionnaires. The analysis includes 632 women who answered all three stages of the survey. Psychological distress was mainly assessed one year after birth by the 12-item General Health Questionnaire. After adjustment for unwanted pregnancy, marital conflicts, marital status, hospitalisation of the baby during the last year, lack of confiding relationship, depressive or anxious troubles before pregnancy, age, educational level and parity, unemployed women had an excess of psychological distress compared with employed women (OR = 1.87; 95% CI = 1.12, 3.13). The ratios for housewives were very close to those of employed women. Among the unemployed women, 60% had recently been without a job, since a few months before or after the birth. An excess of psychological distress among unemployed compared with employed women was observed in all social groups defined by the current or last occupation, but with various extents. Psychological distress was specially linked to the employment status in the group of women with the more qualified occupations. Even after a birth, when women are very much involved in their maternal role, those seeking a job have worse mental health than those in a stable situation, either employed or housewives. In France, the unemployment rate among young women is high. It is specially important that social regulations protecting employment during and after pregnancy are adequately applied. Employers

  3. Outcome of neonates with idiopathic respiratory distress syndrome; where do we go wrong?

    Directory of Open Access Journals (Sweden)

    MBKC Dayasiri


    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.

  4. 47 CFR 80.1119 - Receipt and acknowledgement of distress alerts by coast stations and coast earth stations. (United States)


    ... COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Global Maritime Distress and Safety System (GMDSS) Operating Procedures for Distress and Safety Communications...

  5. A Comparison of High- and Low-Distress Marriages that End in Divorce (United States)

    Amato, Paul R.; Hohmann-Marriott, Bryndl


    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…

  6. 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.


    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

  7. Psychological Distress among Nursing, Physiotherapy and Occupational Therapy Students: A Longitudinal and Predictive Study (United States)

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


    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…

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

    Directory of Open Access Journals (Sweden)

    Ayumi Honda


    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.

  9. Lifestyle and Mental Health Correlates of Psychological Distress in College Students (United States)

    Knowlden, Adam P.; Hackman, Christine L.; Sharma, Manoj


    Objective: College students are at an increased risk of mental distress. The purpose of this study was to determine whether mental and lifestyle factors differed according to self-reported levels of psychological distress. Design and setting: A self-report questionnaire comprising the Kessler-6 Psychological Distress Scale, Revised Life…

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

    LENUS (Irish Health Repository)

    O'Connor, Mairead


    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.

  11. Differences in Psychological Distress and Esteem Based on Sexual Identity Development (United States)

    Shepler, Dustin; Perrone-McGovern, Kristin


    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,…

  12. 47 CFR 80.320 - Radiotelephone distress call and message transmission procedure. (United States)


    ... by its call sign or name, to permit direction-finding stations to determine its position. This... 47 Telecommunication 5 2010-10-01 2010-10-01 false Radiotelephone distress call and message... Procedures Distress, Alarm, Urgency and Safety Procedures § 80.320 Radiotelephone distress call and message...

  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


    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

  14. Elite sport is not an additional source of distress for adolescents with high stress levels. (United States)

    Gerber, Markus; Holsboer-Trachsler, Edith; Pühse, Uwe; Brand, Serge


    This study examined whether participation in elite sport interacts with stress in decreasing or increasing symptoms of depression and anxiety among adolescents, and further, whether the interplay between participation in high-performance sport and stress is related to the perceived quality of sleep. 434 adolescents (278 girls, 156 boys; age: M = 17.2 yr.) from 15 "Swiss Olympic Sport Classes" and 9 conventional classes answered a questionnaire and completed a 7-day sleep log. Analyses of covariance showed that heightened stress was related to more depressive symptoms and higher scores for trait-anxiety. Moreover, those classified as having poor sleep by a median split cutoff reported higher levels of depressive symptoms. No significant (multivariate) main effects were found for high-performance sport athletes. Similarly, no significant two- or three-way interaction effects were found. These results caution against exaggerated expectations concerning sport participation as a stress buffer. Nevertheless, participation in high-performance sport was not found to be an additional source of distress for adolescents who reported high stress levels despite prior research that has pointed toward such a relationship.

  15. Seasonal temperature extremes in Potsdam (United States)

    Kundzewicz, Zbigniew; Huang, Shaochun


    The awareness of global warming is well established and results from the observations made on thousands of stations. This paper complements the large-scale results by examining a long time-series of high-quality temperature data from the Secular Meteorological Station in Potsdam, where observation records over the last 117 years, i.e., from January 1893 are available. Tendencies of change in seasonal temperature-related climate extremes are demonstrated. "Cold" extremes have become less frequent and less severe than in the past, while "warm" extremes have become more frequent and more severe. Moreover, the interval of the occurrence of frost has been decreasing, while the interval of the occurrence of hot days has been increasing. However, many changes are not statistically significant, since the variability of temperature indices at the Potsdam station has been very strong.

  16. Lymphoscintigraphy of the lower extremity

    International Nuclear Information System (INIS)

    Abbasi, N.Z.


    Fifty one lower extremities of 26 normal healthy volunteers and 26 extremities of 13 patients with oedema have been studied. Dynamic quantitative lymphoscintigraphy using 99Tc-m antimony sulphide colloid during passive exercise as well as before and after active exercise was performed. parameters of lymphatic function including percentage of radioactivity cleared from the injection site, the percentage uptake by the inguinal lymph nodes, the time of arrival of activity at the regional lymph nodes and the lymphatic reserve index have been evaluated. The percentage clearance of activity from the injection site was found technically difficult to standardize and proved to be an unreliable parameter of lymphatic function. However, the quantitation of nodal uptake, the lymphatic transit time and the lymphatic reserve capacity accurately depicted the lymphatic functional status of an individual. The physiologic parameters of lymphatic function of the contralateral lower extremities were compared and a physiologic difference in the lymphatic capacity of the two limbs was scintigraphically documented. (author)

  17. Statistical Model of Extreme Shear

    DEFF Research Database (Denmark)

    Hansen, Kurt Schaldemose; Larsen, Gunner Chr.


    In order to continue cost-optimisation of modern large wind turbines, it is important to continuously increase the knowledge of wind field parameters relevant to design loads. This paper presents a general statistical model that offers site-specific prediction of the probability density function...... by a model that, on a statistically consistent basis, describes the most likely spatial shape of an extreme wind shear event. Predictions from the model have been compared with results from an extreme value data analysis, based on a large number of full-scale measurements recorded with a high sampling rate...

  18. Automation Rover for Extreme Environments (United States)

    Sauder, Jonathan; Hilgemann, Evan; Johnson, Michael; Parness, Aaron; Hall, Jeffrey; Kawata, Jessie; Stack, Kathryn


    Almost 2,300 years ago the ancient Greeks built the Antikythera automaton. This purely mechanical computer accurately predicted past and future astronomical events long before electronics existed1. Automata have been credibly used for hundreds of years as computers, art pieces, and clocks. However, in the past several decades automata have become less popular as the capabilities of electronics increased, leaving them an unexplored solution for robotic spacecraft. The Automaton Rover for Extreme Environments (AREE) proposes an exciting paradigm shift from electronics to a fully mechanical system, enabling longitudinal exploration of the most extreme environments within the solar system.

  19. Hygienic diagnosis in extreme conditions

    International Nuclear Information System (INIS)

    Sofronov, G.A.


    Review for book by M.P. Zakharchenko, S.A. Lopatin, G.N. Novozhilov, V.I. Zakharov Hygienic diagnosis in extreme conditions is presented discussing the problem of people health preservation under extreme conditions. Hygienic diagnosis is considered illustrated by cases of hostilities (Afghan War), earthquake response in Armenia (1988) and Chernobyl accident response. Attention is paid to the estimation of radiation doses to people and characteristics of main types of dosimeters. The high scientific level of the book is marked

  20. Extreme Conditions Modeling Workshop Report

    Energy Technology Data Exchange (ETDEWEB)

    Coe, R. G.; Neary, V. S.; Lawson, M. J.; Yu, Y.; Weber, J.


    Sandia National Laboratories (SNL) and the National Renewable Energy Laboratory (NREL) hosted the Wave Energy Converter (WEC) Extreme Conditions Modeling (ECM) Workshop in Albuquerque, NM on May 13th-14th, 2014. The objective of the workshop was to review the current state of knowledge on how to model WECs in extreme conditions (e.g. hurricanes and other large storms) and to suggest how U.S. Department of Energy (DOE) and national laboratory resources could be used to improve ECM methods for the benefit of the wave energy industry.

  1. Comparing the meanings of living with advanced breast cancer between women resilient to distress and women with persistent distress: a qualitative study. (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


    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.

  2. Moving in extreme environments: what's extreme and who decides? (United States)

    Cotter, James David; Tipton, Michael J


    Humans work, rest and play in immensely varied extreme environments. The term 'extreme' typically refers to insufficiency or excess of one or more stressors, such as thermal energy or gravity. Individuals' behavioural and physiological capacity to endure and enjoy such environments varies immensely. Adverse effects of acute exposure to these environments are readily identifiable (e.g. heat stroke or bone fracture), whereas adverse effects of chronic exposure (e.g. stress fractures or osteoporosis) may be as important but much less discernable. Modern societies have increasingly sought to protect people from such stressors and, in that way, minimise their adverse effects. Regulations are thus established, and advice is provided on what is 'acceptable' exposure. Examples include work/rest cycles in the heat, hydration regimes, rates of ascent to and duration of stay at altitude and diving depth. While usually valuable and well intentioned, it is important to realise the breadth and importance of limitations associated with such guidelines. Regulations and advisories leave less room for self-determination, learning and perhaps adaptation. Regulations based on stress (e.g. work/rest cycles relative to WBGT) are more practical but less direct than those based on strain (e.g. core temperature), but even the latter can be substantively limited (e.g. by lack of criterion validation and allowance for behavioural regulation in the research on which they are based). Extreme Physiology & Medicine is publishing a series of reviews aimed at critically examining the issues involved with self- versus regulation-controlled human movement acutely and chronically in extreme environments. These papers, arising from a research symposium in 2013, are about the impact of people engaging in such environments and the effect of rules and guidelines on their safety, enjoyment, autonomy and productivity. The reviews will cover occupational heat stress, sporting heat stress, hydration, diving

  3. Flexible Word Classes

    DEFF Research Database (Denmark)

    • First major publication on the phenomenon • Offers cross-linguistic, descriptive, and diverse theoretical approaches • Includes analysis of data from different language families and from lesser studied languages This book is the first major cross-linguistic study of 'flexible words', i.e. words...... that cannot be classified in terms of the traditional lexical categories Verb, Noun, Adjective or Adverb. Flexible words can - without special morphosyntactic marking - serve in functions for which other languages must employ members of two or more of the four traditional, 'specialised' word classes. Thus......, flexible words are underspecified for communicative functions like 'predicating' (verbal function), 'referring' (nominal function) or 'modifying' (a function typically associated with adjectives and e.g. manner adverbs). Even though linguists have been aware of flexible world classes for more than...

  4. Storytelling in EFL Classes

    Directory of Open Access Journals (Sweden)

    Emine Bala


    Full Text Available Storytelling is one of the oldest ways of education and oral tradition that is continuously being used to transfer the previous nation‘s cultures, tradition and customs. It constructs a bridge between the new and the old. Storytelling in EFL classes usually provides a meaningful context, interesting atmosphere and is used as a tool to highly motivate students. Although it seems to be mostly based on speaking, it is used to promote other skills such as writing, reading, and listening. Storytelling is mainly regarded to be grounded on imitation and repetition; nevertheless many creative activities can be implemented in the classroom since this method directs learners to use their imaginations. This study discusses the importance of storytelling as a teaching method, and it outlines the advantages of storytelling in EFL classes.

  5. Queen elizabeth class battleships

    CERN Document Server

    Brown, Les


    The 'ShipCraft' series provides in-depth information about building and modifying model kits of famous warship types. Lavishly illustrated, each book takes the modeller through a brief history of the subject class, highlighting differences between sister-ships and changes in their appearance over their careers. This includes paint schemes and camouflage, featuring colour profiles and highly detailed line drawings and scale plans. The modelling section reviews the strengths and weaknesses of available kits, lists commercial accessory sets for super-detailing of the ships, and provides hints on modifying and improving the basic kit. This is followed by an extensive photographic survey of selected high-quality models in a variety of scales, and the book concludes with a section on research references - books, monographs, large-scale plans and relevant websites.This volume covers the five ships of the highly successful Queen Elizabeth class, a design of fast battleship that set the benchmark for the last generati...

  6. World Class Facilities Management

    DEFF Research Database (Denmark)

    Malmstrøm, Ole Emil; Jensen, Per Anker


    Alle der med entusiasme arbejder med Facilities Management drømmer om at levere World Class. DFM drømmer om at skabe rammer og baggrund for, at vi i Danmark kan bryste os at være blandt de førende på verdensplan. Her samles op på, hvor tæt vi er på at nå drømmemålet.......Alle der med entusiasme arbejder med Facilities Management drømmer om at levere World Class. DFM drømmer om at skabe rammer og baggrund for, at vi i Danmark kan bryste os at være blandt de førende på verdensplan. Her samles op på, hvor tæt vi er på at nå drømmemålet....

  7. Storytelling in EFL Classes


    Emine Bala


    Storytelling is one of the oldest ways of education and oral tradition that is continuously being used to transfer the previous nation‘s cultures, tradition and customs. It constructs a bridge between the new and the old. Storytelling in EFL classes usually provides a meaningful context, interesting atmosphere and is used as a tool to highly motivate students. Although it seems to be mostly based on speaking, it is used to promote other skills such as writing, reading, and listening. Storytel...

  8. Esmeraldas-Class Corvettes, (United States)


    The series of ships, named after all the provinces of Ecuador , include: --CA 11 ESMERALDAS, laid down 27 September 1979, launched 11 October 1980... LOJA , laid down 25 March 1981, launched 27 February 1982; fitting out at CNR Ancona. The building program, on schedule so far, calls for the entire class...built and are still building in 16 units for foreign navies (Libya, Ecuador , Iraq) with four possible armament alternatives. In particular, they

  9. [Social classes and poverty]. (United States)

    Benach, Joan; Amable, Marcelo


    Social classes and poverty are two key social determinants fundamental to understand how disease and health inequalities are produced. During the 90's in Spain there has been a notable oscillation in the inequality and poverty levels, with an increase in the middle of the decade when new forms of social exclusion, high levels of unemployment and great difficulties in accessing the labour market, especially for those workers with less resources, emerged. Today society is still characterized by a clear social stratification and the existence of social classes with a predominance of high levels of unemployment and precarious jobs, and where poverty is an endemic social problem much worse than the EU average. To diminish health inequalities and to improve the quality of life will depend very much on the reduction of the poverty levels and the improvement of equal opportunities and quality of employment. To increase understanding of how social class and poverty affect public health, there is a need to improve the quality of both information and research, and furthermore planners and political decision makers must take into account those determinants when undertaking disease prevention and health promotion.

  10. Pain patterns during adolescence can be grouped into four pain classes with distinct profiles

    DEFF Research Database (Denmark)

    Holden, Sinead; Rathleff, Michael Skovdal; Roos, E. M.


    L (assessed by Euro-QoL 5D-3L). Latent class analysis was used to classify spatial pain patterns, based on the pain sites. The analysis included 2953 adolescents. RESULTS: Four classes were identified as follows: (1) little or no pain (63% of adolescents), (2) majority lower extremity pain (10%), (3) multi......-site bodily pain (22%) and (4) head and stomach pain (3%). The lower extremity multi-site pain group reported highest weekly sports participation (p ....001). Males were more likely to belong to the little or no pain class, whereas females were more likely to belong to the multi-site bodily pain class. CONCLUSIONS: Latent class analysis identified distinct classes of pain patterns in adolescents, characterized by sex, differences in HRQoL and sports...

  11. A Health System-wide Moral Distress Consultation Service: Development and Evaluation. (United States)

    Hamric, Ann B; Epstein, Elizabeth G


    Although moral distress is now a well-recognized phenomenon among all of the healthcare professions, few evidence-based strategies have been published to address it. In morally distressing situations, the "presenting problem" may be a particular patient situation, but most often signals a deeper unit- or system-centered issue. This article describes one institution's ongoing effort to address moral distress in its providers. We discuss the development and evaluation of the Moral Distress Consultation Service, an interprofessional, unit/system-oriented approach to addressing and ameliorating moral distress.

  12. Angiography of the upper extremity

    International Nuclear Information System (INIS)

    Janevski, B.K.


    This thesis provides a description of the technical and medical aspects of arteriography of the upper extremity and an extensive analysis of the angiographic anatomy and pathology of 750 selective studies performed in more than 500 patients. A short historical review is provided of angiography as a whole and of arteriography of the hand in particular. The method of percutaneous transfemoral catheterization of the arteries of the upper extremity and particularly the arteries of the hand is considered, discussing the problems the angiographer encounters frequently, describing the angiographic complications which may occur and emphasizing the measures to keep them to a minimum. The use of vasodilators in hand angiography is discussed. A short description of the embryological patterns persisting in the arteries of the arm is included in order to understand the congenital variations of the arteries of the upper extremity. The angiographic patterns and clinical aspects of the most common pathological processes involving the arteries of the upper extremities are presented. Special attention is paid to the correlation between angiography and pathology. (Auth.)

  13. Extreme conditions (p, T, H)

    Energy Technology Data Exchange (ETDEWEB)

    Mesot, J [Lab. for Neutron Scattering ETH Zurich, Zurich (Switzerland) and Paul Scherrer Institute, Villigen (Switzerland)


    The aim of this paper is to summarize the sample environment which will be accessible at the SINQ. In order to illustrate the type of experiments which will be feasible under extreme conditions of temperature, magnetic field and pressure at the SINQ a few selected examples are also given. (author) 7 figs., 14 refs.

  14. Book review: Extreme ocean waves (United States)

    Geist, Eric L.


    ‘‘Extreme Ocean Waves’’ is a collection of ten papers edited by Efim Pelinovsky and Christian Kharif that followed the April 2007 meeting of the General Assembly of the European Geosciences Union. A note on terminology: extreme waves in this volume broadly encompass different types of waves, includ- ing deep-water and shallow-water rogue waves (alternatively termed freak waves), storm surges from cyclones, and internal waves. Other types of waves such as tsunamis or rissaga (meteotsunamis) are not discussed in this volume. It is generally implied that ‘‘extreme’’ has a statistical connotation relative to the average or significant wave height specific to each type of wave. Throughout the book, in fact, the reader will find a combination of theoretical and statistical/ empirical treatment necessary for the complete examination of this subject. In the introduction, the editors underscore the importance of studying extreme waves, documenting several dramatic instances of damaging extreme waves that occurred in 2007. 

  15. Extreme Energy Events Monitoring report

    CERN Document Server

    Baimukhamedova, Nigina


    Following paper reflects the progress I made on Summer Student Program within Extreme Energy Events Monitor project I was working on. During 8 week period I managed to build a simple detector system that is capable of triggering events similar to explosions (sudden change in sound levels) and measuring approximate location of the event. Source codes are available upon request and settings described further.

  16. Astrobiology: Life in Extreme Environments (United States)

    Kaur, Preeti


    Astrobiology is the study of the origin, evolution and distribution of life in the universe. It seeks to answer two important scientific questions: how did we get here and are we alone in the universe? Scientists begin by studying life on Earth and its limits. The discovery of extremophiles on Earth capable of surviving extremes encourages the…

  17. Improved Extreme Learning Machine and Its Application in Image Quality Assessment

    Directory of Open Access Journals (Sweden)

    Li Mao


    Full Text Available Extreme learning machine (ELM is a new class of single-hidden layer feedforward neural network (SLFN, which is simple in theory and fast in implementation. Zong et al. propose a weighted extreme learning machine for learning data with imbalanced class distribution, which maintains the advantages from original ELM. However, the current reported ELM and its improved version are only based on the empirical risk minimization principle, which may suffer from overfitting. To solve the overfitting troubles, in this paper, we incorporate the structural risk minimization principle into the (weighted ELM, and propose a modified (weighted extreme learning machine (M-ELM and M-WELM. Experimental results show that our proposed M-WELM outperforms the current reported extreme learning machine algorithm in image quality assessment.

  18. Nutrition security under extreme events (United States)

    Martinez, A.


    Nutrition security under extreme events. Zero hunger being one of the Sustainable Development Goal from the United Nations, food security has become a trending research topic. However extreme events impact on global food security is not yet 100% understood and there is a lack of comprehension of the underlying mechanisms of global food trade and nutrition security to improve countries resilience to extreme events. In a globalized world, food is still a highly regulated commodity and a strategic resource. A drought happening in a net food-exporter will have little to no effect on its own population but the repercussion on net food-importers can be extreme. In this project, we propose a methodology to describe and quantify the impact of a local drought to human health at a global scale. For this purpose, nutrition supply and global trade data from FAOSTAT have been used with domestic food production from national agencies and FAOSTAT, global precipitation from the Climate Research Unit and health data from the World Health Organization. A modified Herfindahl-Hirschman Index (HHI) has been developed to measure the level of resilience of one country to a drought happening in another country. This index describes how a country is dependent of importation and how diverse are its importation. Losses of production and exportation due to extreme events have been calculated using yield data and a simple food balance at country scale. Results show that countries the most affected by global droughts are the one with the highest dependency to one exporting country. Changes induced by droughts also disturbed their domestic proteins, fat and calories supply resulting most of the time in a higher intake of calories or fat over proteins.

  19. A New Class of Analytic Functions Defined by Using Salagean Operator

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    R. M. El-Ashwah


    Full Text Available We derive some results for a new class of analytic functions defined by using Salagean operator. We give some properties of functions in this class and obtain numerous sharp results including for example, coefficient estimates, distortion theorem, radii of star-likeness, convexity, close-to-convexity, extreme points, integral means inequalities, and partial sums of functions belonging to this class. Finally, we give an application involving certain fractional calculus operators that are also considered.

  20. Psychological distress in health sciences college students and its relationship with academic engagement

    Directory of Open Access Journals (Sweden)

    Cristina Liébana-Presa


    Full Text Available Objective: To determine the prevalence of psychological distress and its relationship with academic engagement (absorption, dedication and vigor, sex and degree among students from four public universities. Method: A non-experimental,comparative correlational, quantitative investigation without intervention. Study population: 1840 nursing and physical therapy students. The data collection tool used was a questionnaire. Results: A 32.2% prevalence of psychological distress was found in the subjects; a correlation between vigor and psychological distress was found for all of the subjects and also for women. High absorption and dedication scores and low psychological distress scores predicted higher vigor scores. Conclusion: The risk of psychological distress is high, especially for women. Women seem to have a higher level of psychological distress than men. Vigor, energy and mental resilience positively influence psychological distress and can be a vehicle for better results during the learning and studying process.