Debriefing after Human Patient Simulation and Nursing Students' Learning

Science.gov (United States)

Benhuri, Gloria

2014-01-01

Human Patient Simulation (HPS) exercises with life-like computerized manikins provide clinical experiences for nursing students in a safe environment followed by debriefing that promotes learning. Quantitative research in techniques to support learning from debriefing is limited. The purpose of the quantitative quasi-experimental study using a…

Improving patient safety through better teamwork: how effective are different methods of simulation debriefing? Protocol for a pragmatic, prospective and randomised study.

Science.gov (United States)

Freytag, Julia; Stroben, Fabian; Hautz, Wolf E; Eisenmann, Dorothea; Kämmer, Juliane E

2017-06-30

Medical errors have an incidence of 9% and may lead to worse patient outcome. Teamwork training has the capacity to significantly reduce medical errors and therefore improve patient outcome. One common framework for teamwork training is crisis resource management, adapted from aviation and usually trained in simulation settings. Debriefing after simulation is thought to be crucial to learning teamwork-related concepts and behaviours but it remains unclear how best to debrief these aspects. Furthermore, teamwork-training sessions and studies examining education effects on undergraduates are rare. The study aims to evaluate the effects of two teamwork-focused debriefings on team performance after an extensive medical student teamwork training. A prospective experimental study has been designed to compare a well-established three-phase debriefing method (gather-analyse-summarise; the GAS method ) to a newly developed and more structured debriefing approach that extends the GAS method with TeamTAG (teamwork techniques analysis grid). TeamTAG is a cognitive aid listing preselected teamwork principles and descriptions of behavioural anchors that serve as observable patterns of teamwork and is supposed to help structure teamwork-focused debriefing. Both debriefing methods will be tested during an emergency room teamwork-training simulation comprising six emergency medicine cases faced by 35 final-year medical students in teams of five. Teams will be randomised into the two debriefing conditions. Team performance during simulation and the number of principles discussed during debriefing will be evaluated. Learning opportunities, helpfulness and feasibility will be rated by participants and instructors. Analyses will include descriptive, inferential and explorative statistics. The study protocol was approved by the institutional office for data protection and the ethics committee of Charité Medical School Berlin and registered under EA2/172/16. All students will

Debriefing after simulation-based non-technical skill training in healthcare: a systematic review of effective practice.

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Garden, A L; Le Fevre, D M; Waddington, H L; Weller, J M

2015-05-01

Non-technical skills training in healthcare frequently uses high-fidelity simulation followed by a facilitated discussion known as debriefing. This type of training is mandatory for anaesthesia training in Australia and New Zealand. Debriefing by a skilled facilitator is thought to be essential for new learning through feedback and reflective processes. Key elements of effective debriefing need to be clearly identified to ensure that the training is evidence-based. We undertook a systematic review of empirical studies where elements of debriefing have been systematically manipulated during non-technical skills training. Eight publications met the inclusion criteria, but seven of these were of limited generalisability. The only study that was generalisable found that debriefing by novice instructors using a script improved team leader performance in paediatric resuscitation. The remaining seven publications were limited by the small number of debriefers included in each study and these reports were thus analogous to case reports. Generally, performance improved after debriefing by a skilled facilitator. However, the debriefer provided no specific advantage over other post-experience educational interventions. Acknowledging their limitations, these studies found that performance improved after self-led debrief, no debrief (with experienced practitioners), standardised multimedia debrief or after reviewing a DVD of the participants' own eye-tracking. There was no added performance improvement when review of a video recording was added to facilitator-led debriefing. One study reported no performance improvement after debriefing. Without empirical evidence that is specific to the healthcare domain, theories of learning from education and psychology should continue to inform practices and teaching for effective debriefing.

A Randomized Trial of SMART Goal Enhanced Debriefing after Simulation to Promote Educational Actions

Directory of Open Access Journals (Sweden)

Amish Aghera

2017-12-01

Full Text Available Introduction Goal setting is used in education to promote learning and performance. Debriefing after clinical scenario-based simulation is a well-established practice that provides learners a defined structure to review and improve performance. Our objective was to integrate formal learning goal generation, using the SMART framework (Specific, Measurable, Attainable, Realistic, and Time-bound, into standard debriefing processes (i.e., “SMART Goal Enhanced Debriefing” and subsequently measure the impact on the development of learning goals and execution of educational actions. Methods This was a prospective multicenter randomized controlled study of 80 emergency medicine residents at three academic hospitals comparing the effectiveness of SMART Goal Enhanced Debriefing to a standard debriefing. Residents were block randomized on a rolling basis following a simulation case. SMART Goal Enhanced Debriefing included five minutes of formal instruction on the development of SMART learning goals during the summary/application phase of the debrief. Outcome measures included the number of recalled learning goals, self-reported executed educational actions, and quality of each learning goal and educational action after a two-week follow-up period. Results The mean number of reported learning goals was similar in the standard debriefing group (mean 2.05 goals, SD 1.13, n=37 residents, and in the SMART Goal Enhanced Debriefing group (mean 1.93, SD 0.96, n=43, with no difference in learning goal quality. Residents receiving SMART Goal Enhanced Debriefing completed more educational actions on average (Control group actions completed 0.97 (SD 0.87, SMART debrief group 1.44 (SD 1.03 p=0.03. Conclusion The number and quality of learning goals reported by residents was not improved as a result of SMART Goal Enhanced Debriefing. Residents did, however, execute more educational actions, which is consistent with the overarching intent of any educational

Description of hot debriefings after in-hospital cardiac arrests in an international pediatric quality improvement collaborative.

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Sweberg, Todd; Sen, Anita I; Mullan, Paul C; Cheng, Adam; Knight, Lynda; Del Castillo, Jimena; Ikeyama, Takanari; Seshadri, Roopa; Hazinski, Mary Fran; Raymond, Tia; Niles, Dana E; Nadkarni, Vinay; Wolfe, Heather

2018-05-22

The American Heart Association recommends debriefing after attempted resuscitation from in-hospital cardiac arrest (IHCA) to improve resuscitation quality and outcomes. This is the first published study detailing the utilization, process and content of hot debriefings after pediatric IHCA. Using prospective data from the Pediatric Resuscitation Quality Collaborative (pediRES-Q), we analyzed data from 227 arrests occurring between February 1, 2016, and August 31, 2017. Hot debriefings, defined as occurring within minutes to hours of IHCA, were evaluated using a modified Team Emergency Assessment Measure framework for qualitative content analysis of debriefing comments. Hot debriefings were performed following 108 of 227 IHCAs (47%). The median interval to debriefing was 130 min (Interquartile range [IQR] 45, 270). Median debriefing duration was 15 min (IQR 10, 20). Physicians facilitated 95% of debriefings, with a median of 9 participants (IQR 7, 11). After multivariate analysis, accounting for hospital site, debriefing frequency was not associated with patient age, gender, race, illness category or unit type. The most frequent positive (plus) comments involved cooperation/coordination (60%), communication (47%) and clinical standards (41%). The most frequent negative (delta) comments involved equipment (46%), cooperation/coordination (45%), and clinical standards (36%). Approximately half of pediatric IHCAs were followed by hot debriefings. Hot debriefings were multi-disciplinary, timely, and often addressed issues of team cooperation/coordination, communication, clinical standards, and equipment. Additional studies are warranted to identify barriers to hot debriefings and to evaluate the impact of these debriefings on patient outcomes. Copyright © 2018 Elsevier B.V. All rights reserved.

The art and science of debriefing in simulation: Ideal and practice

DEFF Research Database (Denmark)

Dieckmann, Peter; Molin Friis, Susanne; Lippert, Anne

2009-01-01

OBJECTIVES: Describing what simulation centre leaders see as the ideal debriefing for different simulator courses (medical vs. crisis resource management (CRM)-oriented). Describing the practice of debriefing based on interactions between instructors and training participants. METHODS: Study 1...... debriefings in simulation courses for CRM for content (medical vs. CRM-oriented) and type (question vs. utterance). RESULTS: Study 1 - The different roles were seen as equally important for both course types with the exception of 'information provider' which was seen as more relevant for medical courses...

Effects of perioperative briefing and debriefing on patient safety: a prospective intervention study.

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Leong, Katharina Brigitte Margarethe Siew Lan; Hanskamp-Sebregts, Mirelle; van der Wal, Raymond A; Wolff, Andre P

2017-12-14

This study was carried out to improve patient safety in the operating theatre by the introduction of perioperative briefing and debriefing, which focused on an optimal collaboration between surgical team members. A prospective intervention study with one pretest and two post-test measurements: 1 month before and 4 months and 2.5 years after the implementation of perioperative briefing and debriefing, respectively. Operating theatres of a tertiary care hospital with 875 beds in the Netherlands. All members of five surgical teams participated in the perioperative briefing and debriefing. The implementation of perioperative briefing and debriefing from July 2012 to January 2014. The primary outcome was changes in the team climate, measured by the Team Climate Inventory. Secondary outcomes were the experiences of surgical teams with perioperative briefing and debriefing, measured with a structured questionnaire, and the duration of the briefings, measured by an independent observer. Two and a half years after the introduction of perioperative briefing and debriefing, the team climate increased statistically significant (p≤0.05). Members of the five surgical teams strongly agreed with the positive influence of perioperative briefing and debriefing on clear agreements and reminding one another of the agreements of the day. They perceived a higher efficiency of the surgical programme with more operations starting on time and less unexpectedly long operation time. The perioperative briefing took less than 4 min to conduct. Perioperative briefing and debriefing improved the team climate of surgical teams and the efficiency of their work within the operating theatre with acceptable duration per briefing. Surgical teams with alternating team compositions have the most benefit of briefing and debriefing. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise

78 FR 38878 - Critical Incident Stress Plans

Science.gov (United States)

2013-06-28

... Institute (API); American Public Transportation Association (APTA); American Short Line and Regional...-0131, Notice No. 1] RIN 2130-AC00 Critical Incident Stress Plans AGENCY: Federal Railroad... incident stress plans that provide for appropriate support services to be offered to their employees who...

Implementation of surgical debriefing programs in large health systems: an exploratory qualitative analysis.

Science.gov (United States)

Brindle, Mary E; Henrich, Natalie; Foster, Andrew; Marks, Stanley; Rose, Michael; Welsh, Robert; Berry, William

2018-03-27

The role of the "debrief" to address issues related to patient safety and systematic flaws in care is frequently overlooked. In our study, we interview surgical leaders who have developed successful strategies of debriefing within a comprehensive program of quality improvement. Semi-structured interviews of four implementation leaders were performed. The observations, beliefs and strategies of surgical leaders are compared and contrasted. Common themes are identified related to program success and failure. Quality and safety researchers performed, coded and categorized the interviews and coordinated the analysis and interpretation of the results. The authors from the four institutions aided in interpretation and framing of the results. The debriefing programs evaluated were part of comprehensive quality improvement projects. Seven high-level themes and 24 subthemes were identified from the interviews. Themes related to leadership included early engagement, visible ongoing commitment and enforcement. Success appeared to depend upon meaningful and early debriefing feedback. The culture of safety that promoted success included a commitment to open and fair communication and continuous improvement. There were many challenges to the success of debriefing programs. The loss of institutional commitment of resources and personnel was the instigating factor behind the collapse of the program at Michigan. Other areas of potential failure included communication issues and loss of early and meaningful feedback. Leaders of four surgical systems with strong debriefing programs report success using debriefing to improve system performance. These findings are consistent with previously published studies. Success requires commitment of resources, and leadership engagement. The greatest gains may be best achieved by programs that provide meaningful debriefing feedback in an atmosphere dedicated to open communication.

Debriefing Note Secondary Education Support Programme

DEFF Research Database (Denmark)

Webster, Neil; Vagnby, Bo Hellisen; Thomsen, Thomas J.

Debriefing note regarding joint programming for the Secondary Education Support Programme (2003- 2007). The note specifies preparation of SIP Physical Guidelines; Training needs assessment for Physical School Status and Rapid Technical Assessments; SIP/DEP preparation; Selection criteria...

Implications and Benefits of a Long-Term Peer Debriefing Experience on Teacher Researchers

OpenAIRE

Cynthia Schneider; Christy Youker; Joanne Heilman; Melanie Wenrick; Candace Figg

2010-01-01

Peer debriefing ensures the trustworthiness of a qualitative research study. Through peer debriefing, the researcher explores the research design, data collection process, and data analysis while colleagues, serving as critical friends, encourage the researcher to examine the research process from multiple perspectives. This paper examines experiences in a peer debriefing group formed by five female teacher researchers as a part of their graduate requirements for doctoral work, and their cont...

The relationship between facilitators' questions and the level of reflection in postsimulation debriefing.

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Husebø, Sissel Eikeland; Dieckmann, Peter; Rystedt, Hans; Søreide, Eldar; Friberg, Febe

2013-06-01

Simulation-based education is a learner-active method that may enhance teamwork skills such as leadership and communication. The importance of postsimulation debriefing to promote reflection is well accepted, but many questions concerning whether and how faculty promote reflection remain largely unanswered in the research literature. The aim of this study was therefore to explore the depth of reflection expressed in questions by facilitators and responses from nursing students during postsimulation debriefings. Eighty-one nursing students and 4 facilitators participated. The data were collected in February and March 2008, the analysis being conducted on 24 video-recorded debriefings from simulated resuscitation teamwork involving nursing students only. Using Gibbs' reflective cycle, we graded the facilitators' questions and nursing students' responses into stages of reflection and then correlated these. Facilitators asked most evaluative and fewest emotional questions, whereas nursing students answered most evaluative and analytic responses and fewest emotional responses. The greatest difference between facilitators and nursing students was in the analytic stage. Only 23 (20%) of 117 questions asked by the facilitators were analytic, whereas 45 (35%) of 130 students' responses were rated as analytic. Nevertheless, the facilitators' descriptive questions also elicited student responses in other stages such as evaluative and analytic responses. We found that postsimulation debriefings provide students with the opportunity to reflect on their simulation experience. Still, if the debriefing is going to pave the way for student reflection, it is necessary to work further on structuring the debriefing to facilitate deeper reflection. Furthermore, it is important that facilitators consider what kind of questions they ask to promote reflection. We think future research on debriefing should focus on developing an analytical framework for grading reflective questions. Such

Implications and Benefits of a Long-Term Peer Debriefing Experience on Teacher Researchers

Directory of Open Access Journals (Sweden)

Cynthia Schneider

2010-05-01

Full Text Available Peer debriefing ensures the trustworthiness of a qualitative research study. Through peer debriefing, the researcher explores the research design, data collection process, and data analysis while colleagues, serving as critical friends, encourage the researcher to examine the research process from multiple perspectives. This paper examines experiences in a peer debriefing group formed by five female teacher researchers as a part of their graduate requirements for doctoral work, and their continued association as they pursued their professional goals. Three themes emerged based on the analysis of team meeting minutes, reflective journal logs, and case reports constructed reflectively by the five participants. These were: (a essential elements of a successful peer debriefing group are commitment, continuity, and individual expectations being met; (b participation can serve as an important development step in preparation as a professional researcher and educator; and (c academic and emotional support provided by a peer debriefing group is a motivating factor leading to researcher’s perceptions of success. These themes highlight the benefits of including peer debriefing as a part of the action research process of teacher researchers as a means of dealing with the ‘messiness’ that novice teachers researchers encounter when conducting action or self-study research.

Interprofessional team debriefings with or without an instructor after a simulated crisis scenario: An exploratory case study.

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Boet, Sylvain; Pigford, Ashlee-Ann; Fitzsimmons, Amber; Reeves, Scott; Triby, Emmanuel; Bould, M Dylan

2016-11-01

The value of debriefing after an interprofessional simulated crisis is widely recognised; however, little is known about the content of debriefings and topics that prompt reflection. This study aimed to describe the content and topics that facilitate reflection among learners in two types of interprofessional team debriefings (with or without an instructor) following simulated practice. Interprofessional operating room (OR) teams (one anaesthesia trainee, one surgical trainee, and one staff circulating OR nurse) managed a simulated crisis scenario and were randomised to one of two debriefing groups. Within-team groups used low-level facilitation (i.e., no instructor but a one-page debriefing form based on the Ottawa Global Rating Scale). The instructor-led group used high-level facilitation (i.e., gold standard instructor-led debriefing). All debriefings were recorded, transcribed, and thematically analysed using the inductive qualitative methodology. Thirty-seven interprofessional team-debriefing sessions were included in the analysis. Regardless of group allocation (within-team or instructor-led), the debriefings centred on targeted crisis resource management (CRM) content (i.e., communication, leadership, situation awareness, roles, and responsibilities). In both types of debriefings, three themes emerged as topics for entry points into reflection: (1) the process of the debriefing itself, (2) experience of the simulation model, including simulation fidelity, and (3) perceived performance, including the assessment of CRM. Either with or without an instructor, interprofessional teams focused their debriefing discussion on targeted CRM content. We report topics that allowed learners to enter reflection. This is important for understanding how to maximise learning opportunities when creating education activities for healthcare providers that work in interprofessional settings.

The influence of occupational debriefing on post-traumatic stress symptomatology in traumatized police officers

NARCIS (Netherlands)

Carlier, I. V.; Voerman, A. E.; Gersons, B. P.

2000-01-01

Certain individuals, such as police officers, are exposed to traumatic events as part of their occupational roles. In an effort to prevent psychological illnesses, notably the post-traumatic stress disorder, from arising out of work-related traumatic incidents, psychological interventions have been

Debriefing interventions for the prevention of psychological trauma in women following childbirth.

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Bastos, Maria Helena; Furuta, Marie; Small, Rhonda; McKenzie-McHarg, Kirstie; Bick, Debra

2015-04-10

Childbirth is a complex life event that can be associated with both positive and negative psychological responses. When giving birth is experienced as particularly traumatic this can have a negative impact on a woman's postnatal emotional well-being. There has been an increasing focus on women's psychological trauma symptoms following childbirth, including the relatively rare phenomenon of post-traumatic stress disorder (PTSD), and the benefit of debriefing interventions to prevent this. In this review we examined the evidence for debriefing as a preventative intervention for psychological trauma following childbirth. To assess the effects of debriefing interventions compared with standard postnatal care for the prevention of psychological trauma in women following childbirth. The trials registers of the Cochrane Depression, Anxiety and Neurosis Group (CCDANCTR-References and CCDANCTR-Studies) and the Cochrane Pregnancy and Childbirth Group were searched up to 4 March 2015. These registers include relevant randomised controlled trials from the following bibliographic databases: the Cochrane Library (all years to date), MEDLINE (1950 to date), EMBASE (1974 to date), and PsycINFO (1967 to date). Additional searches were conducted in CENTRAL, MEDLINE, EMBASE, PsycINFO, and Maternity and Infant Care. The reference lists of all included studies were checked for additional published reports and citations of unpublished research. Experts in the field were contacted. We included randomised controlled trials (RCTs) and quasi-randomised trials comparing postnatal debriefing interventions with standard postnatal care for the prevention of psychological trauma of women following childbirth. The intervention consisted of at least one debriefing intervention session, which had the purpose of allowing women to describe their experience and to normalise their emotional reaction to that experience. Three authors independently assessed trial quality and extracted data. Meta

Debriefing bystanders of out-of-hospital cardiac arrest is valuable

DEFF Research Database (Denmark)

Møller, Thea Palsgaard; Hansen, Carolina Malta; Fjordholt, Martin

2014-01-01

, positively influencing the ability to cope with the emotional reactions and the cognitive perception of own performance and motivates improvement of CPR skills. Importantly, it increases confidence to provide CPR in the future. Implementation of telephone debriefing to bystanders at Emergency Medical...... the phenomenological approach. RESULTS: Six themes emerged from analysis of debriefing audio files: (1) identification of OHCA; (2) emotional and perceptual experience with OHCA; (3) collaboration with healthcare professionals; (4) patients outcome; (5) coping with the experience and (6) general reflections. When...

The impact of power negotiations on nursing students learning processes in simulation scenario debriefing

DEFF Research Database (Denmark)

Frandsen, Anne; Topperzer, Martha; Sejr Olsen, Pernille

element to obtain critical reflection and learning (3). During debriefing students and facilitators jointly explore what happened in the scenario, and what should be focus of the prospective learning process (4). The aim of this paper is to explore how the negotiations of power (5) in the simulation...... scenario debriefing have an impact on the learning process for novice nursing students. References: Zapko et al 2015: Interdisciplinary Disaster Drill Simulation: Laying the Groundwork for further Research. Nurse Education Perspective Nov. Dec. 36(6):379-82 Motola et al 2013: Simulation in healthcare......Clinical simulation in nursing improves student`s ability to critical thinking, clinical judgement and clinical decision- making(1). The key elements to success are planning, pre- briefing, engagement, a realistic scenario with interruptions and debriefing (2). Debriefing is highlighted as the key...

Breaking Bad News in obstetrics: a randomized trial of simulation followed by debriefing or lecture.

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Karkowsky, Chavi Eve; Landsberger, Ellen J; Bernstein, Peter S; Dayal, Ashlesha; Goffman, Dena; Madden, Robert C; Chazotte, Cynthia

2016-11-01

Although communication skills represent an increasingly important aspect of medical care, little has been done to assess the best method of teaching these skills. Our study was designed to assess simulation-debriefing compared to lecture in teaching skills for Breaking Bad News (BBN) in obstetrics. This is a randomized prospective trial of house staff from a large academic medical center. Subjects initially underwent baseline simulation, followed by evaluation on BBN skills by themselves, a faculty observer, and the standardized patient (SP). The subjects were then immediately randomized to a debriefing session by faculty or to a lecture about BBN. Subsequently, both groups underwent a second simulation with the same three assessments, yielding post-intervention data. 35 subjects completed both simulations. Both debriefing and lecture curricula showed improvement in scores by self (p = 0.010) and faculty (p < 0.001). The debriefing group improved significantly more than the lecture group for self-evaluation; additionally, improvements were greater for the debrief group in verbal and nonverbal skills. Long-term follow-up three months after both interventions demonstrated continued improvement in BBN. Simulation training with debriefing is effective for teaching communication skills, and superior to lecture for self-perceived improvement. Long-term follow-up suggested retention of confidence in BBN skills.

How Should Debriefing Be Undertaken in Web-Based Studies? Findings From a Randomized Controlled Trial

Science.gov (United States)

Kypri, Kypros; Wilson, Amanda

2012-01-01

Background Internet research may raise older ethical issues in new forms or pose new issues. It has been recommended that debriefing information online be kept very short, with further information including study results made available if requested by participants. There are no empirical studies that compare possible alternative methods of debriefing in online studies. Objective To undertake a randomized controlled trial evaluating how to implement the recommended approach by assessing the effects of two different approaches on accessing of additional information. Methods All 11,943 participants in the Effects of Study Design and Allocation (ESDA) study, which employed deception, were randomly assigned to one of two methods of debriefing: Group A received the debriefing information in the body of an email with links to protocol and results pages; Group B was presented with these links after clicking on an initial link in the body of the email to view the debriefing information on a website. Outcomes assessed were the proportions clicking on the links to the protocol and results summary and the time spent on these pages by those accessing them. Results The group who were presented with no debriefing information in the body of the email and went to a website for this information (Group B) were approximately twice as likely to subsequently access the protocol and the results summary. These differences between the two groups were highly statistically significant. Although these differences are clear, the overall proportions accessing such information were low, and there were no differences in mean time spent reading these pages. Only one quarter of Group B actually accessed debriefing information. Conclusions In circumstances where the uptake of fuller information on study design, methods, and findings is deemed important, debriefing information may be better provided via a link and not included in the body of an email. Doing so may, however, reduce the extent of

Debriefing effectiveness following exposure to pornographic rape depictions.

Science.gov (United States)

Malamuth, Neil; Check, James

1984-02-01

Data are presented concerning the ethics of exposing undergraduate students to pornographic rape portrayals followed by a debriefing designed to dispel a number of rape myths. One hundred fifty males and females were randomly assigned to read pornographic stories. Some of these depicted a rape, whereas others depicted mutually consenting intercourse. Afterwards, those exposed to the rape version were given a debriefing which included statements concerning the true horror of rape and the existence of rape myths. About 10 days later, a "Public Survey" ostensibly conducted by a local committee of citizens was given to subjects in their classes. A postexperimental questionnaire confirmed that participants were not aware that this survey was related to the earlier phase of the research. As part of the survey, subjects were presented with actual newspaper articles about which their opinions were solicited. One of these articles, the dependent measure of the study, concerned rape. Subjects indicated their reactions to this article and their opinions about the general causes of rape. The results indicated that those exposed to the rape depictions followed by a "rape debriefing" were less accepting of certain rape myths than subjects exposed to mutually consenting intercourse depictions. Implications of the data for future research in this area are discussed both in terms of work focusing on the potential antisocial impact of violent pornography and of research specifically designed to identify the conditions most likely to change acceptance of rape myths.

Early intervention for post-traumatic stress disorder.

Science.gov (United States)

Bryant, Richard A

2007-02-01

The potentially debilitating effect of posttraumatic stress disorder (PTSD) has created much interest in early intervention strategies that can reduce PTSD. This review critiques the evidence for psychological debriefing approaches and alternate early intervention strategies. The review critiques the randomized controlled trials of psychological debriefing, and early provision of cognitive behavior therapy. The latter approach involves therapy attention on acutely traumatized individuals who are high risk for PTSD development, and particularly in people with acute stress disorder (ASD). Psychological debriefing does not prevent PTSD. Cognitive behaviour therapy strategies have proven efficacy in reducing subsequent PTSD in ASD populations. Despite the promising evidence for early provision of CBT, many people do not benefit from CBT. This review concludes with consideration of major challenges facing early intervention approaches in the context of terrorist attacks and mass disasters.

Considering Face, Rights, and Goals: A Critical Review of Rapport Management in Facilitator-Guided Simulation Debriefing Approaches.

Science.gov (United States)

Loo, May Eng; Krishnasamy, Charmaine; Lim, Wee Shiong

2018-02-01

The rapport between facilitators and learners contributes to a conducive learning environment during simulation debriefing, but a theory to guide rapport management (RM) is lacking. The RM model is a potentially relevant conceptual framework because it describes three interrelated components of rapport-face, rights, and goals-which, when threatened, affect the rapport between interactants. This critical review explores how studies in the simulation debriefing literature describing postevent facilitator-guided debriefing approaches can be viewed through the lens of the RM model. All 34 identified studies alluded to at least one component of rapport, with less than half alluding to all three. There is preliminary evidence that the management of all three components of rapport during debriefing may contribute to improving short-term learning outcomes. Future studies could explore how the RM model can be used to guide debriefing approaches in various contexts and clarify why or how these approaches work.

The Effect of Debriefing and Brief Cognitive-Behavioral Therapy on Postpartum Depression in Traumatic Childbirth: A Randomized Clinical Trial

OpenAIRE

Sedigheh Abdollahpour; Afsaneh Keramat; Seyyed Abbas Mousavi; Ahmad Khosravi; zahra motaghi

2018-01-01

Background & aim: Childbirth is a stressful event in women’s lives, and if a mother perceives it as an unpleasant event, it can influence her postpartum mental health. Depression is a common mental disorder, which can has serious consequences depending on its severity. Therefore, this study aimed to investigate the effect of debriefing and brief cognitive-behavioral therapy on postpartum depression in traumatic childbirth. Methods: This clinical trial was performed on 179 mothers who experien...

Debriefing in Moodle: Written Feedback on Trust and Knowledge Sharing in a Social Dilemma Game

Science.gov (United States)

Oertig, Margaret

2010-01-01

This article describes a new approach to debriefing that uses the discussion forum feature of the Moodle open source course management system to debrief a simulation game with undergraduate business students. The simulation game allowed the students to experience the fragility of trust when sharing knowledge in a global virtual project team. I…

Dealing Collectively with Critical Incident Stress Reactions in High Risk Work Environments

DEFF Research Database (Denmark)

Müller-Leonhardt, Alice; Strøbæk, Pernille Solveig; Vogt, joachim

2015-01-01

organisations. Indeed, we found that the CISM programme once integrated within the socio-cultural patterns of this specific working environment enhanced not only individual feelings of being supported but also organisational safety culture. Keywords: coping; safety culture; critical incident stress management......aim of this paper is to shift the representation of coping patterns within high risk occupations to an existential part of cultural pattern and social structure, which characterises high reliability organisations. Drawing upon the specific peer model of critical incident stress management (CISM......), in which qualified operational peers support colleagues who experienced critical incident stress, the paper discusses critical incident stress management in air traffic control. Our study revealed coping patterns that co-vary with the culture that the CISM programme fostered within this specific high...

Helping without harming: the instructor's feedback dilemma in debriefing--a case study.

Science.gov (United States)

Rudolph, Jenny W; Foldy, Erica Gabrielle; Robinson, Traci; Kendall, Sandy; Taylor, Steven S; Simon, Robert

2013-10-01

Simulation instructors often feel caught in a task-versus-relationship dilemma. They must offer clear feedback on learners' task performance without damaging their relationship with those learners, especially in formative simulation settings. Mastering the skills to resolve this dilemma is crucial for simulation faculty development. We conducted a case study of a debriefer stuck in this task-versus-relationship dilemma. The "2-column case" captures debriefing dialogue and instructor's thoughts and feelings or the "subjective experience." The "learning pathways grid" guides a peer group of faculty in a step-by-step, retrospective analysis of the debriefing. The method uses vivid language to highlight the debriefer's dilemmas and how to surmount them. The instructor's initial approach to managing the task-versus-relationship dilemma included (1) assuming that honest critiques will damage learners, (2) using vague descriptions of learner actions paired with guess-what-I-am-thinking questions, and (3) creating a context she worried would leave learners feeling neither safe nor clear how they could improve. This case study analysis identified things the instructor could do to be more effective including (1) making generous inferences about the learners' qualities, (2) normalizing the challenges posed by the simulation, (3) assuming there are different understandings of what it means to be a team. There are key assumptions and ways of interacting that help instructors resolve the task-versus-relationship dilemma. The instructor can then provide honest feedback in a rigorous yet empathic way to help sustain good or improve suboptimal performance in the future.

Residual stress analysis on materials with steep stress gradient by using X-ray incidence at higher angles

International Nuclear Information System (INIS)

Ohya, Shin-ichi; Yoshioka, Yasuo; Maeno, Shigeki

1996-01-01

X-ray stress measurements for isotropic polycrystalline are materials are usually carried out by the sin 2 ψ method under the assumption of no stress gradient in X-ray penetration depth. When a steep stress gradient exists in the vicinity of surface layer, however, non-linear sin 2 ψ relation is observed and the sin 2 ψ method cannot be applied on such cases. Although several X-ray stress analyzers have been developed for materials with steep stress gradient in the surface layer, it is desirable to use diffraction data at higher incident angles of ψ 0 as possible as close on 90 degrees in order to determine the both values of surface stress and stress gradient with high accuracy. In the present study, an X-ray stress analyzer based on Ω geometry was fabricated to enable X-ray incidence at higher angle of ψ 0 . The X-ray detector was positioned on -η side against X-ray incident beam. Both of the residual surface stress and stress gradient were determined by use of the COSψ method on shot-peened steel and silicon nitride specimens. This prototype stress analyzer was found effective to perform a biaxial or triaxial stress analysis. (author)

Facebook, stress, and incidence of upper respiratory infection in undergraduate college students.

Science.gov (United States)

Campisi, Jay; Bynog, Pamela; McGehee, Hope; Oakland, Joshua C; Quirk, Shannon; Taga, Carlee; Taylor, Morgan

2012-12-01

Having a large social network is generally beneficial to health. However, it is unclear how Internet-based social networks might influence health. Chronic stress can have negative health consequences, and some data suggest that Facebook could be a new source of psychological stress. Thus, we examined undergraduate college student perceptions of Facebook use and incidence of upper respiratory infections (URIs). We hypothesized that subjects with more diverse networks (i.e., more friends on Facebook) would have fewer URIs than their less diverse counterparts; that subjects reporting Facebook-induced stress would be more susceptible to URIs; and that subjects with more diverse networks who report Facebook-induced stress would be less susceptible to URIs than subjects with less diverse social networks who reported Facebook-induced stress. In this prospective study, healthy college students completed online questionnaires that assessed use and perceptions of Facebook and technology, and then were interviewed weekly for 10 weeks to track incidence of URI. URI episodes were defined by a symptom-based criterion. The social network size was significantly related to the rate of URI, such that, the larger the social network, the greater the incidence rate of URI. Most (85.7 percent) respondents experienced some degree of Facebook-induced stress. The effects of Facebook-induced stress on incidence of URI varied across the social network size, such that, the impact of stress on the URI incidence rate increased with the size of the social network. These results are largely in contrast to our hypotheses, but clearly suggest an association between Facebook use, psychological stress, and health.

Emergency and crisis management: critical incident stress management for first responders and business organisations.

Science.gov (United States)

Guenthner, Daniel H

2012-01-01

A literature review was performed on critical incident stress after September 11th, 2001 (9/11), and Hurricanes Katrina and Rita, which focused on the need to implement a holistic critical incident stress management programme for first responders and business organisations. Critical incident stress management is required to handle acute stress and other distress in the face of natural or man-made disasters, including terrorist attacks. A holistic approach to community resilience through a well-planned and implemented critical incident stress management programme has been shown in the literature to promote self-help and self-efficacy of individuals and organisations. The interventions and programme elements defined clearly show how a number of different intervention and prevention strategies will promote business and community resilience and also self-efficacy in a culturally-diverse community and organisation. Implementing a critical incident stress management programme within a responding business organisation is critical because of the fact that first responders are the most susceptible every day to exposure to critical incidents that will affect their mental health; and business employees will suffer some of the same maladies as first responders in the event of a disaster or crisis. Utilising the framework provided, a holistic critical incident stress management programme can be implemented to help reduce the effects of burnout, absenteeism, acute stress, post-traumatic stress, substance use and traumatic stress, and to work to promote community resilience and toughen individuals against the effects of stress. Taking care of the needs of the employees of a business organisation, and of those of first responders, is clearly required.

Role of debriefing as a learning tool in simulation based learning for students of preclinical years at the end of two consecutive modules-initial experience

International Nuclear Information System (INIS)

Ali, L.; Nisar, S.; Ghassan, A.

2015-01-01

The topic of debriefing has been receiving some attention in the simulation literature. Because of the significance of debriefing on learning, evaluation of the de-briefer is done to ensure optimal performance. Structured debriefing as a learning tool was evaluated at the end of modular teaching of first year MBBS. This study is a descriptive cross sectional study to analyze the usefulness of debriefing as an instructional strategy during observed structured clinical examination conducted at the end of two consecutive modules of first year MBBS students. Methods: Performance of 150 students of first year MBBS was evaluated at the end of modules called Foundation module and skin and musculoskeletal module. Debriefing was structured and conducted after training of six staff members who conducted and supervised Objectively Structured Clinical Examination. Results: Apart from description of results of Objectively Structured Clinical Examination that were generally good, students praised the debriefing session. Ninety percent students thought the timing of debriefing to be perfect. Only 2% percent students complained about negative debriefing. Ten percent students wanted the debriefing session to be conducted in camera so that they could evaluate their own performance. Conclusion: Debriefing session at the end of modular teaching Objectively Structured Clinical Examination is a useful learning tool as not only it provides immediate feedback about the performance but gives students opportunity to discuss own performance with the instructor in order to develop habit of lifelong self-directed adult learner. (author)

CRITICAL INCIDENTS AND CRITICAL INCIDENT STRESS MANAGEMENT (CISM – AN EMPLOYEE ASSISTANCE PROGRAMME (EAP PERSPECTIVE

Directory of Open Access Journals (Sweden)

Terblanche, Lourie

2014-04-01

Full Text Available Employees are increasingly becoming victims of critical incidents. From a systems theory point of view, it is necessary to acknowledge the impact of critical incidents not only on the personal life of the employee, but on the workplace itself. Employees respond differently to critical incidents, which makes it even more complicated when this reaches the point of requiring therapeutic intervention. The most common response to critical incidents may be the risk of developing post-traumatic stress disorder (PTSD and/or depression. This reality requires management – through the Employee Assistance Programme (EAP – to be able to effectively deal with such critical incidents.

Evolution of the Pediatric Advanced Life Support course: enhanced learning with a new debriefing tool and Web-based module for Pediatric Advanced Life Support instructors.

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Cheng, Adam; Rodgers, David L; van der Jagt, Élise; Eppich, Walter; O'Donnell, John

2012-09-01

To describe the history of the Pediatric Advanced Life Support course and outline the new developments in instructor training that will impact the way debriefing is conducted during Pediatric Advanced Life Support courses. The Pediatric Advanced Life Support course, first released by the American Heart Association in 1988, has seen substantial growth and change over the past few decades. Over that time, Pediatric Advanced Life Support has become the standard for resuscitation training for pediatric healthcare providers in North America. The incorporation of high-fidelity simulation-based learning into the most recent version of Pediatric Advanced Life Support has helped to enhance the realism of scenarios and cases, but has also placed more emphasis on the importance of post scenario debriefing. We developed two new resources: an online debriefing module designed to introduce a new model of debriefing and a debriefing tool for real-time use during Pediatric Advanced Life Support courses, to enhance and standardize the quality of debriefing by Pediatric Advanced Life Support instructors. In this article, we review the history of Pediatric Advanced Life Support and Pediatric Advanced Life Support instructor training and discuss the development and implementation of the new debriefing module and debriefing tool for Pediatric Advanced Life Support instructors. The incorporation of the debriefing module and debriefing tool into the 2011 Pediatric Advanced Life Support instructor materials will help both new and existing Pediatric Advanced Life Support instructors develop and enhance their debriefing skills with the intention of improving the acquisition of knowledge and skills for Pediatric Advanced Life Support students.

Issues in reflection and debriefing: how nurse educators structure experiential activities.

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Brackenreg, Jenni

2004-12-01

Experiential learning is particularly useful in vocational education programs where theory needs to be linked to practice. Although experiential learning is often advocated in nursing education and the importance of debriefing and reflection is almost always espoused, the focus in the literature has tended to be on detailed descriptions of the action phase with little close analysis of how the reflective phase is facilitated. The Lewinian model described by Kolb [Experiential Learning. Experience as Source of Learning and Development, Prentice-Hall, New Jersey, 1984] and the structuring approach suggested by Thiagarajan [Experiential Learning Packages, Prentice-Hall, Englewood Cliffs, NJ, 1980] have been used as the theoretical context for an exploration of how nurse teachers describe their facilitation of the debriefing and reflective phases of experiential learning activities. Explication of the entire planned experiential learning experience is important for increasing the chances of the student being able to close the experiential learning loop. The more covert reflective phases for facilitating experiential learning are crucial and if neglected, or inexpertly and insensitively handled, may at best lead to poor learning outcomes or at worst lead to emotional damage and ;unfinished business' for the student. Interviews with eight experienced university educators elicited descriptions of how they constructed experiential activities with special reference to their descriptions of how the debriefing or reflective phases were structured.

The Effect of Debriefing and Brief Cognitive-Behavioral Therapy on Postpartum Depression in Traumatic Childbirth: A Randomized Clinical Trial

Directory of Open Access Journals (Sweden)

Sedigheh Abdollahpour

2018-01-01

Full Text Available Background & aim: Childbirth is a stressful event in women’s lives, and if a mother perceives it as an unpleasant event, it can influence her postpartum mental health. Depression is a common mental disorder, which can has serious consequences depending on its severity. Therefore, this study aimed to investigate the effect of debriefing and brief cognitive-behavioral therapy on postpartum depression in traumatic childbirth. Methods: This clinical trial was performed on 179 mothers who experienced a traumatic childbirth and were admitted in postnatal ward of Nohom Dey Hospital in Torbat-e Heydarieh, North East of Iran in 2016. The subjects were randomly allocated into three groups, including two intervention groups of debriefing and brief cognitive-behavioral counseling and a control group. The intervention groups received appropriate counseling for 40-60 minutes in the first 48 postpartum hours and the control group received the routine postpartum care. Edinburgh Postnatal Depression Scale was used to evaluate postpartum depression 4-6 weeks and also three months after the intervention. Post-traumatic stress symptoms in were compared in three groups using t-test, chi-square test, and repeated measures analysis of variance. Results: No significant differences were observed between the mean depression scores of the two intervention groups and that of the control group 4-6 weeks after childbirth. However, three months after delivery, the mean depression scores of the two intervention groups was lower than the control group (P

EAP-based critical incident stress management: utilization of a practice-based assessment of incident severity level in responding to workplace trauma.

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DeFraia, Gary S

2013-01-01

Central to the field of trauma psychology is assessment of the impact of critical incidents on individuals, as measured by individual symptoms of stress. Accordingly, the trauma literature reflects a proliferation of clinical impact of event scales. Workplace incidents however, affect not only individual employees, but also work organizations, requiring a multi-level response. Critical incident stress management (CISM) is the most prevalent multi-level incident response strategy utilized by organizations, often through specialized CISM units operating within their employee assistance programs (EAPs). While EAP-based CISM units seeks to support both individuals and organizations, studies focused on individual stress dominate the literature, mirroring assessment scales that tend to emphasize clinical as opposed to organizational practice. This research contributes to less-prevalent studies exploring incident characteristics as disruptive to organizations, rather than clinical symptoms as disruptive to individuals. To measure incident disruption, an EAP-based CISM unit developed a critical incident severity scale. By analyzing this unit's extensive practice database, this exploratory study examines how critical incident severity level varies among various types of incidents. Employing the methodology of clinical data mining, this practice-based research generates evidence-informed practice recommendations in the areas of EAP-based CISM intake assessment, organizational consultation and incident response planning.

Leadership: briefing and debriefing in the operating room.

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Donnelly, Teresa

2017-07-01

Steelman (2014) stated that the concept of briefing and debriefing used in operating theatres derived from the airline industry in the 1970s. There had been a series of devastating air crashes and the airline industry had come under severe public scrutiny. Investigations identified that, while the crews operating these aircrafts were very skilled and knowledgeable, they lacked competence in their ability to perform as part of a team. Copyright the Association for Perioperative Practice.

Temporal pattern of emotions and cognitive load during simulation training and debriefing.

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Fraser, Kristin; McLaughlin, Kevin

2018-04-24

In the simulated clinical environment, there is a perceived benefit to the emotional activation experienced by learners; however, potential harm of excessive and/or negative emotions has also been hypothesized. An improved understanding of the emotional experiences of learners during each phase of the simulation session will inform instructional design. In this observational study, we asked 174 first-year medical students about their emotional state upon arrival to the simulation lab (t1). They were then trained on a standard simulation scenario, after which they rated their emotional state and perceived cognitive load (t2). After debriefing, we then asked them to again rate their emotions and cognitive load (t3). Students reported that their experience of tranquility (a positive and low-arousal state) dropped from pre-scenario (t1) to post-scenario (t2), and returned to baseline levels after debriefing (t3), from 0.69 (0.87) to 0.14 (0.78) to 0.62 (0.78). Post scenario cognitive load was rated to be moderately high at 6.62 (1.12) and scores increased after debriefing to 6.90 (1.05) d = 0.26, p Cognitive load was associated with the simultaneous measures of emotions at both t2 and t3. Participant emotions are significantly altered through the experience of medical simulation and emotions are associated with subjective ratings of cognitive load.

Schizophrenia research participants' responses to protocol safeguards: recruitment, consent, and debriefing.

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Roberts, Laura Weiss; Warner, Teddy D; Anderson, Charles T; Smithpeter, Megan V; Rogers, Melinda K

2004-04-01

To examine the perspectives and preferences regarding ethically important aspects of recruitment, consent, and debriefing of people with schizophrenia who volunteered for research protocols. A structured interview to assess research-related views of people with schizophrenia was developed and piloted. Data collection occurred at three sites. For this analysis, we examined the subset of responses from schizophrenia patients currently enrolled in a protocol. Data from 28 schizophrenia research volunteers were analyzed. Of these, 22 were men and 11 were voluntary inpatients. Most (n=23) recalled speaking with someone before enrolling in the protocol, and most (n=26) reported trusting the person who told them about it. Participants reported a moderate understanding of their protocols. All but one person (n=27) remembered signing a consent form. Twenty-one volunteers indicated that consent forms are meant to help both the patient and the researcher. Most (n=23) reported making the enrollment decision alone, with 22 making this decision prior to reviewing the consent form. The decision was described as relatively easy. Respondents felt some pressure to enroll, with women experiencing more pressure. Debriefing practices were strongly endorsed by participants. All 28 of the volunteers wished to be informed if a health problem (i.e., "something wrong") was discovered during the protocol. The persons living with schizophrenia who were interviewed for this project expressed interesting perspectives and preferences regarding ethically important aspects of recruitment, consent, and debriefing in clinical research that may help guide efforts to make research processes more attuned to participants and merit further inquiry.

Briefing and debriefing in the cardiac operating room. Analysis of impact on theatre team attitude and patient safety.

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Papaspyros, Sotiris C; Javangula, Kalyana C; Adluri, Rajeshwara Krishna Prasad; O'Regan, David J

2010-01-01

Error in health services delivery has long been recognised as a significant cause of inpatient morbidity and mortality. Root-cause analyses have cited communication failure as one of the contributing factors in adverse events. The formalised fighter pilot mission brief and debrief formed the basis of the National Aeronautics and Space Administration (NASA) crew resource management (CRM) concept produced in 1979. This is a qualitative analysis of our experience with the briefing-debriefing process applied to cardiac theatres. We instituted a policy of formal operating room (OR) briefing and debriefing in all cardiac theatre sessions. The first 118 cases were reviewed. A trouble-free operation was noted in only 28 (23.7%) cases. We experienced multiple problems in 38 (32.2%) cases. A gap was identified in the second order problem solving in relation to instrument repair and maintenance. Theatre team members were interviewed and their comments were subjected to qualitative analysis. The collaborative feeling is that communication has improved. The health industry may benefit from embracing the briefing-debriefing technique as an adjunct to continuous improvement through reflective learning, deliberate practice and immediate feedback. This may be the initial step toward a substantive and sustainable organizational transformation.

How to debrief teamwork interactions: using circular questions to explore and change team interaction patterns.

Science.gov (United States)

Kolbe, Michaela; Marty, Adrian; Seelandt, Julia; Grande, Bastian

2016-01-01

We submit that interaction patterns within healthcare teams should be more comprehensively explored during debriefings in simulation-based training because of their importance for clinical performance. We describe how circular questions can be used for that purpose. Circular questions are based on social constructivism. They include a variety of systemic interviewing methods. The goals of circular questions are to explore the mutual dependency of team members' behavior and recurrent behavior patterns, to generate information, to foster perspective taking, to "fluidize" problems, and to put actions into relational contexts. We describe the nature of circular questions, the benefits they offer, and ways of applying them during debriefings.

Suicide in the Fire Service: Saving the Lives of Firefighters

Science.gov (United States)

2016-03-01

Incident Stress Debriefing have been developed to help individuals develop better coping skills when faced with traumatic situations. The DVA has...Brooks, “The World Trade Center Attack; Helping the Helpers : The Role of Critical Incident Stress Management,” Critical Care 5, no. 6 (November 6...which the individuals learn skills that enable them to comprehend how the way they think and feel has been altered by the trauma—and prolonged

Preventing construction worker injury incidents through the management of personal stress and organizational stressors.

Science.gov (United States)

Leung, Mei-yung; Chan, Isabelle Yee Shan; Yu, Jingyu

2012-09-01

Construction workers (CWs) are positioned at the lowest level of an organization and thus have limited control over their work. For this reason, they are often deprived of their due rewards and training or sometimes are even compelled to focus on production at the expense of their own safety. These organizational stressors not only cause the CWs stress but also impair their safety behaviors. The impairment of safety behaviors is the major cause of CW injury incidents. Hence, to prevent injury incidents and enhance safety behaviors of CWs, the current study aimed to identify the impact of various organizational stressors and stress on CW safety behaviors and injury incidents. To achieve this aim, we surveyed 395 CWs. Using factor analysis, we identified five organizational stressors (unfair reward and treatment, inappropriate safety equipment, provision of training, lack of goal setting, and poor physical environment), two types of stress (emotional and physical), and safety behaviors. The results of correlation and regression analyses revealed the following: (1) injury incidents were minimized by safety behaviors but escalated by a lack of goal setting, (2) safety behaviors were maximized by moderate levels of emotional stress (i.e., an inverted U-shape relationship between these two variables) and increased in line with physical stress and inappropriate safety equipment, (3) emotional stress was positively predicted by the provision of training and inappropriate safety equipment, and (4) physical stress was predicted only by inappropriate safety equipment. Based on these results, we suggest various recommendations to construction stakeholders on how to prevent CW injury incidents. Copyright © 2011 Elsevier Ltd. All rights reserved.

[Second victim : Critical incident stress management in clinical medicine].

Science.gov (United States)

Schiechtl, B; Hunger, M S; Schwappach, D L; Schmidt, C E; Padosch, S A

2013-09-01

Critical incidents in clinical medicine can have far-reaching consequences on patient health. In cases of severe medical errors they can seriously harm the patient or even lead to death. The involvement in such an event can result in a stress reaction, a so-called acute posttraumatic stress disorder in the healthcare provider, the so-called second victim of an adverse event. Psychological distress may not only have a long lasting impact on quality of life of the physician or caregiver involved but it may also affect the ability to provide safe patient care in the aftermath of adverse events. A literature review was performed to obtain information on care giver responses to medical errors and to determine possible supportive strategies to mitigate negative consequences of an adverse event on the second victim. An internet search and a search in Medline/Pubmed for scientific studies were conducted using the key words "second victim, "medical error", "critical incident stress management" (CISM) and "critical incident stress reporting system" (CIRS). Sources from academic medical societies and public institutions which offer crisis management programs where analyzed. The data were sorted by main categories and relevance for hospitals. Analysis was carried out using descriptive measures. In disaster medicine and aviation navigation services the implementation of a CISM program is an efficient intervention to help staff to recover after a traumatic event and to return to normal functioning and behavior. Several other concepts for a clinical crisis management plan were identified. The integration of CISM and CISM-related programs in a clinical setting may provide efficient support in an acute crisis and may help the caregiver to deal effectively with future error events and employee safety.

Preventive osteopathic manipulative treatment and stress fracture incidence among collegiate cross-country athletes.

Science.gov (United States)

Brumm, Lynn F; Janiski, Carrie; Balawender, Jenifer L; Feinstein, Adam

2013-12-01

Stress fractures are common among athletes, particularly distance runners, with many theories regarding the etiologic process of stress fractures and various studies identifying risk factors or suggesting preventive techniques. To our knowledge, no previous studies have discussed the possible causative effects of somatic dysfunction or the preventive capabilities of osteopathic manipulative treatment (OMT). To apply a preventive OMT protocol for cross-country athletes to reduce the incidence of stress fractures. Cohort study. Examinations of cross-country athletes at an NCAA (National Collegiate Athletic Association) Division I university were performed by supervising physician-examiners and first- and second-year osteopathic medical students during several consecutive academic years. Athletes re-enrolled in the study each year they continued to be eligible. The intervention included osteopathic structural examination and OMT that focused on somatic dysfunction identified in the pelvis, sacrum, and lower extremities. More than 1800 participant examinations were performed on 124 male and female participants by 3 supervising physician-examiners and 141 osteopathic medical students over the course of 5 consecutive academic years (2004-2005 to 2008-2009). Data from these academic years were compared with data from the previous 8 academic years (1996-1997 to 2003-2004). An average of 20 new participants enrolled yearly. The number of annual stress fractures per team ranged from 0 to 6 for male participants and 1 to 6 for female participants. The cumulative annual incidence of stress fractures for male participants demonstrated a statistically significant decrease from 13.9% (20 of 144) before intervention to 1.0% (1 of 105) after intervention, resulting in a 98.7% relative reduction in stress-fracture diagnosis (P=.019). The cumulative annual incidence for female participants showed a minimal decrease from 12.9% (23 of 178) before intervention to 12.0% (17 of 142) after

The relationship between facilitators' questions and the level of reflection in postsimulation debriefing

DEFF Research Database (Denmark)

Husebø, Sissel Eikeland; Dieckmann, Peter; Rystedt, Hans

2013-01-01

Simulation-based education is a learner-active method that may enhance teamwork skills such as leadership and communication. The importance of postsimulation debriefing to promote reflection is well accepted, but many questions concerning whether and how faculty promote reflection remain largely...

The effectiveness of crisis resource management and team debriefing in resuscitation education of nursing students: A randomised controlled trial.

Science.gov (United States)

Coppens, Imgard; Verhaeghe, Sofie; Van Hecke, Ann; Beeckman, Dimitri

2018-01-01

The aim of this study was to investigate (i) whether integrating a course on crisis resource management principles and team debriefings in simulation training, increases self-efficacy, team efficacy and technical skills of nursing students in resuscitation settings and (ii) which phases contribute the most to these outcomes. Crisis resource management principles have been introduced in health care to optimise teamwork. Simulation training offers patient safe training opportunities. There is evidence that simulation training increases self-efficacy and team efficacy but the contribution of the different phases like crisis resource management principles, simulation training and debriefing on self-efficacy, team efficacy and technical skills is not clear. Randomised controlled trial in a convenience sample (n = 116) in Belgium. Data were collected between February 2015-April 2015. Participants in the intervention group (n = 60) completed a course on crisis resource management principles, followed by a simulation training session, a team debriefing and a second simulation training session. Participants in the control group (n = 56) only completed two simulation training sessions. The outcomes self-efficacy, team efficacy and technical skills were assessed after each simulation training. An ancillary analysis of the learning effect was conducted. The intervention group increased on self-efficacy (2.13%, p = .02) and team efficacy (9.92%, p crisis resource management principles and team debriefings in simulation training increases self-efficacy and team efficacy. The debriefing phase contributes the most to these effects. By partnering with healthcare settings, it becomes possible to offer interdisciplinary simulation training that can increase patient safety. © 2017 John Wiley & Sons Ltd.

Number of recent stressful life events and incident cardiovascular disease: Moderation by lifetime depressive disorder.

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Berntson, Jessica; Patel, Jay S; Stewart, Jesse C

2017-08-01

We investigated whether number of recent stressful life events is associated with incident cardiovascular disease (CVD) and whether this relationship is stronger in adults with a history of clinical depression. Prospective data from 28,583 U.S. adults (mean age=45years) initially free of CVD who participated in Waves 1 (2001-2002) and 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) were examined. Number of past-year stressful life events (Wave 1), lifetime depressive disorder (Wave 1), and incident CVD (Wave 2) were determined by structured interviews. There were 1069 cases of incident CVD. Each additional stressful life event was associated with a 15% increased odds of incident CVD [Odds Ratio (OR)=1.15, 95% Confidence Interval (CI): 1.11, 1.19]. As hypothesized, a stressful life events by lifetime depressive disorder interaction was detected (P=0.003). Stratified analyses indicated that stressful life events had a stronger association with incident CVD among adults with (OR=1.18, 95% CI: 1.10, 1.27, n=4908) versus without (OR=1.10, 95% CI: 1.07, 1.14, n=23,675) a lifetime depressive disorder. Our findings suggest that a greater number of recent stressful life events elevate the risk of new-onset CVD and that this risk is potentiated in adults with a history of clinical depression. Copyright © 2017 Elsevier Inc. All rights reserved.

Stress measurements by multi-reflection grazing-incidence X-ray diffraction method (MGIXD) using different radiation wavelengths and different incident angles

International Nuclear Information System (INIS)

Marciszko, Marianna; Baczmański, Andrzej; Braham, Chedly; Wróbel, Mirosław; Wroński, Sebastian; Cios, Grzegorz

2017-01-01

The presented study introduces the development of the multi-reflection grazing-incidence X-ray diffraction method (MGIXD) for residual stress determination. The proposed new methodology is aimed at obtaining more reliable experimental data and increasing the depth of non-destructive stress determination below the sample surface. To verify proposed method measurements were performed on a classical X-ray diffractometer (Cu Kα radiation) and using synchrotron radiation (three different wavelengths: λ = 1.2527 Å, λ = 1.5419 Å and λ = 1.7512 Å). The Al2017 alloy subjected to three different surface treatments was investigated in this study. The obtained results showed that the proposed development of MGIXD method, in which not only different incident angles but also different wavelengths of X-ray are used, can be successfully applied for residual stress determination, especially when stress gradients are present in the sample.

Debriefing after High-Fidelity Simulation and Knowledge Retention: A Quasi-Experimental Study

Science.gov (United States)

Olson, Susan L.

2013-01-01

High-fidelity simulation (HFS) use in nursing education has been a frequent research topic in recent years. Previous research included studies on the use of HFS with nursing students, focusing on their feelings of self-confidence and anxiety. However, research focused specifically on the debriefing portion of HFS was limited. This quantitative,…

Effects of perioperative briefing and debriefing on patient safety: a prospective intervention study.

NARCIS (Netherlands)

Leong, K.B.M.S.L.; Hanskamp-Sebregts, M.E.; Wal, R.A. van der; Wolff, AP

2017-01-01

OBJECTIVES: This study was carried out to improve patient safety in the operating theatre by the introduction of perioperative briefing and debriefing, which focused on an optimal collaboration between surgical team members. DESIGN: A prospective intervention study with one pretest and two post-test

Planning and Facilitating Debriefs of Experiential Learning Activities in Skills-Based Health Education

Science.gov (United States)

Johns, Judith A.; Moyer, Matthew T.; Gasque, Lisa M.

2017-01-01

Purpose: This paper highlights the importance of conducting structured, student-centered discussions, known as debriefs, following experiential learning activities in health education. Drawing upon Kolb's experiential learning theory and literature from scholars in simulation-based training, the authors outline key considerations for planning and…

A Systemic-Constructivist Approach to the Facilitation and Debriefing of Simulations and Games

Science.gov (United States)

Kriz, Willy Christian

2010-01-01

This article introduces some basic concepts of a systemic-constructivist perspective. These show that gaming simulation corresponds closely to a systemic-constructivist approach to learning and instruction. Some quality aspects of facilitating and debriefing simulation games are described from a systemic-constructivist point of view. Finally, a…

Introduction of a prehospital critical incident monitoring system--pilot project results.

Science.gov (United States)

Stella, Julian; Davis, Anna; Jennings, Paul; Bartley, Bruce

2008-01-01

Hospital medical incident monitoring improves preventable morbidity and mortality rates. Error management systems have been adopted widely in this setting. Data relating to incident monitoring in the prehospital setting is limited. Implementation of an incident monitoring process in a prehospital setting. This is a prospective, descriptive study of the pilot phase of the implementation of an incident monitoring process in a regional prehospital setting, with a focus on trauma care. Paramedics and emergency department staff submitted anonymous incident reports, and a chart review was performed on patients who met major trauma criteria. Selected trauma cases were analyzed by a structured interview/debriefing process to elucidate undocumented incidents. A project committee coded and logged all incidents and developed recommendations. Of 4,429 ambulance responses, 41 cases were analyzed. Twenty-four (58.5%; 95% CI = 49.7-67.4%) were reported anonymously, and the rest were major trauma patients. A total of 77 incidents were identified (mean per case = 1.8; CI = 1.03-2.57). Anonymous cases revealed 26 incidents (mean = 1.1; CI = 0.98-1.22); eight trauma debriefings revealed 38 incidents (mean = 4.8; CI = 0.91-8.69) and nine trauma chart reviews revealed 13 incidents (mean = 1.6; CI = 1.04-2.16). A total of 56 of 77 (72.7%; CI = 65.5-80.0%) incidents related to system inadequacies, and 15 (57.7%; CI = 46.7-68.6%) anonymously reported incidents related to resource problems. A total of 35 of 77 (45.5%; CI = 40.4-50.5%) incidents had minimal or no impact on the patients' outcomes. Thirty-four of 77 (44.2%; CI = 39.3-49.1%) incidents were considered mitigated by circumstance. Incident monitoring led to generalized feedback in most cases (65 of 77; 84.4%; CI = 77.6-91.3%); in three cases (3.9%; CI = 3.7-4.1%), specific education occurred; two cases were reported to an external body (2.6%; CI = 2.5-2.7%); three cases resulted in remedial action (3.9%; CI = 3.7-4.1%); four for

[Teaching non-technical skills for critical incidents: Crisis resource management training for medical students].

Science.gov (United States)

Krüger, A; Gillmann, B; Hardt, C; Döring, R; Beckers, S K; Rossaint, R

2009-06-01

Physicians have to demonstrate non-technical skills, such as communication and team leading skills, while coping with critical incidents. These skills are not taught during medical education. A crisis resource management (CRM) training was established for 4th to 6th year medical students using a full-scale simulator mannikin (Emergency Care Simulator, ECS, METI). The learning objectives of the course were defined according to the key points of Gaba's CRM concept. The training consisted of theoretical and practical parts (3 simulation scenarios with debriefing). Students' self-assessment before and after the training provided the data for evaluation of the training outcome. A total of 65 students took part in the training. The course was well received in terms of overall course quality, debriefings and didactic presentation, the mean overall mark being 1.4 (1: best, 6: worst). After the course students felt significantly more confident when facing incidents in clinical practice. The main learning objectives were achieved. The effectiveness of applying the widely used ECS full-scale simulator in interdisciplinary teaching has been demonstrated. The training exposes students to crisis resource management issues and motivates them to develop non-technical skills.

The Relationship of Stressors and Stress on Injury Incident of Construction Workers in Penang

Directory of Open Access Journals (Sweden)

Muhd Ali Khairul Ammar

2016-01-01

Full Text Available Construction Workers (CWs are the main source of manpower that is necessary to every construction project. Non conducive and hazardous working environment at construction site will affect the physiological health of the construction labour. This study is conducted to explore the impact of job stress and emotional stress to the CWs that potentially lead to injuries incident in Penang. Twelve stressors were identified through factor analysis. Then, the stressors are classified into five main categories. Questionnaires were developed according to the stressstressor relationship. The correlation between factors of injury incident (stressor and stress shows that lack of autonomy and inappropriate safety equipment lead to the emotional stress among the CWs with 0.287 and 0.204 respectively. In addition, poor physical environment causes the job stress among CWs with the correlation of 0.270.

Debriefing to Improve Student Ability to Assess and Plan for the Care of Persons With Disability.

Science.gov (United States)

Takeda, Mikiko Y; Smith, Mark J; Cone, Catherine J

2017-12-01

Although recent literature suggests that students should be trained in the care of persons with disability (PWDs) as a form of cultural sensitivity (CS), healthcare professionals may receive limited experience during their formal training. After pharmacy students in 2 previous years of testing failed to adequately assess and plan for the care of a standardized patient's chief complaint and disability in an Objective Structured Clinical Examination (OSCE), the investigators added debriefing to the OSCE to determine if it would improve student's ability to assess and plan for the care of PWD. Two sequentially enrolled second-year pharmacy school student cohorts participated in this study (control n = 90; intervention n = 82). During the OSCE, students interviewed and examined a standardized patient with a simulated physical disability and other chronic disease states. Students were then instructed to develop a care plan considering the patient's disability and other disease states. The intervention cohort received debriefing; the control did not. Students documented the care plan in a subjective, objective, assessment, and plan (SOAP) note. Investigators assessed SOAP note score (general ability of students to write a SOAP note) and CS score (specific ability to care for PWD) to determine the effectiveness of the debriefing. The intervention group showed a significantly higher percent mean CS score than the control group (93.6% ± 19% and 61.1% ± 30.7%, respectively, P improvement in pass rates (those students scoring ≥70% on the OSCE) of 59.4% with 92.7% of the students passing in the intervention group versus 33.3% of the students passing in the control group (P improved students' performance in developing care plans for disabled patients. Ideally, longitudinal studies should be completed to determine if these skills transfer from debriefings to clinical practice. Development of effective training and assessment methods is essential for students to obtain

Latest developments in post-traumatic stress disorder: diagnosis and treatment.

Science.gov (United States)

Greenberg, Neil; Brooks, Samantha; Dunn, Rebecca

2015-06-01

Most people will experience a traumatic event during their lives. However, not all will develop Post-Traumatic Stress Disorder (PTSD). There have been recent changes in diagnostic criteria for PTSD and there are a number of treatment options available. This review is based on published literature in the field of PTSD, its management and the recently published DSM-V. The most influential risk factors relate to the post-incident environment rather than pre-incident or the incident itself. There are two established and effective psychological therapies; trauma-focussed cognitive behavioural therapy and eye movement desensitization and reprocessing. It is unclear what actually constitutes a traumatic event. Psychological debriefing or counselling interventions, shortly after trauma-exposure are found to be ineffective and may cause harm. Medication, whilst common practice, is not recommended as first line management. Future psychotherapies for PTSD may be just as effective if delivered in carefully considered group settings or through remote means. Research into the most effective ways to prevent individuals at risk of developing PTSD is still at an early stage and development of effective early interventions could substantially reduce the morbidity associated with PTSD. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Incidence and Time to Return to Training for Stress Fractures during Military Basic Training

Directory of Open Access Journals (Sweden)

Alexander M. Wood

2014-01-01

Full Text Available Currently, little is known about the length of time required to rehabilitate patients from stress fractures and their return to preinjury level of physical activity. Previous studies have looked at the return to sport in athletes, in a general population, where rehabilitation is not as controlled as within a captive military population. In this study, a longitudinal prospective epidemiological database was assessed to determine the incidence of stress fractures and the time taken to rehabilitate recruits to preinjury stage of training. Findings demonstrated a background prevalence of 5% stress fractures in Royal Marine training; femoral and tibial stress fractures take 21.1 weeks to return to training with metatarsal stress fractures being the most common injury taking 12.2 weeks. Rehabilitation from stress fractures accounts for 814 weeks of recruit rehabilitation time per annum. Stress fracture incidence is still common in military training; despite this stress fracture recovery times remain constant and represent a significant interruption in training. It takes on average 5 weeks after exercise specific training has restarted to reenter training at a preinjury level, regardless of which bone has a stress fracture. Further research into their prevention, treatment, and rehabilitation is required to help reduce these burdens.

Incidence of depression, anxiety and stress following traumatic injury: a longitudinal study.

Science.gov (United States)

Wiseman, Taneal A; Curtis, Kate; Lam, Mary; Foster, Kim

2015-03-28

Traumatic injury and mental health disorders are co-associated. Early identification of depression, anxiety and stress following injury, and subsequent preventive intervention, may reduce the long-term symptoms and negative impacts associated with depression and anxiety. The purpose of the study was to determine the incidence, severity and predictors of depression, anxiety and stress in injured patients in the acute phase of care, and at six months following injury, as well as the effectiveness of an in-hospital screening tool. This descriptive longitudinal study of trauma patients was conducted at a Level 1 Metropolitan Trauma Centre in Australia over 14 months. Participants were interviewed using the Depression Anxiety Stress Scale short-form version (DASS-21) during hospital admission then at 3 and 6 months after injury. Descriptive statistics were performed to evaluate participant characteristics and incidence of depression, anxiety and stress. Correlations and logistic regression were conducted to investigate the ability of the DASS-21 to predict symptoms of depression, anxiety and stress and to investigate factors associated with depression, anxiety and stress 6 months after injury. 201 participants ranging in age (18-94 years) and injury severity participated in the baseline interview and 109 completed all 3 interviews over 6 months. Over half (54%) reported above normal scores for depression, anxiety and/or stress in at least one of the 3 time points. Intensive care unit admission and high levels of depression, anxiety and stress at 3 months post injury were predictors for high levels of depression, anxiety and stress at 6 months. Low scores for depression, anxiety and stress during admission were correlated with low scores for depression, anxiety and stress at 3 and 6 months. Depression, anxiety and stress in patients hospitalised following injury is common and should be anticipated in patients who have had an intensive care admission. Screening at 3

Greater support and debriefing may help student midwives to process traumatic birth experiences

OpenAIRE

Kitson-Reynolds, Ellen

2015-01-01

Implications for practice and researchIncorporating resilience training and a multidisciplinary debriefing approach within clinical and academic environments would develop a culture of support and compassion for the workforce and ultimately effective care for women using maternity services. Further research surrounding the effectiveness of resilience education for student midwives is required to elicit greater understanding of the effect on woman-centred care.

Mindfulness-based stress reduction teachers, practice characteristics, cancer incidence, and health: a nationwide ecological description.

Science.gov (United States)

Robb, Sara Wagner; Benson, Kelsey; Middleton, Lauren; Meyers, Christine; Hébert, James R

2015-02-14

Studies have demonstrated the potential of the Mindfulness-Based Stress Reduction (MBSR) program to improve the condition of individuals with health outcomes such as hypertension, diabetes, and chronic pain; improve psychological well-being; reduce stress levels; and increase survival among cancer patients. To date, only one study has focused on the effect of long-term meditation on stress, showing a positive protective relationship. However, the relationship between meditation and cancer incidence remains unexplored. The objective of this study was to describe the state-level relationship between MBSR instructors and their practices and county-level health outcomes, including cancer incidence, in the United States. This ecologic study was performed using geospatial mapping and descriptive epidemiology of statewide MBSR characteristics and overall health, mental health state rankings, and age-adjusted cancer incidence rates. Weak to moderate state-level correlations between meditation characteristics and colorectal and cervical cancer incidence were detected, with states with more meditation (e.g., more MBSR teachers per population) correlated with a decreased cancer incidence. A negative correlation was detected between lung & bronchus cancer and years teaching MBSR only. Moderate positive correlations were detected between Hodgkin's Lymphoma and female breast cancer in relation to all meditation characteristics. Statistically significant correlations with moderate coefficients were detected for overall health ranks and all meditation characteristics, most strongly for total number of years teaching MBSR and total number of years of general meditation practice. Our analyses might suggest that a relationship exists between the total number of MBSR teachers per state and the total number of years of general meditation practice per state, and colorectal and cervical cancer incidence. Positive correlations were observed with overall health rankings. Despite this study

The Incidence of Posttraumatic Stress Disorder After Floods: A Meta-Analysis.

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Chen, Long; Liu, Aizhong

2015-06-01

This study analyzes the incidence of posttraumatic stress disorder (PTSD) among flood victims, between different flood intensities, and between different time points after a flood. A search of several electronic literature databases was conducted to collect data on the incidence of PTSD after a flood. Loney criteria for research quality were used to evaluate the quality of selected search results. The combined incidence of PTSD was estimated using the Freeman-Tukey double arcsine transformation method. Subgroup analyses were conducted on different trauma intensities and different time points after a flood. Sensitivity analysis was performed to evaluate the impact of research quality. Fourteen articles were included in this meta-analysis, including a total of 40 600 flood victims; 3862 victims were diagnosed with PTSD. The combined incidence of PTSD was 15.74%. The subgroup analyses showed that the incidence of PTSD in victims who experienced severe and moderate flood intensity was higher than that in victims who experienced mild flood intensity. The incidence of PTSD was lower at 6 or more months after a flood (11.45%) than within 6 months (16.01%) of a flood. In conclusion, the incidence of PTSD among floods of different trauma intensities was statistically significant.

Mantram repetition for stress management in veterans and employees: a critical incident study.

Science.gov (United States)

Bormann, Jill E; Oman, Doug; Kemppainen, Jeanne K; Becker, Sheryl; Gershwin, Madeline; Kelly, Ann

2006-03-01

This paper reports a study assessing the usefulness of a mantram repetition programme. Complementary/alternative therapies are becoming commonplace, but more research is needed to assess their benefits. A 5-week programme teaching a 'mind-body-spiritual' technique of silently repeating a mantram - a word or phrase with spiritual meaning - to manage stress was developed. A mantram was chosen by individuals, who were taught to repeat it silently throughout the day or night to interrupt unwanted thoughts and elicit the relaxation response. Participants who attended a 5-week course were invited to participate in the study. Of those who consented, a randomly selected subset (n = 66) was contacted approximately 3 months after the course for a telephone interview using the critical incident interviewing technique. Participants were asked whether the intervention was helpful or not, and if helpful, to identify situations where it was applied. Interviews were transcribed and incidents were identified and categorized to create a taxonomy of uses. The data were collected in 2001-2002. Participants included 30 veterans, mostly males (97%), and 36 hospital employees, mostly females (86%). Mean age was 56 years (sd = 12.94). Fifty-five participants (83.3%) practiced the technique and reported 147 incidents where the programme was helpful. Outcomes were organized into a taxonomy of incidents using four major categories that included managing: (a) emotions other than stress (51%); (b) stress (23.8%); (c) insomnia (12.9%); and (d) unwanted thoughts (12.3%). A group of raters reviewed the categories for inter-rater reliability. The majority of participants from two distinct samples reported that the mantram programme was helpful in a variety of situations. The critical incident interviewing method was found to be practical, efficient, and thorough in collecting and analyzing data. Such qualitative methods contribute to understanding the benefits of mind-body complementary therapies.

Incidence of depression, anxiety and stress following traumatic injury: a longitudinal study

OpenAIRE

Wiseman, Taneal A; Curtis, Kate; Lam, Mary; Foster, Kim

2015-01-01

Background Traumatic injury and mental health disorders are co-associated. Early identification of depression, anxiety and stress following injury, and subsequent preventive intervention, may reduce the long-term symptoms and negative impacts associated with depression and anxiety. The purpose of the study was to determine the incidence, severity and predictors of depression, anxiety and stress in injured patients in the acute phase of care, and at six months following injury, as well as the ...

Post-Traumatic Stress Disorder and Risk for Incident Rheumatoid Arthritis.

Science.gov (United States)

Lee, Yvonne C; Agnew-Blais, Jessica; Malspeis, Susan; Keyes, Katherine; Costenbader, Karen; Kubzansky, Laura D; Roberts, Andrea L; Koenen, Karestan C; Karlson, Elizabeth W

2016-03-01

To examine the association between symptoms of post-traumatic stress disorder (PTSD) and rheumatoid arthritis (RA) risk in a prospective cohort and to characterize the role of smoking in this relationship. A subset (n = 54,224) of the Nurses' Health Study II, a prospective cohort of female nurses, completed the Brief Trauma Questionnaire and a screen for PTSD symptoms. Participants were categorized based on trauma exposure and number of PTSD symptoms. Incident RA cases (n = 239) from 1989 to 2011 were identified. Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs) between PTSD symptoms and incident RA. To identify the impact of smoking, secondary and subgroup analyses were performed. In all analyses, PTSD and smoking were lagged 2 years before the development of RA. Compared to no history of trauma/PTSD symptoms, the HR for ≥4 PTSD symptoms and incident RA was 1.76 (95% CI 1.16-2.67) in models adjusted for age, race, and socioeconomic status. The risk for RA increased with an increasing number of PTSD symptoms (P = 0.01). When smoking was added to the model, the HR for RA remained elevated (HR 1.60 [95% CI 1.05-2.43]). In a subgroup analysis, excluding women who smoked before PTSD onset, results were unchanged (HR 1.68 [95% CI 1.04-2.70]). This study suggests that women with high PTSD symptomatology have an elevated risk for RA, independent of smoking, adding to emerging evidence that stress is an important determinant of physical health. © 2016, American College of Rheumatology.

[Effect of Debriefing Based on the Clinical Judgment Model on Simulation Based Learning Outcomes of End-of-Life Care for Nursing Students: A Non-Randomized Controlled Trial].

Science.gov (United States)

Jeong, Kyung In; Choi, Ja Yun

2017-12-01

This study was conducted to identify effects of debriefing based on the clinical judgment model for nursing students on their knowledge, skill performance, clinical judgment, self-confidence and learner satisfaction during simulation based end-of-life care (ELC) education. Simulation based ELC education was developed in six steps as follows: selection of learning subjects and objects, development of learning tools, a trial run of simulation-based education, students' skill training, and evaluators' training. Forty-eight senior nursing students (25 in the experimental group and 23 in the control group) participated in the simulation-based ELC education using a high-fidelity simulator. Debriefing based on the clinical judgment was compared with the usual debriefing. ANCOVA showed that there were differences in knowledge (F=4.81, p=.034), skill performance (F=68.33, psatisfaction (t=-0.38, p=.704) between the experimental and control groups. This study found that debriefing based on the clinical judgement model is effective for supporting nursing students for reflecting on clinical judgment and improving their diverse competencies in complex clinical settings such as ELC. © 2017 Korean Society of Nursing Science

Medical students review of formative OSCE scores, checklists, and videos improves with student-faculty debriefing meetings.

Science.gov (United States)

Bernard, Aaron W; Ceccolini, Gabbriel; Feinn, Richard; Rockfeld, Jennifer; Rosenberg, Ilene; Thomas, Listy; Cassese, Todd

2017-01-01

Performance feedback is considered essential to clinical skills development. Formative objective structured clinical exams (F-OSCEs) often include immediate feedback by standardized patients. Students can also be provided access to performance metrics including scores, checklists, and video recordings after the F-OSCE to supplement this feedback. How often students choose to review this data and how review impacts future performance has not been documented. We suspect student review of F-OSCE performance data is variable. We hypothesize that students who review this data have better performance on subsequent F-OSCEs compared to those who do not. We also suspect that frequency of data review can be improved with faculty involvement in the form of student-faculty debriefing meetings. Simulation recording software tracks and time stamps student review of performance data. We investigated a cohort of first- and second-year medical students from the 2015-16 academic year. Basic descriptive statistics were used to characterize frequency of data review and a linear mixed-model analysis was used to determine relationships between data review and future F-OSCE performance. Students reviewed scores (64%), checklists (42%), and videos (28%) in decreasing frequency. Frequency of review of all metric and modalities improved when student-faculty debriefing meetings were conducted (p<.001). Among 92 first-year students, checklist review was associated with an improved performance on subsequent F-OSCEs (p = 0.038) by 1.07 percentage points on a scale of 0-100. Among 86 second year students, no review modality was associated with improved performance on subsequent F-OSCEs. Medical students review F-OSCE checklists and video recordings less than 50% of the time when not prompted. Student-faculty debriefing meetings increased student data reviews. First-year student's review of checklists on F-OSCEs was associated with increases in performance on subsequent F-OSCEs, however this

Examining critical care nurses' critical incident stress after in hospital cardiopulmonary resuscitation (CPR).

Science.gov (United States)

Laws, T

2001-05-01

The object of this study was to determine if critical care nurses' emotional responses to having performed cardiopulmonary resuscitation were indicative of critical incident stress. A descriptive approach was employed using a survey questionnaire of 31 critical care nurses, with supportive interview data from 18 of those participants. Analysis of the data generated from the questionnaire indicated that the respondents experienced thought intrusion and avoidance behaviour. A majority of those interviewed disclosed that they had experienced a wide range of emotional stressors and physical manifestations in response to having performed the procedure. The findings from both questionnaire and interview data were congruent with signs of critical incident stress, as described in the literature. This has been found to be detrimental to employees' mental health status and, for this reason, employers have a duty of care to minimise the risk of its occurrence and to manage problems as they arise.

An Investigation of the Development of Pre-Service Teacher Assessment Literacy through Individualized Tutoring and Peer Debriefing

Science.gov (United States)

Odo, Dennis Murphy

2016-01-01

Many pre-service teachers lack deep understanding of assessment concepts and have low selfefficacy for using assessments but pre-service on-campus programs have been shown to support their assessment literacy development. Likewise, individualized tutoring has helped pre-service candidates improve instructional practice and peer debriefing has been…

Focused and Corrective Feedback Versus Structured and Supported Debriefing in a Simulation-Based Cardiac Arrest Team Training: A Pilot Randomized Controlled Study.

Science.gov (United States)

Kim, Ji-Hoon; Kim, Young-Min; Park, Seong Heui; Ju, Eun A; Choi, Se Min; Hong, Tai Yong

2017-06-01

The aim of the study was to compare the educational impact of two postsimulation debriefing methods-focused and corrective feedback (FCF) versus Structured and Supported Debriefing (SSD)-on team dynamics in simulation-based cardiac arrest team training. This was a pilot randomized controlled study conducted at a simulation center. Fourth-year medical students were randomly assigned to the FCF or SSD group, with each team composed of six students and a confederate. Each team participated in two simulations and the assigned debriefing (FCF or SSD) sessions and then underwent a test simulation. Two trained raters blindly assessed all of the recorded simulations using checklists. The primary outcome was the improvement in team dynamics scores between baseline and test simulation. The secondary outcomes were improvements before and after training in team clinical performance scores, self-assessed comprehension of and confidence in cardiac arrest management and team dynamics, as well as evaluations of the postsimulation debriefing intervention. In total, 95 students participated [FCF (8 teams, n = 47) and SSD (8 teams, n = 48)]. The SSD team dynamics score during the test simulation was higher than at baseline [baseline: 74.5 (65.9-80.9), test: 85.0 (71.9-87.6), P = 0.035]. However, there were no differences in the improvement in the team dynamics or team clinical performance scores between the two groups (P = 0.328, respectively). There was no significant difference in improvement in team dynamics scores during the test simulation compared with baseline between the SSD and FCF groups in a simulation-based cardiac arrest team training in fourth-year Korean medical students.

Critical Incident Stress Management (CISM) in complex systems: cultural adaptation and safety impacts in healthcare.

Science.gov (United States)

Müller-Leonhardt, Alice; Mitchell, Shannon G; Vogt, Joachim; Schürmann, Tim

2014-07-01

In complex systems, such as hospitals or air traffic control operations, critical incidents (CIs) are unavoidable. These incidents can not only become critical for victims but also for professionals working at the "sharp end" who may have to deal with critical incident stress (CIS) reactions that may be severe and impede emotional, physical, cognitive and social functioning. These CIS reactions may occur not only under exceptional conditions but also during every-day work and become an important safety issue. In contrast to air traffic management (ATM) operations in Europe, which have readily adopted critical incident stress management (CISM), most hospitals have not yet implemented comprehensive peer support programs. This survey was conducted in 2010 at the only European general hospital setting which implemented CISM program since 2004. The aim of the article is to describe possible contribution of CISM in hospital settings framed from the perspective of organizational safety and individual health for healthcare professionals. Findings affirm that daily work related incidents also can become critical for healthcare professionals. Program efficiency appears to be influenced by the professional culture, as well as organizational structure and policies. Overall, findings demonstrate that the adaptation of the CISM program in general hospitals takes time but, once established, it may serve as a mechanism for changing professional culture, thereby permitting the framing of even small incidents or near misses as an opportunity to provide valuable feedback to the system. Copyright © 2014 Elsevier Ltd. All rights reserved.

Association of stressful life events with incident falls and fractures in older men: the Osteoporotic Fractures in Men (MrOS) Study

Science.gov (United States)

Fink, Howard A.; Kuskowski, Michael A.; Marshall, Lynn M.

2014-01-01

Background: small, retrospective studies suggest that major life events and/or sudden emotional stress may increase fall and fracture risk. The current study examines these associations prospectively. Methods: a total of 5,152 men aged ≥65 years in the Osteoporotic Fractures in Men study self-reported data on stressful life events for 1 year prior to study Visit 2. Incident falls and fractures were ascertained for 1 year after Visit 2. Fractures were centrally confirmed. Results: a total of 2,932 (56.9%) men reported ≥1 type of stressful life event. In men with complete stressful life event, fall and covariate data (n = 3,949), any stressful life event was associated with a 33% increased risk of incident fall [relative risk (RR) 1.33, 95% confidence interval (CI) 1.19–1.49] and 68% increased risk of multiple falls (RR = 1.68, 95% CI = 1.40–2.01) in the year following Visit 2 after adjustment for age, education, Parkinson's disease, diabetes, stroke, instrumental activities of daily living (IADL) impairment, chair stand time, walk speed, multiple past falls, depressive symptoms and antidepressant use. Risk increased with the number of types of stressful life events. Though any stressful life event was associated with a 58% increased age-adjusted risk for incident fracture, this association was attenuated and no longer statistically significant after additional adjustment for total hip bone mineral density, fracture after age 50, Parkinson's disease, stroke and IADL impairment. Conclusions: in this cohort of older men, stressful life events significantly increased risk of incident falls independent of other explanatory variables, but did not independently increase incident fracture risk. PMID:24002237

Cultural Capital in the Classroom: The Significance of Debriefing as a Pedagogical Tool in Simulation-Based Learning

Science.gov (United States)

Richards, Bedelia; Camuso, Lauren

2015-01-01

Although social inequality is critical to the study of sociology, it is particularly challenging to teach about race, class and gender inequality to students who belong to privileged social groups. Simulation games are often used successfully to address this pedagogical challenge. While debriefing is a critical component of simulation exercises…

Observation of Computer-Supported, Collaborative Work Tool Usage during Briefing and Debriefing Phases of Coalition Mission Training Research for Maple Skies

National Research Council Canada - National Science Library

Bennett, Jeff; Lamoureux, T. M

2006-01-01

.... The opportunity was taken to conduct a video analysis and questionnaire survey of participants in a distributed briefing and debriefing environment during the Maple Skies simulation training event...

Work-related critical incidents in hospital-based health care providers and the risk of post-traumatic stress symptoms, anxiety, and depression: a meta-analysis.

Science.gov (United States)

de Boer, Jacoba; Lok, Anja; Van't Verlaat, Ellen; Duivenvoorden, Hugo J; Bakker, Arnold B; Smit, Bert J

2011-07-01

This meta-analysis reviewed existing data on the impact of work-related critical incidents in hospital-based health care professionals. Work-related critical incidents may induce post-traumatic stress symptoms or even post-traumatic stress disorder (PTSD), anxiety, and depression and may negatively affect health care practitioners' behaviors toward patients. Nurses and doctors often cope by working part time or switching jobs. Hospital administrators and health care practitioners themselves may underestimate the effects of work-related critical incidents. Relevant online databases were searched for original research published from inception to 2009 and manual searches of the Journal of Traumatic Stress, reference lists, and the European Traumatic Stress Research Database were conducted. Two researchers independently decided on inclusion and study quality. Effect sizes were estimated using standardized mean differences with 95% confidence intervals. Consistency was evaluated, using the I(2)-statistic. Meta-analysis was performed using the random effects model. Eleven studies, which included 3866 participants, evaluated the relationship between work-related critical incidents and post-traumatic stress symptoms. Six of these studies, which included 1695 participants, also reported on the relationship between work-related critical incidents and symptoms of anxiety and depression. Heterogeneity among studies was high and could not be accounted for by study quality, character of the incident, or timing of data collection. Pooled effect sizes for the impact of work-related critical incidents on post-traumatic stress symptoms, anxiety, and depression were small to medium. Remarkably, the effect was more pronounced in the longer than in the shorter term. In conclusion, this meta-analysis supports the hypothesis that work-related critical incidents are positively related to post-traumatic stress symptoms, anxiety, and depression in hospital-based health care professionals

Screening and Predicting Posttraumatic Stress and Depression in Children Following Single-Incident Trauma

Science.gov (United States)

Nixon, Reginald D. V.; Ellis, Alicia A.; Nehmy, Thomas J.; Ball, Shelley-Anne

2010-01-01

Three screening methods to predict posttraumatic stress disorder (PTSD) and depression symptoms in children following single-incident trauma were tested. Children and adolescents (N = 90; aged 7-17 years) were assessed within 4 weeks of an injury that led to hospital treatment and followed up 3 and 6 months later. Screening methods were adapted…

Risk for Incident Hypertension Associated With Posttraumatic Stress Disorder in Military Veterans and the Effect of Posttraumatic Stress Disorder Treatment.

Science.gov (United States)

Burg, Matthew M; Brandt, Cynthia; Buta, Eugenia; Schwartz, Joseph; Bathulapalli, Harini; Dziura, James; Edmondson, Donald E; Haskell, Sally

Posttraumatic stress disorder (PTSD) increases cardiovascular disease and cardiovascular mortality risk. Neither the prospective relationship of PTSD to incident hypertension risk nor the effect of PTSD treatment on hypertension risk has been established. Data from a nationally representative sample of 194,319 veterans were drawn from the Veterans Administration (VA) roster of United States service men and women. This included veterans whose end of last deployment was from September 2001 to July 2010 and whose first VA medical visit was from October 1, 2001 to January 1, 2009. Incident hypertension was modeled as 3 events: (1) a new diagnosis of hypertension and/or (2) a new prescription for antihypertensive medication, and/or (3) a clinic blood pressure reading in the hypertensive range (≥140/90 mm Hg, systolic/diastolic). Posttraumatic stress disorder diagnosis was the main predictor. Posttraumatic stress disorder treatment was defined as (1) at least 8 individual psychotherapy sessions of 50 minutes or longer during any consecutive 6 months and/or (2) a prescription for selective serotonin reuptake inhibitor medication. Over a median 2.4-year follow-up, the incident hypertension risk independently associated with PTSD ranged from hazard ratio (HR), 1.12 (95% confidence interval [CI], 1.08-1.17; p < .0001) to HR, 1.30 (95% CI, 1.26-1.34; p < .0001). The interaction of PTSD and treatment revealed that treatment reduced the PTSD-associated hypertension risk (e.g., from HR, 1.44 [95% CI, 1.38-1.50; p < .0001] for those untreated, to HR, 1.20 [95% CI, 1.15-1.25; p < .0001] for those treated). These results indicate that reducing the long-term health impact of PTSD and the associated costs may require very early surveillance and treatment.

Work-related critical incidents in hospital-based health care providers and the risk of post-traumatic stress symptoms, anxiety, and depression: a meta-analysis

NARCIS (Netherlands)

de Boer, Jacoba; Lok, Anja; van 't Verlaat, Ellen; Duivenvoorden, Hugo J.; Bakker, Arnold B.; Smit, Bert J.

2011-01-01

This meta-analysis reviewed existing data on the impact of work-related critical incidents in hospital-based health care professionals. Work-related critical incidents may induce post-traumatic stress symptoms or even post-traumatic stress disorder (PTSD), anxiety, and depression and may negatively

Hidden Grief and Lasting Emotions in Emergency Department Nurses.

Science.gov (United States)

Schwab, Darcie; Napolitano, Nancy; Chevalier, Kelly; Pettorini-D'Amico, Susan

2016-11-01

The emergency department (ED) environment poses unique risks to developing moral distress and posttraumatic stress disorder (PTSD) in nurses. This impacts ED registered nurses' (RNs') ability to remain resilient. The purpose of this article is to explore the benefit of recognizing the signs and symptoms of burnout, introduce interventions to combat PTSD, and improve resiliency in ED RNs. The use of the wounded healer theory provides a framework to help nurse managers develop strategies such as critical incident stress debriefing (CISD) to address emotional distress.

The System-Wide Effect of Real-Time Audiovisual Feedback and Postevent Debriefing for In-Hospital Cardiac Arrest: The Cardiopulmonary Resuscitation Quality Improvement Initiative.

Science.gov (United States)

Couper, Keith; Kimani, Peter K; Abella, Benjamin S; Chilwan, Mehboob; Cooke, Matthew W; Davies, Robin P; Field, Richard A; Gao, Fang; Quinton, Sarah; Stallard, Nigel; Woolley, Sarah; Perkins, Gavin D

2015-11-01

To evaluate the effect of implementing real-time audiovisual feedback with and without postevent debriefing on survival and quality of cardiopulmonary resuscitation quality at in-hospital cardiac arrest. A two-phase, multicentre prospective cohort study. Three UK hospitals, all part of one National Health Service Acute Trust. One thousand three hundred and ninety-five adult patients who sustained an in-hospital cardiac arrest at the study hospitals and were treated by hospital emergency teams between November 2009 and May 2013. During phase 1, quality of cardiopulmonary resuscitation and patient outcomes were measured with no intervention implemented. During phase 2, staff at hospital 1 received real-time audiovisual feedback, whereas staff at hospital 2 received real-time audiovisual feedback supplemented by postevent debriefing. No intervention was implemented at hospital 3 during phase 2. The primary outcome was return of spontaneous circulation. Secondary endpoints included other patient-focused outcomes, such as survival to hospital discharge, and process-focused outcomes, such as chest compression depth. Random-effect logistic and linear regression models, adjusted for baseline patient characteristics, were used to analyze the effect of the interventions on study outcomes. In comparison with no intervention, neither real-time audiovisual feedback (adjusted odds ratio, 0.62; 95% CI, 0.31-1.22; p=0.17) nor real-time audiovisual feedback supplemented by postevent debriefing (adjusted odds ratio, 0.65; 95% CI, 0.35-1.21; p=0.17) was associated with a statistically significant improvement in return of spontaneous circulation or any process-focused outcome. Despite this, there was evidence of a system-wide improvement in phase 2, leading to improvements in return of spontaneous circulation (adjusted odds ratio, 1.87; 95% CI, 1.06-3.30; p=0.03) and process-focused outcomes. Implementation of real-time audiovisual feedback with or without postevent debriefing did not

Managing mild casualties in mass-casualty incidents: lessons learned from an aborted terrorist attack.

Science.gov (United States)

Bloch, Yuval H; Leiba, Adi; Veaacnin, Nurit; Paizer, Yohanan; Schwartz, Dagan; Kraskas, Ahuva; Weiss, Gali; Goldberg, Avishay; Bar-Dayan, Yaron

2007-01-01

Mildly injured and "worried well" patients can have profound effects on the management of a mass-casualty incident. The objective of this study is to describe the characteristics and lessons learned from an event that occurred on 28 August 2005 near the central bus station in Beer-Sheva, Israel. The unique profile of injuries allows for the examination of the medical and operational aspects of the management of mild casualties. Data were collected during and after the event, using patient records and formal debriefings. They were processed focusing on the characteristics of patient complaints, medical response, and the dynamics of admission. A total of 64 patients presented to the local emergency department, including two critical casualties. The remaining 62 patients were mildly injured or suffered from stress. Patient presentation to the emergency department was bi-phasic; during the first two hours following the attack (i.e., early phase), the rate of arrival was high (one patient every three minutes), and anxiety was the most frequent chief complaint. During the second phase, the rate of arrival was lower (one patient every 27 minutes), and the typical chief complaint was somatic. Additionally, tinnitus and complaints related to minor trauma also were recorded frequently. Psychiatric consultation was obtained for 58 (91%) of the patients. Social services were involved in the care of 47 of the patients (73%). Otolaryngology and surgery consultations were obtained for 45% and 44%, respectively. The need for some medical specialties (e.g., surgery and orthopedics) mainly was during the first phase, whereas others, mainly psychiatry and otolaryngology, were needed during both phases. Only 13 patients (20%) needed a consultation from internal medicine. Following a terrorist attack, a large number of mildly injured victims and those experiencing stress are to be expected, without a direct relation to the effectiveness of the attack. Mildly injured patients tend to

On the determination of stress profiles in expanded austenite by grazing incidence X-ray diffraction and successive layer removal

DEFF Research Database (Denmark)

Fernandes, Frederico Augusto Pires; Christiansen, Thomas L.; Winther, Grethe

2015-01-01

Surface layers of expanded austenite resulting from nitriding typically exhibit large gradients in residual stress and composition. Evaluation of residual-stress profiles is explored by means of grazing incidence X-ray diffraction (GI-XRD), probing shallow depths, combined with successive layer...... removal. Several factors complicating the stress determination are analysed and discussed: (1) ghost stresses arising from a small variation in the shallow information depths probed with GI-XRD, (2) selection of the grain interaction model used to calculate the X-ray elastic constants for conversion...

On the determination of stress profiles in expanded austenite by grazing incidence X-ray diffraction and successive layer removal

International Nuclear Information System (INIS)

Fernandes, Frederico A.P.; Christiansen, Thomas L.; Winther, Grethe; Somers, Marcel A.J.

2015-01-01

Surface layers of expanded austenite resulting from nitriding typically exhibit large gradients in residual stress and composition. Evaluation of residual-stress profiles is explored by means of grazing incidence X-ray diffraction (GI-XRD), probing shallow depths, combined with successive layer removal. Several factors complicating the stress determination are analysed and discussed: (1) ghost stresses arising from a small variation in the shallow information depths probed with GI-XRD, (2) selection of the grain interaction model used to calculate the X-ray elastic constants for conversion of lattice strains into residual stress and (3) the composition dependence of these elastic constants

Work-related stress and posttraumatic stress in emergency medical services.

Science.gov (United States)

Donnelly, Elizabeth

2012-01-01

Recent research efforts in emergency medical services (EMS) has identified variability in the ability of EMS personnel to recognize their level of stress-related impairment. Developing a better understanding of how workplace stress may affect EMS personnel is a key step in the process of increasing awareness of the impact of work-related stress and stress-related impairment. This paper demonstrates that for those in EMS, exposure to several types of workplace stressors is linked to stress reactions. Stress reactions such as posttraumatic stress symptomatology (PTSS) have the potential to negatively influence the health of EMS providers. This research demonstrates that two different types of work-related stress and alcohol use influence the development of PTSS. A probability sample of nationally registered emergency medical technician (EMT)-Basics and EMT-Paramedics (n = 1,633) completed an Internet-based survey. Respondents reported their levels of operational and organizational types of chronic stress, critical incident stress, alcohol use, and PTSS. Ordinary least squares regression illustrated that when demographic factors were controlled, organizational and operational forms of chronic stress, critical incident stress, and alcohol use were all significant predictors of PTSS (p stress and critical incident stress (p stress and alcohol use (p stress reaction. Higher levels of chronic stress, critical incident stress, and alcohol use significantly related to an increased level of PTSS. Further, for those reporting high levels of alcohol use or critical incident stress, interactions with high levels of chronic operational stress were associated with higher rates of PTSS. For those interested in the impact of work-related stress in EMS, these findings indicate that attention must be paid to levels of stress associated with both critical incident exposure as well as the chronic stress providers experience on a day-to-day basis.

Critical incidents and critical incident stress management (CISM) - an employee assistance programme (EAP) perspective

OpenAIRE

Terblanche, Lourie; van Wyk, André

2014-01-01

Employees are increasingly becoming victims of critical incidents. From a systems theory point of view, it is necessary to acknowledge the impact of critical incidents not only on the personal life of the employee, but on the workplace itself. Employees respond differently to critical incidents, which makes it even more complicated when this reaches the point of requiring therapeutic intervention. The most common response to critical incidents may be the risk of developing post-traumatic s...

The incidence of technological stress among baccalaureate nurse educators using technology during course preparation and delivery.

Science.gov (United States)

Burke, Mary S

2009-01-01

The concept of technology-related stress was first introduced in the 1980s when computers became more prevalent in the business and academic world. Nurse educators have been impacted by the rapid changes in technology in recent years. A review of the literature revealed no research studies that have been conducted to investigate the incidence of technological stress among nurse educators. The purpose of this descriptive-correlational study was to describe the technological stressors that Louisiana baccalaureate nurse educators experienced while teaching nursing theory courses. A researcher-developed questionnaire, the nurse educator technostress scale (NETS) was administered to a census sample of 311 baccalaureate nurse educators in Louisiana. Findings revealed that Louisiana baccalaureate nurse educators are experiencing technological stress. The variable, perceived administrative support for use of technology in the classroom, was a significant predictor in a regression model predicting Louisiana baccalaureate nurse educators' technological stress (F=14.157, p<.001).

Acetabular stress fractures in military endurance athletes and recruits: incidence and MRI and scintigraphic findings

International Nuclear Information System (INIS)

Williams, T.R.; Puckett, M.L.; Shin, A.Y.; Gorman, J.D.; Denison, G.

2002-01-01

Objective: To evaluate the incidence and the MRI and scintigraphic appearance of acetabular stress (fatigue) fractures in military endurance athletes and recruits. Design and patients: One hundred and seventy-eight active duty military endurance trainees with a history of activity-related hip pain were evaluated by both MRI and bone scan over a 2-year period. Patients in the study ranged in age from 17 to 45 years. They had hip pain related to activity and had plain radiographs of the hip and pelvis that were interpreted as normal or equivocal. The study was originally designed to evaluate the MRI and scintigraphic appearance of femoral neck stress fractures. Patients had scintigraphy and a limited MRI examination (coronal imaging only) within 48 h of the bone scan. Twelve patients demonstrated imaging findings compatible with acetabular stress fractures. Results: Stress fractures are common in endurance athletes and in military populations; however, stress fracture of the acetabulum is uncommon. Twelve of 178 patients (6.7%) in our study had imaging findings consistent with acetabular stress fractures. Two patterns were identified. Seven of the 12 (58%) patients had acetabular roof stress fractures. In this group, two cases of bilateral acetabular roof stress fractures were identified, one with a synchronous tensile sided femoral neck stress fracture. The remaining five of 12 (42%) patients had anterior column stress fractures, rarely occurring in isolation, and almost always occurring with inferior pubic ramus stress fracture (4 of 5, or 80%). One case of bilateral anterior column stress fractures was identified without additional sites of injury. Conclusions: Stress fractures are commonplace in military populations, especially endurance trainees. Acetabular stress fractures are rare and therefore unrecognized, but do occur and may be a cause for activity-related hip pain in a small percentage of military endurance athletes and recruits. (orig.)

Analysis of performance and stress caused by a simulation of a mass casualty incident.

Science.gov (United States)

Nieto Fernández-Pacheco, Antonio; Castro Delgado, Rafael; Arcos González, Pedro; Navarro Fernández, José Luis; Cerón Madrigal, José Joaquín; Juguera Rodriguez, Laura; Perez Alonso, Nuria; Armero-Barranco, David; Lidon López Iborra, María; Damian, Escribano Tortosa; Pardo Rios, Manuel

2018-03-01

To determine the stress that is potentially produced in professional health workers due to a mass casualty incident (MCI) simulated exercise, and its relation to prior academic training and the role played in the simulation. Observational study of stress in a MCI. For this work, two MCI drills comprised of 40 victims each were conducted. Two randomized groups of 36 students each were created: Master's Students Group (MSG) and Undergraduate Student Group (USG). The role performed by each student (triage or sectorization) was assessed. The stress level was determined by prior and subsequent measurements of alpha-amylase (αA), HR, SBP and DBP. The percentage of victims that were correctly triaged was 88.6%, 91.84% for MSG and 83.76% for the USG (p=0.004). The basal αA was 97,107.50±72,182.67IU/L and the subsequent αA was 136,195.55±90,176.46±IU/L (pperformed the triage and those who performed sectorization but there were no differences between undergraduate and Masters' students. Conducting a simulated exercise caused stress in personnel involved in the MCI, with a greater impact on participants who performed triage, although it was not influenced by their prior academic level. The stress level in our case did not affect or determine the performance of acquired skills. Copyright © 2017 Elsevier Ltd. All rights reserved.

Incidence of posttraumatic stress disorder after traffic accidents in Germany.

Science.gov (United States)

Brand, Stephan; Otte, Dietmar; Petri, Maximilian; Decker, Sebastian; Stübig, Timo; Krettek, Christian; Müller, Christian W

2014-01-01

Posttraumatic stress disorder (PTSD) is possibly an overlooked diagnosis of victims suffering from traffic accidents sustaining serious to severe injuries. This paper investigates the incidence of PTSD after traffic accidents in Germany. Data from an accident research unit were analyzed in regard to collision details, and preclinical and clinical data. Preclinical data included details on crash circumstances and estimated injury severity as well as data on victims' conditions (e.g. heart rate, blood pressure, consciousness, breath rate). Clinical data included initial assessment in the emergency department, radiographic diagnoses, and basic life parameters comparable to the preclinical data as well as follow-up data on the daily ward. Data were collected in the German-In-Depth Accident Research study, and included gender, type of accident (e.g. type of vehicle, road conditions, rural or urban area), mental disorder, and AIS (Abbreviated Injury Scale) head score. AIS represent a scoring system to measure the injury severity of traffic accident victims. A total 258 out of 32807 data sets were included in this analysis. Data on accident and victims was collected on scene by specialized teams following established algorithms. Besides higher AIS Head scores for male motorcyclists compared to all other subgroups, no significant correlation was found between the mean maximum AIS score and the occurrence of PTSD. Furthermore, there was no correlation between higher AIS head scores, gender, or involvement in road traffic accidents and PTSD. In our study the overall incidence of PTSD after road traffic accidents was very low (0.78% in a total of 32.807 collected data sets) when compared to other published studies. The reason for this very low incidence of PTSD in our patient sample could be seen in an underestimation of the psychophysiological impact of traffic accidents on patients. Patients suffering from direct experiences of traumatic events such as a traffic accident

Reported incidence and precipitating factors of work-related stress and mental ill-health in the United Kingdom (1996-2001).

Science.gov (United States)

Cherry, Nicola M; Chen, Yiqun; McDonald, J Corbett

2006-09-01

Work-related mental ill-health appears to be increasing. Population-based data on incidence are scarce but in the United Kingdom occupational physicians and psychiatrists report these conditions to voluntary surveillance schemes. To estimate the incidence of work-related stress and mental illness reported 1996-2001 by occupational physicians and 1999-2001 by psychiatrists. Estimated annual average incidence rates were calculated by sex, occupation and industry against appropriate populations at risk. An in-house coding scheme was used to classify and analyse data on precipitating events. An estimated annual average of 3,624 new cases were reported by psychiatrists, and 2,718 by occupational physicians; the rates were higher for men in reports based on the former and for women on the latter. Most diagnoses were of anxiety/depression or work-related stress, with post-traumatic stress accounting for approximately 10% of cases reported by psychiatrists. High rates of ill-health were seen among professional and associated workers and in those in personal and protective services. Factors (such as work overload) intrinsic to the job and issues with interpersonal relations were the most common causes overall. The steep increase in new cases of work-related mental ill-health reported by occupational physicians since 1996 may reflect a greater willingness by workers to seek help but may also signify an increasing dissonance between workers' expectations and the work environment. Greater expertise is needed to improve the workplace by adjustment of job demands, improvement of working relations, increasing workers' capacities and management of organizational change.

Stress and coping in Singaporean nurses: a literature review.

Science.gov (United States)

Lim, Joanne; Bogossian, Fiona; Ahern, Kathy

2010-06-01

Stress is ubiquitous in the nursing profession and is also prevalent in Asian countries, particularly the "four tigers of Asia": Singapore, Hong Kong, Taiwan, and South Korea. Based on the theoretical framework of Lazarus and Folkman (1984), the present review of the nursing literature aims to identify sources and effects of stress in Singaporean nurses and the coping strategies they use. Nurses reported major stressors including shortage of staff, high work demands and conflict at work. Common coping strategies included problem orientation, social support and relaxation techniques. Several studies reported nurses' intent to leave the profession. Recommendations to minimize the impact of stress include in-service programs to facilitate a problem-solving approach to resolving work-related issues such as conflict. Relaxation therapy and debriefing sessions may also help in reducing negative effects of work stressors. Finally, nurses' emotional coping can be enhanced by strengthening sources of social support, particularly from family.

Loss of social resources predicts incident posttraumatic stress disorder during ongoing political violence within the Palestinian Authority.

Science.gov (United States)

Hall, Brian J; Murray, Sarah M; Galea, Sandro; Canetti, Daphna; Hobfoll, Stevan E

2015-04-01

Exposure to ongoing political violence and stressful conditions increases the risk of posttraumatic stress disorder (PTSD) in low-resource contexts. However, much of our understanding of the determinants of PTSD in these contexts comes from cross-sectional data. Longitudinal studies that examine factors associated with incident PTSD may be useful to the development of effective prevention interventions and the identification of those who may be most at-risk for the disorder. A 3-stage cluster random stratified sampling methodology was used to obtain a representative sample of 1,196 Palestinian adults living in Gaza, the West Bank and East Jerusalem. Face-to-face interviews were conducted at two time points 6-months apart. Logistic regression analyses were conducted on a restricted sample of 643 people who did not have PTSD at baseline and who completed both interviews. The incidence of PTSD was 15.0 % over a 6-month period. Results of adjusted logistic regression models demonstrated that talking to friends and family about political circumstances (aOR = 0.78, p = 0.01) was protective, and female sex (aOR = 1.76, p = 0.025), threat perception of future violence (aOR = 1.50, p = 0.002), poor general health (aOR = 1.39, p = 0.005), exposure to media (aOR = 1.37, p = 0.002), and loss of social resources (aOR = 1.71, p = 0.006) were predictive of incident cases of PTSD. A high incidence of PTSD was documented during a 6-month follow-up period among Palestinian residents of Gaza, the West Bank, and East Jerusalem. Interventions that promote health and increase and forestall loss to social resources could potentially reduce the onset of PTSD in communities affected by violence.

First contact: acute stress reactions and experiences of emergency department consultations following an incident of intimate partner violence.

Science.gov (United States)

Olive, Philippa

2017-08-01

The aim of this research was to explore women's emotional and affective responses following an incident of intimate partner violence experienced during emergency department attendances. A growing body of research has explored women's experiences of emergency departments following intimate partner violence still little remains known about the experience and impact of emotional and affective responses during these attendances. A descriptive qualitative design was used, underpinned theoretically by critical realism and postmodern complexity theory to attend to multiple, intersecting mechanisms that lie behind events and experiences. Semistructured interviews with six women who had attended an emergency department directly following an incident of intimate partner violence. Interview data were transcribed and thematically analysed in nvivo9 using a coding framework. There were three interconnected key findings. First, was the commonality of acute stress experiences among women attending an emergency department following partner violence, second was that these acute stress reactions negatively impacted women's consultations, and third was the need for specialist domestic violence services at the point of first contact to assist service users navigate an effective consultation. Acute stress reactions were an important feature of women's experiences of emergency department consultations following intimate partner violence. Attending to psychological first aid; providing a safe and quiet space; and affording access to specialist violence advocacy services at the point of first contact will limit harm and improve health consultation outcomes for this population. This research provides an account of emotional and affective responses experienced by women attending emergency departments following intimate partner violence and explicates how these acute stress reactions impacted their consultation. This research has relevance for practitioners in many first contact health

A Randomized Trial of Cognitive Behaviour Therapy and Cognitive Therapy for Children with Posttraumatic Stress Disorder following Single-Incident Trauma

Science.gov (United States)

Nixon, Reginald David Vandervord; Sterk, Jisca; Pearce, Amanda

2012-01-01

The present study compared the efficacy of trauma-focused cognitive behavior therapy (CBT) with trauma-focused cognitive therapy (without exposure; CT) for children and youth with posttraumatic stress disorder (PTSD). Children and youth who had experienced single-incident trauma (N = 33; 7-17 years old) were randomly assigned to receive 9 weeks of…

incidence of occupational stress among medical radiographers

African Journals Online (AJOL)

Job satisfaction rating was 61.3% and anxiety level was 45.3%. This study has provided a baseline stress level and prevalence among ... theoretical terms predisposes the individual to increased ... checked, burnout ensures. Burnout is an individual's reaction to chronic stress .... neurovegetative functioning of the mental but.

Epidemiology of metatarsal stress fractures versus tibial and femoral stress fractures during elite training.

Science.gov (United States)

Finestone, Aharon; Milgrom, Charles; Wolf, Omer; Petrov, Kaloyan; Evans, Rachel; Moran, Daniel

2011-01-01

The training of elite infantry recruits takes a year or more. Stress fractures are known to be endemic in their basic training and the clinical presentation of tibial, femoral, and metatarsal stress fractures are different. Stress fracture incidence during the subsequent progressively more demanding training is not known. The study hypothesis was that after an adaptation period, the incidence of stress fractures during the course of 1 year of elite infantry training would fall in spite of the increasingly demanding training. Seventy-six male elite infantry recruits were followed for the development of stress fractures during a progressively more difficult training program composed of basic training (1 to 14 weeks), advanced training (14 to 26 weeks), and unit training (26 to 52 weeks). Subjects were reviewed regularly and those with clinical suspicion of stress fracture were assessed using bone scan and X-rays. The incidence of stress fractures was 20% during basic training, 14% during advanced training and 23% during unit training. There was a statistically significant difference in the incidence of tibial and femoral stress fractures versus metatarsal stress fractures before and after the completion of phase II training at week 26 (p=0.0001). Seventy-eight percent of the stress fractures during phases I and II training were either tibial or femoral, while 91% of the stress fractures in phase III training were metatarsal. Prior participation in ball sports (p=0.02) and greater tibial length (p=0.05) were protective factors for stress fracture. The study hypothesis that after a period of soldier adaptation, the incidence of stress fractures would decrease in spite of the increasingly demanding elite infantry training was found to be true for tibial and femoral fractures after 6 months of training but not for metatarsal stress fractures. Further studies are required to understand the mechanism of this difference but physicians and others treating stress fractures

Exposure to daily trauma: The experiences and coping mechanism of Emergency Medical Personnel. A cross-sectional study

Directory of Open Access Journals (Sweden)

Llizane Minnie

2015-03-01

Conclusion: EMS personnel are exposed to critical incidents on a daily basis. Commonly used emotion-focused coping mechanisms are not effective in long-term coping. A key recommendation emanating from this finding is that integrated intervention programmes are needed to assist EMS personnel working in this sustained high-stress environment. The findings can assist health care educators in the design of co-curricular activities intended to help in the development of resilience and the psychological wellbeing of EMS personnel. Policy makers and EMS managers may find the results useful as they evaluate the effectiveness of their current debriefing and support structures.

Post-traumatic stress disorder and incidence of coronary heart disease: a twin study.

Science.gov (United States)

Vaccarino, Viola; Goldberg, Jack; Rooks, Cherie; Shah, Amit J; Veledar, Emir; Faber, Tracy L; Votaw, John R; Forsberg, Christopher W; Bremner, J Douglas

2013-09-10

The aim of this study was to determine whether post-traumatic stress disorder (PTSD) is associated with coronary heart disease (CHD) using a prospective twin study design and objective measures of CHD. It has long been hypothesized that PTSD increases the risk of CHD, but empirical evidence using objective measures is limited. We conducted a prospective study of middle-aged male twins from the Vietnam Era Twin Registry. Among twin pairs without self-reported CHD at baseline, we selected pairs discordant for a lifetime history of PTSD, pairs discordant for a lifetime history of major depression, and pairs without either condition. All underwent a clinic visit after a median follow-up of 13 years. Outcomes included clinical events (myocardial infarction, other hospitalizations for CHD and coronary revascularization) and quantitative measures of myocardial perfusion by [(13)N] ammonia positron emission tomography, including a stress total severity score and coronary flow reserve. A total of 562 twins (281 pairs) with a mean age of 42.6 years at baseline were included in this study. The incidence of CHD was more than double in twins with PTSD (22.6%) than in those without PTSD (8.9%; p Stress total severity score was significantly higher (+95%, p = 0.001) and coronary flow reserve was lower (-0.21, p = 0.02) in twins with PTSD than in those without PTSD, denoting worse myocardial perfusion. Associations were only mildly attenuated in 117 twin pairs discordant for PTSD. Among Vietnam-era veterans, PTSD is a risk factor for CHD. Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

The association between the parenting stress of the mother and the incidence of allergic rhinitis in their children.

Science.gov (United States)

Kim, Min Bum; Kim, Jeong Hong; Lee, Keun-Hwa; Hong, Seong-Chul; Lee, Hye-Sook; Kang, Ju Wan

2017-10-01

The prevalence of allergic rhinitis and the social burden related to the management of allergic rhinitis have persistently increased. There are many studies investigating the association between the allergic diseases of children and the stress of their parent. However, the relationship between parenting stress and the incidence of allergic rhinitis among children requires further investigation. We aimed to investigate the significance of parenting stress for mothers with children treated for allergic rhinitis. The mothers of 250 children in the second and third grade of elementary school were involved in this study. The Parenting Stress Index-Short Form (PSI-SF) was used to measure parenting stress. Additionally, the monthly household income, treatment history for allergic diseases (atopic dermatitis, asthma, and allergic rhinitis) during the past 12 months, and maternal education status were investigated using the questionnaire. Parenting stress index score was significantly higher among the mothers of children treated for allergic rhinitis (76.41 ± 9.35) compared with the parents of children without treatment history for allergic rhinitis (70.06 ± 13.74). Nonetheless, there were no significant differences between the cases of children with atopic dermatitis and those with asthma. We analyzed the association between allergic rhinitis and parenting stress adjusted for the monthly household income, and maternal education status, and showed that a treatment history of allergic rhinitis was significantly associated with parenting stress (coefficient 7.477, 95% interval 1.703-13.252; p = 0.011). Treatment of the children for allergic rhinitis significantly affects the parenting stress of their mother. We recommend that mothers with children with allergic rhinitis should receive appropriate counseling about parenting stress. Copyright © 2017 Elsevier B.V. All rights reserved.

Biomarkers of cardiovascular stress and incident chronic kidney disease.

Science.gov (United States)

Ho, Jennifer E; Hwang, Shih-Jen; Wollert, Kai C; Larson, Martin G; Cheng, Susan; Kempf, Tibor; Vasan, Ramachandran S; Januzzi, James L; Wang, Thomas J; Fox, Caroline S

2013-11-01

Growth differentiation factor-15 (GDF-15), soluble ST2 (sST2), and high-sensitivity troponin I (hsTnI) are emerging predictors of adverse clinical outcomes. We examined whether circulating concentrations are related to the development of kidney disease in the community. Plasma GDF-15, sST2, and hsTnI concentrations were measured in 2614 Framingham Offspring cohort participants (mean age 57 years, 54% women) at the sixth examination cycle (1995-1998). Associations of biomarkers with incident chronic kidney disease [CKD, eGFR statistically significant in primary analyses. Participants were followed over a mean of 9.5 years. Higher plasma GDF-15 was associated with incident CKD [multivariable-adjusted odds ratio (OR) 1.9 per 1-U increase in log-GDF-15, 95% CI 1.6-2.3, P statistic increased from 0.826 to 0.845 (P = 0.0007), and categorical net reclassification was 6.3% (95% CI, 2.7-9.9%). Higher circulating GDF-15 is associated with incident renal outcomes and improves risk prediction of incident CKD. These findings may provide insights into the mechanisms of renal injury.

Adherence to Mediterranean diet and 10-year incidence (2002-2012) of diabetes: correlations with inflammatory and oxidative stress biomarkers in the ATTICA cohort study.

Science.gov (United States)

Koloverou, E; Panagiotakos, D B; Pitsavos, C; Chrysohoou, C; Georgousopoulou, E N; Grekas, A; Christou, A; Chatzigeorgiou, M; Skoumas, I; Tousoulis, D; Stefanadis, C

2016-01-01

The purpose of this work was to investigate the links between oxidative stress, inflammation and coagulation and their effect on Mediterranean diet-diabetes relationship. In 2001-2002, a random sample of 1514 men (18-87 years old) and 1528 women (18-89 years old) was selected to participate in the ATTICA study, where Athens is the major metropolis. A validated questionnaire was used to assess lifestyle and dietary factors. Adherence to Mediterranean diet was recorded using MedDietScore. Among others, oxidative stress and inflammatory biomarkers were recorded. During 2011-2012, the 10-year follow-up was performed. Diabetes incidence was defined according to the American Diabetes Association criteria. A total of 191 incident cases of diabetes were documented, yielding an incidence of 12.9% (13.4% in men and 12.4% in women). Medium and high adherence was found to decrease diabetes risk by 49% (95% CI: 0.30, 0.88) and 62% (95% CI: 0.16, 0.88), respectively, compared with low adherence. A logarithmic trend between Mediterranean diet and diabetes incidence was also revealed (p for trend = 0.042). Individuals with abnormal waist circumference (>94 for men, >80 for women) were benefited the most. Wholegrain cereals, fruits and legumes had the greatest predictive ability. The anti-diabetic effect of Mediterranean diet correlated with measurements of tumour necrosis factor-α, homocysteine and total antioxidant capacity. The reported results support the role of Mediterranean diet as a promising dietary tool for the primary prevention of diabetes, by attenuating inflammation and fostering total antioxidant capacity. This dietary pattern may have therapeutic potential for many cardiometabolic disorders associated with inflammation and/or oxidative stress. Copyright © 2015 John Wiley & Sons, Ltd.

The role of maternal stress in early pregnancy in the aetiology of gastroschisis: an incident case control study.

Directory of Open Access Journals (Sweden)

Stephen R Palmer

Full Text Available The incidence of gastroschisis, a congenital anomaly where the infant abdominal wall is defective and intestines protrude from the abdominal cavity, is increasing in many countries. The role of maternal stress in some adverse birth outcomes is now well established. We tested the hypothesis that major stressful life events in the first trimester are risk factors for gastroschisis, and social support protective, in a case-control study in the United Kingdom.Gastroschisis cases and three controls per case (matched for maternal age were identified at routine 18-20 week fetal anomaly ultrasound scan, in 2007-2010. Face to face questionnaire interviews were carried out during the antenatal period (median 24 weeks gestation asking about serious stressful events and social support in the first trimester. Data were analysed using conditional logistic regression.Two or more stressful life events in the first trimester (adjusted OR 4.9; 95% CI 1.2-19.4, and moving address in the first trimester (aOR 4.9; 95% CI 1.7-13.9 were strongly associated with risk of gastroschisis, independent of behavioural risk factors including smoking, alcohol, and poor diet. Perceived availability of social support was not associated with reduced risk of gastroschisis (aOR 0.8; 95% CI 0.2-3.1.Stressful maternal life events in the first trimester of pregnancy including change of address were strongly associated with a substantial increase in the risk of gastroschisis, independent of stress related high risk behaviours such as smoking, alcohol consumption and poor diet. This suggests that stress pathways are involved in the aetiology of gastroschisis.

Training lay-people to use automatic external defibrillators: are all of their needs being met?

Science.gov (United States)

Harrison-Paul, Russell; Timmons, Stephen; van Schalkwyk, Wilna Dirkse

2006-10-01

We explored the experiences of lay people who have been trained to use automatic external defibrillators. The research questions were: (1) How can training courses help prepare people for dealing with real life situations? (2) Who is ultimately responsible for providing critical incident debriefing and how should this be organised? (3) What is the best process for providing feedback to those who have used an AED? Fifty-three semi-structured, qualitative interviews were conducted, some with those who had been trained and others with trainers. Locations included airports, railway stations, private companies and first responder schemes. Geographically, we covered Nottinghamshire, Lincolnshire, Yorkshire, Staffordshire, Essex and the West Midlands in the UK. Our analysis of the data indicates that most people believe scenarios based within their place of work were most useful in preparing for 'real life'. Many people had not received critical incident debriefing after using an AED. There were a variety of systems in place to provide support after an incident, many of which were informal. Training scenarios should be conducted outside the classroom. There should be more focus on critical incident debriefing during training and a clear identification of who should provide support after an incident. Other issues which were of interest included: (1) people's views on do not attempt resuscitation (DNAR); (2) perceived boundaries of responsibility when using an AED; (3) when is someone no longer 'qualified' to use an AED?

Human factors in resuscitation teaching.

Science.gov (United States)

Norris, Elizabeth M; Lockey, Andrew S

2012-04-01

There is an increasing interest in human factors within the healthcare environment reflecting the understanding of their impact on safety. The aim of this paper is to explore how human factors might be taught on resuscitation courses, and improve course outcomes in terms of improved mortality and morbidity for patients. The delivery of human factors training is important and this review explores the work that has been delivered already and areas for future research and teaching. Medline was searched using MESH terms Resuscitation as a Major concept and Patient or Leadership as core terms. The abstracts were read and 25 full length articles reviewed. Critical incident reporting has shown four recurring problems: lack of organisation at an arrest, lack of equipment, non functioning equipment, and obstructions preventing good care. Of these, the first relates directly to the concept of human factors. Team dynamics for both team membership and leadership, management of stress, conflict and the role of debriefing are highlighted. Possible strategies for teaching them are discussed. Four strategies for improving human factors training are discussed: team dynamics (including team membership and leadership behaviour), the influence of stress, debriefing, and conflict within teams. This review illustrates how human factor training might be integrated further into life support training without jeopardising the core content and lengthening the courses. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

FBI's Employee Assistance Program: an advanced law enforcement model.

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McNally, V J

1999-01-01

As we approach the 21st century the FBI has enhanced its Employee Assistance Program (EAP) to include EAP services, Peer Support and Critical Incident Stress Management/Debriefing (CISM/D) and Chaplains' Program. This EAP is now anticipating the future to include a Compassion Fatigue Program for its counselors and coordinators, as well as developing CISD protocols for incidents involving weapons of mass destruction. As the FBI has accepted new challenges in the investigative arena throughout the world, so the FBI's Employee Assistance and related programs have set out to support their employees and family members with a continuum of integrated confidential services. The FBI recognizes that its most important asset is its personnel, and EAP is the vehicle to assist the FBI family in remaining healthy and strong for the continuous quest to fulfill its mission.

The paediatric Confusion Assessment Method for the Intensive Care Unit (pCAM-ICU: Translation and cognitive debriefing for the German-speaking area

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Clemens de Grahl

2012-04-01

Full Text Available Purpose: To date there are only a few studies published, dealing with delirium in critically ill patients. The problem with these studies is that prevalence rates of delirium could only be estimated because of the lack of validated delirium assessment tools for the paediatric intensive care unit (PICU. The paediatric Confusion Assessment Method for the Intensive Care Unit (pCAM-ICU was specifically developed and validated for the detection of delirium in PICU patients. The purpose of this study was the translation of the English pCAM-ICU into German according to international validated guidelines. Methods: The translation process was performed according to the principles of good practice for the translation and cultural adaptation process for patient reported outcomes measures: From three independently created German forward-translation versions one preliminary German version was developed, which was then retranslated to English by a certified, state-approved translator. The back-translated version was submitted to the original author for evaluation. The German translation was evaluated by clinicians and specialists anonymously (German grades in regards to language and content of the translation. Results: The results of the cognitive debriefing revealed good to very good results. After that the translation process was successfully completed and the final version of the German pCAM-ICU was adopted by the expert committee. Conclusion: The German version of the pCAM-ICU is a result of a translation process in accordance with internationally acknowledged guidelines. Particularly, with respect to the excellent results of the cognitive debriefing, we could finalise the translation and cultural adaptation process for the German pCAM-ICU.

Longitudinal effects of single-dose simulation education with structured debriefing and verbal feedback on endotracheal suctioning knowledge and skills: A randomized controlled trial.

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Jansson, Miia M; Syrjälä, Hannu P; Ohtonen, Pasi P; Meriläinen, Merja H; Kyngäs, Helvi A; Ala-Kokko, Tero I

2017-01-01

We evaluated the longitudinal effects of single-dose simulation education with structured debriefing and verbal feedback on critical care nurses' endotracheal suctioning knowledge and skills. To do this we used an experimental design without other competing intervention. Twenty-four months after simulation education, no significant time and group differences or time × group interactions were identified between the study groups. The need for regularly repeated educational interventions with audiovisual or individualized performance feedback and repeated bedside demonstrations is evident. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Medical management of three workers following a radiation exposure incident

International Nuclear Information System (INIS)

House, R.A.; Sax, S.E.; Rumack, E.R.; Holness, D.L.

1992-01-01

The medical management of three individuals involved in an exposure incident to whole-body radiation at a nuclear generating plant of a Canadian electrical utility is described. The exposure incident resulted in the two highest whole-body radiation doses ever received in a single event by workers in a Canadian nuclear power plant. The individual whole-body doses (127.4 mSv, 92.0 mSv, 22.4 mSv) were below the threshold for acute radiation sickness but the exposures still presented medical management problems related to assessment and counseling. Serial blood counting and lymphocyte cytogenetic analysis to corroborate the physical dosimetry were performed. All three employees experienced somatic symptoms due to stress and one employee developed post-traumatic stress disorder. This incident indicates that there is a need in such radiation exposure accidents for early and continued counseling of exposed employees to minimize the risk of development of stress-related symptoms

Medical management of three workers following a radiation exposure incident

Energy Technology Data Exchange (ETDEWEB)

House, R.A.; Sax, S.E.; Rumack, E.R.; Holness, D.L. (Department of Occupational and Environmental Health, St. Michael' s Hospital, Toronto, Ontario (Canada))

1992-01-01

The medical management of three individuals involved in an exposure incident to whole-body radiation at a nuclear generating plant of a Canadian electrical utility is described. The exposure incident resulted in the two highest whole-body radiation doses ever received in a single event by workers in a Canadian nuclear power plant. The individual whole-body doses (127.4 mSv, 92.0 mSv, 22.4 mSv) were below the threshold for acute radiation sickness but the exposures still presented medical management problems related to assessment and counseling. Serial blood counting and lymphocyte cytogenetic analysis to corroborate the physical dosimetry were performed. All three employees experienced somatic symptoms due to stress and one employee developed post-traumatic stress disorder. This incident indicates that there is a need in such radiation exposure accidents for early and continued counseling of exposed employees to minimize the risk of development of stress-related symptoms.

Simulation With Debriefing and Guided Reflective Journaling to Stimulate Critical Thinking in Prelicensure Baccalaureate Degree Nursing Students.

Science.gov (United States)

Padden-Denmead, Mary L; Scaffidi, Rose M; Kerley, Regina M; Farside, Amy Lee

2016-11-01

Simulation and guided reflective journaling have been identified as effective teaching and learning methods to develop critical thinking (CT) and clinical reasoning skills in nursing students. A descriptive correlational design was used to determine the relationship between CT and level of reflection using the Holistic Critical Thinking Skills Rubric (HCTSR) and the level of reflection on action assessment (LORAA), respectively, to evaluate 23 baccalaureate student-guided reflective journal entries after a simulation exercise with guided debriefing and after two subsequent clinical experiences. A statistically significant positive relationship (p < .01) was found between mean HCTSR and LORAA scores on all three journal entries, but no relationship to CT during simulation or on standardized test scores. The results also indicated support for use of the guided reflection after significant learning experiences. The LORAA and the HCTSR are effective measures of level of reflection and CT to evaluate learning from simulation and clinical experiences. [J Nurs Educ. 2016;55(11):645-650.]. Copyright 2016, SLACK Incorporated.

Applying the WHO conceptual framework for the International Classification for Patient Safety to a surgical population.

Science.gov (United States)

McElroy, L M; Woods, D M; Yanes, A F; Skaro, A I; Daud, A; Curtis, T; Wymore, E; Holl, J L; Abecassis, M M; Ladner, D P

2016-04-01

Efforts to improve patient safety are challenged by the lack of universally agreed upon terms. The International Classification for Patient Safety (ICPS) was developed by the World Health Organization for this purpose. This study aimed to test the applicability of the ICPS to a surgical population. A web-based safety debriefing was sent to clinicians involved in surgical care of abdominal organ transplant patients. A multidisciplinary team of patient safety experts, surgeons and researchers used the data to develop a system of classification based on the ICPS. Disagreements were reconciled via consensus, and a codebook was developed for future use by researchers. A total of 320 debriefing responses were used for the initial review and codebook development. In total, the 320 debriefing responses contained 227 patient safety incidents (range: 0-7 per debriefing) and 156 contributing factors/hazards (0-5 per response). The most common severity classification was 'reportable circumstance,' followed by 'near miss.' The most common incident types were 'resources/organizational management,' followed by 'medical device/equipment.' Several aspects of surgical care were encompassed by more than one classification, including operating room scheduling, delays in care, trainee-related incidents, interruptions and handoffs. This study demonstrates that a framework for patient safety can be applied to facilitate the organization and analysis of surgical safety data. Several unique aspects of surgical care require consideration, and by using a standardized framework for describing concepts, research findings can be compared and disseminated across surgical specialties. The codebook is intended for use as a framework for other specialties and institutions. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Customer focused incident monitoring in anaesthesia.

Science.gov (United States)

Khan, F A; Khimani, S

2007-06-01

The database of incident forms relating to anaesthesia services in an institutional risk management programme were reviewed for 2003-2005, the aim being to identify any recurring patterns. Incidents were prospectively categorised as relating to attitude/behaviour, communication breakdown, delay in service, or were related to care, cost, environment, equipment, security, administrative process, quality of service or miscellaneous. The total number of anaesthesia-related incidents reported during the period was 287, which related to 0.44% of the total number of anaesthetics administered during the time period. In all, 170 incidents were reported by the department, 96 by internal customers and 21 by external customers. Only 30% of the complaints came from the operating room. Thirty-four per cent of all incidents related to communication, behaviour and delay in service. A requirement to teach communication skills and stress handling formally in anaesthesia training programmes, and at the time of induction of staff into the department, has been identified.

Dynamic Response of Underground Circular Lining Tunnels Subjected to Incident P Waves

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Hua Xu

2014-01-01

Full Text Available Dynamic stress concentration in tunnels and underground structures during earthquakes often leads to serious structural damage. A series solution of wave equation for dynamic response of underground circular lining tunnels subjected to incident plane P waves is presented by Fourier-Bessel series expansion method in this paper. The deformation and stress fields of the whole medium of surrounding rock and tunnel were obtained by solving the equations of seismic wave propagation in an elastic half space. Based on the assumption of a large circular arc, a series of solutions for dynamic stress were deduced by using a wave function expansion approach for a circular lining tunnel in an elastic half space rock medium subjected to incident plane P waves. Then, the dynamic response of the circular lining tunnel was obtained by solving a series of algebraic equations after imposing its boundary conditions for displacement and stress of the circular lining tunnel. The effects of different factors on circular lining rock tunnels, including incident frequency, incident angle, buried depth, rock conditions, and lining stiffness, were derived and several application examples are presented. The results may provide a good reference for studies on the dynamic response and aseismic design of tunnels and underground structures.

Lessons denied: a history of therapeutic response to combat stress reaction during Israel's War of Independence (1948), the Sinai Campaign (1956) and the Six Day War (1967)

Science.gov (United States)

Witztum, E; Levy, A; Solomon, Z

1996-01-01

The current article examines the history of therapeutic response in the Israel Defense Forces toward combat stress reaction during two decades, and in the course of three wars: the 1948 War of Independence, the 1956 Sinai Campaign, and the 1967 Six Day War. Three independent sources were used: recorded debriefing materials; interviews conducted with therapists, commanders and military historians; and professional literature on the wars in Hebrew and other languages. The collected material is described and issues of attitudes, treatment approaches and preparedness are discussed.

Individual reactions to stress predict performance during a critical aviation incident.

Science.gov (United States)

Vine, Samuel J; Uiga, Liis; Lavric, Aureliu; Moore, Lee J; Tsaneva-Atanasova, Krasimira; Wilson, Mark R

2015-01-01

Understanding the influence of stress on human performance is of theoretical and practical importance. An individual's reaction to stress predicts their subsequent performance; with a "challenge" response to stress leading to better performance than a "threat" response. However, this contention has not been tested in truly stressful environments with highly skilled individuals. Furthermore, the effect of challenge and threat responses on attentional control during visuomotor tasks is poorly understood. Thus, this study aimed to examine individual reactions to stress and their influence on attentional control, among a cohort of commercial pilots performing a stressful flight assessment. Sixteen pilots performed an "engine failure on take-off" scenario, in a high-fidelity flight simulator. Reactions to stress were indexed via self-report; performance was assessed subjectively (flight instructor assessment) and objectively (simulator metrics); gaze behavior data were captured using a mobile eye tracker, and measures of attentional control were subsequently calculated (search rate, stimulus driven attention, and entropy). Hierarchical regression analyses revealed that a threat response was associated with poorer performance and disrupted attentional control. The findings add to previous research showing that individual reactions to stress influence performance and shed light on the processes through which stress influences performance.

Efficacy of an internet-based learning module and small-group debriefing on trainees' attitudes and communication skills toward patients with substance use disorders: results of a cluster randomized controlled trial.

Science.gov (United States)

Lanken, Paul N; Novack, Dennis H; Daetwyler, Christof; Gallop, Robert; Landis, J Richard; Lapin, Jennifer; Subramaniam, Geetha A; Schindler, Barbara A

2015-03-01

To examine whether an Internet-based learning module and small-group debriefing can improve medical trainees' attitudes and communication skills toward patients with substance use disorders (SUDs). In 2011-2012, 129 internal and family medicine residents and 370 medical students at two medical schools participated in a cluster randomized controlled trial, which assessed the effect of adding a two-part intervention to the SUDs curricula. The intervention included a self-directed, media-rich Internet-based learning module and a small-group, faculty-led debriefing. Primary study outcomes were changes in self-assessed attitudes in the intervention group (I-group) compared with those in the control group (C-group) (i.e., a difference of differences). For residents, the authors used real-time, Web-based interviews of standardized patients to assess changes in communication skills. Statistical analyses, conducted separately for residents and students, included hierarchical linear modeling, adjusted for site, participant type, cluster, and individual scores at baseline. The authors found no significant differences between the I- and C-groups in attitudes for residents or students at baseline. Compared with those in the C-group, residents, but not students, in the I-group had more positive attitudes toward treatment efficacy and self-efficacy at follow-up (Pcommunication skills toward patients with SUDs among residents. Enhanced attitudes and skills may result in improved care for these patients.

[Posttraumatic stress disorder (PTSD) as a consequence of the interaction between an individual genetic susceptibility, a traumatogenic event and a social context].

Science.gov (United States)

Auxéméry, Y

2012-10-01

peritraumatic distress have emerged as the strongest predictors for PTSD and have to be treated as soon as possible with the debriefing or the pharmacology; initial evidence suggests the potential benefits of early intervention, shortly after the trauma, and psychological debriefing has received increasing interest from the scientific community. However the Anglo-Saxon techniques (such as Critical Incident Stress Debriefing also known as the Mitchell model) are in total contrast with the French approach. In the first case the emotional response is controlled to ensure the pursuit of the group action, whilst in the second case the debriefing concerns patients with acute symptoms in order to prevent the development of a PTSD structuring of the latter. The facts, emotions and thoughts are not partitioned but inter-linked, thus enabling a fragmentation of the traumatic experience. In the face of the annihilation experienced, speech production by the subject is restored linking the person to the human community, once abandoned. However, debate continues on the efficacy of single session debriefing in the prevention of PTSD. At the time of the acute stress reactions, benzodiazepines are contraindicated at this stage as they promote dissociation and ulterior revivals. On the other hand, treatment with propranolol could be proposed: a two or three week course of propranolol begun in the aftermath of a traumatic event can reduce subsequent PTSD symptoms. A genetic polymorphism is evidently at work in the development of a PTSD via the regulation of the expression of genes of interest to the serotoninergic system and the adrenocorticotropic axis. The 5-HTTLPR (promoter region of SLC6A4 witch encodes the serotonin transporter) constitutes a genetic candidate region that may modulate emotional responses to traumatic events. The interaction between variation at the 5HTTLPR and stressful life events could predict depression and PTSD. Considering the dopaminergic pathway, the A1 allele coding

Structural properties and growth evolution of diamond-like carbon films with different incident energies: A molecular dynamics study

International Nuclear Information System (INIS)

Li, Xiaowei; Ke, Peiling; Zheng, He; Wang, Aiying

2013-01-01

Structural properties and growth evolution of diamond-like carbon (DLC) films with different incident energies were investigated systematically by the molecular dynamics simulation using a Tersoff interatomic potential for carbon-carbon interaction. The results revealed that the density, sp 3 fraction and residual compressive stress as a function of incident energy increased firstly and then decreased; when the incident energy was 70 eV/atom, the density could reach to 3.0 g/cm 3 with the maximal compressive stress of 15.5 GPa. Structure analysis indicated that the deviation of both bond angles and lengths from the equilibrium position led to the generation of a large residual stress, while the high compressive stress mainly attributed to the decrease of both bond angles and lengths among carbon atoms. The growth of DLC films underwent a formation process of “Line-Net” structure accompanied with the interaction of many atomic motion mechanisms, and the “Point” stage was only found for DLC films with low incident energy.

The Psychedelic Debriefing in Alcohol Dependence Treatment: Illustrating Key Change Phenomena through Qualitative Content Analysis of Clinical Sessions

Directory of Open Access Journals (Sweden)

Elizabeth M. Nielson

2018-02-01

Full Text Available Research on the clinical applications of psychedelic-assisted psychotherapy has demonstrated promising early results for treatment of alcohol dependence. Detailed description of the content and methods of psychedelic-assisted psychotherapy, as it is conducted in clinical settings, is scarce.Methods: An open-label pilot (proof-of-concept study of psilocybin-assisted treatment of alcohol dependence (NCT01534494 was conducted to generate data for a phase 2 RCT (NCT02061293 of a similar treatment in a larger population. The present paper presents a qualitative content analysis of the 17 debriefing sessions conducted in the pilot study, which occurred the day after corresponding psilocybin medication sessions.Results: Participants articulated a series of key phenomena related to change in drinking outcomes and acute subjective effects of psilocybin.Discussion: The data illuminate change processes in patients' own words during clinical sessions, shedding light on potential therapeutic mechanisms of change and how participants express effects of psilocybin. This study is unique in analyzing actual clinical sessions, as opposed to interviews of patients conducted separately from treatment.

The Psychedelic Debriefing in Alcohol Dependence Treatment: Illustrating Key Change Phenomena through Qualitative Content Analysis of Clinical Sessions.

Science.gov (United States)

Nielson, Elizabeth M; May, Darrick G; Forcehimes, Alyssa A; Bogenschutz, Michael P

2018-01-01

Research on the clinical applications of psychedelic-assisted psychotherapy has demonstrated promising early results for treatment of alcohol dependence. Detailed description of the content and methods of psychedelic-assisted psychotherapy, as it is conducted in clinical settings, is scarce. Methods: An open-label pilot (proof-of-concept) study of psilocybin-assisted treatment of alcohol dependence (NCT01534494) was conducted to generate data for a phase 2 RCT (NCT02061293) of a similar treatment in a larger population. The present paper presents a qualitative content analysis of the 17 debriefing sessions conducted in the pilot study, which occurred the day after corresponding psilocybin medication sessions. Results: Participants articulated a series of key phenomena related to change in drinking outcomes and acute subjective effects of psilocybin. Discussion: The data illuminate change processes in patients' own words during clinical sessions, shedding light on potential therapeutic mechanisms of change and how participants express effects of psilocybin. This study is unique in analyzing actual clinical sessions, as opposed to interviews of patients conducted separately from treatment.

Mindful Application of Aviation Practices in Healthcare.

Science.gov (United States)

Powell-Dunford, Nicole; Brennan, Peter A; Peerally, Mohammad Farhad; Kapur, Narinder; Hynes, Jonny M; Hodkinson, Peter D

2017-12-01

Evidence supports the efficacy of incorporating select recognized aviation practices and procedures into healthcare. Incident analysis, debrief, safety brief, and crew resource management (CRM) have all been assessed for implementation within the UK healthcare system, a world leader in aviation-based patient safety initiatives. Mindful application, in which aviation practices are specifically tailored to the unique healthcare setting, show promise in terms of acceptance and long-term sustainment. In order to establish British healthcare applications of aviation practices, a PubMed search of UK authored manuscripts published between 2005-2016 was undertaken using search terms 'aviation,' 'healthcare,' 'checklist,' and 'CRM.' A convenience sample of UK-authored aviation medical conference presentations and UK-authored patient safety manuscripts were also reviewed. A total of 11 of 94 papers with UK academic affiliations published between 2005-2016 and relevant to aviation modeled healthcare delivery were found. The debrief process, incident analysis, and CRM are the primary practices incorporated into UK healthcare, with success dependent on cultural acceptance and mindful application. CRM training has gained significant acceptance in UK healthcare environments. Aviation modeled incident analysis, debrief, safety brief, and CRM training are increasingly undertaken within the UK healthcare system. Nuanced application, in which the unique aspects of the healthcare setting are addressed as part of a comprehensive safety approach, shows promise for long-term success. The patient safety brief and aviation modeled incident analysis are in earlier phases of implementation, and warrant further analysis.Powell-Dunford N, Brennan PA, Peerally MF, Kapur N, Hynes JM, Hodkinson PD. Mindful application of aviation practices in healthcare. Aerosp Med Hum Perform. 2017; 88(12):1107-1116.

Development of stress analyzer using whole back reflection ring

International Nuclear Information System (INIS)

Shitaba, Yuichi; Ishikawa, Tetsuro; Ohya, Shin-ichi; Akita, Koichi

2006-01-01

The X-ray stress measurement based on sin 2 ψ method has been widely adopted. This technique is not entirely efficient, because it is necessary to measure each diffraction profile one after other at five and more incident X-ray angles. On the other hand, stress measurement based on cosα method was proposed using X-ray film as detector. In this method, the stresses are determined from Debye-ring obtained at a single X-ray incident angle with high efficiency. However, it has the problem in this accuracy on stress determination. In this study, a new stress analyzer with sixteen position sensitive proportional counters (PSPC) radially arranged for incidence X-ray was developed. We examined to determine the plane stress components by multi-regression analysis using sixteen diffraction angles on a Debye-ring. As a result, stress components of σ x and τ xy were measured with sufficient accuracy. However, a stress of σ y had large dispersion, because of low strain sensitivity in the y direction. Moreover, it was clarified that σ y had pseud-multicollinearity on multi-regression analysis. The accuracy of σ y value itself could not be improved, though an analysis to eliminate an effect of pseud-multicollinearity was carried out. In this paper, we proposed the new method to determine the components using two Debye rings obtained by X-ray incidences in both x and y directions. We tried to measure the residual stress components in the butt welded joint using the method. As a result, it was confirmed that the stresses, σ x and σ y , were obtained in the sufficient accuracy, and that the shear stress, τ xy , was arising near the bond in the welds. (author)

Preventing post-traumatic stress disorder following childbirth and traumatic birth experiences: a systematic review.

Science.gov (United States)

de Graaff, Lisanne F; Honig, Adriaan; van Pampus, Mariëlle G; Stramrood, Claire A I

2018-06-01

Between 9 and 44% of women experience giving birth as traumatic, and 3% of women develop a post-traumatic stress disorder following childbirth. Knowledge on risk factors is abundant, but studies on treatment are limited. This study aimed to present an overview of means to prevent traumatic birth experiences and childbirth-related post-traumatic stress disorder. Major databases [Cochrane; Embase; PsycINFO; PubMed (Medline)] were searched using combinations of the key words and their synonyms. After screening titles and abstracts and reading 135 full-text articles, 13 studies were included. All evaluated secondary prevention, and none primary prevention. Interventions included debriefing, structured psychological interventions, expressive writing interventions, encouraging skin-to-skin contact with healthy newborns immediately postpartum and holding or seeing the newborn after stillbirth. The large heterogeneity of study characteristics precluded pooling of data. The writing interventions to express feelings appeared to be effective in prevention. A psychological intervention including elements of exposure and psycho-education seemed to lead to fewer post-traumatic stress disorder symptoms in women who delivered via emergency cesarean section. No research has been done on primary prevention of traumatic childbirth. Research on secondary prevention of traumatic childbirth and post-traumatic stress disorder following delivery provides insufficient evidence that the described interventions are effective in unselected groups of women. In certain subgroups, results are inhomogeneous. © 2018 Nordic Federation of Societies of Obstetrics and Gynecology.

Effects of oxygen partial pressure and annealing temperature on the residual stress of hafnium oxide thin-films on silicon using synchrotron-based grazing incidence X-ray diffraction

Energy Technology Data Exchange (ETDEWEB)

Biswas, Debaleen [Saha Institute of Nuclear Physics, 1/AF Bidhannagar, Kolkata 700 064 (India); Sinha, Anil Kumar [ISU, Raja Ramanna Centre for Advanced Technology, Indore 452 013 (India); Homi Bhabha National Institute, BARC, Mumbai 400 094 (India); Chakraborty, Supratic, E-mail: supratic.chakraborty@saha.ac.in [Saha Institute of Nuclear Physics, 1/AF Bidhannagar, Kolkata 700 064 (India)

2016-10-30

Highlights: • Residual stress estimation thin hafnium oxide film with thickness of <10 nm. • A mathematical expression is proposed for stress estimation of thin-film using GIXRD. • Residual stress varies with argon content in Ar/O{sub 2} plasma and annealing temperature. • Variation of stress is explained by IL swelling and enhanced structural relaxation. - Abstract: Synchrotron radiation-based grazing incidence X-ray diffraction (GI-XRD) technique is employed here to estimate the residual stress of < 10 nm thin hafnium oxide film deposited on Si (100) substrate at different argon/oxygen ratios using reactive rf sputtering. A decrease in residual stress, tensile in nature, is observed at higher annealing temperature for the samples deposited with increasing argon ratio in the Ar/O{sub 2} plasma. The residual stress of the films deposited at higher p{sub Ar} (Ar:O{sub 2} = 4:1) is also found to be decreased with increasing annealing temperature. But the stress is more or less constant with annealing temperature for the films deposited at lower Ar/O{sub 2} (1:4) ratio. All the above phenomena can be explained on the basis of swelling of the interfacial layer and enhanced structural relaxation in the presence of excess Hf in hafnium oxide film during deposition.

Comparison of markers of oxidative stress, inflammation and arterial stiffness between incident hemodialysis and peritoneal dialysis patients – an observational study

Directory of Open Access Journals (Sweden)

Ratanjee Sharad

2009-03-01

Full Text Available Abstract Background Patients on peritoneal and hemodialysis have accelerated atherosclerosis associated with an increase in cardiovascular morbidity and mortality. The atherosclerosis is associated with increased arterial stiffness, endothelial dysfunction and elevated oxidative stress and inflammation. The aims of this study are to investigate the effects of peritoneal and hemodialysis on arterial stiffness, vascular function, myocardial structure and function, oxidative stress and inflammation in incident patients with end stage kidney disease. Methods This is an observational study. Eighty stage five CKD patients will be enrolled and followed for one-year. Primary outcome measures will be changes in 1 arterial stiffness measured by aortic pulse wave velocity, 2 oxidative stress assessed by plasma F2 isoprostanes and 3 inflammation measured by plasma pentraxin-3. Secondary outcomes will include additional measures of oxidative stress and inflammation, changes in vascular function assessed using the brachial artery reactivity technique, carotid artery intimal medial thickness, augmentation index and trans thoracic echocardiography to assess left ventricular geometry, and systolic and diastolic function. Patients will undergo these measures at baseline (6–8 weeks prior to starting dialysis therapy, then at six and 12 months after starting dialysis. Discussion The results of this study may guide the choice of dialysis modality in the first year of treatment. It may also lead to a larger study prospectively assessing the effect of dialysis modality on cardiovascular morbidity and mortality. Trial Registration ACTRN12609000049279

Regional comparison of cancer incidence

International Nuclear Information System (INIS)

Obralic, N.; Gavrankapetanovic, F.; Dizdarevic, Z.; Duric, O.; Sisic, F.; Selak, I.; Balta, S.; Nakas, B.

2004-01-01

Background. Due to specific war and post-war situation in Balkan region, differences in the number, type, development, biological course, treatment of malignant tumours and its outcome are possible. In order to perceive the situation realistically, it is necessary to gather continuously exact data about malignant tumours and compare them with the data from other European and world countries.The aim of the study was to collect and analyse the data on cancer incidence in the region of Sarajevo city, which represents a symbol of difficult times in the recent past, and to compare it to the incidence in the neighbouring countries. Patients and methods. Data on all newly diagnosed cancer cases, permanent residents of Sarajevo Canton, in the years 1999 and 2000 were collected. Crude incidence rate has been calculated according to the years observed, gender and localizations of the disease The data were compared to the cancer registries of Slovenia and Croatia and were observed in the light of specific local situation. Results. The crude cancer incidence of all sites but skin was the highest in both years and by both genders in Croatia. The incidence of the most common tumours (lung and breast cancer) was similar in all three countries. The differences in the incidence between both genders in the Sarajevo canton were registered in laryngeal and urinary bladder cancer, as well as in bone and cartilage sarcoma. Cervical cancer had extremely high incidence and was high up on the incidence list in the Sarajevo canton, which correlates with the data in developing countries. The incidence of other tumours in the post-war period is reaching expected numbers. Conclusions. It is difficult to identify whether the war and post-war stress, irregular and insufficient nutrition during and after the siege of the city of Sarajevo or some other factor influenced the cancer incidence among exposed population. The prevalence of smoking in the whole region is extremely high, in Bosnia and

Country Stress Events; Does Governance Matter?

OpenAIRE

Anna Kochanova; Carlos Caceres

2012-01-01

This paper analyzes the linkages between governance quality and country stress events. It focuses on two types of events: fiscal and political stress events, for which two innovative stress indicators are introduced. The results suggest that weaker governance quality is associated with a higher incidence of both fiscal and political stress events. In particular, internal accountability, which measures the responsiveness of governments to improving the quality of the bureaucracy, public servic...

Effects of incident cluster size, substrate temperature, and incident energy on bombardment of Ni clusters onto Cu (0 0 1) surface studied using molecular dynamics simulation

International Nuclear Information System (INIS)

Lin, Shiang-Jiun; Wu, Cheng-Da; Fang, Te-Hua; Chen, Guan-Hung

2012-01-01

The bombardment process of a Ni cluster onto a Cu (0 0 1) surface is studied using molecular dynamics (MD) simulations based on the tight-binding second-moment approximation (TB-SMA) many-body potential. The effects of incident cluster size, substrate temperature, and incident energy are evaluated in terms of molecular trajectories, kinetic energy, stress, self-diffusion coefficient, and sputtering yield. The simulation results clearly show that the penetration depth and Cu surface damage increase with increasing incident cluster size for a given incident energy per atom. The self-diffusion coefficient and the penetration depth of a cluster significantly increase with increasing substrate temperature. An incident cluster can be scattered into molecules or atoms that become embedded in the surface after incidence. When the incident energy is increased, the number of volcano-like defects and the penetration depth increase. A high sputtering yield can be obtained by increasing the incident energy at high temperature. The sputtering yield significantly increases with cluster size when the incident energy is above 5 eV/atom.

Incidence and etiology of lumbar spondylolysis: review of the literature.

Science.gov (United States)

Sakai, Toshinori; Sairyo, Koichi; Suzue, Naoto; Kosaka, Hirofumi; Yasui, Natsuo

2010-05-01

Lumbar spondylolysis is a defect of the pars interarticularis known to occur as a stress fracture. Its incidence varies considerably depending on ethnicity, sex, and sports activity. However, there are few literature reviews describing its incidence in different ethnic groups or in people who engage in different sports. We reviewed the most relevant articles on spondylolysis published in scientific journals. First, we focused on its incidence in various ethnic groups distributed by sex, the familial occurrence, and in patients with relevant diseases. Second, we focused on the incidence of spondylolysis in relation to the sports practiced by the patients. Although placing special emphasis on the incidence of lumbar spondylolysis in the general population in Japan, we also reviewed the Japanese and English literature to investigate its incidence among those who engage in different sports. The incidence of lumbar spondylolysis in the general Japanese population was 5.9%. Most studies report that the incidence in higher in male subjects than in female subjects. We found that Japanese rugby and judo players were prone to suffer lumbar spondylolysis, at an incidence of about 20%. However, the incidence for Japanese professional soccer and baseball players was much higher, at 30%, which was more than five times the incidence in the general Japanese population. The incidence of lumbar spondylolysis varies depending on ethnicity, sex, family history, relevant disease, and sports activity.

Molecular dynamics simulation for the influence of incident angles of energetic carbon atoms on the structure and properties of diamond-like carbon films

International Nuclear Information System (INIS)

Li, Xiaowei; Ke, Peiling; Lee, Kwang-Ryeol; Wang, Aiying

2014-01-01

The influence of incident angles of energetic carbon atoms (0–60°) on the structure and properties of diamond-like carbon (DLC) films was investigated by the molecular dynamics simulation using a Tersoff interatomic potential. The present simulation revealed that as the incident angles increased from 0 to 60°, the surface roughness of DLC films increased and the more porous structure was generated. Along the growth direction of DLC films, the whole system could be divided into four regions including substrate region, transition region, stable region and surface region except the case at the incident angle of 60°. When the incident angle was 45°, the residual stress was significantly reduced by 12% with little deterioration of mechanical behavior. The further structure analysis using both the bond angles and bond length distributions indicated that the compressive stress reduction mainly resulted from the relaxation of highly distorted C–C bond length. - Highlights: • The dependence of films properties on different incident angles was investigated. • The change of incident angles reduced the stress without obvious damage of density. • The stress reduction attributed to the relaxation of highly distorted bond length

The addition of voice prompts to audiovisual feedback and debriefing does not modify CPR quality or outcomes in out of hospital cardiac arrest--a prospective, randomized trial.

Science.gov (United States)

Bohn, Andreas; Weber, Thomas P; Wecker, Sascha; Harding, Ulf; Osada, Nani; Van Aken, Hugo; Lukas, Roman P

2011-03-01

Chest compression quality is a determinant of survival from out-of-hospital cardiac arrest (OHCA). ERC 2005 guidelines recommend the use of technical devices to support rescuers giving compressions. This prospective randomized study reviewed influence of different feedback configurations on survival and compression quality. 312 patients suffering an OHCA were randomly allocated to two different feedback configurations. In the limited feedback group a metronome and visual feedback was used. In the extended feedback group voice prompts were added. A training program was completed prior to implementation, performance debriefing was conducted throughout the study. Survival did not differ between the extended and limited feedback groups (47.8% vs 43.9%, p = 0.49). Average compression depth (mean ± SD: 4.74 ± 0.86 cm vs 4.84 ± 0.93 cm, p = 0.31) was similar in both groups. There were no differences in compression rate (103 ± 7 vs 102 ± 5 min(-1), p=0.74) or hands-off fraction (16.16% ± 0.07 to 17.04% ± 0.07, p = 0.38). Bystander CPR, public arrest location, presenting rhythm and chest compression depth were predictors of short term survival (ROSC to ED). Even limited CPR-feedback combined with training and ongoing debriefing leads to high chest compression quality. Bystander CPR, location, rhythm and chest compression depth are determinants of survival from out of hospital cardiac arrest. Addition of voice prompts does neither modify CPR quality nor outcome in OHCA. CC depth significantly influences survival and therefore more focus should be put on correct delivery. Further studies are needed to examine the best configuration of feedback to improve CPR quality and survival. ClinicalTrials.gov (NCT00449969), http://www.clinicalTrials.gov. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

The non-technical skills used by anaesthetic technicians in critical incidents reported to the Australian Incident Monitoring System between 2002 and 2008.

Science.gov (United States)

Rutherford, J S; Flin, R; Irwin, A

2015-07-01

The outcome of critical incidents in the operating theatre has been shown to be influenced by the behaviour of anaesthetic technicians (ATs) assisting anaesthetists, but the specific non-technical skills involved have not been described. We performed a review of critical incidents (n=1433) reported to the Australian Incident Monitoring System between 2002 and 2008 to identify which non-technical skills were used by ATs. The reports were assessed if they mentioned anaesthetic assistance or had the boxes ticked to identify "inadequate assistance" or "absent supervision or assistance". A total of 90 critical incidents involving ATs were retrieved, 69 of which described their use of non-technical skills. In 20 reports, the ATs ameliorated the critical incident, whilst in 46 they exacerbated the critical incident, and three cases had both positive and negative non-technical skills described. Situation awareness was identified in 39 reports, task management in 23, teamwork in 21 and decision-making in two, but there were no descriptions of issues related to leadership, stress or fatigue management. Situation awareness, task management and teamwork appear to be important non-technical skills for ATs in the development or management of critical incidents in the operating theatre. This analysis has been used to support the development of a non-technical skills taxonomy for anaesthetic assistants.

Effectiveness of a stress management pilot program aimed at reducing the incidence of sports injuries in young football (soccer) players.

Science.gov (United States)

Olmedilla-Zafra, Aurelio; Rubio, Victor J; Ortega, Enrique; García-Mas, Alexandre

2017-03-01

Several attempts to reduce the incidence of sport injuries using psychosocial interventions produced fruitful, although inconclusive results. This paper presents the effectiveness and implementation issues of a pilot 3-month stress-management and muscle relaxation program aimed at reducing sport injury incidence. Pre-post treatment-non treatment group comparison. The program was administered by a trained psychologist on a once-a-week, 1-h session basis. Seventy-four male soccer players from four National Youth league teams voluntarily participated. Teams were randomly assigned to either treatment/non-treatment group. Injury protocol, Self-monitoring cards, Athletes' satisfaction and commitment survey, Coaches' interview. Group main effect and Time-Group interaction effect were both statistically significant, F(1,60) = 8.30, p = 0.005, η 2 p  = 0.121, with the average number of injuries larger in the post-treatment phase of non-treatment group (p = 0.005, η 2 p  = 0.077). There was a significant decrease in the average number of injuries for the intervention group before and after implementing the program (p youth soccer sport injuries, with a high level of satisfaction and commitment from the athletes, as well as high acceptance from the coaches. Copyright © 2016 Elsevier Ltd. All rights reserved.

Physiological basis of barley yield under near optimal and stress conditions

Directory of Open Access Journals (Sweden)

Pržulj Novo

2004-01-01

Full Text Available Average barley yield fall below its potential due to incidence of stresses. Water stress is the main environmental factor limiting yield. The component a priori more sensitive to most stresses is the amount of radiation absorbed. The effect of stresses influence on the total amount of radiation absorbed by barley crop during its vegetation and the photosynthetic efficiency of radiation conversion. Growth inhibition is accompanied by reductions in leaf and cell wall extensibility. Grain yield under drought conditions is source limited. Supply of assimilates to the developing inflorescence plays a critical role in establishing final grain number and grain size. Grain weight is negatively affected by drought, high temperature, and any other factors that may reduce grain filling duration and grain filling rate. Awns and glaucousness confer better performance of barley under drought stress conditions. Barley responds with an increased accumulation of a number of proteins when subjected to different stress inducing cell dehydration. Screening techniques that are able to identify desirable genotypes based on the evaluation of physiological traits related to stress evasion and stress resistance maybe useful in breeding barley for resistance to stress, particularly drought stress. Crop management and breeding can reduce the incidence of stress on yield. The effect of these practices is sustained by an understanding of their physiology. In this paper the physiological basis of the processes determining barley yield and the incidence of stresses on photosynthetic metabolism that determine grain yield of barley is discussed. .

End-of-life care in intensive care units

African Journals Online (AJOL)

2006-11-16

Nov 16, 2006 ... Department of Nursing Education, Faculty of Health Sciences, University of the ..... stress. The pain, distress and high mortality rates ensure that they are continually .... counselling and debriefing to staff to prevent burnout.

Self reported stress and risk of breast cancer: prospective cohort study

DEFF Research Database (Denmark)

Nielsen, Naja Rod; Zhang, Zuo-Feng; Kristensen, Tage S

2005-01-01

cancer, and impairment of oestrogen synthesis induced by chronic stress may explain a lower incidence of breast cancer in women with high stress. Impairment of normal body function should not, however, be considered a healthy response, and the cumulative health consequences of stress may......OBJECTIVE: To assess the relation between self reported intensity and frequency of stress and first time incidence of primary breast cancer. DESIGN: Prospective cohort study with 18 years of follow-up. SETTING: Copenhagen City heart study, Denmark. PARTICIPANTS: The 6689 women participating...... in the Copenhagen City heart study were asked about their perceived level of stress at baseline in 1981-3. These women were followed until 1999 in the Danish nationwide cancer registry, with

Medial tibial stress syndrome in high school cross-country runners: incidence and risk factors.

Science.gov (United States)

Plisky, Melody S; Rauh, Mitchell J; Heiderscheit, Bryan; Underwood, Frank B; Tank, Robert T

2007-02-01

Prospective cohort. To determine (1) the cumulative seasonal incidence and overall injury rate of medial tibial stress syndrome (MTSS) and (2) risk factors for MTSS with a primary focus on the relationship between navicular drop values and MTSS in high school cross-country runners. MTSS is a common injury among runners. However, few studies have reported the injury rate and risk factors for MTSS among adolescent runners. Data collected included measurement of bilateral navicular drop and foot length, and a baseline questionnaire regarding the runner's height, body mass, previous running injury, running experience, and orthotic or tape use. Runners were followed during the season to determine athletic exposures (AEs) and occurrence of MTSS. The overall injury rate for MTSS was 2.8/1000 AEs. Although not statistically different, girls had a higher rate (4.3/1000 AEs) than boys (1.7/1000 AEs) (P = .11). Logistic regression modeling indicated that only gender and body mass index (BMI) were significantly associated with the occurrence of MTSS. However, when controlled for orthotic use, only BMI was associated with risk of MTSS. No significant associations were found between MTSS and navicular drop or foot length. Our findings suggest that navicular drop may not be an appropriate measure to identify runners who may develop MTSS during a cross-country season; thus, additional studies are needed to identify appropriate preseason screening tools.

Incidence and Risk Factors for Intensive Care Unit–related Post-traumatic Stress Disorder in Veterans and Civilians

Science.gov (United States)

Jackson, James C.; Morandi, Alessandro; Girard, Timothy D.; Hughes, Christopher G.; Thompson, Jennifer L.; Kiehl, Amy L.; Elstad, Mark R.; Wasserstein, Mitzi L.; Goodman, Richard B.; Beckham, Jean C.; Chandrasekhar, Rameela; Dittus, Robert S.; Ely, E. Wesley; Pandharipande, Pratik P.

2016-01-01

Rationale: The incidence and risk factors of post-traumatic stress disorder (PTSD) related to the intensive care unit (ICU) experience have not been reported in a mixed veteran and civilian cohort. Objectives: To describe the incidence and risk factors for ICU-related PTSD in veterans and civilians. Methods: This is a prospective, observational, multicenter cohort enrolling adult survivors of critical illness after respiratory failure and/or shock from three Veterans Affairs and one civilian hospital. After classifying those with/without preexisting PTSD (i.e., PTSD before hospitalization), we then assessed all subjects for ICU-related PTSD at 3 and 12 months post hospitalization. Measurements and Main Results: Of 255 survivors, 181 and 160 subjects were assessed for ICU-related PTSD at 3- and 12-month follow-up, respectively. A high probability of ICU-related PTSD was found in up to 10% of patients at either follow-up time point, whether assessed by PTSD Checklist Event-Specific Version (score ≥ 50) or item mapping using the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV). In the multivariable regression, preexisting PTSD was independently associated with ICU-related PTSD at both 3 and 12 months (P < 0.001), as was preexisting depression (P < 0.03), but veteran status was not a consistent independent risk factor for ICU-related PTSD (3-month P = 0.01, 12-month P = 0.48). Conclusions: This study found around 1 in 10 ICU survivors experienced ICU-related PTSD (i.e., PTSD anchored to their critical illness) in the year after hospitalization. Preexisting PTSD and depression were strongly associated with ICU-related PTSD. PMID:26735627

Impact of child death on paediatric trainees.

Science.gov (United States)

Hollingsworth, Clare E; Wesley, Carla; Huckridge, Jaymie; Finn, Gabrielle M; Griksaitis, Michael J

2018-01-01

To assess the prevalence of symptoms of acute stress reactions (ASR) and post-traumatic stress disorder (PTSD) in paediatric trainees following their involvement in child death. A survey designed to identify trainees' previous experiences of child death combined with questions to identify features of PTSD. Quantitative interpretation was used alongside a χ 2 test. A p value of death of a child, although 190/284 (67%) had no training in child death. 118/248 (48%) of trainees were given a formal debrief session following their most recent experience. 203/251 (81%) of trainees reported one or more symptoms or behaviours that could contribute to a diagnosis of ASR/PTSD. 23/251 (9%) of trainees met the complete criteria for ASR and 13/251 (5%) for PTSD. Attending a formal debrief and reporting feelings of guilt were associated with an increase in diagnostic criteria for ASR/PTSD (p=0.036 and pdeath of a child. The feeling of guilt should be identified and acknowledged to allow prompt signposting to further support, including psychological assessment or intervention if required. Clear recommendations need to be made about the safety of debriefing sessions as, in keeping with existing evidence, our data suggest that debrief after the death of a child may be associated with the development of symptoms suggestive of ASR/PTSD. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Shock-absorbing insoles reduce the incidence of lower limb overuse injuries sustained during Royal Marine training.

Science.gov (United States)

House, Carol; Reece, Allyson; Roiz de Sa, Dan

2013-06-01

This study was undertaken to determine whether the incidence of lower limb overuse injuries (LLOIs) sustained during Royal Marine training could be reduced by issuing the recruits with shock-absorbing insoles (SAIs) to wear in their military boots. This was a retrospective longitudinal trial conducted in two phases. Injury data from 1,416 recruits issued with standard Saran insoles and 1,338 recruits issued with SAI were compared. The recruits in the two groups were of similar height, body mass, and aerobic fitness and followed the same training course. The incidence of LLOI sustained by the recruits was lower (p tibial periostitis, tenosynovitis of foot, achilles tendonopathy, other tendonopathy and anterior knee pain were lower (p Tibial stress fracture incidence was lower (p < 0.05) in the SAI Group but metatarsal and femoral stress fracture incidences were the same for the two insole groups. Thus, issuing SAIs to military recruits undertaking a sustained, arduous physical training program with a high incidence of LLOI would provide a beneficial reduction in the incidence of LLOI. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

Incidence of stressful life events and influence of sociodemographic and clinical variables on the onset of first-episode psychosis.

Science.gov (United States)

Butjosa, Anna; Gómez-Benito, Juana; Huerta-Ramos, Elena; Del Cacho, Núria; Barajas, Ana; Baños, Iris; Usall, Judith; Dolz, Montserrat; Sánchez, Bernardo; Carlson, Janina; Maria Haro, Josep; Ochoa, Susana

2016-11-30

This study presents a quantitative analysis of the incidence of stressful life events (SLEs) and the variables gender, age at onset, family history and psychotic symptoms in patients with first-episode psychosis (FEP). A descriptive, cross-sectional methodology was used to interview 68 patients with FEP between 13 and 47 years of age. The Psychiatric Epidemiology Research Interview Life Events Scale collected one-year period prior to onset of FEP - used to analyse the subcategories academic, work, love and marriage, children, residence, legal affairs, finances and social activities-, Positive and Negative Syndrome Scale, and Clinical Global Impression-Schizophrenia scale were used to assess the relevance of certain SLEs during adolescence. Age at onset showed a significant negative correlation with the categories academic and social activities. By contrast, it showed a positive correlation with work and children. A significant relationship was found between paternal family history and social activities and between maternal family history and academic and love and marriage. Finally, an inverse relationship was observed between negative symptoms and the categories children and finance. Depressive symptoms were significantly correlated with the category academic. Our results show the importance of SLEs during adolescence and suggest that there is a clear need to develop preventive actions that promote effective strategies for dealing with the accumulation of psychosocial stress. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

A critical incident reporting system in anaesthesia.

Science.gov (United States)

Madzimbamuto, F D; Chiware, R

2001-01-01

To audit the recently established Critical Incident Reporting System in the Department of Anaesthesia and Critical Care Medicine, University of Zimbabwe Medical School. The system was set up with the purpose of improving the quality of care delivered by the department. Cross sectional study. A critical incident was defined as 'any adverse and reversible event in theatre, during or immediately after surgery that if it persisted without correction would cause harm to the patient'. The anaesthetic or recovery room staff filled a critical incident form anonymously. Data was collected from critical incident reporting forms for analysis. The anaesthetic service in the two teaching hospitals of Harare Central and Parirenyatwa General Hospitals. Between May and October 2000, 62 completed critical incident forms were collected. The nature of the incident and the monitoring used were recorded, the cause was classified as human, equipment or monitoring failure and the outcome for each patient reported. There was no formal system for reminding staff to fill in their critical incident forms. A total of 14,165 operations were performed over the reporting period: 62 critical incident forms were collected, reporting 130 incidents, giving a rate of 0.92% (130/14,165). Of these, 42 patients were emergencies and 20 elective. The incidents were hypotension, hypoxia, bradycardia, ECG changes, aspiration, laryngospasm, high spinal, and cardiac arrest. Monitoring present on patients who had critical incidents was: capnography 57%, oxymetry 90% and ECG 100%. Other monitors are not reported. Human error contributed in 32/62 of patients and equipment failure in 31/62 of patients. Patient outcome showed 15% died, 23% were unplanned admissions to HDU while 62% were discharged to the ward with little or no adverse outcome. Despite some under reporting, the critical incident rate was within the range reported in the literature. Supervision of juniors is not adequate, especially on call. The

Psychosocial stress as a risk factor for sepsis: a population-based cohort study.

Science.gov (United States)

Ojard, Connor; Donnelly, John P; Safford, Monika M; Griffin, Russell; Wang, Henry E

2015-01-01

To characterize the relationship between stress and future risk of sepsis. We also evaluated the role of depression in this relationship. We used population-based data on 30,183 participants in the Reasons for Geographic and Racial Differences in Stroke cohort, characterizing stress using the Perceived Stress Scale (PSS) and depressive symptoms using the Center for Epidemiologic Studies Depression Scale (CES-D). We identified incident sepsis events as hospitalizations for a serious infection with the presence of at least two systemic inflammatory response syndrome criteria. We assessed associations between PSS and incidence of sepsis for 1 and 10 years of follow-up, adjusting for demographics and chronic medical conditions and assessing the role of health behaviors and CES-D in these relationships. In 2003 to 2012, 1500 participants experienced an episode of sepsis. Mean PSS and CES-D scores were 3.2 (2.9) and 1.2 (2.1). PSS was associated with increased 1-year adjusted incidence of sepsis (hazard ratio [HR] = 1.21 per PSS standard deviation, 95% confidence interval = 1.06-1.38); multivariable adjustment for health behaviors and CES-D did not change this association (1.20, 1.03-1.39). PSS was also associated with increased 10-year adjusted incidence of sepsis (HR = 1.07 per PSS standard deviation; 95% confidence interval = 1.02-1.13). Multivariable adjustment showed that health behaviors did not affect this long-term association, whereas the addition of CES-D reduced the association between PSS and sepsis during 10-year follow-up (HR = 1.04, 0.98-1.11). Increased stress was associated with higher 1-year adjusted incidence of sepsis, even after accounting for depressive symptoms. The association between stress and 10-year adjusted incidence of sepsis was also significant, but this association was reduced when adjusting for depressive symptoms. Reduction of stress may limit short-term sepsis risk.

A randomized trial of cognitive behavior therapy and cognitive therapy for children with posttraumatic stress disorder following single-incident trauma: Predictors and outcome at 1-year follow-up.

Science.gov (United States)

Nixon, Reginald D V; Sterk, Jisca; Pearce, Amanda; Weber, Nathan

2017-07-01

The 1-year outcome and moderators of adjustment for children and youth receiving treatment for posttraumatic stress disorder (PTSD) following single-incident trauma was examined. Children and youth who had experienced single-incident trauma (N = 33; 7-17 years old) were randomly assigned to receive 9 weeks of either trauma-focused cognitive behavior therapy (CBT) or trauma-focused cognitive therapy (without exposure; CT) that was administered to them and their parents individually. Intent-to-treat analyses demonstrated that both groups maintained posttreatment gains in PTSD, depression and general anxiety symptoms reductions at 1-year follow-up, with no children meeting criteria for PTSD. A large proportion of children showed good end-state functioning at follow-up (CBT: 65%; CT: 71%). Contrary to 6-month outcomes, maternal adjustment no longer moderated children's outcome, nor did any other tested variables. The findings confirm the positive longer-term outcomes of using trauma-focused cognitive-behavioral methods for PTSD secondary to single-incident trauma and that these outcomes are not dependent on the use of exposure. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Unannounced in situ simulation of obstetric emergencies

DEFF Research Database (Denmark)

Sorensen, Jette Led; Lottrup, Pernille; van der Vleuten, Cees

2014-01-01

none of the obstetricians reported this. Information obtained through debriefing sessions generated learning points. CONCLUSIONS: The number of staff members with a positive perception of multiprofessional unannounced ISS increased after implementation; however, one-third considered ISS to be stressful...

Stress fractures in the lower extremity

International Nuclear Information System (INIS)

Berger, Ferco H.; Jonge, Milko C. de; Maas, Mario

2007-01-01

Stress fractures are fatigue injuries of bone usually caused by changes in training regimen in the population of military recruits and both professional and recreational athletes. Raised levels of sporting activity in today's population and refined imaging technologies have caused a rise in reported incidence of stress fractures in the past decades, now making up more than 10% of cases in a typical sports medicine practice. Background information (including etiology, epidemiology, clinical presentation and treatment and prevention) as well as state of the art imaging of stress fractures will be discussed to increase awareness amongst radiologists, providing the tools to play an important role in diagnosis and prognosis of stress fractures. Specific fracture sites in the lower extremity will be addressed, covering the far majority of stress fracture incidence. Proper communication between treating physician, physical therapist and radiologist is needed to obtain a high index of suspicion for this easily overlooked entity. Radiographs are not reliable for detection of stress fractures and radiologist should not falsely be comforted by them, which could result in delayed diagnosis and possibly permanent consequences for the patient. Although radiographs are mandatory to rule out differentials, they should be followed through when negative, preferably by magnetic resonance imaging (MRI), as this technique has proven to be superior to bone scintigraphy. CT can be beneficial in a limited number of patients, but should not be used routinely

Incidence of stress on top management and its impact upon health and work area

Directory of Open Access Journals (Sweden)

Dana Maria Staňková

2009-01-01

Full Text Available Within the frame of this paper the key theoretical knowledge to the selected topic is described, the presentation of partial results and discussion on the issue of the psychological aspects of managerial work, focusing on stress and its manifestations are submitted. The aim of this research was to identify the most frequent stress symptoms in the physiological, emotional and behavioral field and to define the main factors which cause them in work and private life terms. For the purpose of this research of stress effects on health area a questionnaire technology of our own design was chosen. For a deeper understanding of sources of an increased psychological stress in managerial activities a technique of interviews with the top managers was used. Research investigation has showed the action of stress on the senior managers, particularly increased during the current economic recession. The most significant signs of stress are manifested in physiological area, especially by fatigue, headache, digestion problems and sleep disturbances, as in the emotional area by anxiety, excessive concern and overall irritability. At the same time stress impacts also the behavioral area, where it has a negative impact to the work and family life. In the course of processing this subject, an absolutely obvious need occurred for a deeper processing of this large area of work stress, which will be subsequently dealing with, and whose output will be, the methodology of anti-stress strategy for HR (Human Resources managers and Senior Executives of companies to prevent stress, promote health and quality of living conditions in the workplace.

Fracture patterns and stresses in granite

International Nuclear Information System (INIS)

Price, N.J.

1979-01-01

If granite bodies are to be used as receptacles for toxic waste materials, the presence or absence of barren fractures and the virgin stresses in the granite are of fundamental importance. Unfortunately, very little is known regarding the incidence of fractures, or stresses, which exist at depths (of about 1 km) in granite bodies. A simple analysis is presented of a hypothetical intrusion which indicates the magnitudes of stresses and the possible fracture development which may be expected in such bodies. (auth)

Post-traumatic stress disorder and cardiovascular disease.

Science.gov (United States)

Edmondson, Donald; von Känel, Roland

2017-04-01

In this paper, a first in a Series of two, we look at the evidence for an association of post-traumatic stress disorder with incident cardiovascular disease risk and the mechanisms that might cause this association, as well as the prevalence of post-traumatic stress disorder due to cardiovascular disease events and its associated prognostic risk. We discuss research done after the publication of previous relevant systematic reviews, and survey currently funded research from the two most active funders in the field: the National Institutes of Health and the US Veterans Administration. We conclude that post-traumatic stress disorder is a risk factor for incident cardiovascular disease, and a common psychiatric consequence of cardiovascular disease events that might worsen the prognosis of the cardiovascular disease. There are many candidate mechanisms for the link between post-traumatic stress disorder and cardiovascular disease, and several ongoing studies could soon point to the most important behavioural and physiological mechanisms to target in early phase intervention development. Similarly, targets are emerging for individual and environmental interventions that might offset the risk of post-traumatic stress disorder after cardiovascular disease events. Copyright © 2017 Elsevier Ltd. All rights reserved.

Stress fractures in elite cross-country athletes.

Science.gov (United States)

Laker, Scott R; Saint-Phard, Deborah; Tyburski, Mark; Van Dorsten, Brent

2007-04-01

This retrospective and comparative survey investigates an unusual number of stress fractures seen within a Division I college cross-country team. An anonymous questionnaire-designed to observe factors known to increase stress fracture incidence-was distributed to members of the current and previous seasons' teams. Running surface, sleep hours, intake of calcium, and shoe type were among the factors investigated. Eleven lower extremity stress fractures were found in nine athletes. Athletes with stress fractures reported significantly fewer workouts per week on the new track. All other study parameters had no statistically significant effect on stress fractures in these athletes.

Dietary toxins, endoplasmic reticulum (ER) stress and diabetes.

Science.gov (United States)

Hettiarachchi, Kalindi D; Zimmet, Paul Z; Myers, Mark A

2008-05-01

The incidence of Type 1 diabetes has been increasing at a rate too rapid to be due to changes in genetic risk. Instead changes in environmental factors are the likely culprit. The endoplasmic reticulum (ER) plays an important role in the production of newly synthesized proteins and interference with these processes leads to ER stress. The insulin-producing beta cells are particularly prone to ER stress as a result of their heavy engagement in insulin production. Increasing evidence suggests ER stress is central to initiation and progression of Type 1 diabetes. An early environmental exposure, such as toxins and viral infections, can impart a significant physiological load on beta cells to initiate abnormal processing of proinsulin, ER stress and insulin secretory defects. Release of altered proinsulin from the beta cells early in life may trigger autoimmunity in those with genetic susceptibility leading to cytokine-induced nitric oxide production and so exacerbating ER stress in beta cells, ultimately leading to apoptosis of beta cells and diabetes. Here we suggest that ER stress is an inherent cause of beta cell dysfunction and environmental factors, in particular dietary toxins derived from Streptomyces in infected root vegetables, can impart additional stress that aggravates beta cell death and progression to diabetes. Furthermore, we propose that the increasing incidence of Type 1 diabetes may be accounted for by increased dietary exposure to ER-stress-inducing Streptomyces toxins.

[Peptic ulcer disease and stress].

Science.gov (United States)

Herszényi, László; Juhász, Márk; Mihály, Emese; Tulassay, Zsolt

2015-08-30

The discovery that Helicobacter pylori infection is the major cause of peptic ulcer disease revolutionised our views on the etiology and treatment of the disease. This discovery has tempted many experts to conclude that psychological factors and, specifically, stress are unimportant. However, Helicobacter pylori infection alone does not explain fully the incidence and prevalence of peptic ulcer disease. It has been demonstrated that stress can cause peptic ulcer disease even in the absence of Helicobacter pylori infection, supporting a multicausal model of peptic ulcer etiology. Psychological stress among other risk factors can function as a cofactor with Helicobacter pylori infection.

Drought stress had a predominant effect over heat stress on three tomato cultivars subjected to combined

DEFF Research Database (Denmark)

Zhou, Rong; Yu, Xiaqing; Ottosen, Carl-Otto

2017-01-01

and relative water content of all cultivars significantly decreased under drought and combined stress as compared to control. The net photosynthesis and starch content were significantly lower under drought and combined stress than control in the three cultivars. Stomata and pore length of the three cultivars......BACKGROUND: Abiotic stresses due to environmental factors could adversely affect the growth and development of crops. Among the abiotic stresses, drought and heat stress are two critical threats to crop growth and sustainable agriculture worldwide. Considering global climate change, incidence...... of combined drought and heat stress is likely to increase. The aim of this study was to shed light on plant growth performance and leaf physiology of three tomatoes cultivars ('Arvento', 'LA1994' and 'LA2093') under control, drought, heat and combined stress. RESULTS: Shoot fresh and dry weight, leaf area...

The effect of stress fracture interventions in a single elite infantry training unit (1983-2015).

Science.gov (United States)

Milgrom, Charles; Finestone, Aharon S

2017-10-01

Stress fractures can be seen as an undesired byproduct of demanding physical training. The threshold value of stress that places an individual bone at high risk for stress fracture has not been identified. In a prospective study of stress fractures in 1983, a 31% incidence was found during demanding Israeli infantry basic training by bone scan criteria. Within a subgroup of these recruits, an elite infantry unit was found to have a 40% incidence. Since then and until 2015, eight additional induction companies of the same elite infantry unit were prospectively monitored for stress fractures during their basic training. In all of the studies, stress fracture surveillance and the examining orthopedist were the same. A retrospective review of all nine studies and of eight training changes was performed to look for a temporal trend in stress fracture incidence and to see if these might be related to training changes. There was a statistically significant trend for lower radiological proven stress fractures (p=0.0001) and radiological proven stress fractures plus clinical stress fractures (p=0.0013), as well as lower stress fracture severity by radiological criteria (p=0.0001) between 1983 and 2015. The only training change that was associated, by multivariate logistic regression, with a decreased incidence of stress fracture was restricting training to the authorized training protocol (odds ratio, 3874; 95% CI, 1.526 to 9.931; p=0.004). Increased recruit weight was found by multivariate analysis to be associated with lower stress fracture incidence (odds ratio 1.034; 95% CI, 1.00 to 1.070; p=0.051). Moving the training to a base with flatter terrain and reducing the formal marching distance by 1/3 was associated with a decrease in high grade stress fractures (odds ratio, 10.03; 95% CI, 3.5 to 28.4; p=0.0001). Neither the combined changes of enforcing a seven hour a night sleep regimen, training in more comfortable boots and adding a physical therapist to the unit nor

The stressed eyewitness: the interaction of thematic arousal and post-event stress in memory for central and peripheral event information

OpenAIRE

Echterhoff, Gerald; Wolf, Oliver T.

2012-01-01

Both arousal during the encoding of stimuli and subsequent stress can affect memory, often by increasing memory for important or central information. We explored whether event-based (thematic) arousal and post-event stress interact to selectively enhance eyewitnesses' memory for the central aspects of an observed incident. Specifically, we argue that memory for stimuli should be enhanced when (1) the stimuli are encoded under arousal (vs. non-arousal), and (2) stress is experienced soon after...

COMT Diplotype Amplifies Effect of Stress on Risk of Temporomandibular Pain.

Science.gov (United States)

Slade, G D; Sanders, A E; Ohrbach, R; Bair, E; Maixner, W; Greenspan, J D; Fillingim, R B; Smith, S; Diatchenko, L

2015-09-01

When measured once, psychological stress predicts development of painful temporomandibular disorder (TMD). However, a single measurement fails to characterize the dynamic nature of stress over time. Moreover, effects of stress on pain likely vary according to biological susceptibility. We hypothesized that temporal escalation in stress exacerbates risk for TMD, and the effect is amplified by allelic variants in a gene, catechol-O-methyltransferase (COMT), regulating catechol neurotransmitter catabolism. We used data from the Orofacial Pain: Prospective Evaluation and Risk Assessment prospective cohort study of 2,707 community-dwelling adults with no lifetime history of TMD on enrollment. At baseline and quarterly periods thereafter, the Perceived Stress Scale (PSS) measured psychological stress. Genotyped DNA from blood samples determined COMT diplotypes. During follow-up of 0.25 to 5.2 y, 248 adults developed examiner-verified incident TMD. PSS scores at baseline were 20% greater (P stress escalation was limited to incident cases with COMT diplotypes coding for low-activity COMT, signifying impaired catabolism of catecholamines. Cox regression models confirmed significant effects on TMD hazard of both baseline PSS (P stress showed that a postbaseline increase of 1.0 standard deviation in PSS more than doubled risk of TMD incidence in subjects with low-activity COMT diplotypes (hazard ratio = 2.35; 95% confidence limits: 1.66, 3.32), an effect not found in subjects with high-activity COMT diplotypes (hazard ratio = 1.42; 95% confidence limits: 0.96, 2.09). Findings provide novel insights into dynamic effects of psychological stress on TMD pain, highlighting that effects are most pronounced in individuals whose genetic susceptibility increases responsiveness to catecholamine neurotransmitters. © International & American Associations for Dental Research 2015.

Medication incidents reported to an online incident reporting system.

LENUS (Irish Health Repository)

Alrwisan, Adel

2011-01-15

AIMS: Approximately 20% of deaths from adverse events are related to medication incidents, costing the NHS an additional £500 million annually. Less than 5% of adverse events are reported. This study aims to assess the reporting rate of medication incidents in NHS facilities in the north east of Scotland, and to describe the types and outcomes of reported incidents among different services. Furthermore, we wished to quantify the proportion of reported incidents according to the reporters\\' profession. METHODS: A retrospective description was made of medication incidents reported to an online reporting system (DATIX) over a 46-month-period (July 2005 to April 2009). Reports originated from acute and community hospitals, mental health, and primary care facilities. RESULTS: Over the study period there were 2,666 incidents reported with a mean monthly reporting rate of 78.2\\/month (SD±16.9). 6.1% of all incidents resulted in harm, with insulin being the most commonly implicated medication. Nearly three-quarters (74.2%, n=1,978) of total incidents originated from acute hospitals. Administration incidents were implicated in the majority of the reported medication incidents (59%), followed by prescribing (10.8%) and dispensing (9.9%), while the nondescript "other medication incidents" accounted for 20.3% of total incidents. The majority of reports were made by nursing and midwifery staff (80%), with medical and dental professionals reporting the lowest number of incidents (n=56, 2%). CONCLUSIONS: The majority of medication incidents in this study were reported by nursing and midwifery staff, and were due to administration incidents. There is a clear need to elucidate the reasons for the limited contribution of the medical and dental professionals to reporting medication incidents.

The impact of work-related stress on medication errors in Eastern Region Saudi Arabia.

Science.gov (United States)

Salam, Abdul; Segal, David M; Abu-Helalah, Munir Ahmad; Gutierrez, Mary Lou; Joosub, Imran; Ahmed, Wasim; Bibi, Rubina; Clarke, Elizabeth; Qarni, Ali Ahmed Al

2018-05-07

To examine the relationship between overall level and source-specific work-related stressors on medication errors rate. A cross-sectional study examined the relationship between overall levels of stress, 25 source-specific work-related stressors and medication error rate based on documented incident reports in Saudi Arabia (SA) hospital, using secondary databases. King Abdulaziz Hospital in Al-Ahsa, Eastern Region, SA. Two hundred and sixty-nine healthcare professionals (HCPs). The odds ratio (OR) and corresponding 95% confidence interval (CI) for HCPs documented incident report medication errors and self-reported sources of Job Stress Survey. Multiple logistic regression analysis identified source-specific work-related stress as significantly associated with HCPs who made at least one medication error per month (P stress were two times more likely to make at least one medication error per month than non-stressed HCPs (OR: 1.95, P = 0.081). This is the first study to use documented incident reports for medication errors rather than self-report to evaluate the level of stress-related medication errors in SA HCPs. Job demands, such as social stressors (home life disruption, difficulties with colleagues), time pressures, structural determinants (compulsory night/weekend call duties) and higher income, were significantly associated with medication errors whereas overall stress revealed a 2-fold higher trend.

New insights into secondary prevention in post-traumatic stress disorder

Science.gov (United States)

Zohar, Joseph; Juven-Wetzler, Alzbeta; Sonnino, Rachel; Cwikel-Hamzany, Shlomit; Balaban, Evgenya; Cohen, Hagit

2011-01-01

Post-traumatic stress disorder (PTSD) is unique amongst psychiatric disorders in two ways. Firstly, there is usually a very clear point of onset- the traumatic event The second unique feature of PTSD is that it is characterized by a failure of the normal response to resolve. Given these two characteristics, PTSD appears a good candidate for secondary prevention, ie, interventions immediately after the trauma. Evidence available starting from current concepts and contemporary research of potential secondary prevention interventions are presented. Common practices in the aftermath of trauma such as debriefing and benzodiazepines need to be carefully considered, taking into account their potential harm to the spontaneous recovery process, and the trajectory of PTSD, and not only judging them according to their immediate (comforting) effects. A discussion of the balance required between aiding recovery but not interfering with the potent natural resolution of symptoms (that is expected in most cases), along with potential avenues of future research, are presented. Results of a small pilot study with a single intervention of hydrocortisone immediately after trauma appear to be promising, and clearly indicate the need for further studies. PMID:22033784

Reduced incidence of stress ulcer in germ-free Sprague Dawley rats.

Science.gov (United States)

Paré, W P; Burken, M I; Allen, E D; Kluczynski, J M

1993-01-01

Recent findings with respect to the role of spiral gram-negative bacteria in peptic ulcer disease have stimulated interest in discerning the role of these agents in stress ulcer disease. We tested the hypothesis that a standard restraint-cold ulcerogenic procedure would fail to produce ulcers in axenic rats. Axenic, as well as normal Sprague Dawley rats, were exposed to a cold-restraint procedure. The germ-free condition was maintained throughout the study in the axenic rats. Axenic rats had significantly fewer ulcers as compared to normal rats exposed to the standard cold-restraint procedure, as well as handling control rats. The data represent the first report suggesting a microbiologic component in the development of stress ulcer using the rat model.

StressModEx--Physiotherapist-led Stress Inoculation Training integrated with exercise for acute whiplash injury: study protocol for a randomised controlled trial.

Science.gov (United States)

Ritchie, Carrie; Kenardy, Justin; Smeets, Rob; Sterling, Michele

2015-07-01

Whiplash associated disorders are the most common non-hospitalised injuries following a road traffic crash. Up to 50% of individuals who experience a whiplash injury will not fully recover and report ongoing pain and disability. Most recovery, if it occurs, takes place in the first 2-3 months post injury, indicating that treatment provided in the early stages is critical to long-term outcome. However, early management approaches for people with acute whiplash associated disorders are modestly effective. One reason may be that the treatments have been non-specific and have not targeted the processes shown to be associated with poor recovery, such as post-traumatic stress symptoms. Targeting and modulating these early stress responses in the early management of acute whiplash associated disorders may improve health outcomes. Early aggressive psychological interventions in the form of psychological debriefing may be detrimental to recovery and are now not recommended for management of early post-traumatic stress symptoms. In contrast, Stress Inoculation Training (SIT) is a cognitive behavioural approach that teaches various general problem-solving and coping strategies to manage stress-related anxiety (ie, relaxation training, cognitive restructuring and positive self-statements) and provides important information to injured individuals about the impact of stress on their physical and psychological wellbeing. While referral to a psychologist may be necessary in some cases where acute stress disorder or other more significant psychological reactions to stress are evident, in the case of acute whiplash injuries, it is neither feasible nor necessary for a psychologist to deliver the early stress modulation intervention to all injured individuals. The feasibility of using other specially trained health professionals to deliver psychological interventions has been explored in conditions such as chronic low back pain, chronic whiplash and cancer, but few trials have studied

The incidence of schizophrenia in European immigrants to Canada.

Science.gov (United States)

Smith, G N; Boydell, J; Murray, R M; Flynn, S; McKay, K; Sherwood, M; Honer, W G

2006-10-01

The risk for schizophrenia in immigrants to Europe is approximately three times that of native-born populations. Discrimination and marginalization may influence the risk for schizophrenia within migrant populations. The primary objective of the present study was to determine whether the risk associated with migration was also evident 100 years ago. A second objective was to determine whether changing social stresses are associated with changes to the incidence of schizophrenia. During the first two decades of the twentieth century, the Provincial Mental Hospital was the sole provider of psychiatric services in British Columbia, Canada. Detailed clinical records have been preserved for 99.5% of 2477 patients who had a psychiatric admission between 1902 and 1913. Diagnoses were made after a detailed file review and 807 patients met DSM-IV criteria for first-episode schizophrenia, schizophreniform disorder, schizoaffective disorder, or psychosis not otherwise specified. Diagnoses had high inter-rater reliability. The incidence of schizophrenia in migrants from Britain or Continental Europe was compared with that in the Canadian-born population using indirect standardization and Poisson models. Migration from Britain or Continental Europe to Canada in the early twentieth century was associated with an increased rate of schizophrenia; IRR=1.54, (95% CI=1.33-1.78). Incidence increased over time in immigrants but not in the native-born population and this increase occurred during a period of economic recession. Migration was a risk factor for schizophrenia a century ago as it is today. This risk occurred in white migrants from Europe and increased during a period of increased social stress.

Perceived stress and risk of ischemic heart disease: causation or bias?

DEFF Research Database (Denmark)

Nielsen, Naja Rod; Kristensen, Tage S; Prescott, Eva

2006-01-01

BACKGROUND: It is unclear whether the commonly recognized link between stress and cardiovascular disease is causal or the result of reporting bias. The objective of this study was to address the association between perceived stress and first incidence of ischemic heart disease and to evaluate...... the suggested reporting bias by addressing subdiagnoses of ischemic heart disease separately. METHODS: The 11,839 men and women who participated in the Copenhagen City Heart Study were at baseline (1981-1983) asked about their stress level. The participants were followed in nationwide registries until the year...... 2000, and fewer than 0.1% were lost to follow-up. During follow-up, 2316 individuals were diagnosed with ischemic heart disease. RESULTS: High levels of stress were associated with slightly higher risk of incident ischemic heart disease in both women (hazard ratio = 1.23; 95% confidence interval = 1...

SAMJ IZINDABA.indd

African Journals Online (AJOL)

self-care. The multiple stressors encountered in most medical fields can lead to depression, addiction and burnout. Incorporating the arts into the medical curriculum emphasises the value of play and creativity as means to manage stress, ambiguity and uncertainty. Artistic practice assists medics to reflect, debrief, and.

Excess Stress Fractures, Musculoskeletal Injuries, and Health Care Utilization Among Unfit and Overweight Female Army Trainees.

Science.gov (United States)

Krauss, Margot R; Garvin, Nadia U; Boivin, Michael R; Cowan, David N

2017-02-01

Musculoskeletal injuries are prevalent among military trainees and certain occupations. Fitness and body mass index (BMI) have been associated with musculoskeletal conditions, including stress fractures. The incidence of, and excess health care utilization for, stress fracture and non-stress fracture overuse musculoskeletal injuries during the first 6 months of service is higher among unfit female recruits. Those who exceeded body fat limits are at a greater risk of incident stress fractures, injuries, or health care utilization compared with weight-qualified recruits. Cohort study; Level of evidence, 3. All applicants to the United States Army were required to take a preaccession fitness test during the study period (February 2005-September 2006). The test included a 5-minute step test scored as pass or fail. BMI was recorded at application. There were 2 distinct comparisons made in this study: (1) between weight-qualified physically fit and unfit women and (2) between weight-qualified physically fit women and those who exceeded body fat limits. We compared the incidence of, and excess health care utilization for, musculoskeletal injuries, including stress fractures and physical therapy visits, during the first 183 days of military service. Among the weight-qualified women, unfit participants had a higher non-stress fracture injury incidence and related excess health care utilization rate compared with fit women, with rate ratios of 1.32 (95% CI, 1.14-1.53) and 1.18 (95% CI, 1.10-1.27), respectively. Among fit women, compared with the weight-qualified participants, those exceeding body fat limits had higher rate ratios for non-stress fracture injury incidence and related excess health care utilization of 1.27 (95% CI, 1.07-1.50) and 1.20 (95% CI, 1.11-1.31), respectively. Weight-qualified women who were unfit had a higher incidence of stress fractures and related excess health care utilization compared with fit women, with rate ratios of 1.62 (95% CI, 1

Life Change Events as a Predictor of Accident Incidence in a College Population.

Science.gov (United States)

Furney, Steven R.

1983-01-01

To test the relationship between stressful life-change events and accident incidence, researchers administered the College Schedule of Recent Experience to male students at a large midwestern university. The study's implications for identifying high-risk persons and for accident prevention are discussed. (PP)

User's guide for Reactor Incident Root Cause Coding Tree

International Nuclear Information System (INIS)

Busch, D.A.; Paradies, M.W.

1986-01-01

The Reactor Incident (RI) Cause Coding Tree is designed to allow identification of root causes of RI's, thereby leading to trending of useful information and developing of corrective actions to prevent recurrence. This guide explains the terminology of the RI Cause Coding Tree and how to use the tree. Using this guide for cause coding is stressed to allow consistency of coding among all RI investigators. 8 figs

Autonomic modulations of heart rate variability are associated with sports injury incidence in sprint swimmers.

Science.gov (United States)

Lima-Borges, Dayanne S; Martinez, Paula F; Vanderlei, Luiz Carlos M; Barbosa, Fernando S S; Oliveira-Junior, Silvio A

2018-03-28

Young athletes' participation in competitive sports is becoming increasingly common, and this increased involvement raises concerns about the occurrence of overtraining and sports injuries. Since these issues are poorly understood, this study analyzed heart rate variability, stress/recovery relationship, and sports injury incidence during a training macrocycle of young sprint and endurance swimmers. Thirty teenage swimmers (aged 12 to 17 years) were divided into two groups as follows: Sprint (n = 17) and Endurance (n = 13). Subjects were evaluated over 20 weeks, based on the following three schedules: general, specific, and competitive. In addition to heart rate variability and sports injury incidence, the Recovery-Stress-Questionnaire of Athletes was used to analyse stress/recovery states in athletes. All procedures were developed at the initial moment and at the end of each periodization step. The Sprint group presented a reduced standard deviation of normal-normal beats (73.0 ± 6.6 vs. 54.1 ± 3.5 ms; p sports injury than the Endurance group (0.0214 ± 0.0068 vs. 0.0136 ± 0.0050 cases/1000 hours). Sprint training was associated with progressive activation of the sympathetic nervous system as well as a higher incidence of sports injury in comparison to endurance swimming during a training macrocycle.

Parenting stress in parents of children with cochlear implants: relationships among parent stress, child language, and unilateral versus bilateral implants.

Science.gov (United States)

Sarant, Julia; Garrard, Philippa

2014-01-01

Little attention has been focused on stress levels of parents of children with cochlear implants (CIs). This study examined the stress experience of 70 parents of children with CIs by comparing stress levels in this group of parents to those in parents of children without disabilities, identifying primary stressors, examining the relationship between parent stress and child language, and comparing stress in parents of children with bilateral and unilateral CIs. Parents completed a parent stress questionnaire, and the receptive vocabulary and language abilities of the children were evaluated. Results indicated that these parents had a higher incidence of stress than the normative population. Parent stress levels and child language outcomes were negatively correlated. Child behavior and lack of spousal and social support were the prime causes of parent stress. Parents of children with bilateral CIs were significantly less stressed than were parents of children with unilateral CIs.

Post-Traumatic Stress Disorder among French Armed Forces Members in Afghanistan: A New Approach.

Science.gov (United States)

Paul, Frédéric; Marimoutou, Catherine; Pommier de Santi, Vincent; Clervoy, Patrick

2016-01-01

During the 20th century, the management of war-related psychological trauma shifted from neurology to psychiatry. After September 11, 2001, the French forces participated in a multinational force deployed in Afghanistan to fight against terrorism. Post-traumatic stress disorder (PTSD) became a priority. We report the daily work of the psychiatrists involved in this mission and the organization developed to psychologically support wounded military personnel. The doctrine of early intervention psychiatrization and the technique of collective debriefing are the key points of this procedure. The psychiatrist is also responsible for the healthcare community, particularly vulnerable when confronted with severe ballistic injuries. One aim of this organization is also to screen PTSD in soldiers returning from Afghanistan. The military general practitioner is a pivotal point of this procedure built to detect PTSD, anxiety, depressive reaction and behavioral problems. The French health service has developed a genuine care strategy aimed at identifying patients, accompanying them in the formalities for recognition and compensation, and offering them treatment locally by arranging clinical psychology consultations near their home. © 2016 S. Karger AG, Basel.

Stress in emergency departments: experiences of nurses and doctors.

LENUS (Irish Health Repository)

Healy, Sonya

2012-01-31

The effects of stressful incidents on emergency department (ED) staff can be profound. Witnessing aggression, violence or the death of patients, or participating in resuscitation, can be emotionally and physically demanding. Despite the frequency of these events, ED staff do not become immune to the stress they cause, and are often ill prepared and under supported to cope with them. This article reports on a study of nurses\\' and doctors\\' attitudes to, and experiences of, workplace stress in three EDs in Ireland, and offers some suggestions on how stress among ED staff can be reduced.

Nursing care of children after a traumatic incident.

Science.gov (United States)

Mulvihill, Deanna

2007-01-01

The objective of this study was to describe the nursing interventions with children and their parents to reduce the impact of a traumatic incident. A traumatic incident can be a natural disaster, a plane or car accident, or child abuse. The author has conducted an interdisciplinary integrative review of the research literature on the health impact of childhood trauma. This research is summarized and the results are synthesized and presented in a diagram that demonstrates the strong relationships that trauma has to both short and long-term health status. The impact of post-traumatic stress disorder (PTSD) and interventions to reduce its impact are described. Predictability and continuity in nursing care grounded in both routine and personnel are important. Nurses can teach self-soothing techniques and coping skills prior to using exploratory dialogue to assist the child and the parent in reviewing the traumatic incident. Nurses can also act as advocates for unsafe situations and practices, such as corporal punishment. Assessment of children for history of trauma is indicated, especially children who exhibit signs of short-term health effects. Areas for health education and future research are also presented.

The prevalence and antecedents of occupational stress among radiographers in Zimbabwe: Interplay of economics and culture

Directory of Open Access Journals (Sweden)

Chingarande George R, Ndlovu Bekezela

2013-04-01

Full Text Available The purpose and objectives of this study were to find out the incidence of Occupational Stress amongst radiographers and also to find out the main stressors that they are exposed to. A cross sectional survey using both qualitative and quantitative methodologies and a questionnaire as a research tool was conducted. The questionnaire was given to all radiographers working in the general radiology department of the six departments/centres that participated in the study. The results revealed that there is a high incidence of occupational stress among medical radiographers working in general radiology. The results also showed that the most frequently encountered stressors in the general radiology department are pressure to complete tasks/overwork, inadequate salaries and inadequate holiday/vacation time. There were no significant differences in the incidences of occupational stress between male and female radiographers. However, there were differences in the perceptions of the two genders on the causes of stress. This was attributed to the cultural gender role expectations.

Stress-Related Mental Health Symptoms in Coast Guard: Incidence, Vulnerability, and Neurocognitive Performance

Directory of Open Access Journals (Sweden)

Richard J. Servatius

2017-09-01

Full Text Available U.S. Coast Guard (CG personnel face occupational stressors (e.g., search and rescue which compound daily life stressors encountered by civilians. However, the degree CG personnel express stress-related mental health symptoms of posttraumatic stress disorder (PTSD and major depressive disorder (MDD is understudied as a military branch, and little is known concerning the interplay of vulnerabilities and neurocognitive outcomes in CG personnel. The current study addressed this knowledge gap, recruiting 241 active duty CG personnel (22% female to assess mental health, personality, and neurocognitive function. Participants completed a battery of scales: PTSD Checklist with military and non-military prompts to screen for PTSD, Psychological Health Questionnaire 8 for MDD, and scales for behaviorally inhibited (BI temperament, and distressed (Type D personality. Neurocognitive performance was assessed with the Defense Automated Neurobehavioral Assessment (DANA battery. Cluster scoring yielded an overall rate of PTSD of 15% (95% CI: 11–20% and 8% (95% CI: 3–9% for MDD. Non-military trauma was endorsed twice that of military trauma in those meeting criteria for PTSD. Individual vulnerabilities were predictive of stress-related mental health symptoms in active duty military personnel; specifically, BI temperament predicted PTSD whereas gender and Type D personality predicted MDD. Stress-related mental health symptoms were also associated with poorer reaction time and response inhibition. These results suggest rates of PTSD and MDD are comparable among CG personnel serving Boat Stations to those of larger military services after combat deployment. Further, vulnerabilities distinguished between PTSD and MDD, which have a high degree of co-occurrence in military samples. To what degree stress-related mental healthy symptoms and attendant neurocognitive deficits affect operational effectiveness remains unknown and warrant future study.

Problem-Based Learning--A Corporate Training Model for Community Colleges.

Science.gov (United States)

Flint, Wendy

2003-01-01

Argues that problem-based learning, which stresses relevant learner issues and allows for the flexibility of the situation and the learners in the classroom, can be used to better prepare students for the workplace. Presents the five steps the process takes students through--engagement, inquiry, solution building, debriefing and reflection, and…

Impact of heat stress during seed development on soybean seed metabolome

Science.gov (United States)

Seed development is a temperature-sensitive process that is much more vulnerable than vegetative tissues to abiotic stresses. Climate change is expected to increase the incidence and severity of summer heatwaves, and the impact of heat stress on seed development is expected to become more widespread...

Stress Induced Hyperglycemia and the Subsequent Risk of Type 2 Diabetes in Survivors of Critical Illness

Science.gov (United States)

Plummer, Mark P.; Finnis, Mark E.; Phillips, Liza K.; Kar, Palash; Bihari, Shailesh; Biradar, Vishwanath; Moodie, Stewart; Horowitz, Michael; Shaw, Jonathan E.; Deane, Adam M.

2016-01-01

Objective Stress induced hyperglycemia occurs in critically ill patients who have normal glucose tolerance following resolution of their acute illness. The objective was to evaluate the association between stress induced hyperglycemia and incident diabetes in survivors of critical illness. Design Retrospective cohort study. Setting All adult patients surviving admission to a public hospital intensive care unit (ICU) in South Australia between 2004 and 2011. Patients Stress induced hyperglycemia was defined as a blood glucose ≥ 11.1 mmol/L (200 mg/dL) within 24 hours of ICU admission. Prevalent diabetes was identified through ICD-10 coding or prior registration with the Australian National Diabetes Service Scheme (NDSS). Incident diabetes was identified as NDSS registration beyond 30 days after hospital discharge until July 2015. The predicted risk of developing diabetes was described as sub-hazard ratios using competing risk regression. Survival was assessed using Cox proportional hazards regression. Main Results Stress induced hyperglycemia was identified in 2,883 (17%) of 17,074 patients without diabetes. The incidence of type 2 diabetes following critical illness was 4.8% (821 of 17,074). The risk of diabetes in patients with stress induced hyperglycemia was approximately double that of those without (HR 1.91 (95% CI 1.62, 2.26), phyperglycemia identifies patients at subsequent risk of incident diabetes. PMID:27824898

The German bakery waste incident; use of a combined approach of screening and confirmation for dioxins in feed and food

NARCIS (Netherlands)

Hoogenboom, L.A.P.; Bovee, T.F.H.; Portier, L.; Weg, van der G.; Onstenk, C.G.M.; Traag, W.A.

2004-01-01

During the last six years several incidents have occurred with dioxins in feed, stressing the need for rapid screening methods for these compounds. The most recent incident was the contamination of bakery waste used for animal feed due to the use of waste wood for drying of the material. In addition

Job stress and productivity increase.

Science.gov (United States)

Adaramola, Samson Sunday

2012-01-01

This paper examines mental and physical pressures that workers bear at work. The authors discuss how on the-job stress affects a person's capabilities and productivity, and how such pressures lend to higher incidences of accidents at work. The paper also discuss methods of reducing job-related stress and increasing productivity. An intervention was conducted amongst workers in a private firm. It shows mental and emotional pressure can affect performance and productivity of a worker on the job. One of the biggest influences of today's worker is on the-job stress. Job stress occurs when the requirements of the job do not match the capabilities, resources, or needs of the worker. This consequently affects how a person would normally deal with customer service problems, grievances, violence, conflict, and decisions on the job. Stress is an inevitable part of everyday life, and is therefore a distinct part of a person's job. To properly control the outcome of stress, there are certain precautions and methods that should be taken that will boost productivity.

Understanding placebo, nocebo, and iatrogenic treatment effects.

Science.gov (United States)

Bootzin, Richard R; Bailey, Elaine T

2005-07-01

Placebo and nonplacebo treatments have both positive and negative effects on patient outcomes. To better understand the patterning of treatment effects, three specific interventions will be discussed that are reported to produce more harm than benefit: critical incident stress debriefing, group therapy for adolescents with conduct disorders, and psychotherapy for dissociative identity disorder. In each case, there is an interaction between mechanisms thought to underlie both placebo and specific treatment effects. Mechanisms hypothesized to underlie placebo and nocebo effects include patient expectancy, self-focused attention to symptoms, motivation to change, and sociocultural role-enactment cues. In the three treatments discussed, specific mechanisms interact with nonspecific mechanisms to produce iatrogenic effects. To advance knowledge, it is important both to specify the theory of treatment and its expected outcomes and to put the theory to test. Only with attention to the empirical findings from programmatic research of specific and nonspecific effects and their interaction is it possible to improve the outcomes of treatment beyond the status quo.

Stress and sleep reactivity: a prospective investigation of the stress-diathesis model of insomnia.

Science.gov (United States)

Drake, Christopher L; Pillai, Vivek; Roth, Thomas

2014-08-01

To prospectively assess sleep reactivity as a diathesis of insomnia, and to delineate the interaction between this diathesis and naturalistic stress in the development of insomnia among normal sleepers. Longitudinal. Community-based. 2,316 adults from the Evolution of Pathways to Insomnia Cohort (EPIC) with no history of insomnia or depression (46.8 ± 13.2 y; 60% female). None. Participants reported the number of stressful events they encountered at baseline (Time 1), as well as the level of cognitive intrusion they experienced in response to each stressor. Stressful events (OR = 1.13; P stress-induced cognitive intrusion (OR = 1.61; P stressful events on risk for insomnia (P sleep reactivity significantly increased risk for insomnia (OR = 1.78; P sleep reactivity moderated the effects of stress-induced intrusion (P sleep reactivity. Trait sleep reactivity also constituted a significant risk for depression (OR = 1.67; P sleep reactivity is a significant risk factor for incident insomnia, and that it triggers insomnia by exacerbating the effects of stress-induced intrusion. Sleep reactivity is also a precipitant of depression, as mediated by insomnia. These findings support the stress-diathesis model of insomnia, while highlighting sleep reactivity as an important diathesis. Drake CL, Pillai V, Roth T. Stress and sleep reactivity: a prospective investigation of the stress-diathesis model of insomnia.

Critical incident exposure in South African emergency services personnel: prevalence and associated mental health issues

Science.gov (United States)

Ward, C L; Lombard, C J; Gwebushe, N

2006-01-01

Objectives To assess critical incident exposure among prehospital emergency services personnel in the developing world context of South Africa; and to assess associated mental health consequences. Methods We recruited a representative sample from emergency services in the Western Cape Province, South Africa, to participate in this cross sectional epidemiological study. Questionnaires covered critical incident exposure, general psychopathology, risky alcohol use, symptoms of post‐traumatic stress disorder (PTSD), and psychological and physical aggression between co‐workers. Open ended questions addressed additional stressors. Results Critical incident exposure and rates of general psychopathology were higher than in studies in the developed world. Exposure to critical incidents was associated with general psychopathology, symptoms of PTSD, and with aggression between co‐workers, but not with alcohol use. Ambulance, fire, and sea rescue services had lower general psychopathology scores than traffic police. The sea rescue service also scored lower than traffic police on PTSD and psychological aggression. The defence force had higher rates of exposure to physical assault, and in ambulance services, younger staff were more vulnerable to assault. Women had higher rates of general psychopathology and of exposure to psychological aggression. Other stressors identified included death notification, working conditions, and organisational problems. Conclusions Service organisations should be alert to the possibility that their personnel are experiencing work ‐related mental health and behavioural problems, and should provide appropriate support. Attention should also be given to organisational issues that may add to the stress of incidents. Workplace programmes should support vulnerable groups, and address death notification and appropriate expression of anger. PMID:16498167

Stress ulcer prophylaxis in patients being weaned from the ventilator in a respiratory care center: A randomized control trial

Directory of Open Access Journals (Sweden)

Chien-Chu Lin

2016-01-01

Conclusion: Stress ulcer prophylaxis with lansoprazole in patients being weaned from mechanical ventilators led to a lower but not statistically significant incidence of apparent upper gastrointestinal bleeding. There was no significant increase of incidence of ventilator-associated pneumonia in the prophylaxis group. Further larger scale studies are needed to clarify the benefit of stress ulcer prophylaxis in such patients.

Residual stress in ion implanted titanium nitride studied by parallel beam glancing incidence x-ray diffraction

International Nuclear Information System (INIS)

Geist, D.E.; Perry, A.J.; Treglio, J.R.; Valvoda, V.; Rafaja, D.

1995-01-01

Ion implantation is known to increase the lifetime of cutting tools. Current theories are the increase in lifetime is caused by an increase in the residual stress, or by work hardening of the surface associated with the implantation. In this work the effect of ion implantation on the residual stress in titanium nitride coatings made by the standard industrial methods of chemical and physical vapor deposition (CVD and PVD) is studied. It is found in the as-received condition (unimplanted), the residual stress levels are near zero for CVD materials and highly compressive, of the order of 6 GPa, for PVD materials. Ion implantation has no effect on the residual stress in the coatings made by CVD. Nitrogen does increase the compressive residual stress by some 10% in the near surface regions of PVD coatings, while nickel-titanium dual metal ion implantation does not have any effect. It appears that the lifetime increase is not associated with residual stress effects

A Study on the Residual Stress Improvement of PWSCC(Primary Water Stress Corrosion Cracking) in DMW(Dissimilar Metal Weld)

International Nuclear Information System (INIS)

Kang, Sung Sik; Kim, Seok Hun; Lee, Seung Gun; Park, Heung Bae

2010-01-01

Since 2000s, most of the cracks are found in welds, especially in (DMW) dissimilar metal welds such as pressurizer safety relief nozzle, reactor head penetration, reactor bottom mounted instrumentation (BMI), and reactor nozzles. Even the cracks are revealed as a primary water stress corrosion cracking (PWSCC), it is difficult to find the cracks by current non destructive examination. The PWSCC is occurred by three incident factors, such as susceptible material, environmental corrosive condition, and welding residual stress. If one of the three factors can be erased or decreased, the PWSCC could be prevented. In this study, we performed residual stress analysis for DMW and several residual stress improvement methods. As the preventive methods of PWSCC, we used laser peening(IP) method, inlay weld(IW) method, and induction heating stress improvement(IHSI) method. The effect of residual stress improvement for preventive methods was compared and discussed by finite element modeling and residual stress of repaired DMW

Transcriptional changes associated with reduced spontaneous liver tumor incidence in mice chronically exposed to high dose arsenic

International Nuclear Information System (INIS)

Nelson, Gail M.; Ahlborn, Gene J.; Allen, James W.; Ren, Hongzu; Corton, J. Christopher; Waalkes, Michael P.; Kitchin, Kirk T.; Diwan, Bhalchandra A.; Knapp, Geremy; Delker, Don A.

2009-01-01

Exposure of male C3H mice in utero (from gestational days 8-18) to 85 ppm sodium arsenite via the dams' drinking water has previously been shown to increase liver tumor incidence by 2 years of age. However, in our companion study (Ahlborn et al., 2009), continuous exposure to 85 ppm sodium arsenic (from gestational day 8 to postnatal day 365) did not result in increased tumor incidence, but rather in a significant reduction (0% tumor incidence). The purpose of the present study was to examine the gene expression responses that may lead to the apparent protective effect of continuous arsenic exposure. Genes in many functional categories including cellular growth and proliferation, gene expression, cell death, oxidative stress, protein ubiquitination, and mitochondrial dysfunction were altered by continuous arsenic treatment. Many of these genes are known to be involved in liver cancer. One such gene associated with rodent hepatocarcinogenesis, Scd1, encodes stearoyl-CoA desaturase and was down-regulated by continuous arsenic treatment. An overlap between the genes in our study affected by continuous arsenic exposure and those from the literature affected by long-term caloric restriction suggests that reduction in the spontaneous tumor incidence under both conditions may involve similar gene pathways such as fatty acid metabolism, apoptosis, and stress response.

An investigation into psychological stress and its determinants in Xinjiang desert oil workers

Science.gov (United States)

Ning, Li; Guan, Suzhen; Liu, Jiwen

2018-01-01

Abstract The present study aims to investigate psychological stress and its determinants in Xinjiang field oil workers. Specifically, we aim to elucidate the mechanisms underlying psychological stress by comprehensively and quantitatively evaluating the processes involved in psychological stress, the factors which influence it, and their relationship. The participants were 1200 field oil workers in Xinjiang who had been in service for at least 1 year. A structural equation model based on data from the symptom checklist, social support research scale, personality questionnaire, occupational burnout questionnaire, and occupational stress questionnaire was constructed to investigate the social (environmental) factors that influence physiological stress and the interplay among these factors. The positive incidence of psychological stress in the field oil workers in Xinjiang was 12.54%. The structural equation model indicated that the main factors that influenced psychological stress in these workers included social support (0.077), occupational role (0.165), personal strain response (0.139), personality (0.189), and occupational burnout (0.380). Among these factors, occupational role, personality, and occupational burnout had a relatively strong predictive power for psychological stress reactions. The cortisol level in workers with positive psychological stress was significantly higher than that in workers with negative psychological stress. Occupational stress, personality, and occupational burnout exert an impact on psychological stress in field oil workers. Therefore, interventions to address these factors should be taken to reduce the incidence of psychological stress. PMID:29642166

Upper extremity and rib stress fractures in a child

International Nuclear Information System (INIS)

Moon, B.S.; Price, C.T.; Campbell, J.B.

1998-01-01

Stress fractures in children are rare compared with the incidence in [ults. This report describes an 11-year-old girl with stress fractures of the acromion, clavicle, and first rib on the left and contralateral fractures of the first and second ribs. It was eventually discovered that these fractures were caused by a nervous tic consisting of repetitive, vigorous shrugging and translation of the shoulders. (orig.)

Incidence and prevalence of elite male cricket injuries using updated consensus definitions

Directory of Open Access Journals (Sweden)

Orchard JW

2016-12-01

Full Text Available John W Orchard, Alex Kountouris, Kevin Sims National Cricket Centre, Cricket Australia, Brisbane, Australia Background: T20 (Twenty20 or 20 over cricket has emerged in the last decade as the most popular form of cricket (in terms of spectator attendances. International consensus cricket definitions, first published in 2005, were updated in 2016 to better reflect the rise to prominence of T20 cricket.  Methods: Injury incidence and prevalence rates were calculated using the new international methods and units for elite senior male Australian cricketers over the past decade (season 2006–2007 to season 2015–2016 inclusive.  Results: Over the past 10 seasons, average match injury incidence, for match time-loss injuries, was 155 injuries/1,000 days of play, with the highest daily rates in 50-over cricket, followed by 20-over cricket and First-Class matches. Annual injury incidence was 64 injuries/100 players per season, and average annual injury prevalence was 12.5% (although fast bowlers averaged 20.6%, much higher than other positions. The most common injury was the hamstring strain (seasonal incidence 8.7 injuries/100 players per season. The most prevalent injury was lumbar stress fractures (1.9% of players unavailable at all times owing to these injuries, which represents 15% of all missed playing time.  Discussion: The hamstring strain has emerged from being one of the many common injuries in elite cricket a decade ago to being clearly the most common injury in the sport at the elite level. This is presumably in association with increased T20 cricket. Lumbar stress fractures in fast bowlers are still the most prevalent injury in the sport of cricket at the elite level, although these injuries are more associated with high workloads arising from the longer forms of the game. Domestic and international matches have very similar match injury incidence rates across the formats, but injury prevalence is higher in international players as

Incidence and remission of lower urinary tract symptoms during 12 years after the first delivery: A cohort study

DEFF Research Database (Denmark)

Viktrup, L.; Lose, G.

2008-01-01

Purpose: We estimated the incidence and remission of lower urinary tract symptoms during the 12 years following the first pregnancy and delivery. Materials and Methods: In a cohort study 242 primiparae were questioned about lower urinary tract symptoms 3 months, 5 years and 12 years after the first...... of stress urinary incontinence, urge urinary incontinence, urgency, diurnal frequency and nocturia during the same period occurred in 1 of 11 cases (9.1%), 2 of 5 (40%), 2 of 5 (40%), 4 of 7 (57.1%) and I of 1 (100%), respectively. From 5 to 12 years after the first delivery the incidence of stress urinary...... urge urinary incontinence and 15 (24.2%) had mixed urinary incontinence 12 years later. Of 13 women with pure urge urinary incontinence during the first pregnancy and puerperium 3 (23.1%) had pure urge urinary incontinence, 2 (15.4%) had pure stress urinary incontinence and 3 (23.1%) had mixed urinary...

[Relationship between depression symptoms and stress in occupational populations].

Science.gov (United States)

Yu, Shan-fa; Yao, San-qiao; Ding, Hui; Ma, Liang-qing; Yang, Yan; Wang, Zhi-hui

2006-03-01

To explore the relationship between the depression symptoms and occupational stress in occupational populations. Depression symptoms were measured by using the center for epidemiological survey-depression scale. The occupational stress instrument were employed to investigate the stressors, personalities, social support, and coping strategies as well as the subject's age, length of service, sex, educational level and marriage status. Chi(2) test was used for analyzing the difference of depression. The multiple covariance analysis was used for testing the difference of stressors, personalities, social support, and coping strategies among the groups with different scores of depression. The variables obtained in the optional prediction equation were identified by multiple stepwise regression analysis. The incidence rate of definite depression symptoms was 40.2%. The total average score was 21.74 +/- 8.99. Henan province had the highest incidence rate of depression symptoms, 43.8%, Hebei 39.4%, and Beijing the lowest, 23.4%. The male workers had the higher incidence rate of depression symptoms, 43. 0% than female, 35.4% (P affect the mental health.

Epidemiology of mixed, stress, and urgency urinary incontinence in middle-aged/older women: the importance of incontinence history.

Science.gov (United States)

Komesu, Yuko M; Schrader, Ronald M; Ketai, Loren H; Rogers, Rebecca G; Dunivan, Gena C

2016-05-01

Urinary incontinence (UI) is common and the relationship among its subtypes complex. Our objective was to describe the natural history and predictors of the incontinence subtypes stress, urgency, and mixed, in middle-aged and older US women. We tested our hypothesis that UI subtype history predicted future occurrence, evaluating subtype incidence/remission over multiple time points in a stable cohort of women. We analyzed longitudinal urinary incontinence data in 10,572 community-dwelling women aged ≥50 in the 2004-2010 Health and Retirement Study. Mixed, stress, and urgency incontinence prevalence (2004, 2006, 2008, 2010) and 2-year cumulative incidence and remissions (2004-2006, 2006-2008, 2008-2010) were estimated. Patient characteristics and incontinence subtype status 2004-2008 were entered into a multivariable, transition model to determine predictors for incontinence subtype occurrence in 2010. The prevalence of each subtype in this population (median age 63-66) was 2.6-8.9 %. Subtype incidence equaled 2.1-3.5 % and remissions for each varied between 22.3 and 48.7 %. Incontinence subtype incidence predictors included ethnicity/race, age, body mass index, and functional limitations. Compared with white women, black women had decreased odds of incident stress incontinence and Hispanic women had increased odds of stress incontinence remission. The age range 80-90 and severe obesity predicted incident mixed incontinence. Functional limitations predicted mixed and urgency incontinence. The strongest predictor of incontinence subtype was subtype history. The presence of the respective incontinence subtypes in 2004 and 2006 strongly predicted 2010 recurrence (odds ratio [OR] stress incontinence = 30.7, urgency OR = 47.4, mixed OR = 42.1). Although the number of remissions was high, a previous history of incontinence subtypes predicted recurrence. Incontinence status is dynamic, but tends to recur over the longer term.

Living in critical times: The impact of critical incidents on frontline ambulance personnel--a qualitative perspective.

LENUS (Irish Health Repository)

Gallagher, Sharon

2007-01-01

Little is known about the impact of Critical Incidents (CIs) on the lives of ambulance personnel. One-to-one interviews were conducted with 27 participants who had experienced CIs during the previous 12 months in order to: assess the nature and impact of CIs on health and well-being; examine attitudes toward support services; and explore barriers to service use. The results showed that incidents involving children, suicides, and grotesque mutilation were the most distressing. Participants reported a wide range of physical and mental health problems including sleep difficulties, angry outbursts, irrationality and feelings of alienation. Key themes included: low support service uptake due to fears relating to confidentiality and machismo; a perceived lack of concern and support from management; and a need for professional counselling and stress awareness training. Emergency Medical Controllers (EMCs) also reported a number of difficulties unique to their role. The findings suggest that exposure to CIs has a significant impact on health and well-being; this has important implications for recognizing and appropriately addressing the health and training needs of ambulance personnel, including the effective management of Critical Incident Stress.

Stres i wypalenie zawodowe w pracy ratowników medycznych = Stress and a burn-out syndrome at work among paramedics

Directory of Open Access Journals (Sweden)

Magdalena Żurowska-Wolak

2015-06-01

4.      Zakład Zdrowia Publicznego, Warszawski Uniwersytet Medyczny, Warszawa     Adres do korespondencji: Magdalena Żurowska-Wolak tel: 503 196 836;  e- mail: m_zurowska@vp.pl   Streszczenie: Zawód ratownika medycznego jest jednym zawodów, w których narażenie na stres jest wysokie oraz istnieje ryzyko wystąpienia zespołu wypalenia zawodowego. Celem badania było poznanie sposobów radzenia sobie ze stresem, stosowanych przez ratowników medycznych oraz występowania wśród nich objawów wypalenia zawodowego. Najczęstszym z nich było występowanie dużego zmęczenia po pracy. Większość badanych (64%  potwierdziła wykorzystywanie konstruktywnych sposobów radzenia sobie ze stresem, jak również niekonstruktywne stosowanie używek, w szczególności kofeiny i nikotyny, których spożycie wzrastało w sytuacjach trudnych. Na podstawie badań można wnioskować, że wśród ratowników medycznych, pracujących w Krakowie i okolicach, występuje niebezpiecznie dużo objawów wypalenia zawodowego. Świadczy to o potrzebie stworzenia i realizacji przez ich pracodawców działań, obniżających poziom stresu wśród pracowników oraz zapobiegających wystąpieniu wypalenia zawodowego – jak debriefing, trenieng technik radzenia sobie ze stresem czy wspierania aktywności fizycznej. Jest to o tyle istotne, iż skutki stresu oraz wypalenia odczuwają nie tylko sami ratownicy. Skutki te są dolegliwe także dla pracodawców, którzy zatrudniają gorzej funkcjonujących pracowników oraz pacjentów, otrzymujących usługi o niższej jakości.   Abstract: Paramedics are one of the professions where the risk of exposure to stress is high as well as the risk of occurrence of the burnout syndrome. The aim of the study was to analyze methods of stress reduction and symptoms of the burnout syndrome among 122 paramedics from Kraków and surrounding area. The most prevalent symptom was severe tiredness after working hours. The majority of respondents

Emergence Delirium With Post-traumatic Stress Disorder Among Military Veterans

OpenAIRE

Nguyen, Son; Pak, Mila; Paoli, Daniel; Neff, Donna F

2016-01-01

The clinical characteristics of emergence delirium (ED) associated with post-traumatic stress disorder (PTSD) among military veterans encompass transient agitation, restlessness, disorientation, and violent verbal and physical behaviors?due to?re-experiencing of PTSD-related incidents. Two cases of?ED after general anesthesia associated with PTSD are presented. Different?anesthesia methods were applied for the?two cases.?A traditional medical approach appeared not to prevent the incidence of ...

Occupational Stress and Professional Development of Primary School Teachers

Directory of Open Access Journals (Sweden)

Mateja Modrej

2015-12-01

Full Text Available The occupation of primary school teachers is considered one of the most stressful professions. The survey was used to determine the incidence of stress in 110 primary school teachers in urban and rural schools in Slovenia, depending on seniority. Its aim was to learn about stress symptoms, stressful situations and strategies to manage stress among teachers. The results show that teachers evaluate their work as a very responsible one and in majority do not think about changing their job. Teachers most often perceive physical and emotional symptoms of stress. They are faced with stressful situations when working with pupils, at their professional work, and in relations with colleagues, school management, and parents. When difficulties arise in their work, teachers most often turn for help to a colleague or the school management; and they manage their stress by going for a walk and talking to their friends.

The incidence of meconium-stained amniotic fluid from 1980 through 1986, by year and gestational age.

Science.gov (United States)

Dysart, M; Graves, B W; Sharp, E S; Cotsonis, G

1991-09-01

The annual incidence of meconium-stained amniotic fluid was analyzed for changes in a total obstetric sample of 45,115 singleton, vertex, liveborn infants over a 7-year study period. The incidence of meconium-stained amniotic fluid for the total obstetric population was calculated for each year of the study period. The sample was then stratified by estimated gestational age, and the incidence of meconium-stained amniotic fluid was calculated for each gestational age group. The incidence of meconium-stained amniotic fluid increased 40.9% over the study period, from 18.8% in 1980 to 26.5% in 1986 (P less than .001). This increase was found to be in a consistent linear trend (P less than .05). The incidence of meconium-stained amniotic fluid was also found to increase significantly in a linear trend as gestational age of the fetus increased. These findings lend support to both the maturational theory and the stress theory of meconium passage in utero.

Inner strategies of coping with operational work amongst SAPS officers

Directory of Open Access Journals (Sweden)

Masefako A. Gumani

2013-11-01

Research purpose: The objective of this study was to describe inner coping strategies used by officers in the Vhembe district (South Africa to reconstruct stressful and traumatic experiences at work. Motivation for the study: Most studies on coping amongst SAPS officers focus on organisational stress and not on the impact of the officers’ operational work. Research design, approach and method: An exploratory design was used and 20 SAPS officers were selected through purposive sampling. In-depth face-to-face and telephone interviews, as well as diaries were used to collect data, which were analysed using content thematic data analysis. Main findings: The results showed that the main categories of coping strategies that led to management of the impact of operational work amongst the selected sample were centred around problem-focused and emotion-focused strategies, with some use of reappraisal and minimal use of avoidance. Considering the context of the officers’ work, the list of dimensions of inner coping strategies amongst SAPS officers should be extended. Practical/managerial implications: Intervention programmes designed for the SAPS, including critical incident stress debriefing, should take the operational officers’ inner strategies into account to improve the management of the impact of their work. Contribution/value-add: This study contributes to the body of knowledge on the inner coping strategies amongst SAPS officers, with special reference to operational work in a specific setting.

Starting on haemodialysis: a qualitative study to explore the experience and needs of incident patients.

Science.gov (United States)

Lai, Alden Yuanhong; Loh, Angela Ping Ping; Mooppil, Nandakumar; Krishnan, Deby Sarojiuy Pala; Griva, Konstadina

2012-01-01

Dialysis can be very stressful with the initial months onto treatment being highly critical in terms of both adaptation and mortality. This qualitative study aimed to explore the lived experiences of incident haemodialysis patients in Singapore. Topics related to the end-stage renal disease diagnosis and haemodialysis treatment were raised with 13 incident haemodialysis patients in the form of semi-structured interviews, and interpretative phenomenological analysis was undertaken as the framework for data analysis. Emotional distress, treatment-related concerns and social support emerged as main issues following a critical review of themes. Our study revealed that incident haemodialysis patients have emotional and informational needs, highlighting the importance of intervention programmes in particular to this patient group to promote better psychosocial adjustment to the disease and its treatment.

[Fatigue syndrome: Stress, Burnout and depression in Urology.

Science.gov (United States)

Rodríguez-Socarrás, Moisés; Vasquez, Juan Luis; Uvin, Pieter; Skjold-Kingo, Pernille; Gómez Rivas, Juan

2018-01-01

To determine the factors related to stress, Burnout and depression in urology, as well as consequences in residents and urologists, in addition to the possible applicable strategies to diminish and treat them. Depression, stress and Burnout syndrome has become a problem in urology specialty. These topics have gained interest in international congresses and urological associations. Efforts are being made to find related factors as well as possible strategies and applicable support programs. Burnout frequency is higher among health professionals than general population, 40-76% in students and residents, its incidence has skyrocketed in recent years, in addition Urology is one of the specialties with highest incidence and severity. Its increase has been related to work overload, documentation, administrative/bureaucratic workload, hostile work environment; its consequences include poor work performance, medical errors, depression, substance abuse, disruption in family and couple relationships and suicidal ideation. Strategies for prevention including resilience training, lifestyle balance, teamwork, and support programs. Stress, burnout and depression are problems in urology, early detection, promoting individual techniques in resilience, lifestyle and teamwork are fundamental now and for the future of the specialty. Developing and implementing support programs should be seriously considered by health systems and urological associations.

Post-traumatic stress disorder status in a rescue group after the Wenchuan earthquake relief.

Science.gov (United States)

Huang, Junhua; Liu, Qunying; Li, Jinliang; Li, Xuejiang; You, Jin; Zhang, Liang; Tian, Changfu; Luan, Rongsheng

2013-07-15

Previous studies have suggested that the incidence of post-traumatic stress disorder in earthquake rescue workers is relatively high. Risk factors for this disorder include demographic characteristics, earthquake-related high-risk factors, risk factors in the rescue process, personality, social support and coping style. This study examined the current status of a unit of 1 040 rescue workers who participated in earthquake relief for the Wenchuan earthquake that occurred on May 12(th), 2008. Post-traumatic stress disorder was diagnosed primarily using the Clinician-Administered Post-traumatic Stress Disorder Scale during structured interviews. Univariate and multivariate statistical analyses were used to examine major risk factors that contributed to the incidence of post-traumatic stress disorder. Results revealed that the incidence of this disorder in the rescue group was 5.96%. The impact factors in univariate analysis included death of family members, contact with corpses or witnessing of the deceased or seriously injured, near-death experience, severe injury or mental trauma in the rescue process and working at the epicenter of the earthquake. Correlation analysis suggested that post-traumatic stress disorder was positively correlated with psychotic and neurotic personalities, negative coping and low social support. Impact factors in multivariate logistic regression analysis included near-death experience, severe injury or mental trauma, working in the epicenter of the rescue, neurotic personality, negative coping and low social support, among which low social support had the largest odds ratio of 20.42. Findings showed that the occurrence of post-traumatic stress disorder was the result of the interaction of multiple factors.

Post-traumatic stress disorder status in a rescue group after the Wenchuan earthquake relief

Science.gov (United States)

Huang, Junhua; Liu, Qunying; Li, Jinliang; Li, Xuejiang; You, Jin; Zhang, Liang; Tian, Changfu; Luan, Rongsheng

2013-01-01

Previous studies have suggested that the incidence of post-traumatic stress disorder in earthquake rescue workers is relatively high. Risk factors for this disorder include demographic characteristics, earthquake-related high-risk factors, risk factors in the rescue process, personality, social support and coping style. This study examined the current status of a unit of 1 040 rescue workers who participated in earthquake relief for the Wenchuan earthquake that occurred on May 12th, 2008. Post-traumatic stress disorder was diagnosed primarily using the Clinician-Administered Post-traumatic Stress Disorder Scale during structured interviews. Univariate and multivariate statistical analyses were used to examine major risk factors that contributed to the incidence of post-traumatic stress disorder. Results revealed that the incidence of this disorder in the rescue group was 5.96%. The impact factors in univariate analysis included death of family members, contact with corpses or witnessing of the deceased or seriously injured, near-death experience, severe injury or mental trauma in the rescue process and working at the epicenter of the earthquake. Correlation analysis suggested that post-traumatic stress disorder was positively correlated with psychotic and neurotic personalities, negative coping and low social support. Impact factors in multivariate logistic regression analysis included near-death experience, severe injury or mental trauma, working in the epicenter of the rescue, neurotic personality, negative coping and low social support, among which low social support had the largest odds ratio of 20.42. Findings showed that the occurrence of post-traumatic stress disorder was the result of the interaction of multiple factors. PMID:25206499

Computer incident response and forensics team management conducting a successful incident response

CERN Document Server

Johnson, Leighton

2013-01-01

Computer Incident Response and Forensics Team Management provides security professionals with a complete handbook of computer incident response from the perspective of forensics team management. This unique approach teaches readers the concepts and principles they need to conduct a successful incident response investigation, ensuring that proven policies and procedures are established and followed by all team members. Leighton R. Johnson III describes the processes within an incident response event and shows the crucial importance of skillful forensics team management, including when and where the transition to forensics investigation should occur during an incident response event. The book also provides discussions of key incident response components. Provides readers with a complete handbook on computer incident response from the perspective of forensics team management Identify the key steps to completing a successful computer incident response investigation Defines the qualities necessary to become a succ...

Medial tibial stress syndrome: a critical review

NARCIS (Netherlands)

Moen, Maarten H.; Tol, Johannes L.; Weir, Adam; Steunebrink, Miriam; de Winter, Theodorus C.

2009-01-01

Medial tibial stress syndrome (MTSS) is one of the most common leg injuries in athletes and soldiers. The incidence of MTSS is reported as being between 4% and 35% in military personnel and athletes. The name given to this condition refers to pain on the posteromedial tibial border during exercise,

Occupational stress and the importance of self-care and resilience: focus on veterinary nursing.

Science.gov (United States)

Lloyd, Ciaran; Campion, Deirdre P

2017-01-01

Burnout and compassion fatigue are frequently mentioned in relation to veterinary work. Veterinary nursing is a caring profession and those who seek a career within this field do so because of a natural empathetic desire to care for animals. However it is the individuals who are the most caring and empathetic towards others that will be most at risk of experiencing occupational stress when they are confronted with psychologically demanding workplace roles and working environments. Burnout is considered an 'unintentional end point' for certain individuals who are exposed to chronic stress within their working environment. When suffering burnout, a person may experience emotional exhaustion, may become more cynical or they may have a reduced sense of personal accomplishment in regards to their own work. Signs of burnout can include increased levels of absenteeism at work, or the working standards of that staff member may decline below that of what would normally be expected of them. This could directly impact on patient care in the veterinary practice. Working in a role that places emotional demands on staff, such as a need to show compassion and empathy towards clients who are emotionally distressed, puts staff at risk from experiencing compassion fatigue. Workplace supports may include appropriate debriefing sessions among willing participants, particularly after an emotionally stressful encounter with a client. Taking personal responsibility for care of one's own mental and physical health is just as important as taking care of the patient's health. Personal strategies may include lifestyle changes, adopting a healthier lifestyle, reduction of working hours, and ensuring adequate sleep. Adopting healthy self-care strategies can promote characteristics of "resilience" - personal qualities or traits such as optimism, self-confidence, level headedness, hardiness, and having the ability to be resourceful during times of adversity. All veterinary staff may be better

Stress and periodontal disease: The link and logic!!

Directory of Open Access Journals (Sweden)

Sachin Goyal

2013-01-01

Full Text Available Stress is an equated response to constant adverse stimuli. At one point or another everybody suffers from stress. Stress is compatible with good health, being necessary to cope with the challenges of everyday life. Problems start when the stress response is inappropriate to the intensity of the challenge. Psychological stress can down regulate the cellular immune response. Communication between the central nervous system and the immune system occurs via a complex network of bidirectional signals linking the nervous, endocrine, and immune systems. Stress disrupts the homeostasis of this network, which in turn, alters immune function. Direct association between periodontal disease and stress remains to be proven, which is partly due to lack of an adequate animal models and difficulty to quantifying the amount and duration of stress and also there are many factors influencing the incidence and severity of periodontal disease. Nevertheless, more recent studies indicate that psychosocial stress represents a risk indicator for periodontal disease and should be addressed before and during treatment. This paper discusses how stress may modulate host response to bacteria and influence the course and progression of periodontal disease.

Work stress and innate immune response.

Science.gov (United States)

Boscolo, P; Di Gioacchino, M; Reale, M; Muraro, R; Di Giampaolo, L

2011-01-01

Several reports highlight the relationship between blood NK cytotoxic activity and life style. Easy life style, including physical activity, healthy dietary habits as well as good mental health are characterized by an efficient immune response. Life style is related to the type of occupational activity since work has a central part in life either as source of income or contributing to represent the social identity. Not only occupational stress, but also job loss or insecurity are thus considered serious stressful situations, inducing emotional disorders which may affect both neuroendocrine and immune systems; reduced reactivity to mitogens and/or decreased blood NK cytotoxic activity was reported in unemployed workers or in those with a high perception of job insecurity and/or job stress. Although genetic factors have a key role in the pathogenesis of autoimmune disorders, occupational stress (as in night shifts) was reported associated to an increased incidence of autoimmune disorders. Monitoring blood NK response may thus be included in the health programs as an indirect index of stressful job and/or poor lifestyle.

Oxidative Stress: A New Target for Pancreatic Cancer Prognosis and Treatment

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Javier Martinez-Useros

2017-03-01

Full Text Available Pancreatic ductal adenocarcinoma (PDAC is one of the most lethal types of tumors, and its incidence is rising worldwide. Survival can be improved when tumors are detected at an early stage; however, this cancer is usually asymptomatic, and the disease only becomes apparent after metastasis. Several risk factors are associated to this disease. Chronic pancreatitis, diabetes, and some infectious disease are the most relevant risk factors. Incidence of PDAC has increased in the last decades. It is hypothesized it could be due to other acquired risk habits, like smoking, high alcohol intake, and obesity. Indeed, adipose tissue is a dynamic endocrine organ that secretes different pro-inflammatory cytokines, enzymes, and other factors that activate oxidative stress. Reactive oxygen species caused by oxidative stress, damage DNA, proteins, and lipids, and produce several toxic and high mutagenic metabolites that could modify tumor behavior, turning it into a malignant phenotype. Anti-oxidant compounds, like vitamins, are considered protective factors against cancer. Here, we review the literature on oxidative stress, the molecular pathways that activate or counteract oxidative stress, and potential treatment strategies that target reactive oxygen species suitable for this kind of cancer.

Traumatic stress and psychological functioning in a South African adolescent community sample

OpenAIRE

Swain, Karl D.; Pillay, Basil J.; Kliewer, Wendy

2017-01-01

Background: Traumatic stress may arise from various incidents often leading to posttraumatic stress disorder (PTSD). The lifetime prevalence of PTSD is estimated at 1% – 2% in Western Europe, 6% – 9% in North America and at just over 10% in countries exposed to long-term violence. In South Africa, the lifetime prevalence for PTSD in the general population is estimated at 2.3%. Aim: To examine the prevalence of posttraumatic stress symptomatology and related psychological functioning in a ...

The Incidence and Types of Occupational Role Stress among University Research Administrators

Science.gov (United States)

Katsapis, Christine C. A.

2012-01-01

This study explored the types of stressors prevalent in the self-reports of university research administrators (URAs) and examined whether or not the degree or type of role stress was influenced by: a) the affiliation of their office unit within their institution, or b) their type. Randomly selected members of NCURA were invited via e-mail to…

Scrutinizing incident reporting in anaesthesia: why is an incident perceived as critical?

DEFF Research Database (Denmark)

Maaløe, R; la Cour, M; Hansen, A

2006-01-01

The purpose of the present study was to measure the incidence and type of incidents that occurred in relation to anaesthesia and surgery during a 1-year period in six Danish hospitals. Furthermore, we wanted to identify risk factors for incidents, as well as risk factors for incidents being deeme...... critical....

Stress and breast cancer: a systematic update on the current knowledge

DEFF Research Database (Denmark)

Nielsen, Naja Rod; Grønbaek, Morten

2006-01-01

A vast body of research has been carried out to examine the relationship between psychological stress and the risk of breast cancer. Previous reviews on this issue have mainly focused on stressful life events and have included both prospective and retrospective studies. The results from...... these reviews have revealed conflicting data. We evaluate whether stressful life events, work-related stress, or perceived global stress are differentially associated with breast cancer incidence and breast cancer relapse in prospective studies. Systematic and explicit methods were used to identify, select......, and critically appraise relevant studies. The substantial variability in the manner in which stress was conceptualized and measured did not allow for the calculation of a quantitative summary estimate for the association between stress and breast cancer. Despite the heterogeneity in the results obtained...

The differential influence of life stress on individual symptoms of depression.

Science.gov (United States)

Fried, E I; Nesse, R M; Guille, C; Sen, S

2015-06-01

Life stress consistently increases the incidence of major depression. Recent evidence has shown that individual symptoms of major depressive disorder (MDD) differ in important dimensions such as their genetic and etiological background, but the impact of stress on individual MDD symptoms is not known. Here, we assess whether stress affects depression symptoms differentially. We used the chronic stress of medical internship to examine changes of the nine Diagnostic and Statistical Manual (DSM)-5 criterion symptoms for depression in 3021 interns assessed prior to and throughout internship. All nine depression symptoms increased in response to stress (all P stress (P Stress differentially affects the DSM-5 depressive symptoms. Analyses of individual symptoms reveal important insights obfuscated by sum-scores. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Cardiovascular Reactivity, Stress, and Physical Activity

Directory of Open Access Journals (Sweden)

Chun-Jung eHuang

2013-11-01

Full Text Available Psychological stress has been proposed as a major contributor to the progression of cardiovascular disease (CVD. Acute mental stress can activate the sympathetic-adrenal-medullary (SAM axis, eliciting the release of catecholamines (NE and EPI resulting in the elevation of heart rate (HR and blood pressure (BP. Combined stress (psychological and physical can exacerbate these cardiovascular responses, which may partially contribute to the elevated risk of CVD and increased proportionate mortality risks experienced by some occupations (e.g., firefighting and law enforcement. Studies have supported the benefits of physical activity on physiological and psychological health, including the cardiovascular response to acute stress. Aerobically trained individuals exhibit lower sympathetic nervous system (e.g., HR reactivity and enhanced cardiovascular efficiency (e.g., lower vascular reactivity and decreased recovery time in response to physical and/or psychological stress. In addition, resistance training has been demonstrated to attenuate cardiovascular responses and improve mental health. This review will examine stress-induced cardiovascular reactivity and plausible explanations for how exercise training and physical fitness (aerobic and resistance exercise can attenuate cardiovascular responses to stress. This enhanced functionality may facilitate a reduction in the incidence of stroke and myocardial infarction. Finally, this review will also address the interaction of obesity and physical activity on cardiovascular reactivity and CVD.

Posttraumatic stress disorder in bosnian war veterans: Analysis of stress events and risk factors

Directory of Open Access Journals (Sweden)

Kuljić Blagoje

2004-01-01

Full Text Available The aim of this study was to determine the incidence of Post-Traumatic Stress Disorder (PTSD, the characteristics of stress-related events, and the risk factors for the development of PTSD. The total patient sample consisted of 100 Bosnian war veterans. Watson’s PTSD module was used in establishing PTSD diagnosis. Patients fulfilled the following questionnaires: personal data form, Posttraumatic Symptom Scale PTSS-10 (Holen, Impact of Event Scale (Horowitz, Life Event Scale, and Eysenck Personality Inventory. PTSD was diagnosed in 30% of the examined patients. Larger number of stress-related events, particularly of those regarded as life-threatening, wounding/death of a close person, and material losses were more frequent in persons with PTSD. The risk factors for the development of PTSD in this study were: age (30-40, marital status (married, lower level of education, the front-line combat exposure, neurotic manifestations, family problems in childhood, and neuroticism.

Income inequality and schizophrenia: increased schizophrenia incidence in countries with high levels of income inequality.

Science.gov (United States)

Burns, Jonathan K; Tomita, Andrew; Kapadia, Amy S

2014-03-01

Income inequality is associated with numerous negative health outcomes. There is evidence that ecological-level socio-environmental factors may increase risk for schizophrenia. The aim was to investigate whether measures of income inequality are associated with incidence of schizophrenia at the country level. We conducted a systematic review of incidence rates for schizophrenia, reported between 1975 and 2011. For each country, national measures of income inequality (Gini coefficient) along with covariate risk factors for schizophrenia were obtained. Multi-level mixed-effects Poisson regression was performed to investigate the relationship between Gini coefficients and incidence rates of schizophrenia controlling for covariates. One hundred and seven incidence rates (from 26 countries) were included. Mean incidence of schizophrenia was 18.50 per 100,000 (SD = 11.9; range = 1.7-67). There was a significant positive relationship between incidence rate of schizophrenia and Gini coefficient (β = 1.02; Z = 2.28; p = .02; 95% CI = 1.00, 1.03). Countries characterized by a large rich-poor gap may be at increased risk of schizophrenia. We suggest that income inequality impacts negatively on social cohesion, eroding social capital, and that chronic stress associated with living in highly disparate societies places individuals at risk of schizophrenia.

Time trends in the incidence of work-related mental ill-health and musculoskeletal disorders in the UK.

Science.gov (United States)

Carder, Melanie; McNamee, Roseanne; Turner, Susan; Hodgson, John Timothy; Holland, Fiona; Agius, Raymond M

2013-05-01

To determine UK trends (from 1996 to 2009) in incidence of work-related mental ill-health and musculoskeletal disorders, for all industry as well as for health and social care employees. Second, to investigate whether there may have been a recent shift from a physical to psychological perspective in how patients present their illness by comparing reporting trends for back pain and 'other work stress'. Multilevel models were used to investigate changes in incidence of work-related illness, as diagnosed by specialist physicians. The dependent variable comprised case reports to The Health and Occupation Research network. Comparisons were made between medical specialties, industry (health and social care vs all other employees), gender and diagnosis. Trends for Occupational Physicians' (OP) reporting mental ill-health (average annual increase +3.7% (95% CI +2.2% to +5.2%)) differed significantly (phealth and social care employees. A fall in incidence of musculoskeletal disorders for OPs of -5.8% (95% CI -7.3% to -4.3%) and rheumatologists' reporting -6.6% (95% CI -8.3% to -4.8%) was found, with little variation by gender or industry. Within health and social care, an increase in incidence of 'other work stress' was accompanied by a similar decrease in 'spine/back pain'. The evidence presented is consistent with a shift in the presentation of ill-health from a physical to psychological perspective, although changes in hazards, prevention measures and physician awareness should also be considered as explanations.

Long-term impact of earthquake stress on fasting glucose control and diabetes prevalence among Chinese adults of Tangshan.

Science.gov (United States)

An, Cuixia; Zhang, Yun; Yu, Lulu; Li, Na; Song, Mei; Wang, Lan; Zhao, Xiaochuan; Gao, Yuanyuan; Wang, Xueyi

2014-01-01

To investigate the long-term influence of stresses from the 1976 Tangshan earthquake on blood glucose control and the incidence of diabetes mellitus in Chinese people of Tangshan. 1,551 adults ≥ 37 years of age were recruited for this investigation in Tangshan city of China, where one of the deadliest earthquakes occurred in 1796. All subjects finished a questionnaire. 1,030 of them who experienced that earthquake were selected into the exposure group, while 521 were gathered as the control group who have not exposed to any earthquake. The numbers of subjects who were first identified with diabetes or had normal FBG but with diabetic history were added for the calculation of diabetes prevalence. Statistic-analysis was applied on the baseline data, and incidences of IFG as well as diabetes among all groups. Statistic comparisons indicate there is no significant difference on average fasting glucose levels between the control group and the exposure group. However, the prevalence of IFG and diabetes among the exposure group displays significant variance with the control group. The prevalence of diabetes among exposure groups is significantly higher than the control group. Women are more likely to have diabetes after experiencing earthquake stresses compared to men. The earthquake stress was linked to higher diabetes incidence as an independent factor. The earthquake stress has long-term impacts on diabetes incidence as an independent risk factor. Emerging and long-term managements regarding the care of IFG and diabetes in populations exposed to earthquake stress should be concerned.

Impact of occupational stress on stroke across occupational classes and genders.

Science.gov (United States)

Tsutsumi, Akizumi; Kayaba, Kazunori; Ishikawa, Shizukiyo

2011-05-01

The aims of the present study were to analyze the association between incident stroke, occupational class and stress and to examine whether the association is found in both men and women in a prospective study of Japanese male and female workers. A total of 3190 male and 3363 female Japanese community-dwelling workers aged 65 or under with no history of cardiovascular disease were followed. Occupational stress was evaluated using a demand-control questionnaire. The impact on stroke was examined in stratified analyses of occupational classes. We identified 147 incident strokes (91 in men and 56 in women) during the 11-year follow-up period. Men with high strain jobs (combination of high job demand and low job control) were nearly three times more likely to suffer from a stroke than men with low strain jobs (combination of low job demand and high job control). Among male workers in low occupational classes (blue-collar and non-managerial work), job strain was associated with a higher risk of stroke. In contrast, there was no association between job strain and incident stroke among male workers in high occupational classes (white-collar and managerial work). No statistically significant differences were found for stroke incidence among the job characteristic categories in all the female participants. However, significant, over five-fold excess risks were found among white-collar and managerial female workers exposed to high job strain, compared with their counterparts with low strain jobs. Our study of Japanese workers provided supportive evidence for vulnerability to occupational stress among lower occupational class workers in males but not in females. Copyright © 2011 Elsevier Ltd. All rights reserved.

Two incidents that changed quality management in the Australian livestock export industry

Directory of Open Access Journals (Sweden)

Peter R. Stinson

2008-03-01

Full Text Available Quality assurance in Australia's livestock export industry arose from a need to address animal welfare concerns. It was initially instigated by industry in the form of an accreditation scheme which contained standards, auditing requirements and training requirements. Two major incidents in long haul shipping of livestock demonstrated that risk management in the industry cannot be achieved through compliance with standards alone. A thorough investigation of the first incident recommended the introduction of formal risk management to complement a standards regime. This approach is applicable to the management of major risks, such as heat stress and disease. It is also especially suited to commercial risks, such as the rejection of cargo and where voyage or market specific treatments are needed and depend upon the expertise of the exporter. However, before these recommendations on risk management could be fully implemented, a significant public incident occurred which altered the direction of quality assurance in industry. The Australian response was to transfer authority to government regulators with a tightening of standards. This focuses on the need to ensure ownership of quality assurance programmes by the exporter. Formal risk management has been a casualty of the second incident and, unfortunately, has not been introduced.

Initiation model for intergranular stress corrosion cracking in BWR pipes

International Nuclear Information System (INIS)

Hishida, Mamoru; Kawakubo, Takashi; Nakagawa, Yuji; Arii, Mitsuru.

1981-01-01

Discussions were made on the keys of intergranular stress corrosion cracking of austenitic stainless steel in high-temperature water in laboratories and stress corrosion cracking incidents in operating plants. Based on these discussions, a model was set up of intergranular stress corrosion cracking initiation in BWR pipes. Regarding the model, it was presumed that the intergranular stress corrosion cracking initiates during start up periods whenever heat-affected zones in welded pipes are highly sensitized and suffer dynamic strain in transient water containing dissolved oxygen. A series of BWR start up simulation tests were made by using a flowing autoclave system with slow strain rate test equipment. Validity of the model was confirmed through the test results. (author)

Stress and its risk factors in medical students: an observational study from a medical college in India.

Science.gov (United States)

Nandi, Madhumita; Hazra, Avijit; Sarkar, Sumantra; Mondal, Rakesh; Ghosal, Malay Kumar

2012-01-01

Stress in medical students is well established. It may affect academic performance and lead to anxiety, depression, substance abuse, and burnouts. There is limited data on stress in Indian medical students. We conducted an analytical observational study to assess the magnitude of stress and identify possible "stressors" in medical students of a teaching hospital in Kolkata. This questionnaire-based study was conducted in the Institute of Post Graduate Medical Education and Research, Kolkata with consenting undergraduate students of 3rd, 6th, and 9th (final) semesters, during lecture classes in individual semesters on a particular day. The students were not informed about the session beforehand and were assured of confidentiality. The first part of the questionnaire captured personal and interpersonal details which could be sources of stress. The rest comprised three rating scales--the 28-item General Health Questionnaire to identify the existence of stress, the Warwick-Edinburgh mental well-being scale to assess the mental well-being, and the revised version of the Lubben social network scale to assess the social networking. The responses and scores were compared between the three semesters as well as between various subgroups based on baseline characteristics. Data from 215 respondents were analyzed--approximately 75% were male, 45% came from rural background, 25% from low-income families, and 60% from vernacular medium. Totally, 113 (52.56%; 95% confidence interval: 43.35-61.76%) students were found to be stressed, without significant difference in stress incidence between the semesters. About 60% of the female students were stressed in contrast to 50% of the males, but this observed difference was not statistically significant. The mental well-being and social networking of stressed respondents suffered in comparison to their non-stressed counterparts. The stress incidence in medical students in this institution in India is high and is negatively affecting their

Preventing work-related stress among staff working in children's cancer Principal Treatment Centres in the UK: a brief survey of staff support systems and practices.

Science.gov (United States)

Beresford, B; Gibson, F; Bayliss, J; Mukherjee, S

2018-03-01

Growing evidence of the association between health professionals' well-being and patient and organisational outcomes points to the need for effective staff support. This paper reports a brief survey of the UK's children's cancer Principal Treatment Centres (PTCs) regarding staff support systems and practices. A short on-line questionnaire, administered in 2012-2013, collected information about the availability of staff support interventions which seek to prevent work-related stress among different members of the multi-disciplinary team (MDT). It was completed by a member of staff with, where required, assistance from colleagues. All PTCs (n = 19) participated. Debriefs following a patient death was the most frequently reported staff support practice. Support groups were infrequently mentioned. There was wide variability between PTCs, and between professional groups, regarding the number and type of interventions available. Doctors appear to be least likely to have access to support. A few Centres routinely addressed work-related stress in wider staff management strategies. Two Centres had developed a bespoke intervention. Very few Centres were reported to actively raise awareness of support available from their hospital's Occupational Health department. A minority of PTCs had expert input regarding staff support from clinical psychology/liaison psychiatry. © 2016 The Authors. European Journal of Cancer Care Published by John Wiley & Sons Ltd.

Incidents with hazardous radiation sources

International Nuclear Information System (INIS)

Schoenhacker, Stefan

2016-01-01

Incidents with hazardous radiation sources can occur in any country, even those without nuclear facilities. Preparedness for such incidents is supposed to fulfill globally agreed minimum standards. Incidents are categorized in incidents with licensed handling of radiation sources as for material testing, transport accidents of hazardous radiation sources, incidents with radionuclide batteries, incidents with satellites containing radioactive inventory, incidents wit not licensed handling of illegally acquired hazardous radiation sources. The emergency planning in Austria includes a differentiation according to the consequences: incidents with release of radioactive materials resulting in restricted contamination, incidents with release of radioactive materials resulting in local contamination, and incidents with the hazard of e@nhanced exposure due to the radiation source.

Incidents analysis

International Nuclear Information System (INIS)

Francois, P.

1996-01-01

We undertook a study programme at the end of 1991. To start with, we performed some exploratory studies aimed at learning some preliminary lessons on this type of analysis: Assessment of the interest of probabilistic incident analysis; possibility of using PSA scenarios; skills and resources required. At the same time, EPN created a working group whose assignment was to define a new approach for analysis of incidents on NPPs. This working group gave thought to both aspects of Operating Feedback that EPN wished to improve: Analysis of significant incidents; analysis of potential consequences. We took part in the work of this group, and for the second aspects, we proposed a method based on an adaptation of the event-tree method in order to establish a link between existing PSA models and actual incidents. Since PSA provides an exhaustive database of accident scenarios applicable to the two most common types of units in France, they are obviously of interest for this sort of analysis. With this method we performed some incident analyses, and at the same time explores some methods employed abroad, particularly ASP (Accident Sequence Precursor, a method used by the NRC). Early in 1994 EDF began a systematic analysis programme. The first, transient phase will set up methods and an organizational structure. 7 figs

Incidents analysis

Energy Technology Data Exchange (ETDEWEB)

Francois, P

1997-12-31

We undertook a study programme at the end of 1991. To start with, we performed some exploratory studies aimed at learning some preliminary lessons on this type of analysis: Assessment of the interest of probabilistic incident analysis; possibility of using PSA scenarios; skills and resources required. At the same time, EPN created a working group whose assignment was to define a new approach for analysis of incidents on NPPs. This working group gave thought to both aspects of Operating Feedback that EPN wished to improve: Analysis of significant incidents; analysis of potential consequences. We took part in the work of this group, and for the second aspects, we proposed a method based on an adaptation of the event-tree method in order to establish a link between existing PSA models and actual incidents. Since PSA provides an exhaustive database of accident scenarios applicable to the two most common types of units in France, they are obviously of interest for this sort of analysis. With this method we performed some incident analyses, and at the same time explores some methods employed abroad, particularly ASP (Accident Sequence Precursor, a method used by the NRC). Early in 1994 EDF began a systematic analysis programme. The first, transient phase will set up methods and an organizational structure. 7 figs.

Stress fractures in athletes

International Nuclear Information System (INIS)

Steingruber, I.E.; Wolf, C.; Gruber, H.; Czermak, B.V.; Mallouhi, A.; Jaschke, W.; Gabriel, M.

2002-01-01

Stress fractures may pose a diagnostic dilemma for radiologists since they are sometimes difficult to demonstrate on plain films and may simulate a tumour. They were first described in military personnel and professional athletes. Recently, there is an increasing incidence in the general population due to increasing sportive activities. Stress fractures occur most often in the lower extremities, especially in the tibia, the tarsal bone, the metatarsal bone, the femur and the fibula. In the upper extremities, they are commonly found in the humerus, the radius and the ulna. Some fractures of the lower extremities appear to be specific for particular sports, for example, fractures of the tibia affect mostly distance runners. Whereas stress fractures of the upper extremities are generally associated with upper limb-dominated sports. A correct diagnosis requires a careful clinical evaluation. The initial plain radiography may be normal. Further radiological evaluation could be performed by means of computerised tomography, magnetic resonance imaging and bone scanning. The latter two techniques are especially helpful for establishing a correct initial diagnosis. (orig.) [de

Stress fractures in military training

International Nuclear Information System (INIS)

Jofre, M.J.; Sierralta, M.P.

2002-01-01

During military training, the incidence of overuse injuries like stress fractures increase. The aim of the study was to investigate the utility of bone scan in a military population with clinical suspected stress fractures or periostitis. Material and methods: A three-year retrospective analysis was made on patients who were clinically diagnosed with stress fractures at the Military Hospital Nuclear Medicine Department. Thirty-seven patients were studied (mean age 23. +/- 8 y.o; 31 males), 28 cases of which (76%) had tibial stress syndrome. Other localizations were lumbar spine, femoral, fibular, tarsal or metatarsal. Bone scintigraphy was performed injecting 1036 MBq of Tc99m-MDP i.v. Whole body images and lateral projections of lower extremities were done. Results: Bone scan in tibial syndrome was positive for 23 cases (82%), 65% of them were bilateral and 13% also had femoral injuries. X-rays were done in 10 cases and were all negative. In other localizations, the bone scans were negative, but demonstrated other degenerative lesions. All stress fractures were conservatively treated with non-steroidal anti-inflammatories and suspension of physical activity. Conclusions: Bone scan is a reliable confirmatory tool for tibial stress syndrome diagnosis. In addition, it helps to determine both the severity and extension of the injury as well as support the indication of rest in the military population

Stress fractures in military training

Energy Technology Data Exchange (ETDEWEB)

Jofre, M J; Sierralta, M P [Military Hospital Nuclear Medicine Department, Santiago (Chile)

2002-09-01

During military training, the incidence of overuse injuries like stress fractures increase. The aim of the study was to investigate the utility of bone scan in a military population with clinical suspected stress fractures or periostitis. Material and methods: A three-year retrospective analysis was made on patients who were clinically diagnosed with stress fractures at the Military Hospital Nuclear Medicine Department. Thirty-seven patients were studied (mean age 23. +/- 8 y.o; 31 males), 28 cases of which (76%) had tibial stress syndrome. Other localizations were lumbar spine, femoral, fibular, tarsal or metatarsal. Bone scintigraphy was performed injecting 1036 MBq of Tc99m-MDP i.v. Whole body images and lateral projections of lower extremities were done. Results: Bone scan in tibial syndrome was positive for 23 cases (82%), 65% of them were bilateral and 13% also had femoral injuries. X-rays were done in 10 cases and were all negative. In other localizations, the bone scans were negative, but demonstrated other degenerative lesions. All stress fractures were conservatively treated with non-steroidal anti-inflammatories and suspension of physical activity. Conclusions: Bone scan is a reliable confirmatory tool for tibial stress syndrome diagnosis. In addition, it helps to determine both the severity and extension of the injury as well as support the indication of rest in the military population.

Specific and unspecific responses of plants to cold and drought stress

Indian Academy of Sciences (India)

Madhu Sudhan

2007-03-22

Mar 22, 2007 ... Introduction. Cold, drought and salinity are those environmental stressors which affect .... The general stress concept emphasizing the incidence of a specific primary and a less specific secondary strain by a specific stressor.

Age, subjective stress, and depression after ischemic stroke.

Science.gov (United States)

McCarthy, Michael J; Sucharew, Heidi J; Alwell, Kathleen; Moomaw, Charles J; Woo, Daniel; Flaherty, Matthew L; Khatri, Pooja; Ferioli, Simona; Adeoye, Opeolu; Kleindorfer, Dawn O; Kissela, Brett M

2016-02-01

The incidence of stroke among younger adults in the United States is increasing. Few studies have investigated the prevalence of depressive symptoms after stroke among different age groups or the extent to which subjective stress at the time of stroke interacts with age to contribute to post-stroke depression. The present study examined whether there exists an age gradient in survivors' level of depressive symptoms and explored the extent to which financial, family, and health-related stress may also impact on depression. Bivariate analyses (N = 322) indicated significant differences in depression and stress by age group, as well as differences in age and stress by 3-month depression status. Linear regression analyses indicated that survivors between the ages of 25-54 and 55-64 years old had, on average, significantly higher depressive symptom scores. Those with financial, family, and health-related stress at the time of stroke, irrespective of age, also had significantly higher scores.

Medical ethics in peace and in the armed conflict.

Science.gov (United States)

Schapowal, Andreas G; Baer, Hans-Ulrich

2002-08-01

Global medical ethics on the basis of the General Declaration of Human Rights by the United Nations is a key subject for the 21st century. World Health Organization's new definition of health includes "spiritual health," a term that has to be defined in international consensus despite different anthropologies, cultures, and religions. Old issues in medical ethics such as assisted suicide are still waiting for global consensus among the "pro-life" and "pro-choice" parties. So far The Netherlands and Belgium are the only countries where euthanasia has been legalized, whereas the U.S. Supreme Court has denied a right of medically assisted suicide. The respect of nature is also the basis for guidelines in new issues in medical ethics such as gene therapy and human cloning, which are controversially discussed. Military medical ethics should provide regulations for morally correct decisions in armed conflicts including the war against international terrorism and in peacekeeping missions. Triage of the wounded, distribution of medical aid, and critical incident stress debriefing for soldiers and their relatives are key issues.

Wheelchair incidents

NARCIS (Netherlands)

Drongelen AW van; Roszek B; Hilbers-Modderman ESM; Kallewaard M; Wassenaar C; LGM

2002-01-01

This RIVM study was performed to gain insight into wheelchair-related incidents with powered and manual wheelchairs reported to the USA FDA, the British MDA and the Dutch Center for Quality and Usability Research of Technical Aids (KBOH). The data in the databases do not indicate that incidents with

The appraisal of chronic stress and the development of the metabolic syndrome

DEFF Research Database (Denmark)

Bergmann, N; Gyntelberg, F; Faber, J

2014-01-01

. Thirty-nine studies were included. An association between chronic psychosocial stress and the development of MES was generally supported. Regarding the four elements of MES: i) weight gain: the prospective studies supported etiological roles for relationship stress, perceived stress, and distress, while...... the studies on work-related stress (WS) showed conflicting results; ii) dyslipidemi: too few studies on psychosocial stress as a risk factor for dyslipidemia were available to draw a conclusion; however, a trend toward a positive association was present; iii) type 2 diabetes mellitus (DM2): prospective......Chronic psychosocial stress has been proposed as a risk factor for the development of the metabolic syndrome (MES). This review gives a systematic overview of prospective cohort studies investigating chronic psychosocial stress as a risk factor for incident MES and the individual elements of MES...

Stress in crisis managers: evidence from self-report and psychophysiological assessments.

Science.gov (United States)

Janka, A; Adler, C; Fischer, L; Perakakis, P; Guerra, P; Duschek, S

2015-12-01

Directing disaster operations represents a major professional challenge. Despite its importance to health and professional performance, research on stress in crisis management remains scarce. The present study aimed to investigate self-reported stress and psychophysiological stress responses in crisis managers. For this purpose, 30 crisis managers were compared with 30 managers from other disciplines, in terms of self-reported stress, health status and psychophysiological reactivity to crisis-related and non-specific visual and acoustic aversive stimuli and cognitive challenge. Crisis managers reported lower stress levels, a more positive strain-recuperation-balance, greater social resources, reduced physical symptoms, as well as more physical exercise and less alcohol consumption. They exhibited diminished electrodermal and heart rate responses to crisis-related and non-specific stressors. The results indicate reduced stress and physical complaints, diminished psychophysiological stress reactivity, and a healthier life-style in crisis managers. Improved stress resistance may limit vulnerability to stress-related performance decline and facilitate preparedness for major incidents.

Incivility in the workplace: incidence and impact.

Science.gov (United States)

Cortina, L M; Magley, V J; Williams, J H; Langhout, R D

2001-01-01

This study extends the literature on interpersonal mistreatment in the workplace by examining the incidence, targets, instigators, and impact of incivility (e.g., disrespect, condescension, degradation). Data were collected from 1,180 public-sector employees, 71% of whom reported some experience of workplace incivility in the previous 5 years. As many as one third of the most powerful individuals within the organization instigated these uncivil acts. Although women endured greater frequencies of incivility than did men, both genders experienced similarly negative effects on job satisfaction, job withdrawal, and career salience. Uncivil workplace experiences were also associated with greater psychological distress; however, indices of psychological and physical health were relatively unaffected. The authors discuss these findings in the context of organizational and cognitive stress theories.

Packing stress reduction in polymer-lipid monolayers at the air-water interface: An X-ray grazing-incidence diffraction and reflectivity study

Energy Technology Data Exchange (ETDEWEB)

Kuhl, T.L.; Majewski, J.; Howes, P.B.; Kjaer, K.; Nahmen, A. von; Lee, K.Y.C.; Ocko, B.; Israelachvili, J.N.; Smith, G.S.

1999-08-25

Using synchrotron grazing-incidence X-ray diffraction (GIXD) and reflectivity (XR), the authors have determined the in-plane and out-of-plane structure of phospholipid monolayers at the air-water interface as a function of hydrophilic lipid headgroup size. Di-stearoyl-phosphatidyl-ethanolamine (DSPE) lipid monolayers were systematically modified by chemically grafting hydrophilic poly(ethylene glycol) (PEG) chains of MW = 90 g/mol (2 ethylene oxide, EO, units), MW = 350 g/mol (8 EO units), and MW = 750 g/mol (17 EO units) to the lipid headgroups. The monolayers were studied in the solid phase at a surface pressure of 42 mN/m. At these high lipid packing densities, the PEG chains are submerged in the water subphase. The increased packing stresses from these bulky polymer headgroups distort the unit cell and the in-plane packing modes of the monolayers, leading to large out-of-plane alterations and staggering of the lipid molecules. Surprisingly, a change in the molecular packing of the monolayer toward higher packing densities (lower area per molecule) was observed on increasing the PEG MW to 750 g/mol (17 EO units). This rearrangement of the monolayer structure may be due to a conformational change in the PEG chains.

The effect of oblique angle of sound incidence, realistic edge conditions, curvature and in-plane panel stresses on the noise reduction characteristics of general aviation type panels

Science.gov (United States)

Grosveld, F.; Lameris, J.; Dunn, D.

1979-01-01

Experiments and a theoretical analysis were conducted to predict the noise reduction of inclined and curved panels. These predictions are compared to the experimental results with reasonable agreement between theory and experiment for panels under an oblique angle of sound incidence. Theoretical as well as experimental results indicate a big increase in noise reduction when a flat test panel is curved. Further curving the panel slightly decreases the noise reduction. Riveted flat panels are shown to give a higher noise reduction in the stiffness-controlled frequency region, while bonded panels are superior in this region when the test panel is curved. Experimentally measured noise reduction characteristics of flat aluminum panels with uniaxial in-plane stresses are presented and discussed. These test results indicate an important improvement in the noise reduction of these panels in the frequency range below the fundamental panel/cavity frequency.

Increase in the incidence of type 1 diabetes in Israeli children following the Second Lebanon War.

Science.gov (United States)

Zung, Amnon; Blumenfeld, Orit; Shehadeh, Naim; Dally Gottfried, Orna; Tenenbaum Rakover, Yardena; Hershkovitz, Eli; Gillis, David; Zangen, David; Pinhas-Hamiel, Orit; Hanukoglu, Aaron; Rachmiel, Marianna; Shalitin, Shlomit

2012-06-01

Type 1 diabetes is an autoimmune disease occurring in genetically susceptible individuals. The precipitating cause is unclear. Recently, the Second Lebanon War exposed a large civilian population in northern Israel to significant psychological stress in the form of repeated barrages of missile attacks. We hypothesized that trends in regional incidence of type 1 diabetes before and after the war would reflect an association with stress. All type 1 diabetes patients aged 0-17 yr who were reported to the Israel Juvenile Diabetes Register (n = 1822) in the four pre-war (2002-2005) and two post-war years (2006-2007) were included in the study. The patients were stratified by gender, age, ethnicity, family history of type 1 diabetes, season at diagnosis, and region of residency, namely, those who lived in the northern regions that were attacked and those in other regions. The post-war incidence of type 1 diabetes was increased in the northern regions (rate ratio, RR = 1.27; p = 0.037), with no change in the other regions. This change was more prominent in males (RR = 1.55; p = 0.005) but similar in summer and winter, in different ages, and in different ethnic groups. There was no change in the proportion of new patients with a family history of the disease. For the first time in a large population, we found a positive association between the trauma of war and an increase in the incidence of type 1 diabetes in children and adolescents. The increase in incidence was not associated with genetic susceptibility to the disease. © 2011 John Wiley & Sons A/S.

Reduction of the radiogenic tumor incidence by stimulation with lyophilized fetal cells

International Nuclear Information System (INIS)

Bause, R.; Gros, C.J.; Landsberger, A.; Renner, H.; Klinikum Nuernberg

1983-01-01

The effect of an immunization treatment with lyophilized xenogenic fetal cells was studied in 7 months old, female albino rats (strain Wistar). The tumor incidence was measured after a sublethal whole-body irradiation with 600 cGy. Furthermore, the spleen of the individual animals was histologically examined. 3,5 to 6 months after a whole-body irradiation with 600 cGy, the tumor incidence was 55%. The tumors found were tubular adenocarcinomas of the thyroid gland. A significant reduction of the tumor incidence can be achieved by an immunostimulation with xenogenic, lyophilized, fetal cells (connective tissue and bone marrow, respectively) administered twice, namely eight days before and four days after the whole-body irradiation. The tumor incidence measured after 3,5 months was 10% and 15%, respectively, and after 6 months 15% and 25%, respectively. No significant tumor protection is achieved, however, by a single stimulation before whole-body irradiation and by a stimulation performed one or two times after whole-body irradiation. Histologic examinations of the spleen show in the immunostimulized animals a strong regeneration of the immune system with a significantly increased number of follicles and a significant increase of lumphocytes in the red pulp. The authors stress the possible clinical importance for radio-oncology of an immunostimulation with lyophilized, xenogenic, fetal cells. (orig.) [de

Impact and Penetration of Thin Aluminum 2024 Flat Panels at Oblique Angles of Incidence

Science.gov (United States)

Ruggeri, Charles R.; Revilock, Duane M.; Pereira, J. Michael; Emmerling, William; Queitzsch, Gilbert K., Jr.

2015-01-01

The U.S. Federal Aviation Administration (FAA) and the National Aeronautics and Space Administration (NASA) are actively involved in improving the predictive capabilities of transient finite element computational methods for application to safety issues involving unintended impacts on aircraft and aircraft engine structures. One aspect of this work involves the development of an improved deformation and failure model for metallic materials, known as the Tabulated Johnson-Cook model, or MAT224, which has been implemented in the LS-DYNA commercial transient finite element analysis code (LSTC Corp., Livermore, CA) (Ref. 1). In this model the yield stress is a function of strain, strain rate and temperature and the plastic failure strain is a function of the state of stress, temperature and strain rate. The failure criterion is based on the accumulation of plastic strain in an element. The model also incorporates a regularization scheme to account for the dependency of plastic failure strain on mesh size. For a given material the model requires a significant amount of testing to determine the yield stress and failure strain as a function of the three-dimensional state of stress, strain rate and temperature. In addition, experiments are required to validate the model. Currently the model has been developed for Aluminum 2024 and validated against a series of ballistic impact tests on flat plates of various thicknesses (Refs. 1 to 3). Full development of the model for Titanium 6Al-4V is being completed, and mechanical testing for Inconel 718 has begun. The validation testing for the models involves ballistic impact tests using cylindrical projectiles impacting flat plates at a normal incidence (Ref. 2). By varying the thickness of the plates, different stress states and resulting failure modes are induced, providing a range of conditions over which the model can be validated. The objective of the study reported here was to provide experimental data to evaluate the model

Incidence of Mental Health Diagnoses in Veterans of Operations Iraqi Freedom, Enduring Freedom, and New Dawn, 2001-2014.

Science.gov (United States)

Ramsey, Christine; Dziura, James; Justice, Amy C; Altalib, Hamada Hamid; Bathulapalli, Harini; Burg, Matthew; Decker, Suzanne; Driscoll, Mary; Goulet, Joseph; Haskell, Sally; Kulas, Joseph; Wang, Karen H; Mattocks, Kristen; Brandt, Cynthia

2017-02-01

To evaluate gender, age, and race/ethnicity as predictors of incident mental health diagnoses among Operations Iraqi Freedom, Enduring Freedom, and New Dawn veterans. We used US Veterans Health Administration (VHA) electronic health records from 2001 to 2014 to examine incidence rates and sociodemographic risk factors for mental health diagnoses among 888 142 veterans. Posttraumatic stress disorder (PTSD) was the most frequently diagnosed mental health condition across gender and age groups. Incidence rates for all mental health diagnoses were highest at ages 18 to 29 years and declined thereafter, with the exceptions of major depressive disorder (MDD) in both genders, and PTSD among women. Risk of incident bipolar disorder and MDD diagnoses were greater among women; risk of incident schizophrenia, and alcohol- and drug-use disorders diagnoses were greater in men. Compared with Whites, risk incident PTSD, MDD, and alcohol-use disorder diagnoses were lower at ages 18 to 29 years and higher at ages 45 to 64 years for both Hispanics and African Americans. Differentiating high-risk demographic and gender groups can lead to improved diagnosis and treatment of mental health diagnoses among veterans and other high-risk groups.

Incident Information Management Tool

CERN Document Server

Pejovic, Vladimir

2015-01-01

Flaws of\tcurrent incident information management at CMS and CERN\tare discussed. A new data\tmodel for future incident database is\tproposed and briefly described. Recently developed draft version of GIS-­‐based tool for incident tracking is presented.

Work stress and cardiovascular disease: a life course perspective.

Science.gov (United States)

Li, Jian; Loerbroks, Adrian; Bosma, Hans; Angerer, Peter

2016-05-25

Individuals in employment experience stress at work, and numerous epidemiological studies have documented its negative health effects, particularly on cardiovascular disease (CVD). Although evidence on the various interrelationships between work stress and CVD has been accumulated, those observations have not yet been conceptualized in terms of a life course perspective. Using the chain of risk model, we would like to propose a theoretical model incorporating six steps: (1) work stress increases the risk of incident CVD in healthy workers. (2) Among those whose work ability is not fully and permanently damaged, work stress acts as a determinant of the process of return to work after CVD onset. (3) CVD patients experience higher work stress after return to work. (4) Work stress increases the risk of recurrent CVD in workers with prior CVD. (5) CVD patients who fully lose their work ability transit to disability retirement. (6) Disability retirees due to CVD have an elevated risk of CVD mortality. The life course perspective might facilitate an in-depth understanding of the diverse interrelationships between work stress and CVD, thereby leading to work stress management interventions at each period of the lifespan and three-level prevention of CVD.

Self-reported stress and risk of endometrial cancer: a prospective cohort study

DEFF Research Database (Denmark)

Nielsen, Naja Rod; Strandberg-Larsen, Katrine; Grønbaek, Morten

2007-01-01

OBJECTIVES: To assess a possible relationship between perceived stress and first-time incidence of primary endometrial cancer. Psychological stress may affect the synthesis and metabolism of estrogens and thereby be related to risk of endometrial cancer. METHODS: The 6760 women participating...... in the Copenhagen City Heart Study were asked about their stress level at baseline from 1981 to 1983. These women were prospectively followed up in the Danish nationwide cancer registry until 2000 and ...-up, 72 women were diagnosed with endometrial cancer. For each increase in stress level on a 7-point stress scale, there was a lower risk of primary endometrial cancer (hazard ratio (HR) = 0.88; 95% confidence interval (CI), 0.76-1.01). This inverse association was particularly strong in women who...

Radiological incidents in radiotherapy

International Nuclear Information System (INIS)

Hobzova, L.; Novotny, J.

2008-01-01

In many countries a reporting system of radiological incidents to national regulatory body exists and providers of radiotherapy treatment are obliged to report all major and/or in some countries all incidents occurring in institution. State Office for Nuclear Safety (SONS) is providing a systematic guidance for radiotherapy departments from 1997 by requiring inclusion of radiation safety problems into Quality assurance manual, which is the basic document for obtaining a license of SONS for handling with sources of ionizing radiation. For that purpose SONS also issued the recommendation 'Introduction of QA system for important sources in radiotherapy-radiological incidents' in which the radiological incidents are defined and the basic guidance for their classification (category A, B, C, D), investigation and reporting are given. At regular periods the SONS in co-operation with radiotherapy centers is making a survey of all radiological incidents occurring in institutions and it is presenting obtained information in synoptic communication (2003 Motolske dny, 2005 Novy Jicin). This presentation is another summary report of radiological incidents that occurred in our radiotherapy institutions during last 3 years. Emphasis is given not only to survey and statistics, but also to analysis of reasons of the radiological incidents and to their detection and prevention. Analyses of incidents in radiotherapy have led to a much broader understanding of incident causation. Information about the error should be shared as early as possible during or after investigation by all radiotherapy centers. Learning from incidents, errors and near misses should be a part of improvement of the QA system in institutions. Generally, it is recommended that all radiotherapy facilities should participate in the reporting, analyzing and learning system to facilitate the dissemination of knowledge throughout the whole country to prevent errors in radiotherapy.(authors)

Employee Assistance Programmes: The Emperor's New Clothes of Stress Management?

Science.gov (United States)

Arthur, Andrew R.

2000-01-01

Discusses the employee assistance program (EAP), a benefit increasingly provided by United Kingdom employers that claims to reduce the effects of stress on individuals and organizations, provide a management tool to improve workplace performance and productivity, and respond to critical incidents. Describes EAPs, their history, development and…

NEUROENDOCRINE FUNCTIONS OF PUERPERAE WITH POSTPARTUM DEPRESSION AGGRAVATED BY STRESSFUL CHILDBIRTH-RELATED EVENTS.

Science.gov (United States)

Song, W; Yu, S

2015-01-01

In the period of gestation, delivery and post-delivery, fear and tension produced in puerperae are likely to evolve into depression as they worry too much about delivery pain. In recent years, it has been noted that stressful events during this period aggravate postpartum depression. To discuss the effect of these childbirth-related stressful events on neuroendocrine functions of patients with postpartum depression, 300 full-term puerperae who had been admitted to the Beijing Obstetrics and Gynecology Hospital, Capital Medical University between October, 2011 and October, 2013 and who had suffered from stressful childbirth-related events were enrolled as a study group. This group was divided into six subgroups, i.e., A, B, C, D, E and F, based on the number of stressful events they had suffered which were labeled by numbers 1 to 6. Additionally, 100 puerperae from the same hospital who had not suffered from childbirth-related stressful events were taken as controls. Relevant clinical indexes, including serum adrenocorticotropic hormone (ACTH), plasma 5-hydroxytryptamine (5-HT), noradrenaline ELISA (NE), dopamine (DA) and cortisol level were measured and compared. It was found that incidence probability of postpartum depression was significantly different between the study group (13.67%, 41/300) and the control group (7%, 7/100). Moreover, the incidence probability of postpartum depression of puerperae suffering from no less than 4 childbirth-related stressful events was higher than those suffering from no more than 3, and the difference was statistically significant (Pdepression.

Stress corrosion in low alloy steels

International Nuclear Information System (INIS)

Scott, P.M.; Tice, D.R.

1988-01-01

The main variables affecting environmentally induced crack initiation and growth in low alloy pressure vessel steels exposed to high temperature aqueous environments are reviewed. Considerable background knowledge is available on many of the important factors such as stress, crack tip stress intensity, strain rate, steel composition and microstructure, environmental temperature, chemistry, oxidising capacity and flowrate. This information is also compared with known plant incidents of environmentally induced or assisted cracking. Certain gaps in these data and their interpretation are judged to remain particularly in the case where oxygenated water is present. These arise predominantly in the definition of margins available on plant water chemistry specifications before risk of environmentally induced cracking becomes unacceptable and in quantifying the beneficial effect of high water flowrates. (orig.)

Stress corrosion in low alloy steels

International Nuclear Information System (INIS)

Scott, P.M.; Tice, D.R.

1990-01-01

The main variables affecting environmentally induced crack initiation and growth in low alloy pressure vessel steels exposed to high temperature aqueous environments are reviewed. Considerable background knowledge is available on many of the important factors such as stress, crack tip stress intensity, strain rate, steel composition and microstructure, environmental temperature, chemistry, oxidising capacity and flowrate. This information is also compared with known plant incidents of environmentally induced or assisted cracking. Certain gaps in these data and their interpretation are judged to remain particularly in the case where oxygenated water is present. These arise predominantly in the definition of margins available on plant water chemistry specifications before risk of environmentally incuced cracking becomes unacceptable and in quantifying the beneficial effect of high water flowrates. (orig.)

Posttraumatic Stress Disorder among Motor Vehicle Accident Victims

Directory of Open Access Journals (Sweden)

Marina Yuabova

2013-05-01

Full Text Available Motor vehicle accidents (MVA have been a leading contributor to posttraumatic stress disorder (PTSD. Given the high rate of MVA incidents, it is of crucial importance to detect and diagnose PTSD in primary care. Assessing PTSD requires detecting and treating physiologic responses associated with MVA incidents. Responses such as elevated heart rate and blood pressure following an incident as well as psychological processes have been found to predict the likelihood of developing PTSD months or years after the occurrence. Screening for PTSD requires the implementation of multiple assessment tools to accurately detect the presence of PTSD. Clinicians chose assessment tools based on scales used to screen for anxiety, social dysfunction, somatic complaints and depression. Indeed, it cannot be overstated that clinicians must conduct early assessment and diagnosis of PTSD while evaluating the multiple factors that impact upon whether or not an individual will develop PTSD after a MVA.

Stress ulcer prophylaxis in the intensive care unit

DEFF Research Database (Denmark)

Krag, Morten Brøgger; Perner, A; Wetterslev, J

2013-01-01

Stress ulcer prophylaxis (SUP) is regarded as standard of care in the intensive care unit (ICU). However, recent randomized, clinical trials (RCTs) and meta-analyses have questioned the rationale and level of evidence for this recommendation. The aim of the present systematic review was to evaluate...... incidence of gastrointestinal (GI) bleeding varies considerably. Data on the incidence and severity of GI bleeding in general ICUs in the developed world as of today are lacking. The best intervention for SUP is yet to be settled by balancing efficacy and harm. In essence, it is unresolved if intensive care...... patients benefit overall from SUP. The following clinically research questions are unanswered: (1) What is the incidence of GI bleeding, and which interventions are used for SUP in general ICUs today?; (2) Which criteria are used to prescribe SUP?; (3) What is the best SUP intervention?; (4) Do intensive...

Absenteeism, Burnout and Symptomatology of Teacher Stress: Sex Differences

Science.gov (United States)

Bermejo-Toro, Laura; Prieto-Ursúa, María

2014-01-01

Although numerous studies have been carried out confirming high levels in symptomatology of stress and depression in the teaching profession, research focusing on sex differences in these problems has been both scarce and inconclusive. The aim of this study is to analyse differences with regards to sex in the incidence of absenteeism, work-related…

Coupling of morphology to surface transport in ion-beam-irradiated surfaces: normal incidence and rotating targets

International Nuclear Information System (INIS)

Munoz-Garcia, Javier; Cuerno, Rodolfo; Castro, Mario

2009-01-01

Continuum models have proved their applicability to describe nanopatterns produced by ion-beam sputtering of amorphous or amorphizable targets at low and medium energies. Here we pursue the recently introduced 'hydrodynamic approach' in the cases of bombardment at normal incidence, or of oblique incidence onto rotating targets, known to lead to self-organized arrangements of nanodots. Our approach stresses the dynamical roles of material (defect) transport at the target surface and of local redeposition. By applying results previously derived for arbitrary angles of incidence, we derive effective evolution equations for these geometries of incidence, which are then numerically studied. Moreover, we show that within our model these equations are identical (albeit with different coefficients) in both cases, provided surface tension is isotropic in the target. We thus account for the common dynamics for both types of incidence conditions, namely formation of dots with short-range order and long-wavelength disorder, and an intermediate coarsening of dot features that improves the local order of the patterns. We provide for the first time approximate analytical predictions for the dependence of stationary dot features (amplitude and wavelength) on phenomenological parameters, that improve upon previous linear estimates. Finally, our theoretical results are discussed in terms of experimental data.

The influence of psycho-emotional stress in children of primary school age on the incidence of recurrent upper respiratory tract infections and the functional state of the myocardium

Directory of Open Access Journals (Sweden)

L.S. Ovcharenko

2017-10-01

Full Text Available Background. Scientific and technical progress, intensification of educational process and information overload have a negative effect on unformed central nervous system of primary schoolchildren, causing stress, which affects the increase in the incidence of recurrent upper respiratory tract infections (URTI and the functional state of the myocardium. In view of this, we analyzed a functional state of myocardium in children with recurrent URTI. The critical duration of the work of primary school child with electronic means of communication, which affects the quality of nighttime sleep and the nature of awakening in the morning, was established. We have studied the relationship of the above mentioned with the incidence of URTI, the level of school anxiety and functional reserve of the myocardium. The purpose of the study was to evaluate the functional reserve of the myocardium in children of primary school age, depending on the incidence of URTI and the level of psycho-emotional activity. Materials and me­thods. 239 children aged 6 to 9 years were examined. The analysis of the functional reserve of the myocardium was carried out in pupils with different incidence of the URTI, depending on the age. The influence of electronic communications on the quality of nighttime sleep and morning awakening was stu­died, and the level of school anxiety was evaluated. During the study, children were divided into two groups. Group 1 — children with recurrent acute respiratory diseases (n = 143. Group 2 — children who occasionally have URTI (n = 96. Results. Out of 239 children with recurrent acute respiratory infections, we have identified 173 children with reduced functional reserve of the myocardium (72.4 %. Among children with recurrent URTI, the incidence of reduced functional reserve of the myocardium was 76.2 %, and in occasionally ill children — 66.7 %. Children with recurrent URTI use electronic means of communication more often than

Sternal stress fracture in a gymnast: A case report and literature review

African Journals Online (AJOL)

There is a high incidence of injuries among gymnasts.1 This is not surprising given the ... stress fracture. A common example of poor posture in gymnasts is excessive ... Dimakatso Althea Ramagole (MB ChB, MSc (Sports Med)). Dina Christina ...

Prospective Cohort Study to Elucidate the Correlation between Occupational Stress and Hypertension Risk in Oil Workers from Kelamayi City in the Xinjiang Uygur Autonomous Region of China.

Science.gov (United States)

Li, Rong; Gao, Xiaoyan; Liu, Bo; Ge, Hua; Ning, Li; Zhao, Junling; Liu, Jiwen

2016-12-22

The purpose of this study was to assess the major risk factors for hypertension in oil workers, and investigate the effect of occupational stress on the incidence of hypertension after controlling for other risk factors. A prospective cohort approach was used following enrollment of 1354 oil workers. The occupational stress experienced by oil workers was higher than for the general population in China. By the end of the cohort study, 231 new cases of hypertension among the oil workers had been diagnosed. The cumulative incidence of hypertension was 17.06%. There were 44, 112, and 75 workers who developed hypertension in the low, intermediate, and high occupational stress groups, which represented a 12.0%, 15.6%, and 20.3% cumulative incidence, respectively (chi-square value = 9.812, p occupational stress group was 1.549 (1.072-2.236) compared to the low exposure group, and 2.337 (1.191-4.585) in female subjects. Our study indicated that an increase in occupational stress was associated with an increased risk of hypertension after other factors were adjusted.

Stress Wave Attenuation in Aluminum Alloy and Mild Steel Specimens Under SHPB Tensile Testing

Science.gov (United States)

Pothnis, J. R.; Ravikumar, G.; Arya, H.; Yerramalli, Chandra S.; Naik, N. K.

2018-02-01

Investigations on the effect of intensity of incident pressure wave applied through the striker bar on the specimen force histories and stress wave attenuation during split Hopkinson pressure bar (SHPB) tensile testing are presented. Details of the tensile SHPB along with Lagrangian x- t diagram of the setup are included. Studies were carried out on aluminum alloy 7075 T651 and IS 2062 mild steel. While testing specimens using the tensile SHPB setup, it was observed that the force calculated from the transmitter bar strain gauge was smaller than the force obtained from the incident bar strain gauge. This mismatch between the forces in the incident bar and the transmitter bar is explained on the basis of stress wave attenuation in the specimens. A methodology to obtain force histories using the strain gauges on the specimen during SHPB tensile testing is also presented. Further, scanning electron microscope images and photomicrographs are given. Correlation between the microstructure and mechanical properties is explained. Further, uncertainty analysis was conducted to ascertain the accuracy of the results.

Thyroid cancer incidence in the Ukraine after the Chernobyl accident: comparison with spontaneous incidences

International Nuclear Information System (INIS)

Sobolev, B.; Kairo, I.; Likhtarev, I.; Heidenreich, W.F.; Jacob, P.; Goulko, G.

1997-01-01

The thyroid cancer incidence in the Ukraine among those born in the period 1968-1986 was analyzed with the aim to identify the enhancement due to the Chernobyl accident. Since any Ukrainian data referring to the time period before the accident are scarce and the variation of spontaneous incidences in other countries is immense, the Ukrainian incidences in the period 1986-1989 were used to estimate the baseline risk. Following 1990, the incidence in the southern part of the Ukraine increased by about 30%, independent of age. In the other parts the increase of the incidence depended on age at exposure. In the age group of 9-year-old children, the incidences in three regions defined as the 'high-dose area', the northern, and the middle oblasts, increased by factors of 50, 20, and 6, respectively. These rates (1991-1995) are well above spontaneous rates in other countries. In the age group of 17-year-old juveniles, the incidence increased by a factor of 6 for the 'high dose area' and in the three northern oblasts, whereas in the nine 'middle' oblasts it was similar to the incidence of the 'southern' Ukraine. These rates are within the range found in other countries. (orig.)

The stressed eyewitness: The interaction of thematic arousal and post-event stress in memory for central and peripheral event information

Directory of Open Access Journals (Sweden)

Gerald eEchterhoff

2012-08-01

Full Text Available Both arousal during the encoding of stimuli and subsequent stress can affect memory, often by increasing memory for important or central information. We explored whether event-based (thematic arousal and post-event stress interact to selectively enhance eyewitnesses’ memory for the central aspects of an observed incident. Specifically, we argue that memory for stimuli should be enhanced when (a the stimuli are encoded under arousal (vs. non-arousal, and (b stress is experienced soon after the encoding episode.We designed an experiment that extended previous research by manipulating arousal without changing the stimulus material, distinguishing between central and peripheral event information, and using a dynamic, life-like event instead of static pictures. After watching a video depicting a burglary under high or low thematic arousal, psychosocial stress was induced or not induced by the Trier Social Stress Test. Salivary cortisol was measured at standard intervals. Consistent with our prediction, we found a significant thematic arousal x post-event stress x centrality interaction, indicating that the recognition advantage for central event items over peripheral event items was most pronounced under both high thematic arousal and post-event stress. Because stress was induced after encoding this interaction cannot be explained by possible differences at encoding, such as narrowed attention. The centrality effect of post-event stress under high thematic arousal was statistically mediated by the cortisol increase, which suggests a key role of the stress hormone. We discuss implications of our findings for psychological and neuroscientific theories of emotional memory formation.

Cancer incidence among waiters

DEFF Research Database (Denmark)

Reijula, Jere; Kjaerheim, Kristina; Lynge, Elsebeth

2015-01-01

AIMS: To study cancer risk patterns among waiters in the Nordic countries. METHODS: We identified a cohort of 16,134 male and 81,838 female waiters from Denmark, Finland, Iceland, Norway and Sweden. During the follow-up period from 1961 to 2005, we found that 19,388 incident cancer cases were...... diagnosed. Standardised incidence ratio (SIR) was defined as the observed number of cancer cases divided by the expected number, based on national age, time period and gender-specific cancer incidence rates in the general population. RESULTS: The SIR of all cancers in waiters, in the five countries combined...... INCIDENCE IN SOME CANCER SITES CAN LIKELY BE EXPLAINED BY HIGHER ALCOHOL CONSUMPTION, THE PREVALENCE OF SMOKING AND OCCUPATIONAL EXPOSURE TO TOBACCO SMOKE HOPEFULLY, THE INCIDENCE OF CANCER AMONG WAITERS WILL DECREASE IN THE FUTURE, DUE TO THE BANNING OF TOBACCO SMOKING IN RESTAURANTS AND BARS IN THE NORDIC...

Moderators and Mediators of the Relationship Between Stress and Insomnia: Stressor Chronicity, Cognitive Intrusion, and Coping

Science.gov (United States)

Pillai, Vivek; Roth, Thomas; Mullins, Heather M.; Drake, Christopher L.

2014-01-01

Study Objectives: To assess moderators, such as stressor chronicity, and mediators, including stress response in the form of cognitive intrusion and coping behavior, of the prospective association between naturalistic stress and incident insomnia. Design: Longitudinal. Setting: Epidemiological. Participants: A community-based sample of good sleepers (n = 2,892) with no lifetime history of insomnia. Interventions: None. Measurements and Results: Participants reported the number of stressful events they had encountered at baseline, as well as the perceived severity and chronicity of each event. Similarly, volitional stress responses such as coping, as well as more involuntary responses such as cognitive intrusion were assayed for each stressor. Follow-up assessment 1 y hence revealed an insomnia incidence rate of 9.1%. Stress exposure was a significant predictor of insomnia onset, such that the odds of developing insomnia increased by 19% for every additional stressor. Chronicity significantly moderated this relationship, such that the likelihood of developing insomnia as a result of stress exposure increased as a function of chronicity. Cognitive intrusion significantly mediated the association between stress exposure and insomnia. Finally, three specific coping behaviors also acted as mediators: behavioral disengagement, distraction, and substance use. Conclusions: Most studies characterize the relationship between stress exposure and insomnia as a simple dose-response phenomenon. However, our data suggest that certain stressor characteristics significantly moderate this association. Stress response in the form of cognitive intrusion and specific maladaptive coping behaviors mediate the effects of stress exposure. These findings highlight the need for a multidimensional approach to stress assessment in future research and clinical practice. Citation: Pillai V, Roth T, Mullins HM, Drake CL. Moderators and mediators of the relationship between stress and insomnia

Incidência de cefaléia em uma comunidade hospitalar Headache incidence in a hospital community

Directory of Open Access Journals (Sweden)

VIVIANE H. FLUMIGNAN ZÉTOLA

1998-09-01

Full Text Available O objetivo foi determinar em um grupo de pessoas de uma comunidade hospitalar a incidência de cefaléia e para esta a frequência, principais características e investigações médicas mais solicitadas. Utilizamos a combinação de questionário e entrevista. Do total de 1006 fichas aleatoriamente preenchidas, 987 pessoas responderam corretamente aos quesitos e destas 380 (38,5% eram portadoras de cefaléia. Baseados na Classificação Internacional de Cefaléia dividimos os portadores em dois principais grupos, a migrânea e a cefaléia do tipo tensional. As demais foram agrupadas num terceiro grupo. A idade média foi 31,18 anos, com predomínio do sexo feminino em todos os tipos de cefaléia. A presença de história familiar foi positiva em 76,8% dos entrevistados. As características mais frequentes foram: localização frontal, tipo pulsátil e intensidade moderada. O principal fator desencadeante foi o estresse. A procura de acompanhamento médico deu-se em 41,3% dos portadores. Destes, aproximadamente 56% consultaram um clínico geral, 23% consultaram um neurologista e 21% procuraram outras especialidades. O RX de crânio foi o exame mais solicitado pelos generalistas e o eletrencefalograma pelos neurologistas. A tomografia computadorizada do crânio não foi solicitada com frequênciaThe purpose was to describe the main features of headache incidence in a hospital community, its frequency and the most requested medical investigation. Due to the stressful work environment, hospital is considered to hold a high-risk population. Interviews and questionnaires were utilized. Of a 1006 files, which were randomly filled out, 987 could be analyzed. Of all, 38,5% were from headache sufferers. By using a table of pain symptoms taken from the International Headache Society classification as a pattern, headaches were assigned as migraine, tension-type and other. The mean age was 31.18 and the frequency in females was higher than in males, at any

Prognostic value of normal stress-only myocardial perfusion imaging: a comparison between conventional and CZT-based SPECT

Energy Technology Data Exchange (ETDEWEB)

Yokota, Shu; Ottervanger, Jan Paul; Timmer, Jorik R. [Isala Hospital, Department of Cardiology, Zwolle (Netherlands); Mouden, Mohamed; Engbers, Elsemiek [Isala Hospital, Department of Cardiology, Zwolle (Netherlands); Isala Hospital, Department of Nuclear Medicine, Zwolle (Netherlands); Knollema, Siert; Jager, Pieter L. [Isala Hospital, Department of Nuclear Medicine, Zwolle (Netherlands)

2016-02-15

Single photon emission computed tomography (SPECT) myocardial perfusion imaging has proven to have prognostic importance in patients with suspected stable coronary artery disease (CAD). The recently introduced ultrafast cadmium zinc telluride (CZT)-based gamma cameras have been associated with less equivocal findings and more normal interpretations, allowing stress-only imaging to be performed more often. However, it is yet unclear whether normal stress-only CZT SPECT has comparable prognostic value as normally interpreted stress-only conventional SPECT. The study population consisted of 1,650 consecutive patients without known CAD with normal stress-only myocardial perfusion results with either conventional (n = 362) or CZT SPECT (n = 1,288). The incidence of major adverse cardiac events (MACE, all-cause death, non-fatal myocardial infarction and/or coronary revascularization) was compared between the conventional SPECT and CZT SPECT groups. Multivariable analyses using the Cox model were used to adjust for differences in baseline variables. Patients scanned with CZT were less often male (33 vs 39 %), had less often hypercholesterolaemia (41 vs 50 %) and had more often a family history of CAD (57 vs 49 %). At a median follow-up time of 37 months (interquartile range 28-45 months) MACE occurred in 68 patients. The incidence of MACE was 1.5 %/year in the CZT group, compared to 2.0 %/year in the conventional group (p = 0.08). After multivariate analyses, there was a trend to a lower incidence of MACE in the CZT SPECT group (hazard ratio 0.61, 95 % confidence interval 0.35-1.04, p = 0.07). The prognostic value of normal stress-only CZT SPECT is at least comparable and may be even better than that of normal conventional stress SPECT. (orig.)

Psychological Trauma in the Workplace: Variation of Incident Severity among Industry Settings and between Recurring vs Isolated Incidents.

Science.gov (United States)

DeFraia, G S

2015-07-01

Psychologically traumatic workplace events (known as critical incidents) occur within various work environments, with workgroups in certain industries vulnerable to multiple incidents. With the increasing prevalence of incidents in the USA, incident response is a growing practice area within occupational medicine, industrial psychology, occupational social work and other occupational health professions. To analyze a measure of incident severity based on level of disruption to the workplace and explore whether incident severity varied among different industry settings or between workgroups experiencing multiple vs single traumatic incidents. Administrative data mining was employed to examine practice data from a workplace trauma response unit in the USA. Bivariate analyses were conducted to test whether scores from an instrument measuring incident severity level varied among industry settings or between workgroups impacted by multiple vs isolated events. Incident severity level differed among various industry settings. Banks, retail stores and fast food restaurants accounted for the most severe incidents, while industrial and manufacturing sites reported less severe incidents. Workgroups experiencing multiple incidents reported more severe incidents than workgroups experiencing a single incident. Occupational health practitioners should be alert to industry differences in several areas: pre-incident resiliency training, the content of business recovery plans, assessing worker characteristics, strategies to assist continuous operations and assisting workgroups impacted by multiple or severe incidents.

Mapping residual stress fields from Vickers hardness indents using Raman microprobe spectroscopy

Energy Technology Data Exchange (ETDEWEB)

Sparks, R.G.; Enloe, W.S.; Paesler, M.A.

1988-12-01

Micro-Raman spectroscopy is used to map the residual stress fields in the vicinity of Vickers hardness indents. Both 514.5 and 488.0 nm, light is used to excite the effect and the resulting shifted and broadened Raman peaks are analyzed using computer deconvolution. Half-wave plates are used to vary the orientation of the incident later light`s polarization state with respect to crystal orientation. The Raman scattered light is then analyzed for polarization dependences which are indicative of the various components of the Raman scattering tensor. Such studies can yield valuable information about the orientation of stress components in a well known stress field. The results can then be applied to the determination of stress components in machined semiconductor materials.

Correlation between Mental Health and Incidence of Sudden Hearing Loss in Referred Patients to Otolaryngology Services of Hamadan City

Directory of Open Access Journals (Sweden)

F. Farahani

2008-01-01

Full Text Available Introduction & Objective: In recent years mental health attracts attention of many researchers, and severe emotional stress that can interfere in creation of different organic diseases is one of the most prominent of this aspects. Sudden hearing loss (S.H.L. is one of these disorders that could followed after stress and eventually may heal completely, relatively or lead to permanent deafness. S.H.L. could influence on interpersonal relationships and in this way could change quality of life negatively, so enough and appropriate attention is necessary. In this research by determination of level of stress we intended to study relationship between mental health and incidence of S.H.L.Materials & Methods: In this case – control study 65 patients that referred to otolaryngology services of Hamadan during 2005-2006 with S.H.L. (case group compared to 89 healthy subjects (control group. Control group were free from any systemic diseases and were matched from sex and age aspects to the case group. In case group after complete audiometric evaluation and confirmation of S.H.L, stress level was assessed using GHQ-28 questionnaire. This questionnaire contained 28 questions in 4 different fields: somatic symptoms, anxiety and insomnia, social problems and depression. Linkert scoring method was used for scoring of questionnaires and all data were analyzed using T-Test and chi-square test.Results: During 4 months incidence of S.H.L. in referred patients were 5.1%, significant statistical relationships between S.H.L. and level of stress (P<0.001 and severity of hearing loss and level of stress (P<0.05, r =0.34 were found. The most common audiometric pattern was downward slopping pattern (56.92%. Evaluation of level of stress between two sex groups did not show any significant difference (P<0.05.Conclusion: Stress can be known as one of the predisposing factors of S.H.L. and may be possible to control by paying more attention to the role of self-awareness and

MISSE 6 Stressed Polymers Experiment Atomic Oxygen Erosion Data

Science.gov (United States)

deGroh, Kim K.; Banks, Bruce A.; Mitchell, Gianna G.; Yi, Grace T.; Guo, Aobo; Ashmeade, Claire C.; Roberts, Lily M.; McCarthy, Catherine E.; Sechkar, Edward A.

2013-01-01

Polymers and other oxidizable materials used on the exterior of spacecraft in the low Earth orbit (LEO) space environment can be eroded away by reaction with atomic oxygen (AO). For spacecraft design, it is important to know the LEO AO erosion yield, Ey (volume loss per incident oxygen atom), of materials susceptible to AO erosion. The Stressed Polymers Experiment was developed and flown as part of the Materials International Space Station Experiment 6 (MISSE 6) to compare the AO erosion yields of stressed and non-stressed polymers to determine if erosion is dependent upon stress while in LEO. The experiment contained 36 thin film polymer samples that were exposed to ram AO for 1.45 years. This paper provides an overview of the Stressed Polymers Experiment with details on the polymers flown, the characterization techniques used, the AO fluence, and the erosion yield results. The MISSE 6 data are compared to data for similar samples flown on previous MISSE missions to determine fluence or solar radiation effects on erosion yield.

Stress, Burnout and Coping Strategies in Preclinical Medical Students

Science.gov (United States)

Fares, Jawad; Al Tabosh, Hayat; Saadeddin, Zein; El Mouhayyar, Christopher; Aridi, Hussam

2016-01-01

It is acknowledged that physicians do not seek the same expert aid for themselves as they would offer their patients. In their preclinical years, medical students appear to espouse comparable behavior. To many, medicine is described as a never-ending path that places the student under heavy stress and burnout from the beginning, leaving him/her vulnerable and with insufficient coping methods. Hence, the objective of this study is to 1) explore the prevalence of stress and burnout among preclinical medical students, and 2) propose solutions to decrease stress and burnout and improve medical education in the preclinical years. A detailed scholarly research strategy using Google Scholar, Scopus, Embase, MEDLINE and PubMed was implemented to highlight key themes that are relevant to preclinical medical students’ stress and burnout. Stress varied among different samples of medical students and ranged between 20.9% and 90%. Conversely, burnout ranged between 27% and 75%. Methods that help in reducing the incidence of stress and burnout by promoting strategies that focus on personal engagement, extracurricular activities, positive reinterpretation and expression of emotion, student-led mentorship programs, evaluation systems, career counseling and life coaching should be adopted. PMID:27042604

Stress, Burnout and Coping Strategies in Preclinical Medical Students.

Science.gov (United States)

Fares, Jawad; Al Tabosh, Hayat; Saadeddin, Zein; El Mouhayyar, Christopher; Aridi, Hussam

2016-02-01

It is acknowledged that physicians do not seek the same expert aid for themselves as they would offer their patients. In their preclinical years, medical students appear to espouse comparable behavior. To many, medicine is described as a never-ending path that places the student under heavy stress and burnout from the beginning, leaving him/her vulnerable and with insufficient coping methods. Hence, the objective of this study is to 1) explore the prevalence of stress and burnout among preclinical medical students, and 2) propose solutions to decrease stress and burnout and improve medical education in the preclinical years. A detailed scholarly research strategy using Google Scholar, Scopus, Embase, MEDLINE and PubMed was implemented to highlight key themes that are relevant to preclinical medical students' stress and burnout. Stress varied among different samples of medical students and ranged between 20.9% and 90%. Conversely, burnout ranged between 27% and 75%. Methods that help in reducing the incidence of stress and burnout by promoting strategies that focus on personal engagement, extracurricular activities, positive reinterpretation and expression of emotion, student-led mentorship programs, evaluation systems, career counseling and life coaching should be adopted.

Subjective stress factors in centrifuge training for military aircrews.

Science.gov (United States)

Lin, Pei-Chun; Wang, Jenhung; Li, Shih-Chin

2012-07-01

This study investigates stress-influence factors perceived by military aircrews undergoing centrifuge training, which lowers the incidence of G-induced loss of consciousness (G-LOC) for the crews of high-performance combat aircrafts. We used questionnaires to assess the subjective stress-influence factors of crews undergoing centrifuge training. Professionals in aviation physiology identified attributes measuring the perceived stress induced by centrifuge training, which were segmented into three constructs by factor analysis, theory lecture, centrifuge equipment, and physical fitness. Considerable interpenetration was discernible between these factors and military rank, age, length of service, flight hours accrued, and type of aircraft piloted. Identifying and quantifying the perceived stressors experienced in human-use centrifuge training enables aviators, astronauts, and air forces of the world to determine which constructs perceptibly increase or alleviate the perceived stress undergone by trainees when partaking in centrifuge training. Copyright © 2011 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Psychological Trauma in the Workplace: Variation of Incident Severity among Industry Settings and between Recurring vs Isolated Incidents

Directory of Open Access Journals (Sweden)

GS DeFraia

2015-07-01

Full Text Available Background: Psychologically traumatic workplace events (known as critical incidents occur within various work environments, with workgroups in certain industries vulnerable to multiple incidents. With the increasing prevalence of incidents in the USA, incident response is a growing practice area within occupational medicine, industrial psychology, occupational social work and other occupational health professions. Objective: To analyze a measure of incident severity based on level of disruption to the workplace and explore whether incident severity varied among different industry settings or between workgroups experiencing multiple vs single traumatic incidents. Methods: Administrative data mining was employed to examine practice data from a workplace trauma response unit in the USA. Bivariate analyses were conducted to test whether scores from an instrument measuring incident severity level varied among industry settings or between workgroups impacted by multiple vs isolated events. Results: Incident severity level differed among various industry settings. Banks, retail stores and fast food restaurants accounted for the most severe incidents, while industrial and manufacturing sites reported less severe incidents. Workgroups experiencing multiple incidents reported more severe incidents than workgroups experiencing a single incident. Conclusion: Occupational health practitioners should be alert to industry differences in several areas: pre-incident resiliency training, the content of business recovery plans, assessing worker characteristics, strategies to assist continuous operations and assisting workgroups impacted by multiple or severe incidents.

Oxidative Stress, Prooxidants, and Antioxidants: The Interplay

Directory of Open Access Journals (Sweden)

Anu Rahal

2014-01-01

Full Text Available Oxidative stress is a normal phenomenon in the body. Under normal conditions, the physiologically important intracellular levels of reactive oxygen species (ROS are maintained at low levels by various enzyme systems participating in the in vivo redox homeostasis. Therefore, oxidative stress can also be viewed as an imbalance between the prooxidants and antioxidants in the body. For the last two decades, oxidative stress has been one of the most burning topics among the biological researchers all over the world. Several reasons can be assigned to justify its importance: knowledge about reactive oxygen and nitrogen species production and metabolism; identification of biomarkers for oxidative damage; evidence relating manifestation of chronic and some acute health problems to oxidative stress; identification of various dietary antioxidants present in plant foods as bioactive molecules; and so on. This review discusses the importance of oxidative stress in the body growth and development as well as proteomic and genomic evidences of its relationship with disease development, incidence of malignancies and autoimmune disorders, increased susceptibility to bacterial, viral, and parasitic diseases, and an interplay with prooxidants and antioxidants for maintaining a sound health, which would be helpful in enhancing the knowledge of any biochemist, pathophysiologist, or medical personnel regarding this important issue.

Effort–Reward Imbalance at Work and Incident Coronary Heart Disease

Science.gov (United States)

Siegrist, Johannes; Nyberg, Solja T.; Lunau, Thorsten; Fransson, Eleonor I.; Alfredsson, Lars; Bjorner, Jakob B.; Borritz, Marianne; Burr, Hermann; Erbel, Raimund; Fahlén, Göran; Goldberg, Marcel; Hamer, Mark; Heikkilä, Katriina; Jöckel, Karl-Heinz; Knutsson, Anders; Madsen, Ida E. H.; Nielsen, Martin L.; Nordin, Maria; Oksanen, Tuula; Pejtersen, Jan H.; Pentti, Jaana; Rugulies, Reiner; Salo, Paula; Schupp, Jürgen; Singh-Manoux, Archana; Steptoe, Andrew; Theorell, Töres; Vahtera, Jussi; Westerholm, Peter J. M.; Westerlund, Hugo; Virtanen, Marianna; Zins, Marie; Batty, G. David; Kivimäki, Mika

2017-01-01

Background: Epidemiologic evidence for work stress as a risk factor for coronary heart disease is mostly based on a single measure of stressful work known as job strain, a combination of high demands and low job control. We examined whether a complementary stress measure that assesses an imbalance between efforts spent at work and rewards received predicted coronary heart disease. Methods: This multicohort study (the “IPD-Work” consortium) was based on harmonized individual-level data from 11 European prospective cohort studies. Stressful work in 90,164 men and women without coronary heart disease at baseline was assessed by validated effort–reward imbalance and job strain questionnaires. We defined incident coronary heart disease as the first nonfatal myocardial infarction or coronary death. Study-specific estimates were pooled by random effects meta-analysis. Results: At baseline, 31.7% of study members reported effort–reward imbalance at work and 15.9% reported job strain. During a mean follow-up of 9.8 years, 1,078 coronary events were recorded. After adjustment for potential confounders, a hazard ratio of 1.16 (95% confidence interval, 1.00–1.35) was observed for effort–reward imbalance compared with no imbalance. The hazard ratio was 1.16 (1.01–1.34) for having either effort–reward imbalance or job strain and 1.41 (1.12–1.76) for having both these stressors compared to having neither effort–reward imbalance nor job strain. Conclusions: Individuals with effort–reward imbalance at work have an increased risk of coronary heart disease, and this appears to be independent of job strain experienced. These findings support expanding focus beyond just job strain in future research on work stress. PMID:28570388

Increasing incidence of pyogenic spondylodiscitis

DEFF Research Database (Denmark)

Kehrer, Michala; Pedersen, Court; Jensen, Thøger G

2014-01-01

Smaller studies indicate that the incidence of pyogenic spondylodiscitis is increasing, possible related to a growing elderly population. Data supporting this is sparse, and we therefore studied patient characteristics and changes in spondylodiscitis incidence 1995-2008.......Smaller studies indicate that the incidence of pyogenic spondylodiscitis is increasing, possible related to a growing elderly population. Data supporting this is sparse, and we therefore studied patient characteristics and changes in spondylodiscitis incidence 1995-2008....

Final Debriefing Note

DEFF Research Database (Denmark)

Vagnby, Bo Hellisen

Review, analysis and discussion regarding the establishment of a system for planning and monitoring of activities related to schools physical environment, i.e. spatial allocation, number and size of schools, construction of new classroom blocks, renovation of schools, maintenance and other physical...

Hip fracture incidence is decreasing in the high incidence area of Oslo, Norway.

Science.gov (United States)

Støen, R O; Nordsletten, L; Meyer, H E; Frihagen, J F; Falch, J A; Lofthus, C M

2012-10-01

This study reports a significant decrease in age-adjusted incidence rates of hip fracture for women in Oslo, Norway, even compared with data from 1978/1979. Use of bisphosphonate may explain up to one third of the decline in the incidence. The aims of the present study were to report the current incidence of hip fractures in Oslo and to estimate the influence of bisphosphonates on the current incidence. Using the electronic diagnosis registers and lists from the operating theaters of the hospitals of Oslo, all patients with ICD-10 codes S72.0 and S72.1 (hip fracture) in 2007 were identified. Medical records of all identified patients were reviewed to verify the diagnosis. Age- and gender-specific annual incidence rates were calculated using the population of Oslo on January 1, 2007 as the population at risk. Data on the use of bisphosphonates were obtained from official registers. A total number of 1,005 hip fractures, 712 (71%) in women, were included. The age-adjusted fracture rates per 10,000 for the age group >50 years were 82.0 for women and 39.1 for men in 2007, compared with 110.8 and 41.4 in 1996/1997, 116.5 and 42.9 in 1988/1989, and 97.5 and 34.5 in 1978/1979, respectively. It was estimated that the use of bisphosphonates may explain up to 13% of the decline in incidence in women aged 60-69 years and up to 34% in women aged 70-79 years. The incidence of hip fractures in women in Oslo has decreased significantly during the last decade and is now at a lower level than in 1978/1979. This reduction was not evident in men. The incidence of hip fractures in Oslo is, however, still the highest in the world.

The incidence of burnout or compassion fatigue in medical dosimetrists as a function of various stress and psychologic factors

Energy Technology Data Exchange (ETDEWEB)

Howard, Michelle, E-mail: Mhoward24601@yahoo.com [University of Wisconsin—La Crosse, WI 54601 (United States)

2013-04-01

ABSTRACT: Burnout and compassion fatigue (CF) adversely affect medical professionals, including those employed in radiation oncology. Previously conducted research acknowledged the presence of burnout in populations of radiation therapists, radiation oncologists, and oncology nursing staff. The aim of the following research was to measure the incidence of burnout or CF in the specific population of medical dosimetrists surveyed. As professional members of the radiation oncology team, this group had not been included in published research data to date. The hypothesis of the subsequent study stated that a comparable incidence of burnout would be observed among medical dosimetrists as had been reported by earlier researchers for a population of radiation therapists. A survey tool based on the Maslach Burnout Inventory (MBI) and distributed to full members of the American Association of Medical Dosimetrists (AAMD) was utilized as the research measurement method. Results obtained indicated an incidence rates of burnout or CF for medical dosimetrists were less than the rates previously measured for radiation therapists (53% vs 11% for emotional exhaustion [EE] and 45% vs 27% for depersonalization [DP]). The incidence of burnout was based on the Burnout Inventory (BI) developed for the research project. Each of the subscales, EE, DP, and decreased personal accomplishment (PA), was considered and analyzed independently. Although not as prevalent among medical dosimetrists as a variety of additional radiation oncology professionals, a significant portion of the population demonstrated signs of burnout or CF. Future concerns abound for the population of medical dosimetrists as a large number of members scored positive for intermediate risk of burnout and CF. Additionally, a large portion of the population was found to be rapidly approaching retirement.

The incidence of burnout or compassion fatigue in medical dosimetrists as a function of various stress and psychologic factors

International Nuclear Information System (INIS)

Howard, Michelle

2013-01-01

ABSTRACT: Burnout and compassion fatigue (CF) adversely affect medical professionals, including those employed in radiation oncology. Previously conducted research acknowledged the presence of burnout in populations of radiation therapists, radiation oncologists, and oncology nursing staff. The aim of the following research was to measure the incidence of burnout or CF in the specific population of medical dosimetrists surveyed. As professional members of the radiation oncology team, this group had not been included in published research data to date. The hypothesis of the subsequent study stated that a comparable incidence of burnout would be observed among medical dosimetrists as had been reported by earlier researchers for a population of radiation therapists. A survey tool based on the Maslach Burnout Inventory (MBI) and distributed to full members of the American Association of Medical Dosimetrists (AAMD) was utilized as the research measurement method. Results obtained indicated an incidence rates of burnout or CF for medical dosimetrists were less than the rates previously measured for radiation therapists (53% vs 11% for emotional exhaustion [EE] and 45% vs 27% for depersonalization [DP]). The incidence of burnout was based on the Burnout Inventory (BI) developed for the research project. Each of the subscales, EE, DP, and decreased personal accomplishment (PA), was considered and analyzed independently. Although not as prevalent among medical dosimetrists as a variety of additional radiation oncology professionals, a significant portion of the population demonstrated signs of burnout or CF. Future concerns abound for the population of medical dosimetrists as a large number of members scored positive for intermediate risk of burnout and CF. Additionally, a large portion of the population was found to be rapidly approaching retirement

Safety culture and learning from incidents: the role of incident reporting and causal analyses

International Nuclear Information System (INIS)

Wilpert, B.

1994-01-01

Nuclear industry more than any other industrial branch has developed and used predictive risk analysis as a method of feedforward control of safety and reliability. Systematic evaluation of operating experience, statistical documentation of component failures, systematic documentation and analysis of incidents are important complementary elements of feedback control: we are dealing here with adjustment and learning from experience, in particular from past incidents. Using preliminary findings from ongoing research at the Research Center Systems Safety at the Berlin University of Technology the contribution discusses preconditions for an effective use of lessons to be learnt from closely matched incident reporting and in depth analyses of causal chains leading to incidents. Such conditions are especially standardized documentation, reporting and analyzing methods of incidents; structured information flows and feedback loops; abstaining from culpability search; mutual trust of employees and management; willingness of all concerned to continually evaluate and optimize the established learning system. Thus, incident related reporting and causal analyses contribute to safety culture, which is seen to emerge from tightly coupled organizational measures and respective change in attitudes and behaviour. (author) 2 figs., 7 refs

Stress Wave attenuation in SiC3D/Al Composite

International Nuclear Information System (INIS)

Yuan Chunyuan; Wang Yangwei; Li Guoju; Zhang Xu; Gao Jubin

2013-01-01

SiC 3D /Al composite is a kind of special composite with interpenetrating network microstructure. The attenuation properties of stress wave propagation along the SiC 3D /Al composite are studied by a Split Hopkinson Pressure Bar system and FEM simulations, and the attenuation mechanism is discussed in this paper. Results show that the attenuation rate of the stress wave in the composite is up to 1.73MPa·mm −1 . The reduction of the amplitude of waves is caused by that plenty of interfaces between SiC and Al within the composite acting with stress waves. When the incident plane wave reaches the SiC 3D /Al interface, reflection wave and transmission wave propagates in different directions along the irregular interface between SiC phase and aluminium phase due to the impedance mismatch of them, which leads to the divergence of stress wave. At the same time, some stress micro-focuses occurs in the aluminium phase for the complex wave superimposition, and some plastic deformation may take place within such micro-regions, which results in the consumption of stress wave energy. In conclusion, the stress wave attenuation is derived from divergence and consumption of stress wave.

X-ray study of residual stress distribution of ground ceramics

International Nuclear Information System (INIS)

Sakaida, Yoshihisa; Tanaka, Keisuke; Ikuhara, Yuichi; Suzuki, Kenzi.

1997-01-01

The residual stress distribution of ground ceramics was determined from the eigen strain existing in the ground surface. The eigen strain of ground ceramics was tensile, and exponentially decreased with the distance from the surface. The residual stress distribution is given as a superposition of an exponential function of compression and a linear function. It is found that the actual residual stress distribution can be approximated by a compressive exponential function because the magnitude of tensile residual stress is negligibly small compared to the compressive residual stress. In the experiments, the diffraction angle was measured on ground silicon nitride for a wide range of sin 2 ψ using the glancing incidence X-ray diffraction technique. A strong nonlinearity was found in the 2θ-sin 2 ψ diagram at very high ψ-angles. From the analysis of nonlinearity, the residual stress distribution was determined. The residual stress distribution of silicon nitride coincided with the distribution calculated from the eigen strain distribution. Transmission electron microscopy was used to clarify the origin of generation of the residual stress. Both strain contrasts and microcracks were observed below the ground surface ; straight dislocations were also observed within silicon nitride grains near the ground surface. (author)

Effect of Hurricane Katrina on the incidence of acute coronary syndrome at a primary angioplasty center in New Orleans.

Science.gov (United States)

Gautam, Sandeep; Menachem, Jonathan; Srivastav, Sudesh K; Delafontaine, Patrice; Irimpen, Anand

2009-10-01

In August 2005, New Orleans was hit by Hurricane Katrina, the costliest natural disaster in US history. Previous studies have shown an increase in acute myocardial infarction (AMI) in the immediate hours to weeks after natural disasters. The goals of our study were to detect any long-term increase in the incidence of AMI after Katrina and to investigate any pertinent contributing factors. This was a single-center retrospective cohort observational study. Patients admitted with AMI to Tulane Health Sciences Center hospital in the 2 years before Katrina and in the 2 years after the hospital reopened (5 months after Katrina) were identified from hospital records. The 2 groups (pre- and post-Katrina) were compared for prespecified demographic and clinical data. In the post-Katrina group, there were 246 admissions for AMI, out of a total census of 11,282 patients (2.18%), as compared with 150 AMI admissions out of a total of 21,229 patients (0.71%) in the pre-Katrina group (P affected (P housing (P = 0.003). The role of chronic stress in the pathogenesis of AMI is poorly understood, especially in the aftermath of natural disasters. Our data suggest that Katrina was associated with prolonged loss of employment and insurance, decreased access to preventive health services, and an increased incidence of AMI. In addition, it appears that chronic stress after a natural disaster can be associated with tobacco abuse and medication and therapeutic noncompliance. We found a 3-fold increased incidence of AMI more than 2 years after Hurricane Katrina. Even allowing for the loss of some local hospitals after the disaster, this represents a significant change in overall health of the study population and supports the need for further study into the health effects of chronic stress.

Sex Differences in Anxiety Disorders: Interactions between Fear, Stress, and Gonadal Hormones

Science.gov (United States)

Maeng, Lisa Y.; Milad, Mohammed R.

2015-01-01

Women are more vulnerable to stress- and fear-based disorders, such as anxiety and post-traumatic stress disorder. Despite the growing literature on this topic, the neural basis of these sex differences remains unclear, and the findings appear inconsistent. The neurobiological mechanisms of fear and stress in learning and memory processes have been extensively studied, and the crosstalk between these systems is beginning to explain the disproportionate incidence and differences in symptomatology and remission within these psychopathologies. In this review, we discuss the intersect between stress and fear mechanisms and their modulation by gonadal hormones and discuss the relevance of this information to sex differences in anxiety and fear-based disorders. Understanding these converging influences is imperative to the development of more effective, individualized treatments that take sex and hormones into account. PMID:25888456

Precursor incident program at EDF

International Nuclear Information System (INIS)

Fourest, B.; Maliverney, B.; Rozenholc, M.; Piovesan, C.

1998-01-01

The precursor program was started by EDF in 1994, after an investigation of the US NRC's Accident Sequence Precursor Program. Since then, reported operational events identified as Safety Outstanding Events have been analyzed whenever possible using probabilistic methods based on PSAs. Analysis provides an estimate of the remaining protection against core damage at the time the incident occurred. Measuring the incidents' severity enables to detect incidents important regarding safety. Moreover, the most efficient feedback actions can be derived from the main accident sequences identified through the analysis. Therefore, incident probabilistic analysis provides a way to assess priorities in terms of treatment and resource allocation, and so, to implement countermeasures preventing further occurrence and development of the most significant incidents. As some incidents cannot be analyzed using this method, probabilistic analysis can only be one among the methods used to assess the nuclear power plants' safety level. Nevertheless, it provides an interesting complement to classical methods of deterministic studies. (author)

A preliminary investigation of workplace stress in platinum miners using subjective and objective measures

CSIR Research Space (South Africa)

Edwards, A

2011-04-01

Full Text Available Workplace stress in the mining environment will affect health and safety outcomes in the workforce that could result in accidents and injuries, as well as poorer worker health. Increased knowledge of the specific characteristics and incidence...

Effect of applied mechanical stress on absorption coefficient of compounds

Energy Technology Data Exchange (ETDEWEB)

Gupta, Manoj Kumar, E-mail: mkgupta.sliet@gmail.com [Department of Applied Sciences, Bhai Gurdas Institute of Engineering and Technology, Sangrur (India); Singh, Gurinderjeet; Dhaliwal, A. S.; Kahlon, K. S. [Department of Physics, Sant Longowal Institute of Engineering & Technology Deemed University, Longowal (Sangrur) India-148106 (India)

2015-08-28

The absorption coefficient of given materials is the parameter required for the basic information. The measurement of absorption coefficient of compounds Al{sub 2}O{sub 3}, CaCO{sub 3}, ZnO{sub 2}, SmO{sub 2} and PbO has been taken at different incident photon energies 26, 59.54, 112, 1173, 1332keV. The studies involve the measurements of absorption coefficient of the self supporting samples prepared under different mechanical stress. This mechanical stress is render in terms of pressure up to 0-6 ton by using hydraulic press. Measurements shows that absorption coefficient of a material is directly proportional to applied mechanical stress on it up to some extent then become independent. Experimentally measured results are in fairly good agreement with in theoretical values obtained from WinXCOM.

Stress, Visual and Musculoskeletal Complaints in Open Plan Office Staff

Directory of Open Access Journals (Sweden)

Vangelova K.

2014-06-01

Full Text Available The aim of the study was to identify the main ergonomic and organizational risks contributing to stress, visual and musculoskeletal disorders in open plan office workers. A total of 73 subjects of mean age 28.3 ±4.7 years were studied. Measurements of salivary cortisol and self-ratings for strain, fatigue, stress symptoms, visual and musculoskeletal complaints were performed. The work places were organized well, but the studied staff reported high work load and time pressure. The data showed higher cortisol levels during the workday under time pressure. High incidence of visual and musculoskeletal complaints mainly in the region of the back and the neck were found, associated with flickering and blinks on the screen monitors and overtime. Optimizing workplace organization could help reduce stress and health complaints of office staff.

Reperfusion does not induce oxidative stress but sustained endoplasmic reticulum stress in livers of rats subjected to traumatic-hemorrhagic shock.

Science.gov (United States)

Duvigneau, Johanna Catharina; Kozlov, Andrey V; Zifko, Clara; Postl, Astrid; Hartl, Romana T; Miller, Ingrid; Gille, Lars; Staniek, Katrin; Moldzio, Rudolf; Gregor, Wolfgang; Haindl, Susanne; Behling, Tricia; Redl, Heinz; Bahrami, Soheyl

2010-03-01

Oxidative stress is believed to accompany reperfusion and to mediate dysfunction of the liver after traumatic-hemorrhagic shock (THS). Recently, endoplasmic reticulum (ER) stress has been suggested as an additional factor. This study investigated whether reperfusion after THS leads to increased oxidative and/or ER stress in the liver. In a rat model, including laparotomy, bleeding until decompensation, followed by inadequate or adequate reperfusion phase, three time points were investigated: 40 min, 3 h, and 18 h after shock. The reactive oxygen and nitrogen species and its scavenging capacity (superoxide dismutase 2), the nitrotyrosine formation in proteins, and the lipid peroxidation together with the status of endogenous antioxidants (alpha-tocopherylquinone-alpha-tocopherol ratio) were investigated as markers for oxidative or nitrosylative stress. Mitochondrial function and cytochrome P450 isoform 1A1 activity were analyzed as representatives for hepatocyte function. Activation of the inositol-requiring enzyme 1/X-box binding protein pathway and up-regulation of the 78-kDa glucose-regulated protein were recorded as ER stress markers. Plasma levels of alanine aminotransferase and Bax/Bcl-XL messenger RNA (mRNA) ratio were used as indicators for hepatocyte damage and apoptosis induction. Oxidative or nitrosylative stress markers or representatives of hepatocyte function were unchanged during and short after reperfusion (40 min, 3 h after shock). In contrast, ER stress markers were elevated and paralleled those of hepatocyte damage. Incidence for sustained ER stress and subsequent apoptosis induction were found at 18 h after shock. Thus, THS or reperfusion induces early and persistent ER stress of the liver, independent of oxidative or nitrosylative stress. Although ER stress was not associated with depressed hepatocyte function, it may act as an early trigger of protracted cell death, thereby contributing to delayed organ failure after THS.

Reflection and transmission of seismic waves under initial stress at the earth's core-mantle boundary

Directory of Open Access Journals (Sweden)

Sukhendu Dey

1980-01-01

Full Text Available In the present paper the influence of the initial stress is shown on the reflection and transmission of P waves at the core-mantle boundary. Taking a particular value of the inherent initial stress, the variations of reflection and transmission coefficients with respect to the angle of emergence are represented by graphs. These graphs when compared with those having no initial stress show that the effect of the initial stress is to produce a reflected P and S waves with numerically higher amplitudes but a transmitted P wave with smaller amplitude. A method is also indicated in this paper to calculate the actual value of the initial stress near the core-mantle boundary by measuring the amplitudes of incident and reflected P waves.

Cancer, acute stress disorder, and repressive coping

DEFF Research Database (Denmark)

Pedersen, Anette Fischer; Zachariae, Robert

2010-01-01

The purpose of this study was to investigate the association between repressive coping style and Acute Stress Disorder (ASD) in a sample of cancer patients. A total of 112 cancer patients recently diagnosed with cancer participated in the study. ASD was assessed by the Stanford Acute Stress...... Reaction Questionnaire, and repressive coping was assessed by a combination of scores from the Marlowe-Crowne Social Desirability Scale, and the Bendig version of the Taylor Manifest Anxiety Scale. Significantly fewer patients classified as "repressors" were diagnosed with ASD compared to patients...... classified as "non-repressors". However, further investigations revealed that the lower incidence of ASD in repressors apparently was caused by a low score on anxiety and not by an interaction effect between anxiety and defensiveness. Future studies have to investigate whether different psychological...

Female False Positive Exercise Stress ECG Testing - Fact Verses Fiction.

Science.gov (United States)

Fitzgerald, Benjamin T; Scalia, William M; Scalia, Gregory M

2018-03-07

Exercise stress testing is a well validated cardiovascular investigation. Accuracy for treadmill stress electrocardiograph (ECG) testing has been documented at 60%. False positive stress ECGs (exercise ECG changes with non-obstructive disease on anatomical testing) are common, especially in women, limiting the effectiveness of the test. This study investigates the incidence and predictors of false positive stress ECG findings, referenced against stress echocardiography (SE) as a standard. Stress echocardiography was performed using the Bruce treadmill protocol. False positive stress ECG tests were defined as greater than 1mm of ST depression on ECG during exertion, without pain, with a normal SE. Potential causes for false positive tests were recorded before the test. Three thousand consecutive negative stress echocardiograms (1036 females, 34.5%) were analysed (age 59+/-14 years. False positive (F+) stress ECGs were documented in 565/3000 tests (18.8%). F+ stress ECGs were equally prevalent in females (194/1036, 18.7%) and males (371/1964, 18.9%, p=0.85 for the difference). Potential causes (hypertension, left ventricular hypertrophy, known coronary disease, arrhythmia, diabetes mellitus, valvular heart disease) were recorded in 36/194 (18.6%) of the female F+ ECG tests and 249/371 (68.2%) of the male F+ ECG tests (preinforce the value of stress imaging, particularly in women. Copyright © 2018 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). All rights reserved.

The Role of the MAPK Signaling, Topoisomerase and Dietary Bioactives in Controlling Cancer Incidence

Directory of Open Access Journals (Sweden)

Khaled A. Selim

2017-04-01

Full Text Available Reactive oxygen species (ROS are common products of mitochondrial oxidative phosphorylation, xenobiotics metabolism and are generated in response to several environmental stress conditions. Some of them play important biochemical roles in cellular signal transduction and gene transcription. On the other hand, ROS are known to be involved in a wide range of human diseases, including cancer. The excessive production of such ROS together with disruption of homeostasis detoxifying mechanisms can mediate a series of cellular oxidative stresses. The oxidative stress of redundant free radicals production can lead to oxidative denaturation of cellular macromolecules including proteins, lipids and DNA. Moreover, oxidative damage is one of the major causes of DNA mutations, replication errors and genomic abnormalities which result in either inhibition or induction of transcription, and end with the disturbance of signal transduction pathways. Among affected signaling pathways are redox-sensitive kinases. The stimulation of these kinases induces several transcription factors through the phosphorylation of their module proteins. The activation of such pathways induces proliferation and cellular transformation. A diet rich in antioxidant compounds has potential health benefits, and there is a growing interest in the role of natural antioxidants in nutrition for prevention and cure of cancer diseases. A controversy has risen regarding the relation between antioxidants and the significant decrease in the risk of cancer incidence. In this review, we will focus on redox-sensitive kinases signaling pathways, highlighting the effects of dietary antioxidant on the prevention, incidence, prognosis or even treatment of human cancers. In addition, we will place emphasis on the chemical classes of pterocarpans as natural anti-oxidants/cancers as well as their underlying mechanisms of action, including their effects on MAPKs and topoisomerase activities.

Suppression of Helicobacter pylori infection during intensive care stay: related to stress ulcer bleeding incidence?

NARCIS (Netherlands)

van der Voort, P. H.; van der Hulst, R. W.; Zandstra, D. F.; Geraedts, A. A.; van der Ende, A.; Tytgat, G. N.

2001-01-01

PURPOSE: To assess the prevalence of active Helicobacter pylori infection in patients admitted to the intensive care unit, to determine the effect of selective gut decontamination on the persistence of this organism, and to explore the possible relationship between H. pylori infection and stress

Work site stress management: national survey results.

Science.gov (United States)

Fielding, J E

1989-12-01

The National Survey of Work Site Health Promotion Activities established baseline data on the frequency of nine types of health promotion activity at private work sites with more than 50 employees in the United States. Stress management activities were provided at 26.6% of work sites. Types of activities at those work sites with some stress management activity included group counseling (58.5%), individual counseling (39.3%), follow-up counseling (25.9%), special events (11.5%), providing information about stress (80.7%), providing a place to relax (64.8%), and making organizational changes to reduce employee stress (81.2%). Frequency of activities varied by industry type and by region of the country. Incidence of most types of activities did not increase as work site size increased, although the likelihood of having any of these activities did increase with work site size. Stress management activities were more likely to be present at work sites with a medical staff or health educator. An increase in output, productivity, or quality was the most frequently cited benefit (46.5%). Negative effects were reported at 2.6% of the work sites. Other health promotion activities found at the work sites surveyed included smoking cessation (61.8%), treatment and control of high blood pressure (36.7%), and weight control (34.7%). Employee Assistance Programs were responsible for stress management at 62% of the work sites with an Employee Assistance Program.

Incident Management: Process into Practice

Science.gov (United States)

Isaac, Gayle; Moore, Brian

2011-01-01

Tornados, shootings, fires--these are emergencies that require fast action by school district personnel, but they are not the only incidents that require risk management. The authors have introduced the National Incident Management System (NIMS) and the Incident Command System (ICS) and assured that these systems can help educators plan for and…

Stress induces pain transition by potentiation of AMPA receptor phosphorylation.

Science.gov (United States)

Li, Changsheng; Yang, Ya; Liu, Sufang; Fang, Huaqiang; Zhang, Yong; Furmanski, Orion; Skinner, John; Xing, Ying; Johns, Roger A; Huganir, Richard L; Tao, Feng

2014-10-08

Chronic postsurgical pain is a serious issue in clinical practice. After surgery, patients experience ongoing pain or become sensitive to incident, normally nonpainful stimulation. The intensity and duration of postsurgical pain vary. However, it is unclear how the transition from acute to chronic pain occurs. Here we showed that social defeat stress enhanced plantar incision-induced AMPA receptor GluA1 phosphorylation at the Ser831 site in the spinal cord and greatly prolonged plantar incision-induced pain. Interestingly, targeted mutation of the GluA1 phosphorylation site Ser831 significantly inhibited stress-induced prolongation of incisional pain. In addition, stress hormones enhanced GluA1 phosphorylation and AMPA receptor-mediated electrical activity in the spinal cord. Subthreshold stimulation induced spinal long-term potentiation in GluA1 phosphomimetic mutant mice, but not in wild-type mice. Therefore, spinal AMPA receptor phosphorylation contributes to the mechanisms underlying stress-induced pain transition. Copyright © 2014 the authors 0270-6474/14/3413737-10$15.00/0.

Cancer, Stress, and Ironies of Cancer Understanding in South Korea.

Science.gov (United States)

Nelson, Laura C

2017-01-01

Cancer incidence has been rising in South Korea, coincident with industrialization and with increased longevity. This has opened the way to a presentation of cancer as a symptom of prosperity and social advancement. Cancer care for older South Koreans is marketed widely as a way of giving back to the older generation, and is often portrayed as an opportunity to mobilize technological achievement alongside family care work to honor aging parents. Because breast cancer tends to affect a younger cohort, however, breast cancer patients seek more specific explanations for their illness in order to prevent recurrence. Many breast cancer patients identify 'stress' as the cause of their cancer, reflecting endemic stress in the lives of ordinary South Korean women. While this implies a critique of society and, specifically, of gender constructs, the emphasis on interpersonal 'stress' situates cancer causality in family relationships rather than in social, political, or environmental contexts. Cancer management and stress explanations together mute inquiry into causality.

Stress analysis of feeder bends using neutrons: new results and cumulative impacts

Energy Technology Data Exchange (ETDEWEB)

Banks, D.; Donaberger, R. [Canadian Neutron Beam Centre, Chalk River, ON (Canada); Leitch, B. [Atomic Energy of Canada Limited, Chalk River, ON (Canada); Rogge, R.B. [Canadian Neutron Beam Centre, Chalk River, ON (Canada)

2014-07-01

Neutron diffraction has played a vital role in stress analysis of bends in carbon steel pipes, known as feeder pipes, in CANDU reactors. Due to incidents of cracking of feeders, extensive R&D programs to manage feeder cracking have been implemented over about ten years. We review the cumulative impacts of this research from the view point of the stress analysis using neutrons, and present new results by examining a feeder bend with a partial crack both experimentally using neutron diffraction and theoretically using a finite element model. (author)

Major depression epidemiology from a diathesis-stress conceptualization

Directory of Open Access Journals (Sweden)

Patten Scott B

2013-01-01

Full Text Available Abstract Background Major depression is a widely used diagnostic category but there is increasing dissatisfaction with its performance. The diathesis-stress model is an alternative approach that does not require the (sometimes arbitrary imposition of categories onto the spectrum of depressive morbidity. However, application of this model has not been well explored and its consistency with available epidemiologic data is uncertain. Methods Simulation provides an opportunity to explore these issues. In this study, a simulation model based on an intuitive representation of diathesis-stress interaction was developed. Both diathesis and stress were represented using continuous distributions, without categorization. A diagnostic threshold was then applied to the simulation output to create nominal categories and to explore their consistency with available information. Results An apparently complex epidemiologic pattern emerged from the diathesis-stress interaction when thresholds were applied: incidence was time dependent, recurrence depended on the number of past episodes, baseline symptoms were associated with an increased risk of subsequent episodes and the remission rate declined with increasing episode duration. Conclusions A diathesis-stress conceptualization coupled with application of a threshold-based diagnostic definition may explain several of the apparent complexities of major depression epidemiology. Some of these complexities may be artifacts of the nominal diagnostic approach. These observations should encourage an empirical exploration of whether diathesis-stress interactions provide a more parsimonious framework for understanding depression than current approaches.

Cancer incidence in atomic bomb survivors. Part IV: Comparison of cancer incidence and mortality

International Nuclear Information System (INIS)

Ron, E.; Preston, D.L.; Mabuchi, Kiyohiko; Thompson, D.E.; Soda, Midori

1994-01-01

This report compares cancer incidence and mortality among atomic bomb survivors in the Radiation Effects Research Foundation Life Span Study (LSS) cohort. Because the incidence data are derived from the Hiroshima and Nagasaki tumor registries, case ascertainment is limited to the time (1958-1987) and geographic restrictions (Hiroshima and Nagasaki) of the registries, whereas mortality data are available from 1950-1987 anywhere in Japan. With these conditions, there were 9,014 first primary incident cancer cases identified among LSS cohort members compared with 7,308 deaths for which cancer was listed as the underlying cause of death on death certificates. When deaths were limited to those occurring between 1958-1987 in Hiroshima or Nagasaki, there were 3,155 more incident cancer cases overall, and 1,262 more cancers of the digestive system. For cancers of the oral cavity and pharynx, skin, breast, female and male genital organs, urinary system and thyroid, the incidence series was at least twice as large as the comparable mortality series. Although the incidence and mortality data are dissimilar in many ways, the overall conclusions regarding which solid cancers provide evidence of a significant dose response generally confirm the mortality findings. When either incidence or mortality data are evaluated, significant excess risks are observed for all solid cancers, stomach, colon, liver (when it is defined as primary liver cancer or liver cancer not otherwise specified on the death certificate), lung, breast, ovary and urinary bladder. No significant radiation effect is seen for cancers of the pharynx, rectum, gallbladder, pancreas, nose, larynx, uterus, prostate or kidney in either series. There is evidence of a significant excess of nonmelanoma skin cancer in the incidence data, but not in the mortality series. 19 refs., 2 figs., 10 tabs

Effects of ion implantation on the microstructure and residual stress of filter arc CrN films

International Nuclear Information System (INIS)

Weng, K.-W.; Chen, Y.-C.; Han Sheng; Hsu, C.-S.; Chen, Y.-L.; Wang, D.-Y.

2008-01-01

Chromium nitride coatings were deposited using a hybrid physical vapor deposition (PVD) system containing a filter arc deposition (FAD) and a metal plasma ion implantation source (MPII). Exactly how surface residual stress affects film characteristics is investigated using glancing incident X-ray diffraction (GIXRD) and pole figure analyses. Compared with unimplanted CrN, implanted carbon typically increases compressive residual stress and hardness. Wear resistance was also improved by implanted carbon

Decreasing incidence rates of bacteremia

DEFF Research Database (Denmark)

Nielsen, Stig Lønberg; Pedersen, C; Jensen, T G

2014-01-01

BACKGROUND: Numerous studies have shown that the incidence rate of bacteremia has been increasing over time. However, few studies have distinguished between community-acquired, healthcare-associated and nosocomial bacteremia. METHODS: We conducted a population-based study among adults with first......-time bacteremia in Funen County, Denmark, during 2000-2008 (N = 7786). We reported mean and annual incidence rates (per 100,000 person-years), overall and by place of acquisition. Trends were estimated using a Poisson regression model. RESULTS: The overall incidence rate was 215.7, including 99.0 for community......-acquired, 50.0 for healthcare-associated and 66.7 for nosocomial bacteremia. During 2000-2008, the overall incidence rate decreased by 23.3% from 254.1 to 198.8 (3.3% annually, p incidence rate of community-acquired bacteremia decreased by 25.6% from 119.0 to 93.8 (3.7% annually, p

Incident wave, infragravity wave, and non-linear low-frequency bore evolution across fringing coral reefs

Science.gov (United States)

Storlazzi, C. D.; Griffioen, D.; Cheriton, O. M.

2016-12-01

Coral reefs have been shown to significantly attenuate incident wave energy and thus provide protection for 100s of millions of people globally. To better constrain wave dynamics and wave-driven water levels over fringing coral reefs, a 4-month deployment of wave and tide gauges was conducted across two shore-normal transects on Roi-Namur Island and two transects on Kwajalein Island in the Republic of the Marshall Islands. At all locations, although incident wave (periods 250 s) heights on the outer reef flat just inshore of the zone of wave breaking, the infragravity wave heights generally equaled the incident wave heights by the middle of the reef flat and exceeded the incident wave heights on the inner reef flat by the shoreline. The infragravity waves generally were asymmetric, positively skewed, bore-like forms with incident-band waves riding the infragravity wave crest at the head of the bore; these wave packets have similar structure to high-frequency internal waves on an internal wave bore. Bore height was shown to scale with water depth, offshore wave height, and offshore wave period. For a given tidal elevation, with increasing offshore wave heights, such bores occurred more frequently on the middle reef flat, whereas they occurred less frequently on the inner reef flat. Skewed, asymmetric waves are known to drive large gradients in velocity and shear stress that can transport material onshore. Thus, a better understanding of these low-frequency, energetic bores on reef flats is critical to forecasting how coral reef-lined coasts may respond to sea-level rise and climate change.

Influence of thyroid states on stress gastric ulcer formation

Energy Technology Data Exchange (ETDEWEB)

Hernandez, D.E.; Walker, C.H.; Mason, G.A.

1988-01-01

This study was designed to test the hypothesis that thyroid states may affect the acute development of gastric lesions induced by cold-resistant stress. Normal (euthyroid), hyperthyroid and hypothyroid rats were used. Gastric lesion incidence and severity was significantly increased in hypothyroid rats, whereas in contrast hyperthyroid rats developed significantly less gastric lesions. As anticipated, plasma levels of thyroxin (T/sub 4/) were significantly elevated in hyperthyroid rats, and undetectable in hypothyroid rats. Acute pretreatment with i.p. cimetidine, but not T/sub 4/ 1 h prior to stress completely prevented gastric lesions formation in hypothyroid rats. Finally, binding of /sup 3/H-dihydroalprenolol to ..beta..-adrenergic receptors on brain membranes prepared from frontal cortex was reduced by 20% in hypothyroid rats after 3 h of stress. These and other data contained herein suggest that thyroid hormones contribute to modulate the responsiveness of the gastric mucosa to stress. The increase rate of ulcerogenesis observed in hypothyroid rats appears to be mediated by gastric acid secretion. The central mechanism for this response may involve decreased brain nonadrenergic receptor function.

Influence of thyroid states on stress gastric ulcer formation

International Nuclear Information System (INIS)

Hernandez, D.E.; Walker, C.H.; Mason, G.A.

1988-01-01

This study was designed to test the hypothesis that thyroid states may affect the acute development of gastric lesions induced by cold-resistant stress. Normal (euthyroid), hyperthyroid and hypothyroid rats were used. Gastric lesion incidence and severity was significantly increased in hypothyroid rats, whereas in contrast hyperthyroid rats developed significantly less gastric lesions. As anticipated, plasma levels of thyroxin (T 4 ) were significantly elevated in hyperthyroid rats, and undetectable in hypothyroid rats. Acute pretreatment with i.p. cimetidine, but not T 4 1 h prior to stress completely prevented gastric lesions formation in hypothyroid rats. Finally, binding of 3 H-dihydroalprenolol to β-adrenergic receptors on brain membranes prepared from frontal cortex was reduced by 20% in hypothyroid rats after 3 h of stress. These and other data contained herein suggest that thyroid hormones contribute to modulate the responsiveness of the gastric mucosa to stress. The increase rate of ulcerogenesis observed in hypothyroid rats appears to be mediated by gastric acid secretion. The central mechanism for this response may involve decreased brain nonadrenergic receptor function

Post-traumatic stress disorder in intensive care unit patients.

Science.gov (United States)

Caiuby, Andrea Vannini Santesso; Andreoli, Paola Bruno de Araújo; Andreoli, Sergio Baxter

2010-03-01

Post-traumatic stress disorder has been detected in patients after treatment in intensive care unit. The main goal of this study is to review the psychological aspects and therapeutic interventions on those patients after their treatment on intensive care unit. Thirty eight articles have been included. The prevalence of post-traumatic stress disorder has varied from 17% up to 30% and the incidence from 14% to 24%. The risk factors were: previous anxiety historic, depression or panic, having delusional traumatic memories (derived from psychic formations as dreams and delirium), belief effects, depressive behavior, stressing experiences and mechanical ventilation. High doses of opiates, symptoms caused by sedation or analgesia reduction and the use of lorazepam were related with the increase of delirium and delusional memory. The disorder sintomatology can be reduced with hydrocortisone administration, with daily sedation interruption. No other effectiveness psychological intervention study was found.

Cyber Incidents Involving Control Systems

Energy Technology Data Exchange (ETDEWEB)

Robert J. Turk

2005-10-01

The Analysis Function of the US-CERT Control Systems Security Center (CSSC) at the Idaho National Laboratory (INL) has prepared this report to document cyber security incidents for use by the CSSC. The description and analysis of incidents reported herein support three CSSC tasks: establishing a business case; increasing security awareness and private and corporate participation related to enhanced cyber security of control systems; and providing informational material to support model development and prioritize activities for CSSC. The stated mission of CSSC is to reduce vulnerability of critical infrastructure to cyber attack on control systems. As stated in the Incident Management Tool Requirements (August 2005) ''Vulnerability reduction is promoted by risk analysis that tracks actual risk, emphasizes high risk, determines risk reduction as a function of countermeasures, tracks increase of risk due to external influence, and measures success of the vulnerability reduction program''. Process control and Supervisory Control and Data Acquisition (SCADA) systems, with their reliance on proprietary networks and hardware, have long been considered immune to the network attacks that have wreaked so much havoc on corporate information systems. New research indicates this confidence is misplaced--the move to open standards such as Ethernet, Transmission Control Protocol/Internet Protocol, and Web technologies is allowing hackers to take advantage of the control industry's unawareness. Much of the available information about cyber incidents represents a characterization as opposed to an analysis of events. The lack of good analyses reflects an overall weakness in reporting requirements as well as the fact that to date there have been very few serious cyber attacks on control systems. Most companies prefer not to share cyber attack incident data because of potential financial repercussions. Uniform reporting requirements will do much to make this

Sex Differences in Mental Stress-Induced Myocardial Ischemia in Patients With Coronary Heart Disease.

Science.gov (United States)

Vaccarino, Viola; Wilmot, Kobina; Al Mheid, Ibhar; Ramadan, Ronnie; Pimple, Pratik; Shah, Amit J; Garcia, Ernest V; Nye, Jonathon; Ward, Laura; Hammadah, Muhammad; Kutner, Michael; Long, Qi; Bremner, J Douglas; Esteves, Fabio; Raggi, Paolo; Quyyumi, Arshed A

2016-08-24

Emerging data suggest that young women with coronary heart disease (CHD) are disproportionally vulnerable to the adverse cardiovascular effects of psychological stress. We hypothesized that younger, but not older, women with stable CHD are more likely than their male peers to develop mental stress-induced myocardial ischemia (MSIMI). We studied 686 patients (191 women) with stable coronary heart disease (CHD). Patients underwent (99m)Tc-sestamibi myocardial perfusion imaging at rest and with both mental (speech task) and conventional (exercise/pharmacological) stress testing. We compared quantitative (by automated software) and visual parameters of inducible ischemia between women and men and assessed age as an effect modifier. Women had a more-adverse psychosocial profile than men whereas there were few differences in medical history and CHD risk factors. Both quantitative and visual indicators of ischemia with mental stress were disproportionally larger in younger women. For each 10 years of decreasing age, the total reversibility severity score with mental stress was 9.6 incremental points higher (interaction, P<0.001) and the incidence of MSIMI was 82.6% higher (interaction, P=0.004) in women than in men. Incidence of MSIMI in women ≤50 years was almost 4-fold higher than in men of similar age and older patients. These results persisted when adjusting for sociodemographic and medical risk factors, psychosocial factors, and medications. There were no significant sex differences in inducible ischemia with conventional stress. Young women with stable CHD are susceptible to MSIMI, which could play a role in the prognosis of this group. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Two 238Pu inhalation incidents

International Nuclear Information System (INIS)

Fleming, R.R.; Hall, R.M.

1978-06-01

Two employees inhaled significant amounts of 238 Pu in separate unrelated contamination incidents in 1977. Both acute exposure incidents are described and the urine, feces, and in-vivo chest count data for each employee. Case B ( 238 PuNO 3 ) received 24 DTPA treatments beginning the day of the incident while, for medical reasons, Case A ( 238 PuO 2 ) received no therapy

Information sharing for traffic incident management.

Science.gov (United States)

2009-01-01

Traffic incident management focuses on developing procedures, implementing policies, and deploying technologies to more quickly identify incidents, improve response times, and more effectively and efficiently manage the incident scene. Because so man...

Stress and suicide in the Nurses' Health Study.

Science.gov (United States)

Feskanich, D; Hastrup, J L; Marshall, J R; Colditz, G A; Stampfer, M J; Willett, W C; Kawachi, I

2002-02-01

Although stress is thought to be a risk factor for suicide, most research has been retrospective or has focused on attempted suicides or suicide ideation. This study examined prospectively the associations between self perceived stress, diazepam use, and death from suicide among adult women. A cohort study was conducted with 14 years of follow up. Stress at home and at work were assessed by questionnaire and scored on a four point scale: minimal, light, moderate, or severe. Eleven states within the United States. Female nurses (n=94 110) who were 36 to 61 years of age when they answered questions on stress and diazepam use in 1982. During 1 272 000 person years of observation 73 suicides were identified. After adjustment for age, smoking, coffee consumption, alcohol intake, and marital status, the relation between self reported stress and suicide remained U shaped. Compared with the light home and work stress categories, which had the lowest incidences of suicide, risks were increased among women reporting either severe (relative risk (RR) = 3.7, 95% confidence intervals (CI) 1.7 to 8.3) or minimal (RR=2.1, 95% CI 1.0 to 4.5) home stress and either severe (RR=1.9, 95% CI 0.8 to 4.7) or minimal (RR=2.4, 95% CI 0.9 to 6.1) work stress. When responses to home and work stress were combined, there was an almost fivefold increase in risk of suicide among women in the high stress category. Risk of suicide was over eightfold among women reporting high stress or diazepam use compared with those reporting low stress and no diazepam use. The relation between self reported stress and suicide seems to be U shaped among adult women. The excess risk for those reporting minimal stress may reflect denial or undiagnosed depression or an association with some other unmeasured risk factor for suicide.

Cancer incidence in Spain, 2015.

Science.gov (United States)

Galceran, J; Ameijide, A; Carulla, M; Mateos, A; Quirós, J R; Rojas, D; Alemán, A; Torrella, A; Chico, M; Vicente, M; Díaz, J M; Larrañaga, N; Marcos-Gragera, R; Sánchez, M J; Perucha, J; Franch, P; Navarro, C; Ardanaz, E; Bigorra, J; Rodrigo, P; Bonet, R Peris

2017-07-01

Periodic cancer incidence estimates of Spain from all existing population-based cancer registries at any given time are required. The objective of this study was to present the current situation of cancer incidence in Spain. The Spanish Network of Cancer Registries (REDECAN) estimated the numbers of new cancer cases occurred in Spain in 2015 by applying the incidence-mortality ratios method. In the calculus, incidence data from population-based cancer registries and mortality data of all Spain were used. In 2015, nearly a quarter of a million new invasive cancer cases were diagnosed in Spain, almost 149,000 in men (60.0%) and 99,000 in women. Globally, the five most common cancers were those of colon-rectum, prostate, lung, breast and urinary bladder. By gender, the four most common cancers in men were those of prostate (22.4%), colon-rectum (16.6%), lung (15.1%) and urinary bladder (11.7%). In women, the most common ones were those of breast (28.0%), colon-rectum (16.9%), corpus uteri (6.2%) and lung (6.0%). In recent years, cancer incidence in men seems to have stabilized due to the fact that the decrease in tobacco-related cancers compensates for the increase in other types of cancer like those of colon and prostate. In women, despite the stabilization of breast cancer incidence, increased incidence is due, above all, to the rise of colorectal and tobacco-related cancers. To reduce these incident cancer cases, improvement of smoking control policies and extension of colorectal cancer screening should be the two priorities in cancer prevention for the next years.

Coping with Secondary Traumatic Stress by General Duty Police Officers: Practical Implications

Science.gov (United States)

Conn, Stephanie M.; Butterfield, Lee D.

2013-01-01

This study used the Critical Incident Technique to examine the factors that helped, hindered, or might have helped 10 general duty police officers to cope with secondary traumatic stress. The data were best represented by 14 categories: self-care, family/significant other support, talking with co-workers, emotional engagement, work environment,…

Haiti and the Earthquake: Examining the Experience of Psychological Stress and Trauma

Science.gov (United States)

Risler, Ed; Kintzle, Sara; Nackerud, Larry

2015-01-01

For approximately 35 seconds on January 10, 2010, an earthquake measuring 7.0 on the Richter scale struck the small Caribbean nation of Haiti. This research used a preexperimental one-shot posttest to examine the incidence of posttraumatic stress disorder (PTSD) and associated trauma symptomatology from the earthquake experienced by a sample of…

Downtime after Critical Incidents in Emergency Medical Technicians/Paramedics

Directory of Open Access Journals (Sweden)

Janice Halpern

2014-01-01

Full Text Available Effective workplace-based interventions after critical incidents (CIs are needed for emergency medical technicians (EMT/paramedics. The evidence for a period out of service post-CI (downtime is sparse; however it may prevent posttraumatic stress disorder (PTSD and burnout symptoms. We examined the hypothesis that downtime post-CI is associated with fewer symptoms of four long-term emotional sequelae in EMT/paramedics: depression, PTSD, burnout, and stress-related emotional symptoms (accepted cut-offs defined high scores. Two hundred and one paramedics completed questionnaires concerning an index CI including downtime experience, acute distress, and current emotional symptoms. Nearly 75% received downtime; 59% found it helpful; 84% spent it with peers. Downtime was associated only with lower depression symptoms, not with other outcomes. The optimal period for downtime was between 1 day being less effective. Planned testing of mediation of the association between downtime and depression by either calming acute post-CI distress or feeling helped by others was not performed because post-CI distress was not associated with downtime and perceived helpfulness was not associated with depression. These results suggest that outcomes of CIs follow different pathways and may require different interventions. A brief downtime is a relatively simple and effective strategy in preventing later depression symptoms.

Testing the association between the incidence of schizophrenia and social capital in an urban area.

Science.gov (United States)

Kirkbride, J B; Boydell, J; Ploubidis, G B; Morgan, C; Dazzan, P; McKenzie, K; Murray, R M; Jones, P B

2008-08-01

Social capital has been considered aetiologically important in schizophrenia but the empirical evidence to support this hypothesis is absent. We tested whether social capital, measured at the neighbourhood level, was associated with the incidence of schizophrenia (ICD-10 F20). MethodWe administered a cross-sectional questionnaire on social capital to 5% of the adult population in 33 neighbourhoods (wards) in South London (n=16 459). The questionnaire contained items relating to two social capital constructs: social cohesion and trust (SC&T) and social disorganization (SocD). Schizophrenia incidence rates, estimated using data from the Aetiology and Ethnicity in Schizophrenia and Other Psychoses (AESOP) study, provided the outcome. We used multi-level Poisson regression to test our hypothesis while controlling for individual- and neighbourhood-level characteristics. We identified 148 cases during 565 576 person-years at-risk. Twenty-six per cent of the variation in incidence rates was attributable to neighbourhood-level characteristics. Response from the social capital survey was 25.7%. The association between SC&T and schizophrenia was U-shaped. Compared with neighbourhoods with medial levels of SC&T, incidence rates were significantly higher in neighbourhoods with low [incidence rates ratio (IRR) 2.0, 95% confidence interval (CI) 1.2-3.3] and high (IRR 2.5, 95% CI 1.3-4.8) levels of SC&T, independent of age, sex, ethnicity, ethnic density, ethnic fragmentation and socio-economic deprivation. ConclusionNeighbourhood variation in SC&T was non-linearly associated with the incidence of schizophrenia within an urban area. Neighbourhoods with low SC&T may fail to mediate social stress whereas high SC&T neighbourhoods may have greater informal social control or may increase the risk of schizophrenia for residents excluded from accessing available social capital.

SU-E-P-07: Retrospective Analysis of Incident Reports at a Radiology Department: Feedback From Incident Reporting System

Energy Technology Data Exchange (ETDEWEB)

Kakinohana, Y; Toita, T; Heianna, J; Murayama, S [School of medicine, University of the Ryukyus, Nishihara-cho, Okinawa (Japan)

2015-06-15

Purpose: To provide an overview of reported incidents that occurred in a radiology department and to describe the most common causal source of incidents. Methods: Incident reports from the radiology department at the University of the Ryukyus Hospital between 2008 and 2013 were collected and analyzed retrospectively. The incident report form contains the following items, causal factors of the incident and desirable corrective actions to prevent recurrence of similar incidents. These items allow the institution to investigate/analyze root causes of the incidents and suggest measures to be taken to prevent further, similar incidents. The ‘causal factors of the incident’ item comprises multiple selections from among 24 selections and includes some synonymous selections. In this study, this item was re-categorized into four causal source types: (i) carelessness, (ii) lack of skill or knowledge, (iii) deficiencies in communication, and (iv) external factors. Results: There were a total of 7490 incident reports over the study period and 276 (3.7%) were identified as originating from the radiology department. The most frequent causal source type was carelessness (62%). The other three types showed similar frequencies (10–14%). The staff members involved in incidents indicate three predominant desirable corrective actions to prevent or decrease the recurrence of similar incidents. These are ‘improvement in communication’ (24%), ‘staff training/education’ (19%), and ‘daily medical procedures’ (22%), and the most frequent was ‘improvement in communication’. Even though the most frequent causal factor was related to carelessness, the most desirable corrective action indicated by the staff members was related to communication. Conclusion: Our finding suggests that the most immediate causes are strongly related to carelessness. However, the most likely underlying causes of incidents would be related to deficiencies in effective communication. At our

The relationship between job-induced post-traumatic stress and work-based social support

Directory of Open Access Journals (Sweden)

S. A. Allen

2000-06-01

Full Text Available Research on the role of social support in occupational samples has suggested that work-based social support [WBSS] may have a significant buffering and main effect on occupational stress. Using occupational stress research as a model, the present research explored the relationship between WBSS and job-induced post-traumatic stress [PTS] in a sample of cash-in-transit security guards that had experienced a high incidence of armed robberies in the line of duty. Results indicate that WBSS has a significant relationship with PTS. Factors associated with elevated PTS levels are discussed and comparisons are made with guards who had not experienced traumatic incidents. Opsomming Navorsing omtrent die rol van sosiale ondersteuning in werkersteekproewe dui daarop dat werkgebaseerde sosiale ondersteuning (WGSO n betekenisvolle bufferings- en hoofeffek op beroepstres het. Die huidige navorsing het die verhouding tussenWGSO en werkgeinduseerde posttraumaties stres (PTS inn steekproefkontant- in-transito sekuriteitswagte, wat n hoë insidensie gewapende roof in die uitvoer van hul dagtaak beleefhet, ondersoek. Die bevindinge dui aan dat daar 'n betekenisvolle verhouding tussenWGSO en PTS bestaan. Faktore wat met PTS geassosieer word, word bespreek en vergelykings word getref met sekuriteitswagte wat geen traumatiese belewenis gehad het nie.

Probing stress state and phase content in ultra-thin Ta films

International Nuclear Information System (INIS)

Whitacre, J.F.; Yalisove, S.M.; Bilello, J.C.; Rek, Z.U.

1998-01-01

Ta films 25 angstrom to 200 angstrom in thickness were sputter-deposited using different sputter gas (Ar) pressures and cathode power settings. The average in-plane stresses were determined using double crystal diffraction topography (DCDT). X-ray analysis (using the grazing incidence x-ray scattering (GIXS) geometry) was performed using a synchrotron light source. To study microstructure and phase content, transmission electron microscopy (TEM) and transmission electron diffraction (TED) were used. Well resolved x-ray patterns were collected for all of the films. The DCDT stress data was found to be consistent with stress effects evidence in the GIXS data. In general, residual stress state was not strongly dependent upon Ar pressure. The strongest evidence of amorphous content was found in both x-ray and TED data taken from 25 angstrom thick films deposited using 2mTorr Ar pressure and 460 W cathode power. These results show that it is possible to create and study ultra-thin Ta films which possess a range of residual stresses and phase compositions

78 FR 38949 - Computer Security Incident Coordination (CSIC): Providing Timely Cyber Incident Response

Science.gov (United States)

2013-06-28

... exposed to various forms of cyber attack. In some cases, attacks can be thwarted through the use of...-3383-01] Computer Security Incident Coordination (CSIC): Providing Timely Cyber Incident Response... systems will be successfully attacked. When a successful attack occurs, the job of a Computer Security...

Behavioral effects of chronic adolescent stress are sustained and sexually dimorphic

Science.gov (United States)

Bourke, Chase H.; Neigh, Gretchen N.

2011-01-01

Evidence suggests that women are more susceptible to stress-related disorders than men. Animal studies demonstrate a similar female sensitivity to stress and have been used to examine the underlying neurobiology of sex-specific effects of stress. Although our understanding of the sex-specific effects of chronic adolescent stress has grown in recent years, few studies have reported the effects of adolescent stress on depressive-like behavior. The purpose of this study was to determine if a chronic mixed modality stressor (consisting of isolation, restraint, and social defeat) during adolescence (PND37-49) resulted in differential and sustained changes in depressive-like behavior in male and female Wistar rats. Female rats exposed to chronic adolescent stress displayed decreased sucrose consumption, hyperactivity in the elevated plus maze, decreased activity in the forced swim test, and a blunted corticosterone response to an acute forced swim stress compared to controls during both adolescence (PND48-57) and adulthood (PND96-104). Male rats exposed to chronic adolescent stress did not manifest significant behavioral changes at either the end of adolescence or in adulthood. These data support the proposition that adolescence may be a stress sensitive period for females and exposure to stress during adolescence results in behavioral effects that persist in females. Studies investigating the sex-specific effects of chronic adolescent stress may lead to a better understanding of the sexually dimorphic incidence of depressive and anxiety disorders in humans and ultimately improve prevention and treatment strategies. PMID:21466807

Targeting safety improvements through identification of incident origination and detection in a near-miss incident learning system

International Nuclear Information System (INIS)

Novak, Avrey; Nyflot, Matthew J.; Ermoian, Ralph P.; Jordan, Loucille E.; Sponseller, Patricia A.; Kane, Gabrielle M.; Ford, Eric C.; Zeng, Jing

2016-01-01

Purpose: Radiation treatment planning involves a complex workflow that has multiple potential points of vulnerability. This study utilizes an incident reporting system to identify the origination and detection points of near-miss errors, in order to guide their departmental safety improvement efforts. Previous studies have examined where errors arise, but not where they are detected or applied a near-miss risk index (NMRI) to gauge severity. Methods: From 3/2012 to 3/2014, 1897 incidents were analyzed from a departmental incident learning system. All incidents were prospectively reviewed weekly by a multidisciplinary team and assigned a NMRI score ranging from 0 to 4 reflecting potential harm to the patient (no potential harm to potential critical harm). Incidents were classified by point of incident origination and detection based on a 103-step workflow. The individual steps were divided among nine broad workflow categories (patient assessment, imaging for radiation therapy (RT) planning, treatment planning, pretreatment plan review, treatment delivery, on-treatment quality management, post-treatment completion, equipment/software quality management, and other). The average NMRI scores of incidents originating or detected within each broad workflow area were calculated. Additionally, out of 103 individual process steps, 35 were classified as safety barriers, the process steps whose primary function is to catch errors. The safety barriers which most frequently detected incidents were identified and analyzed. Finally, the distance between event origination and detection was explored by grouping events by the number of broad workflow area events passed through before detection, and average NMRI scores were compared. Results: Near-miss incidents most commonly originated within treatment planning (33%). However, the incidents with the highest average NMRI scores originated during imaging for RT planning (NMRI = 2.0, average NMRI of all events = 1.5), specifically

Targeting safety improvements through identification of incident origination and detection in a near-miss incident learning system

Energy Technology Data Exchange (ETDEWEB)

Novak, Avrey; Nyflot, Matthew J.; Ermoian, Ralph P.; Jordan, Loucille E.; Sponseller, Patricia A.; Kane, Gabrielle M.; Ford, Eric C.; Zeng, Jing, E-mail: jzeng13@uw.edu [Department of Radiation Oncology, University of Washington Medical Center, 1959 NE Pacific Street, Campus Box 356043, Seattle, Washington 98195 (United States)

2016-05-15

Purpose: Radiation treatment planning involves a complex workflow that has multiple potential points of vulnerability. This study utilizes an incident reporting system to identify the origination and detection points of near-miss errors, in order to guide their departmental safety improvement efforts. Previous studies have examined where errors arise, but not where they are detected or applied a near-miss risk index (NMRI) to gauge severity. Methods: From 3/2012 to 3/2014, 1897 incidents were analyzed from a departmental incident learning system. All incidents were prospectively reviewed weekly by a multidisciplinary team and assigned a NMRI score ranging from 0 to 4 reflecting potential harm to the patient (no potential harm to potential critical harm). Incidents were classified by point of incident origination and detection based on a 103-step workflow. The individual steps were divided among nine broad workflow categories (patient assessment, imaging for radiation therapy (RT) planning, treatment planning, pretreatment plan review, treatment delivery, on-treatment quality management, post-treatment completion, equipment/software quality management, and other). The average NMRI scores of incidents originating or detected within each broad workflow area were calculated. Additionally, out of 103 individual process steps, 35 were classified as safety barriers, the process steps whose primary function is to catch errors. The safety barriers which most frequently detected incidents were identified and analyzed. Finally, the distance between event origination and detection was explored by grouping events by the number of broad workflow area events passed through before detection, and average NMRI scores were compared. Results: Near-miss incidents most commonly originated within treatment planning (33%). However, the incidents with the highest average NMRI scores originated during imaging for RT planning (NMRI = 2.0, average NMRI of all events = 1.5), specifically

Hazmat Yearly Incident Summary Reports

Data.gov (United States)

Department of Transportation — Series of Incident data and summary statistics reports produced which provide statistical information on incidents by type, year, geographical location, and others....

Psychosocial stress in pregnancy and its relation to the onset of premature labour.

Science.gov (United States)

Newton, R W; Webster, P A; Binu, P S; Maskrey, N; Phillips, A B

1979-08-18

A modified life events inventory was presented over a four-month period to 132 consecutive women going into spontaneous labour in Hull and Manchester. Three study groups were identified according to the duration of pregnancy. The levels of psychosocial stress in pregnancy were found to be particularly high in the mothers whose babies were born preterm. Stressful events may precipitate preterm labour in some women. The concept of antenatal care may have to be broadened if the incidence of premature labour and resulting perinatal mortality are to be reduced.

Changes in surface morphology and microcrack initiation in polymers under simultaneous exposure to stress and fast atom bombardment

International Nuclear Information System (INIS)

Michael, R.S.; Frank, S.; Stulik, D.; Dickinson, J.T.

1987-01-01

The authors present studies of the changes in surface morphology due to simultaneous exposure of polymers to stress and fast atom bombardment. The polymers examined were Teflon, Kapton, Nylon, and Kevlar-49. The incident particles were 6 keV xenon atoms. The authors show that in the presence of mechanical stress these polymers show topographical changes at particle doses considerably lower than similar changes produced on unstressed material. Applied stress also promotes the formation of surface microcracks which could greatly reduce mechanical strength of the material

Psychological impact of the Three Mile Island incident

International Nuclear Information System (INIS)

Cleary, P.D.; Houts, P.S.

1984-01-01

This study examines the psychological impact of the Three Mile Island incident. The results are based on data from a panel study of 403 persons living within five miles of Three Mile Island (TMI), and a telephone survey of 1,506 people living within 55 miles of that area. Active coping strategies were associated with continued high levels of distress. Having more friends was related to reduced distress, but introspection, taking protective actions, being active in organizations, and seeking out others were all related to higher levels of distress. High self-esteem was related to a decrease in symptoms and psychotropic drug use, and avoidance behaviors were related to higher than expected numbers of symptoms. Efforts to profile those who used different coping strategies were relatively unsuccessful. The results emphasize the need to consider the nature of the stressor when developing models of coping and response to stressful situations

Health problems and stress in Information Technology and Business Process Outsourcing employees.

Science.gov (United States)

Padma, V; Anand, N N; Gurukul, S M G Swaminatha; Javid, S M A Syed Mohammed; Prasad, Arun; Arun, S

2015-04-01

Stress is high in software profession because of their nature of work, target, achievements, night shift, over work load. 1. To study the demographic profile of the employees. 2. To access the level of job stress and quality of life of the respondents. 3. To study in detail the health problems of the employees. All employees working in IT and BPO industry for more than two years were included into the study. A detailed questionnaire of around 1000 IT and BPO employees including their personal details, stress score by Holmes and Rahe to assess the level of stress and master health checkup profile were taken and the results were analysed. Around 56% had musculoskeletal symptoms. 22% had newly diagnosed hypertension,10% had diabetes, 36% had dyslipidemia, 54% had depression, anxiety and insomnia, 40% had obesity. The stress score was higher in employees who developed diabetes, hypertension and depression. Early diagnosis of stress induced health problems can be made out by stress scores, intense lifestyle modification, diet advice along with psychological counselling would reduce the incidence of health problems in IT sector and improve the quality of work force.

The unified approach of management and critical incident stress management: helping flight attendants and pilots in the aftermath of September 11.

Science.gov (United States)

McIntosh, Tania

2006-01-01

Experience suggests that effective and appropriate responses of an organization's management after a traumatic incident can help mitigate the reactions of primary, secondary, and tertiary victims. This commentary addresses the managerial response of Southwest Airlines to the trauma induced by September 11. It highlights the effectiveness of the unity between the company, the unions, and the Critical Incident Response Team, as well as the types of interventions that were highly regarded by flight attendants and pilots who received such services. This commentary also defines the phenomenon known as fear of flight.

Cancer incidence in parents who lost a child: a nationwide study in Denmark

DEFF Research Database (Denmark)

Li, Jiong; Johansen, Christoffer; Hansen, Dorthe

2002-01-01

BACKGROUND: It has been debated whether psychological stress causes cancer, but the scientific evidence remains contradictory. The objective of this study was to investigate whether the death of a child is related to cancer risk in bereaved parents. METHODS: The authors undertook a follow-up study...... based on national registers. All 21,062 parents who lost a child from 1980 to 1996 were recruited for the exposed cohort together with 293,745 randomly selected, unexposed parents. Cox proportional hazards regression models were used to evaluate the relative risk of cancer incidence up to 18 years after......-induced adverse life styles....

Understanding the relationship between cesarean birth and stress, anxiety, and depression after childbirth: A nationwide cohort study.

Science.gov (United States)

Chen, Hung-Hui; Lai, Jerry Cheng-Yen; Hwang, Shyh-Jou; Huang, Nicole; Chou, Yiing-Jenq; Chien, Li-Yin

2017-12-01

Women who undergo cesarean birth might have an increased risk for poor mental health after childbirth, possibly because of maternal and neonatal physical problems, low parental confidence, and decreased levels of oxytocin. However, this relationship remains controversial and requires further examination. The study aimed to examine the effect of cesarean birth on postpartum stress, anxiety, and depression. This nationwide population-based cohort study was conducted using the Taiwan National Health Insurance Database. A total of 12 619 women who underwent cesarean birth and 12 619 control women who underwent vaginal birth were matched by propensity score based on age, socioeconomic status, residential urbanicity, antepartum comorbidity, and index year of delivery. We compared the incidence of stress, anxiety, and depression during the first postpartum year between cesarean and comparison groups by calculating incidence rate ratios (IRRs). The cesarean group showed a significantly higher risk for stress symptoms (IRR 1.4 [95% confidence interval {CI} 1.02-1.92]), but not anxiety (IRR 1.14 [95% CI 0.95-1.38]) or depression (IRR 1.32 [95% CI 0.94-1.87]), although the IRRs were also greater than one. The cesarean group had a significantly higher risk of any of the above-listed three disorders than the comparison group (incidence 27.6 vs 23.4 per 1000 person-years; IRR 1.18 [95% CI 1.01-1.38]). Cesarean birth was associated with an increased risk of postpartum stress symptoms. Health professionals should avoid unnecessary cesarean birth, pay attention to women who deliver by cesarean, and intervene appropriately in an attempt to improve mental health among postpartum women. © 2017 Wiley Periodicals, Inc.

Sociodemographic status, stress, and risk of prostate cancer. A prospective cohort study

DEFF Research Database (Denmark)

Nielsen, Naja Rod; Kristensen, Tage S; Zhang, Zuo-Feng

2007-01-01

PURPOSE: The social gradient in prostate cancer incidence observed in several studies may be a result of differential access to prostate cancer screening. We aim to assess if socioeconomic status, stress, and marital status are associated with prostate cancer risk in a population with free access...... to health care. METHODS: The 5,496 men who participated in the Copenhagen City Heart Study were asked about their income, educational level, stress level, and marital status during 1981-1983. These men were prospectively followed up in the Danish Cancer Registry until the end of 2002 and fewer than 0...... in prostate cancer risk according to stress (HR = 0.99; 95% CI: 0.90-1.09) or marital status. CONCLUSION: In a racially homogeneous population of Caucasians with free access to health care, we found no evidence of a relation between sociodemographic variables or stress and subsequent risk of prostate cancer....

Work Stress among Professionals in Building Construction Industry in Nigeria

Directory of Open Access Journals (Sweden)

Eziyi Offia Ibem

2011-09-01

Full Text Available This study was undertaken to identify key stress factors among professionals in building construction industry in Nigeria. This is in view of the fact that to date, very little is known about work stress among professionals in building construction industry in this country. The study involved the administration of questionnaire to 107 professionals including architects, builders, civil/structural engineers and quantity surveyors randomly selected from 60 ongoing building projects in Anambra, Ogun and Kaduna States, Nigeria. The data was analysed using descriptive statistics, and findings show that the principal sources of stress were high volume of work, uncomfortable site office environment, lack of feedback on previous and ongoing building projects, and variations in the scope of work in ongoing building projects. The paper suggests that taking responsibility for work which one has adequate capacity to handle, establishing realistic budgets and time frame for project delivery, provision of spatially adequate, visually and thermally comfortable site offices, adoption of appropriate job design practice and education of professionals on stress management strategies will reduce the incidence of stress among professionals in building industry in Nigeria.

Work Stress among Professionals in Building Construction Industry in Nigeria

Directory of Open Access Journals (Sweden)

Eziyi Offia Ibem

2011-09-01

Full Text Available This study was undertaken to identify key stress factors among professionals in building construction industry in Nigeria. This is in view of the fact that to date, very little is known about work stress among professionals in building construction industry in this country. The study involved the administration of questionnaire to 107 professionals including architects, builders, civil/structural engineers and quantity surveyors randomly selected from 60 ongoing building projects in Anambra, Ogun and Kaduna States, Nigeria. The data was analysed using descriptive statistics, and findings show that the principal sources of stress were high volume of work, uncomfortable site office environment, lack of feedback on previous and ongoing building projects, and variations in the scope of work in ongoing building projects. The paper suggests that taking responsibility for work which one has adequate capacity to handle, establishing realistic budgets and time frame for project delivery, provision of spatially adequate, visually and thermally comfortable site offices, adoption of appropriate job design practice and education of professionals on stress management strategies will reduce the incidence of stress among professionals in building industry in Nigeria. 

Activation of ATP-sensitive potassium channel by iptakalim normalizes stress-induced HPA axis disorder and depressive behaviour by alleviating inflammation and oxidative stress in mouse hypothalamus.

Science.gov (United States)

Zhao, Xiao-Jie; Zhao, Zhan; Yang, Dan-Dan; Cao, Lu-Lu; Zhang, Ling; Ji, Juan; Gu, Jun; Huang, Ji-Ye; Sun, Xiu-Lan

2017-04-01

Stress-induced disturbance of the hypothalamic-pituitary-adrenal (HPA) axis is strongly implicated in incidence of mood disorders. A heightened neuroinflammatory response and oxidative stress play a fundamental role in the dysfunction of the HPA axis. We have previously demonstrated that iptakalim (Ipt), a new ATP-sensitive potassium (K-ATP) channel opener, could prevent oxidative injury and neuroinflammation against multiple stimuli-induced brain injury. The present study was to demonstrate the impacts of Ipt in stress-induced HPA axis disorder and depressive behavior. We employed 2 stress paradigms: 8 weeks of continuous restraint stress (chronic restraint stress, CRS) and 2h of restraint stress (acute restraint stress, ARS), to mimic both chronic stress and severe acute stress. Prolonged (4 weeks) and short-term (a single injection) Ipt treatment was administered 30min before each stress paradigm. We found that HPA axis was altered after stress, with different responses to CRS (lower ACTH and CORT, higher AVP, but normal CRH) and ARS (higher CRH, ACTH and CORT, but normal AVP). Both prolonged and short-term Ipt treatment normalized stress-induced HPA axis disorders and abnormal behaviors in mice. CRS and ARS up-regulated mRNA levels of inflammation-related molecules (TNFα, IL-1β, IL-6 and TLR4) and oxidative stress molecules (gp91phox, iNOS and Nrf2) in the mouse hypothalamus. Double immunofluorescence showed CRS and ARS increased microglia activation (CD11b and TNFα) and oxidative stress in neurons (NeuN and gp91phox), which were alleviated by Ipt. Therefore, the present study reveals that Ipt could prevent against stress-induced HPA axis disorders and depressive behavior by alleviating inflammation and oxidative stress in the hypothalamus. Copyright © 2017 Elsevier Inc. All rights reserved.

Electromagnetic stress at the boundary: Photon pressure or tension?

Science.gov (United States)

Wang, Shubo; Ng, Jack; Xiao, Meng; Chan, Che Ting

2016-03-01

It is well known that incident photons carrying momentum ℏk exert a positive photon pressure. But if light is impinging from a negative refractive medium in which ℏk is directed toward the source of radiation, should light exert a photon "tension" instead of a photon pressure? Using an ab initio method that takes the underlying microstructure of a material into account, we find that when an electromagnetic wave propagates from one material into another, the electromagnetic stress at the boundary is, in fact, indeterminate if only the macroscopic parameters are specified. Light can either pull or push the boundary, depending not only on the macroscopic parameters but also on the microscopic lattice structure of the polarizable units that constitute the medium. Within the context of an effective-medium approach, the lattice effect is attributed to electrostriction and magnetostriction, which can be accounted for by the Helmholtz stress tensor if we use the macroscopic fields to calculate the boundary optical stress.

Oxidative stress and antioxidant status in dairy cows during prepartal and postpartal periods

Directory of Open Access Journals (Sweden)

Jana Konvičná

2015-01-01

Full Text Available The aim of the present study was to evaluate the indicators of oxidative stress (malondialdehyde [MDA] and antioxidant status (ferric reducing ability of plasma [FRAP]; superoxide dismutase [SOD]; glutathione peroxidase [GSH-Px]; selenium [Se]; vitamin E in dairy cows of the Slovak Pied cattle from 3 weeks before parturition to 9 weeks after parturition. The mean MDA concentration was significantly (P P P P < 0.05 were recorded between Se and vitamin E (r = 0.897, SOD and GSH-Px (r = 0.903, while Se and GSH-Px had no significantly positive correlation (r = 0.520. Significant changes between MDA and indicators of oxidative stress (SOD, GSH-Px, vitamin E confirm that during parturition and onset of lactation, oxidative stress occurs in dairy cows. Exposure of peripartal cows to oxidative stress may cause an increased incidence of metabolic diseases.

Poster - 27: Incident Learning Practices in Ontario

Energy Technology Data Exchange (ETDEWEB)

Angers, Crystal; Medlam, Gaylene; Liszewski, Brian; Simniceanu, Carina [The Ottawa Hospital Cancer Centre, Mississauga Halton/Central West Regional Cancer Center, Odette Cancer Centre, Cancer Care Ontario (Canada)

2016-08-15

Purpose: The Radiation Incident and Safety Committee (RISC), established and supported by Cancer Care Ontario (CCO), is responsible for advising the Provincial Head of the Radiation Treatment program on matters relating to provincial reporting of radiation incidents with the goal of improved risk mitigation. Methods: The committee is made up of Radiation Incident Leads (RILs) with representation from each of the 14 radiation medicine programs in the province. RISC routinely meets to review recent critical incidents and to discuss provincial reporting processes and future directions of the committee. Regular face to face meetings have provided an excellent venue for sharing incident learning practices. A summary of the incident learning practices across Ontario has been compiled. Results: Almost all programs in Ontario employ an incident learning committee to review incidents and identify corrective actions or process improvements. Tools used for incident reporting include: paper based reporting, a number of different commercial products and software solutions developed in-house. A wide range of classification schema (data taxonomies) are employed, although most have been influenced by national guidance documents. The majority of clinics perform root cause analyses but utilized methodologies vary significantly. Conclusions: Most programs in Ontario employ a committee approach to incident learning. However, the reporting tools and taxonomies in use vary greatly which represents a significant challenge to provincial reporting. RISC is preparing to adopt the National System for Incident Reporting – Radiation Therapy (NSIR-RT) which will standardize incident reporting and facilitate data analyses aimed at identifying targeted improvement initiatives.

Poster - 27: Incident Learning Practices in Ontario

International Nuclear Information System (INIS)

Angers, Crystal; Medlam, Gaylene; Liszewski, Brian; Simniceanu, Carina

2016-01-01

Purpose: The Radiation Incident and Safety Committee (RISC), established and supported by Cancer Care Ontario (CCO), is responsible for advising the Provincial Head of the Radiation Treatment program on matters relating to provincial reporting of radiation incidents with the goal of improved risk mitigation. Methods: The committee is made up of Radiation Incident Leads (RILs) with representation from each of the 14 radiation medicine programs in the province. RISC routinely meets to review recent critical incidents and to discuss provincial reporting processes and future directions of the committee. Regular face to face meetings have provided an excellent venue for sharing incident learning practices. A summary of the incident learning practices across Ontario has been compiled. Results: Almost all programs in Ontario employ an incident learning committee to review incidents and identify corrective actions or process improvements. Tools used for incident reporting include: paper based reporting, a number of different commercial products and software solutions developed in-house. A wide range of classification schema (data taxonomies) are employed, although most have been influenced by national guidance documents. The majority of clinics perform root cause analyses but utilized methodologies vary significantly. Conclusions: Most programs in Ontario employ a committee approach to incident learning. However, the reporting tools and taxonomies in use vary greatly which represents a significant challenge to provincial reporting. RISC is preparing to adopt the National System for Incident Reporting – Radiation Therapy (NSIR-RT) which will standardize incident reporting and facilitate data analyses aimed at identifying targeted improvement initiatives.

Experiences of racism and the incidence of adult-onset asthma in the Black Women's Health Study.

Science.gov (United States)

Coogan, Patricia F; Yu, Jeffrey; O'Connor, George T; Brown, Timothy A; Cozier, Yvette C; Palmer, Julie R; Rosenberg, Lynn

2014-03-01

Chronic stress resulting from experiences of racism may increase the incidence of adult-onset asthma through effects on the immune system and the airways. We conducted prospective analyses of the relation of experiences of racism with asthma incidence in the Black Women's Health Study, a prospective cohort of black women in the United States followed since 1995 with mailed biennial questionnaires. Among 38,142 participants followed from 1997 to 2011, 1,068 reported incident asthma. An everyday racism score was created based on five questions asked in 1997 and 2009 about the frequency in daily life of experiences of racism (eg, poor service in stores), and a lifetime racism score was based on questions about racism on the job, in housing, and by police. We used Cox regression models to derive multivariable incidence rate ratios (IRRs) and 95% CIs for categories of each racism score in relation to incident asthma. The IRRs were 1.45 (95% CI, 1.19-1.78) for the highest compared with the lowest quartile of the 1997 everyday racism score (P for trendracism. Among women who reported the same levels of racism in 1997 and 2009, the IRRs for the highest categories of everyday and lifetime racism were 2.12 (95% CI, 1.55-2.91) and 1.66 (95% CI, 1.20-2.30), respectively. Given the high prevalence of experiences of racism and asthma in black women in the United States, a positive association between racism and asthma is of public health importance.

Emergence Delirium With Post-traumatic Stress Disorder Among Military Veterans.

Science.gov (United States)

Nguyen, Son; Pak, Mila; Paoli, Daniel; Neff, Donna F

2016-12-08

The clinical characteristics of emergence delirium (ED) associated with post-traumatic stress disorder (PTSD) among military veterans encompass transient agitation, restlessness, disorientation, and violent verbal and physical behaviors due to re-experiencing of PTSD-related incidents. Two cases of ED after general anesthesia associated with PTSD are presented. Different anesthesia methods were applied for the two cases. A traditional medical approach appeared not to prevent the incidence of ED. In the second case, dexmedetomidine infusion along with verbal coaching was effective in preventing ED for a veteran known to have "wild wake-ups" with prior anesthetics. Further clinical studies in effectively utilizing dexmedetomidine in this population with PTSD at high risk for ED are warranted.

Stress corrosion cracking of low pressure turbine discs - an industry survey

International Nuclear Information System (INIS)

Lyle, F.F. Jr.; Lamping, G.A.; Leverant, G.R.

1981-01-01

Comprehensive industry survey identifies the key factors responsible for a large number of stress corrosion cracking incidents in low-pressure steam turbine discs of U.S. power plants. The survey included interviews with domestic and foreign utilities, as well as a review of available public documents. Plant operating practices, water treatment methods, turbine design and stress levels, and alloy chemistry and mechanical properties were among the principal variables considered in the study. Analyses of the data identified six potential key variables. Summaries of foreign and U.S. disc-cracking experience, relationship between variables and cracking experience, and the potential key cracking variables identified are presented in this paper. 11 refs

Incidents/accidents classification and reporting in Statoil.

Science.gov (United States)

Berentsen, Rune; Holmboe, Rolf H

2004-07-26

Based on requirements in the new petroleum regulations from Norwegian Petroleum Directorate (NPD) and the realisation of a need to improve and rationalise the routines for reporting and follow up of incidents, Statoil Exploration & Production Norway (Statoil E&P Norway) has formulated a new strategy and process for handling of incidents/accidents. The following past experiences serve as basis for the changes made to incident reporting in Statoil E&P Norway; too much resources were spent on a comprehensive handling and analysis of a vast amount of incidents with less importance for the safety level, taking the focus away from the more severe and important issues at hand, the assessment of "Risk Factor", i.e. the combination of recurrence frequency and consequence, was difficult to use. The high degree of subjectivity involved in the determination of the "Risk Factor" (in particular the estimation of the recurrence frequency) resulted in poor data quality and lack of consistency in the data material. The new system for categorisation and handling of undesirable incidents was established in January 2002. The intention was to get a higher degree of focus on serious incidents (injuries, damages, loss and near misses), with a thorough handling and follow-up. This is reflected throughout the handling of the serious incidents, all the way from immediate notification of the incident, through investigation and follow-up of corrective and preventive actions. Simultaneously, it was also an objective to rationalise/simplify the handling of less serious incidents. These incidents are, however, subjected to analyses twice a year in order to utilize the learning opportunity that they also provide. A year after the introduction of this new system for categorisation and follow-up of undesirable incidents, Statoil's experiences are predominantly good; the intention to get a higher degree of focus on serious incidents (injuries, damages, loss and near misses), has been met, the data

Chronic variable stress improves glucose tolerance in rats with sucrose-induced prediabetes

Science.gov (United States)

Packard, Amy E. B.; Ghosal, Sriparna; Herman, James P.; Woods, Stephen C.; Ulrich-Lai, Yvonne M.

2014-01-01

The incidence of type-2 diabetes (T2D) and the burden it places on individuals, as well as society as a whole, compels research into the causes, factors and progression of this disease. Epidemiological studies suggest that chronic stress exposure may contribute to the development and progression of T2D in human patients. To address the interaction between chronic stress and the progression of T2D, we developed a dietary model of the prediabetic state in rats utilizing unlimited access to 30% sucrose solution (in addition to unlimited access to normal chow and water), which led to impaired glucose tolerance despite elevated insulin levels. We then investigated the effects of a chronic variable stress paradigm (CVS; twice daily exposure to an unpredictable stressor for 2 weeks) on metabolic outcomes in this prediabetic model. Chronic stress improved glucose tolerance in prediabetic rats following a glucose challenge. Importantly, pair-fed control groups revealed that the beneficial effect of chronic stress did not result from the decreased food intake or body weight gain that occurred during chronic stress. The present work suggests that chronic stress in rodents can ameliorate the progression of diet-induced prediabetic disease independent of chronic stress-induced decreases in food intake and body weight. PMID:25001967

Chernobyl health effects: radiation or stress?

International Nuclear Information System (INIS)

Grinkhal', G.

1996-01-01

Consideration is given to results of wide-scale examination of human population, subjected to the effect of radiation in result of Chernobyl accident. The examined contingents consisted of liquidators, evacuated from 30-km zone, people still living in contamination territories, children of irradiated parents and children, who received large radiation doses. High levels of respiratory system diseases, digestive system diseases, cardiovascular diseases and nervous system diseases were revealed for these people. It was revealed that stress, socio-economic and chemical factors played sufficient role in disease incidence. It is shown that fair of radiation may damage more, than radiation itself

Stress transmission through Ti-Ni alloy, titanium and stainless steel in impact compression test.

Science.gov (United States)

Yoneyama, T; Doi, H; Kobayashi, E; Hamanaka, H; Tanabe, Y; Bonfield, W

2000-06-01

Impact stress transmission of Ti-Ni alloy was evaluated for biomedical stress shielding. Transformation temperatures of the alloy were investigated by means of DSC. An impact compression test was carried out with use of split-Hopkinson pressure-bar technique with cylindrical specimens of Ti-Ni alloy, titanium and stainless steel. As a result, the transmitted pulse through Ti-Ni alloy was considerably depressed as compared with those through titanium and stainless steel. The initial stress reduction was large through Ti-Ni alloy and titanium, but the stress reduction through Ti-Ni alloy was more continuous than titanium. The maximum value in the stress difference between incident and transmitted pulses through Ti-Ni alloy or titanium was higher than that through stainless steel, while the stress reduction in the maximum stress through Ti-Ni alloy was statistically larger than that through titanium or stainless steel. Ti-Ni alloy transmitted less impact stress than titanium or stainless steel, which suggested that the loading stress to adjacent tissues could be decreased with use of Ti-Ni alloy as a component material in an implant system. Copyright 2000 Kluwer Academic Publishers

Relationships among Constitution, Stress, and Discomfort in the First Trimester

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Hsiao-Ling Wang

2012-01-01

trimester of pregnancy. We adopted a descriptive and correlational research design and collected data from 261 pregnant women during their first trimester in southern Taiwan using structured questionnaires. Results showed that (1 stress was significantly and positively correlated with Yang-Xu, Yin-Xu, and Tan-Shi-Yu-Zhi constitutions, respectively; (2 Yin-Xu and Tan-Shi-Yu-Zhi constitutions had significant correlations with all symptoms of discomfort, while Yang-Xu had significant correlations with all symptoms of discomfort except for “running nose”; (3 Tan-Shi-Yu-Zhi constitution and stress were two indicators for “fatigue”; Tan-Shi-Yu-Zhi was the indicator for “nausea”; Yang-Xu and Yin-Xu were indicators for “frequent urination.” Our findings also indicate that stress level affects constitutional changes and that stress and constitutional change affect the incidence of discomfort. This research can help healthcare professionals observe these discomforts and provide individualized care for pregnant women, to nurture pregnant women into neutral-type constitution, minimize their levels of discomfort, and promote the health of the fetus and the mother.

Signs of chronic stress in women with recurrent candida vulvovaginitis.

Science.gov (United States)

Ehrström, Sophia M; Kornfeld, Dan; Thuresson, Jessica; Rylander, Eva

2005-10-01

The purpose of this study was to determine whether there is an association between recurrent vulvovaginal candida and chronic stress. Chronic stress affects the hypothalamus-pituitary-adrenal axis, which influences the immune function. Recurrent candida vulvovaginitis is increasing. Women with recurrent vulvovaginal candida (n = 35) and age-matched healthy control subjects (n = 35) collected saliva for the analysis of cortisol. Hormone analyses of blood samples and vulvovaginal examinations were performed. A questionnaire was completed. Morning rise cortisol level was significantly blunted among patients compared with control subjects (P vulvovaginal candida, compared with control subjects. More patients than control subjects reported a history of condyloma, bacterial vaginosis, and herpes genitalis. No differences were seen between patients and control subjects regarding sexual hormone binding globulin, dihydroepiandrosterone, testosterone or Hemoglobin A1c. Morning rise salivary cortisol level is blunted in women with recurrent vulvovaginal candida, which indicates signs of chronic stress. The higher incidence of vulvovaginal infections in these women compared with control subjects may reflect impaired immunity, which may be due to chronic stress.

Relationship between the onset of depression and stress response measured by the Brief Job Stress Questionnaire among Japanese employees: a cohort study.

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Keiko Wada

Full Text Available BACKGROUND: The proportion of Japanese workers experiencing intense worry or stress during working life is in excess of 60%, and the incidence of psychiatric disorders and suicide due to psychological burden from work duties is increasing. To confirm whether the stress response measured by the Brief Job Stress Questionnaire (BJSQ can identify risk for depression, a cohort study was conducted to evaluate whether the stress response measured by BJSQ was associated with the onset of depression. METHODS: A total of 1,810 participants aged 20-70 years in 2005 completed the stress response of the BJSQ and were followed-up until August, 2007 by examining sick pay records. Depression was defined by a description in sick pay records that included "depression" or "depressive symptoms" as a reason for sick leave according to a physician's medical certificate. The participants were divided into quartiles (Ql, Q2, Q3, and Q4 according to the total stress response score of BJSQ at baseline. Furthermore, the participants were divided into a higher score category (Q4 and a lower score category (Q1-Q3. Risk ratios of the stress response of the BJSQ for onset of depression were calculated using a multivariable Cox proportional hazard model. RESULTS: Among 1,810 participants, 14 developed depression during a mean of 1.8 years of follow-up. The risk ratio was 2.96 (95% confidence interval [CI], 1.04-8.42, p for trend = 0.002 when the higher stress response score category of BJSQ was compared with the low stress response score category for sick leave due to depression. After adjusting for gender, age, marital status, and having children, the risk ratios were similar to no adjustment. CONCLUSIONS: These findings suggest that the stress response measured by the BJSQ can demonstrate risk for the onset of depression.

The Impact of Mood and Anxiety Disorders on Incident Hypertension at One Year

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Simon L. Bacon

2014-01-01

Full Text Available Background. Studies assessing the association between psychological factors and hypertension have been equivocal, which may reflect limitations in the assessment of psychological factors. Purpose. To assess the relationship between mood and anxiety disorders, measured using a psychiatric interview, and 1-year incident hypertension. Methods. 197 nonhypertensive individuals undergoing exercise stress testing at baseline provided follow-up data at 1 year. Baseline assessments included a structure psychiatric interview (PRIME-MD, physician diagnosis of hypertension, and measured blood pressure. At follow-up, hypertension status was assessed via self-reported physician diagnosis. Results. Having an anxiety disorder was associated with a 4-fold increase in the risk of developing hypertension (adjusted OR = 4.14, 95% CIs = 1.18–14.56. In contrast, having a mood disorder was not associated with incident hypertension (adjusted OR = 1.21, 95% CIs = 0.24–5.86. Conclusions. There are potential mechanisms which could explain our differential mood and anxiety findings. The impact of screening and treatment of anxiety disorders on hypertension needs to be explored.

Post-traumatic Stress Disorder and Cardiovascular Disease.

Science.gov (United States)

Burg, Matthew M; Soufer, Robert

2016-10-01

Post-traumatic stress disorder (PTSD) is a disabling condition that develops consequent to trauma exposure such as natural disasters, sexual assault, automobile accidents, and combat that independently increases risk for early incident cardiovascular disease (CVD) and cardiovascular (CV) mortality by over 50 % and incident hypertension risk by over 30 %. While the majority of research on PTSD and CVD has concerned initially healthy civilian and military veteran samples, emerging research is also demonstrating that PTSD consequent to the trauma of an acute cardiac event significantly increases risk for early recurrence and mortality and that patient experiences in the clinical pathway that are related to the emergency department environment may provide an opportunity to prevent PTSD onset and thus improve outcomes. Future directions for clinical and implementation science concern broad PTSD and trauma screening in the context of primary care medical environments and the testing of PTSD treatments with CVD-related surrogates and endpoints.

Sensitivity analyses of finite element method for estimating residual stress of dissimilar metal multi-pass weldment in nuclear power plant

Energy Technology Data Exchange (ETDEWEB)

Song, Tae Kwang; Bae, Hong Yeol; Kim, Yun Jae [Korea Unviersity, Seoul (Korea, Republic of); Lee, Kyoung Soo; Park, Chi Yong [Korea Electric Power Research Institute, Daejeon (Korea, Republic of)

2008-09-15

In nuclear power plants, ferritic low alloy steel components were connected with austenitic stainless steel piping system through alloy 82/182 butt weld. There have been incidents recently where cracking has been observed in the dissimilar metal weld. Alloy 82/182 is susceptible to primary water stress corrosion cracking. Weld-induced residual stress is main factor for crack growth. Therefore exact estimation of residual stress is important for reliable operating. This paper presents residual stress computation performed by 6'' safety and relief nozzle. Based on 2 dimensional and 3 dimensional finite element analyses, effect of welding variables on residual stress variation is estimated for sensitivity analysis.

Article retracted, but the message lives on.

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Greitemeyer, Tobias

2014-04-01

The retraction of an original article aims to ensure that readers are alerted to the fact that the findings are not trustworthy. However, the present research suggests that individuals still believe in the findings of an article even though they were later told that the data were fabricated and that the article was retracted. Participants in a debriefing condition and a no-debriefing condition learned about the scientific finding of an empirical article, whereas participants in a control condition did not. Afterward, participants in the debriefing condition were told that the article had been retracted because of fabricated data. Results showed that participants in the debriefing condition were less likely to believe in the findings than participants in the no-debriefing condition but were more likely to believe in the findings than participants in the control condition, suggesting that individuals do adjust their beliefs in the perceived truth of a scientific finding after debriefing-but insufficiently. Mediational analyses revealed that the availability of generated causal arguments underlies belief perseverance. These results suggest that a retraction note of an empirical article in a scientific journal is not sufficient to ensure that readers of the original article no longer believe in the article's conclusions.

Association Between Parenting Stress and Functional Impairment Among Children Diagnosed with Neurodevelopmental Disorders.

Science.gov (United States)

Almogbel, Yasser S; Goyal, Rohit; Sansgiry, Sujit S

2017-05-01

The objective of this study was to examine the association between parenting stress and functional impairment among children with Neurodevelopmental Disorder (NDD). A sample of 150 parents of children diagnosed with NDD were recruited from schools that offer special education services. Parents completed a self-administered survey containing the parenting stress index-short form (PSI-SF) scale and the Columbia Impairment Scale. The multiple logistic regression conducted to compare those with clinically significant PSI-SF scores indicated that the risk of parents with clinically significant scores of parenting stress increased 5.5 times with functionally impaired children with NDD. Further the risk of stress increased 4.6 times when these parents reported having their own disorder/disease. The risk of stress was reduced by 57% for those who had higher than a college level education compared to those with a college level education or below. These findings might help health care providers to initiate early intervention strategies such as peer support and education that can prevent parenting stress and reduce the risk of potential incidence of depression.

Sex, stress, and epigenetics: regulation of behavior in animal models of mood disorders

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Hodes Georgia E

2013-01-01

Full Text Available Abstract Women have a higher incidence of stress related disorders including depression and generalized anxiety disorder, and epigenetic mechanisms likely contribute to this sex difference. Evidence from preclinical research suggests that epigenetic mechanisms are responsible for both sexual dimorphism of brain regions and sensitivity of the stress response. Epigenetic modifications such as DNA methylation and histone modifications can occur transgenerationally, developmentally, or in response to environmental stimuli such as stress exposure. This review will provide an overview of the various forms of epigenetic modifications observed in the central nervous system and will explain how these mechanisms contribute to a sexually dimorphic brain. It will also discuss the ways in which epigenetic alterations coincide with, and functionally contribute to, the behavioral response to stress across the lifespan. Ultimately, this review will focus on novel research utilizing animal models to investigate sex differences in epigenetic mechanisms that influence susceptibility to stress. Exploration of this relationship reveals epigenetic mechanisms with the potential to explain sexual dimorphism in the occurrence of stress related disorders.

Incidence of hyperthyroidism in Sweden.

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Abraham-Nordling, Mirna; Byström, Kristina; Törring, Ove; Lantz, Mikael; Berg, Gertrud; Calissendorff, Jan; Nyström, Helena Filipsson; Jansson, Svante; Jörneskog, Gun; Karlsson, F Anders; Nyström, Ernst; Ohrling, Hans; Orn, Thomas; Hallengren, Bengt; Wallin, Göran

2011-12-01

The incidence of hyperthyroidism has been reported in various countries to be 23-93/100,000 inhabitants per year. This extended study has evaluated the incidence for ~40% of the Swedish population of 9 million inhabitants. Sweden is considered to be iodine sufficient country. All patients including children, who were newly diagnosed with overt hyperthyroidism in the years 2003-2005, were prospectively registered in a multicenter study. The inclusion criteria are as follows: clinical symptoms and/or signs of hyperthyroidism with plasma TSH concentration below 0.2 mIE/l and increased plasma levels of free/total triiodothyronine and/or free/total thyroxine. Patients with relapse of hyperthyroidism or thyroiditis were not included. The diagnosis of Graves' disease (GD), toxic multinodular goiter (TMNG) and solitary toxic adenoma (STA), smoking, initial treatment, occurrence of thyroid-associated eye symptoms/signs, and demographic data were registered. A total of 2916 patients were diagnosed with de novo hyperthyroidism showing the total incidence of 27.6/100,000 inhabitants per year. The incidence of GD was 21.0/100,000 and toxic nodular goiter (TNG=STA+TMNG) occurred in 692 patients, corresponding to an annual incidence of 6.5/100,000. The incidence was higher in women compared with men (4.2:1). Seventy-five percent of the patients were diagnosed with GD, in whom thyroid-associated eye symptoms/signs occurred during diagnosis in every fifth patient. Geographical differences were observed. The incidence of hyperthyroidism in Sweden is in a lower range compared with international reports. Seventy-five percent of patients with hyperthyroidism had GD and 20% of them had thyroid-associated eye symptoms/signs during diagnosis. The observed geographical differences require further studies.

Incidence of ascariasis in gastric carcinoma

Energy Technology Data Exchange (ETDEWEB)

Kim, Jong Woo; Rhee, Hak Song; Bahk, Yong Whee [St Mary' s Hospital Catholic Medical College, Seoul (Korea, Republic of)

1972-09-15

Prompted by the finding that the radiological incidence of small bowel ascariasis in the patient with gastric carcinoma was unexpectedly lower than the incidence in the normal population, a clinical study was performed to investigate possible relationship between gastric carcinoma and intestinal ascariasis. As a preliminary survey, we reviewed the radiological incidence of ascariasis in a total of 2,446 cases of upper GI series performed at the Department of Radiology, St Mary's Hospital Catholic Medical College. These included 1,573 normal subjects, 146 gastric carcinoma patients, 100 benign gastric ulcer and 249 duodenal ulcer patients and 378 other upper GI diseases. Following the preliminary study, a more accurate parasitologic study was conducted in another 578 normal subjects and 51 gastric carcinoma patients. The radiological incidences of ascaiasis in normal subjects and gastric carcinoma patients were 15.1% and 28.1%, respectively. The incidence of overall helminthiasis including ascaris lumbricoides, trichocephalus trichiurus and trichostrongyloides orientalis in normal subjects of the present series was 73.5%. This figure is virtually the same with 69.1% of the general population incidence reported by Kim, et al. (1971), but the incidence in gastric carcinoma patients was 94.1%. The high incidence pattern of overall helminthiasis in gastric carcinoma patients is, however, reversed as for as ascariasis is concerned. Thus, the incidence of ascariasis of gastric carcinoma patients was much lower than that of normal subjects (9.8% vs 19.4%). From the present observation, it is postulated that there can be some possible antagonistic relationship between evolution of gastric carcinoma and small bowel infestation of ascaris lumbricoides.

Incidence of ascariasis in gastric carcinoma

International Nuclear Information System (INIS)

Kim, Jong Woo; Rhee, Hak Song; Bahk, Yong Whee

1972-01-01

Prompted by the finding that the radiological incidence of small bowel ascariasis in the patient with gastric carcinoma was unexpectedly lower than the incidence in the normal population, a clinical study was performed to investigate possible relationship between gastric carcinoma and intestinal ascariasis. As a preliminary survey, we reviewed the radiological incidence of ascariasis in a total of 2,446 cases of upper GI series performed at the Department of Radiology, St Mary's Hospital Catholic Medical College. These included 1,573 normal subjects, 146 gastric carcinoma patients, 100 benign gastric ulcer and 249 duodenal ulcer patients and 378 other upper GI diseases. Following the preliminary study, a more accurate parasitologic study was conducted in another 578 normal subjects and 51 gastric carcinoma patients. The radiological incidences of ascaiasis in normal subjects and gastric carcinoma patients were 15.1% and 28.1%, respectively. The incidence of overall helminthiasis including ascaris lumbricoides, trichocephalus trichiurus and trichostrongyloides orientalis in normal subjects of the present series was 73.5%. This figure is virtually the same with 69.1% of the general population incidence reported by Kim, et al. (1971), but the incidence in gastric carcinoma patients was 94.1%. The high incidence pattern of overall helminthiasis in gastric carcinoma patients is, however, reversed as for as ascariasis is concerned. Thus, the incidence of ascariasis of gastric carcinoma patients was much lower than that of normal subjects (9.8% vs 19.4%). From the present observation, it is postulated that there can be some possible antagonistic relationship between evolution of gastric carcinoma and small bowel infestation of ascaris lumbricoides

Statement of nuclear incidents: statement of incidents at nuclear installations: third quarter 1990

International Nuclear Information System (INIS)

1990-01-01

A summary of nuclear incidents occuring at nuclear installations in Britain between 1st July 1990 and 30th September 1990 is presented here, as published by the Health and Safety Executive, two occurring at Harwell Laboratory and one at Winfrith. None of the incidents caused danger to the public, and doses to site workers were not significant. (UK)

The role of stress in the pathogenesis and maintenance of obsessive-compulsive disorder.

Science.gov (United States)

Adams, T G; Kelmendi, B; Brake, C A; Gruner, P; Badour, C L; Pittenger, C

2018-01-01

Individuals with OCD often identify psychosocial stress as a factor that exacerbates their symptoms, and many trace the onset of symptoms to a stressful period of life or a discrete traumatic incident. However, the pathophysiological relationship between stress and OCD remains poorly characterized: it is unclear whether trauma or stress is an independent cause of OCD symptoms, a triggering factor that interacts with a preexisting diathesis, or simply a nonspecific factor that can exacerbate OCD along with other aspects of psychiatric symptomatology. Nonetheless, preclinical research has demonstrated that stress has conspicuous effects on corticostriatal and limbic circuitry. Specifically, stress can lead to neuronal atrophy in frontal cortices (particularly the medial prefrontal cortex), the dorsomedial striatum (caudate), and the hippocampus. Stress can also result in neuronal hypertrophy in the dorsolateral striatum (putamen) and amygdala. These neurobiological effects mirror reported neural abnormalities in OCD and may contribute to an imbalance between goal-directed and habitual behavior, an imbalance that is implicated in the pathogenesis and expression of OCD symptomatology. The modulation of corticostriatal and limbic circuits by stress and the resultant imbalance between habit and goal-directed learning and behavior offers a framework for investigating how stress may exacerbate or trigger OCD symptomatology.

Multiaxial stress analysis taking account of the penetration depth of x-rays, (1)

International Nuclear Information System (INIS)

Sasaki, Toshihiko; Yoshioka, Yasuo; Kuramoto, Makoto.

1983-01-01

The new theory of X-ray multiaxial stress measurement is proposed. This method takes accounts of the influence concerning to the stress gradient and to the dependence of the penetration depth of X-rays upon the incidence angle. As a basic assumption, it's assumed that (1) stress gradient is linear in respect to the depth from the specimen surface, (2) the penetration depth of X-rays shows linear dependence upon sin 2 PSI, and (3) the lattice strain determined by X-rays corresponds to the weighted averaging strain on the intensity of the diffracted X-rays. Consequently, the stress state within the thin layer near to the surface is expressed by making use of three surface stresses and six stress gradients in this theory. It was proved that these nine stress elements were able to be solved through X-ray method by applying ''the integral method'' proposed by Lode and Peiter in 1976. The verification of the validity on this method was carried out through the numerical simulation and residual stress measurement of a ground S55C. As a result, it was found that this method could get a satisfactory accuracy. This method can estimate the multiaxial stress distribution within the surface layer nondestructively. (author)

Implementation and modification of a three-dimensional radiation stress formulation for surf zone and rip-current applications

Science.gov (United States)

Kumar, N.; Voulgaris, G.; Warner, John C.

2011-01-01

Regional Ocean Modeling System (ROMS v 3.0), a three-dimensional numerical ocean model, was previously enhanced for shallow water applications by including wave-induced radiation stress forcing provided through coupling to wave propagation models (SWAN, REF/DIF). This enhancement made it suitable for surf zone applications as demonstrated using examples of obliquely incident waves on a planar beach and rip current formation in longshore bar trough morphology (Haas and Warner, 2009). In this contribution, we present an update to the coupled model which implements a wave roller model and also a modified method of the radiation stress term based on Mellor (2008, 2011a,b,in press) that includes a vertical distribution which better simulates non-conservative (i.e., wave breaking) processes and appears to be more appropriate for sigma coordinates in very shallow waters where wave breaking conditions dominate. The improvements of the modified model are shown through simulations of several cases that include: (a) obliquely incident spectral waves on a planar beach; (b) obliquely incident spectral waves on a natural barred beach (DUCK'94 experiment); (c) alongshore variable offshore wave forcing on a planar beach; (d) alongshore varying bathymetry with constant offshore wave forcing; and (e) nearshore barred morphology with rip-channels. Quantitative and qualitative comparisons to previous analytical, numerical, laboratory studies and field measurements show that the modified model replicates surf zone recirculation patterns (onshore drift at the surface and undertow at the bottom) more accurately than previous formulations based on radiation stress (Haas and Warner, 2009). The results of the model and test cases are further explored for identifying the forces operating in rip current development and the potential implication for sediment transport and rip channel development. Also, model analysis showed that rip current strength is higher when waves approach at angles of 5

Reactor incident status 1981 annual report

International Nuclear Information System (INIS)

Kiser, S.H.

1982-01-01

Reactor Incident followup action is summarized through periodic status reports. This annual report summarizes action taken or anticipated for Reactor Incidents through December 1981. Incidents for which action has been completed, have been deleted from the report. Quarterly addende will update the report by tabulating incidents for each three month period through the coming year. The report consists of a part for the P, K, and C Reactors. Each reactor part is divided into three sections: Further Technical Analysis or Followup Needed; Funding and/or Implementation Needed; and No Further Technical Analysis Anticipated

Taxonometric Applications in Radiotherapy Incident Analysis

International Nuclear Information System (INIS)

Dunscombe, Peter B.; Ekaette, Edidiong U.; Lee, Robert C.; Cooke, David L.

2008-01-01

Recent publications in both the scientific and the popular press have highlighted the risks to which patients expose themselves when entering a healthcare system. Patient safety issues are forcing us to, not only acknowledge that incidents do occur, but also actively develop the means for assessing and managing the risks of such incidents. To do this, we ideally need to know the probability of an incident's occurrence, the consequences or severity for the patient should it occur, and the basic causes of the incident. A structured approach to the description of failure modes is helpful in terms of communication, avoidance of ambiguity, and, ultimately, decision making for resource allocation. In this report, several classification schemes or taxonomies for use in risk assessment and management are discussed. In particular, a recently developed approach that reflects the activity domains through which the patient passes and that can be used as a basis for quantifying incident severity is described. The estimation of incident severity, which is based on the concept of the equivalent uniform dose, is presented in some detail. We conclude with a brief discussion on the use of a defined basic-causes table and how adding such a table to the reports of incidents can facilitate the allocation of resources

Comparative Incidence of Conformational, Neurodegenerative Disorders.

Directory of Open Access Journals (Sweden)

Jesús de Pedro-Cuesta

Full Text Available The purpose of this study was to identify incidence and survival patterns in conformational neurodegenerative disorders (CNDDs.We identified 2563 reports on the incidence of eight conditions representing sporadic, acquired and genetic, protein-associated, i.e., conformational, NDD groups and age-related macular degeneration (AMD. We selected 245 papers for full-text examination and application of quality criteria. Additionally, data-collection was completed with detailed information from British, Swedish, and Spanish registries on Creutzfeldt-Jakob disease (CJD forms, amyotrophic lateral sclerosis (ALS, and sporadic rapidly progressing neurodegenerative dementia (sRPNDd. For each condition, age-specific incidence curves, age-adjusted figures, and reported or calculated median survival were plotted and examined.Based on 51 valid reported and seven new incidence data sets, nine out of eleven conditions shared specific features. Age-adjusted incidence per million person-years increased from ≤1.5 for sRPNDd, different CJD forms and Huntington's disease (HD, to 1589 and 2589 for AMD and Alzheimer's disease (AD respectively. Age-specific profiles varied from (a symmetrical, inverted V-shaped curves for low incidences to (b those increasing with age for late-life sporadic CNDDs and for sRPNDd, with (c a suggested, intermediate, non-symmetrical inverted V-shape for fronto-temporal dementia and Parkinson's disease. Frequently, peak age-specific incidences from 20-24 to ≥90 years increased with age at onset and survival. Distinct patterns were seen: for HD, with a low incidence, levelling off at middle age, and long median survival, 20 years; and for sRPNDd which displayed the lowest incidence, increasing with age, and a short median disease duration.These results call for a unified population view of NDDs, with an age-at-onset-related pattern for acquired and sporadic CNDDs. The pattern linking age at onset to incidence magnitude and survival might

Comparative Incidence of Conformational, Neurodegenerative Disorders

Science.gov (United States)

de Pedro-Cuesta, Jesús; Rábano, Alberto; Martínez-Martín, Pablo; Ruiz-Tovar, María; Alcalde-Cabero, Enrique; Almazán-Isla, Javier; Avellanal, Fuencisla; Calero, Miguel

2015-01-01

Background The purpose of this study was to identify incidence and survival patterns in conformational neurodegenerative disorders (CNDDs). Methods We identified 2563 reports on the incidence of eight conditions representing sporadic, acquired and genetic, protein-associated, i.e., conformational, NDD groups and age-related macular degeneration (AMD). We selected 245 papers for full-text examination and application of quality criteria. Additionally, data-collection was completed with detailed information from British, Swedish, and Spanish registries on Creutzfeldt-Jakob disease (CJD) forms, amyotrophic lateral sclerosis (ALS), and sporadic rapidly progressing neurodegenerative dementia (sRPNDd). For each condition, age-specific incidence curves, age-adjusted figures, and reported or calculated median survival were plotted and examined. Findings Based on 51 valid reported and seven new incidence data sets, nine out of eleven conditions shared specific features. Age-adjusted incidence per million person-years increased from ≤1.5 for sRPNDd, different CJD forms and Huntington's disease (HD), to 1589 and 2589 for AMD and Alzheimer's disease (AD) respectively. Age-specific profiles varied from (a) symmetrical, inverted V-shaped curves for low incidences to (b) those increasing with age for late-life sporadic CNDDs and for sRPNDd, with (c) a suggested, intermediate, non-symmetrical inverted V-shape for fronto-temporal dementia and Parkinson's disease. Frequently, peak age-specific incidences from 20–24 to ≥90 years increased with age at onset and survival. Distinct patterns were seen: for HD, with a low incidence, levelling off at middle age, and long median survival, 20 years; and for sRPNDd which displayed the lowest incidence, increasing with age, and a short median disease duration. Interpretation These results call for a unified population view of NDDs, with an age-at-onset-related pattern for acquired and sporadic CNDDs. The pattern linking age at onset to

Sex differences in chronic stress effects on cognition in rodents.

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Luine, Victoria; Gomez, Juan; Beck, Kevin; Bowman, Rachel

2017-01-01

Chronic stress causes deleterious changes in physiological function in systems ranging from neural cells in culture to laboratory rodents, sub-human primates and humans. It is notable, however, that the vast majority of research in this area has been conducted in males. In this review, we provide information about chronic stress effects on cognition in female rodents and contrast it with responses in male rodents. In general, females show cognitive resilience to chronic stressors which impair male cognitive function using spatial tasks including the radial arm maze, radial arm water maze, Morris water maze, Y-maze and object placement. Moreover, stress often enhances female performance in some of these cognitive tasks. Memory in females is not affected by stress in non-spatial memory tasks like recognition memory and temporal order recognition memory while males show impaired memory following stress. We discuss possible bases for these sex-dependent differences including the use of different strategies by the sexes to solve cognitive tasks. Whether the sex differences result from changes in non-mnemonic factors is also considered. Sex-dependent differences in alcohol and drug influences on stress responses are also described. Finally, the role of neurally derived estradiol in driving sex differences and providing resilience to stress in females is shown. The importance of determining the nature and extent of sex differences in stress responses is that such differences may provide vital information for understanding why some stress related diseases have different incidence rates between the sexes and for developing novel therapeutic treatments. Copyright © 2016 Elsevier Inc. All rights reserved.

Changing perspectives of stress gastritis prophylaxis.

Science.gov (United States)

Smythe, M A; Zarowitz, B J

1994-09-01

To present recent advances in stress gastritis prophylaxis in the critically ill and review considerations in selection of a prophylactic agent. Information was obtained from MEDLINE search, reference lists from articles identified in search, and from review articles. Emphasis was placed on controlled trials conducted within the last 5 years. All literature was assessed for methodology, results, and conclusions. Results of prospective, randomized trials, and meta-analyses are summarized. Histamine2-receptor antagonists, antacids, and sucralfate appear equally effective in preventing stress gastritis in the critically ill. A definitive cause-effect relationship between histamine2-receptor antagonists and increased incidence of nosocomial pneumonia has not yet been established. The indications for using a prophylactic agent and consideration in selecting an agent should include an evaluation of the following: risk factors for gastritis including the type of intensive care patient, comparative efficacy, adverse effects, drug interactions, cost, and ease of administration. The least expensive, safest agent requiring minimal monitoring is sucralfate. Prevention of stress gastritis has never been shown to reduce morbidity or mortality significantly. Controversies still exist regarding the need to provide prophylaxis, the choice of an agent, and the relative importance of previously identified risk factors. Further well-designed studies are needed before consensus can be reached.

The incidence of and risk factors for emergence delirium in U.S. military combat veterans.

Science.gov (United States)

McGuire, Jason M

2012-08-01

The purpose of this research was to identify the incidence and potential risk factors for emergence delirium (ED) in a U.S. military combat veteran surgical population at Naval Hospital Camp Pendleton. ED is a postanesthetic phenomenon that occurs immediately after emergence from general anesthesia and is characterized by agitation, confusion, and violent behavior. Clinical evidence suggests that ED is increasingly seen among military personnel returning from the wars in Iraq and Afghanistan, and that the incidence of anxiety, depression, and post-traumatic stress disorder (PTSD) are higher in this population than in noncombat troops or nonmilitary populations. The incidence of ED in this sample of 130 postoperative military personnel with combat exposure was 20% (n=26). Those previously diagnosed with a psychological disorder had a higher rate of ED (50%) than those who did not (17.5%), χ(2)=5.53, PPTSD symptoms, and depression [state anxiety: r(128)=0.40, PPTSD: r(128)=0.35, PPTSD, and depression as risk factors. Regression modeling suggested that state-anxiety served as the best predictor. These findings increase clinicians' understanding of ED among combat veterans and give direction to future studies that should focus on preventive treatment. Published by Elsevier Inc.

A simplified method of evaluating the stress wave environment of internal equipment

Science.gov (United States)

Colton, J. D.; Desmond, T. P.

1979-01-01

A simplified method called the transfer function technique (TFT) was devised for evaluating the stress wave environment in a structure containing internal equipment. The TFT consists of following the initial in-plane stress wave that propagates through a structure subjected to a dynamic load and characterizing how the wave is altered as it is transmitted through intersections of structural members. As a basis for evaluating the TFT, impact experiments and detailed stress wave analyses were performed for structures with two or three, or more members. Transfer functions that relate the wave transmitted through an intersection to the incident wave were deduced from the predicted wave response. By sequentially applying these transfer functions to a structure with several intersections, it was found that the environment produced by the initial stress wave propagating through the structure can be approximated well. The TFT can be used as a design tool or as an analytical tool to determine whether a more detailed wave analysis is warranted.

Early life traumatic stressors and the mediating role of PTSD in incident HIV infection among US men, comparisons by sexual orientation and race/ethnicity: results from the NESARC, 2004-2005.

Science.gov (United States)

Reisner, Sari L; Falb, Kathryn L; Mimiaga, Matthew J

2011-08-01

Stressful life events in childhood during critical periods of development have long-term psychological and neurobiological sequelae, which may affect risk for HIV infection across the life course. Data were from a nationally representative sample of 13,274 US men (National Epidemiologic Survey on Alcohol and Related Conditions, 2004-2005). Weighted multivariable logistic regression models examined (1) the association of childhood violent events before age 18 on 12-month incident HIV infection and (2) whether posttraumatic stress disorder (PTSD) diagnosis (clinical interview) mediated the association between early life events and HIV. Overall, the 12-month HIV incidence was incident HIV infection (aOR = 5.75; 95% CI: 4.76 to 6.95). There was evidence that PTSD partially mediated the relationship between early life events and HIV (aOR = 1.14; 95% CI: 1.02 to 1.28). Experiencing early life violent family stressors was associated with HIV infection among men. Early life events and HIV infection were mediated by PTSD, which has implications for understanding disparities in HIV infection. Interventions are urgently needed that address the long-term sequelae of childhood violence.

Improving freight crash incident management.

Science.gov (United States)

2015-06-01

The objective of this study was to determine the most effective way to mitigate the effect of freight : crash incidents on Louisiana freeways. Candidate incident management strategies were reviewed from : practice in other states and from those publi...

Security incidents on the Internet, 1989--1995

Energy Technology Data Exchange (ETDEWEB)

Howard, J.D.

1995-12-31

This paper presents an analysis of trends in Internet security based on an investigation of 4,299 Internet security-related incidents reported to the CERT{reg_sign} Coordination Center (CERT{reg_sign}/CC) from 1989 through 1995. Prior to this research, knowledge of actual Internet security incidents was limited and primarily anecdotal. This research: (1) developed a taxonomy to classify Internet attacks and incidents, (2) organized, classified, and analyzed CERT{reg_sign}/CC incident records, (3) summarized the relative frequency of the use of tools and vulnerabilities, success in achieving access, and results of attacks, (4) estimated total Internet incident activity, (5) developed recommendations for Internet users and suppliers, and (6) developed recommendations for future research. With the exception of denial-of-service attacks, security incidents were found to be increasing at a rate less than Internet growth. Estimates showed that most, if not all, severe incidents were reported to the CERT{reg_sign}/CC, and that more than one out of three above average incidents (in terms of duration and number of sites) were reported. Estimates also indicated that a typical Internet site was involved in, at most, around one incident (of any kind) per year, and a typical Internet host in, at most, around one incident in 45 years. The probability of unauthorized privileged access was around an order of magnitude less likely. As a result, simple and reasonable security precautions should be sufficient for most Internet users.

Development of a highway incident management operational and training guide for incident responders in Illinois.

Science.gov (United States)

2011-08-01

Each year highway traffic incidents, such as crashes, place responders on and beside roadways with : dangerous high-speed traffic. The unexpected conditions of an incident scene have the potential to surprise : unsuspecting or inattentive drivers, po...

Resting heart rate and the incidence and progression of valvular calcium: The Multi-Ethnic Study of Atherosclerosis (MESA).

Science.gov (United States)

Amoakwa, Kojo; Fashanu, Oluwaseun E; Tibuakuu, Martin; Zhao, Di; Guallar, Eliseo; Whelton, Seamus P; O'Neal, Wesley T; Post, Wendy S; Budoff, Matthew J; Michos, Erin D

2018-06-01

Left-sided valvular calcification is associated with cardiovascular disease (CVD) morbidity and mortality. Resting heart rate (RHR) may influence valvular calcium progression through shear stress. Whether RHR, an established CVD risk factor, is associated with valvular calcium progression is unknown. We assessed whether RHR predicts incidence and progression of mitral annular calcium (MAC) and aortic valve calcium (AVC) in a community-based cohort free of CVD at baseline. RHR was obtained from baseline electrocardiograms of 5498 MESA participants. MAC and AVC were quantified using Agatston scoring from cardiac computed tomography scans obtained at baseline and at a second examination during follow-up. We examined associations of RHR with incident MAC/AVC and annual change in MAC/AVC scores, after adjusting for demographics, CVD risk factors, physical activity, and atrioventricular nodal blocker use. At baseline, participants had mean age of 62 ± 10 years and mean RHR of 63 ± 10 bpm; 12.3% and 8.9% had prevalent AVC and MAC, respectively. Over a median of 2.3 years, 4.1% and 4.5% developed incident AVC and MAC, respectively. Each 10 bpm higher RHR was significantly associated with incident MAC [Risk Ratio 1.17 (95% CI 1.03-1.34)], but not incident AVC. However, RHR was associated with AVC progression [β = 1.62 (0.45-2.80) Agatston units/year for every 10 bpm increment], but not MAC progression. Higher RHR was associated with MAC incidence and AVC progression, independent of traditional CVD risk factors. Future studies are needed to determine whether modification of RHR through lifestyle or pharmacologic interventions can reduce valvular calcium incidence or progression. Copyright © 2018 Elsevier B.V. All rights reserved.

Detecting Terrorism Incidence Type from News Summary

DEFF Research Database (Denmark)

Nizamani, Sarwat; Memon, Nasrullah

2012-01-01

The paper presents the experiments to detect terrorism incidence type from news summary data. We have applied classification techniques on news summary data to analyze the incidence and detect the type of incidence. A number of experiments are conducted using various classification algorithms...... and results show that a simple decision tree classifier can learn incidence type with satisfactory results from news data....

Mirror and grating surface figure requirements for grazing incidence synchrotron radiation beamlines: Power loading effects

Energy Technology Data Exchange (ETDEWEB)

Hulbert, S.L.; Sharma, S.

1987-01-01

At present, grazing incidence mirrors are used almost exclusively as the first optical element in VUV and soft x-ray synchrotron radiation beamlines. The performance of these mirrors is determined by thermal and mechanical stress-induced figure errors as well as by figure errors remaining from the grinding and polishing process. With the advent of VUV and soft x-ray undulators and wigglers has come a new set of thermal stress problems related to both the magnitude and the spatial distribution of power from these devices. In many cases the power load on the entrance slits and gratings in these beamlines is no longer negligible. The dependence of thermally-induced front-end mirror figure errors on various storage ring and insertion device parameters (especially those at the National Synchrotron Light Source) and the effects of these figure errors on two classes of soft x-ray beamlines are presented.

Role of stressful life events, avoidant coping styles, and neuroticism in online game addiction among college students: a moderated mediation model

Directory of Open Access Journals (Sweden)

Li Huanhuan

2016-11-01

Full Text Available Online game addiction (OGA is becoming a significant problem worldwide. The aim of this study was to explore the incidence of OGA and the roles of stressful life events, avoidant coping styles (ACSs, and neuroticism in OGA. A total of 651 Chinese college students were selected by random cluster sampling. Subjects completed the Chinese version of Young’s eight-item Internet Addiction Scale (CIAS, Online Game Cognition Addiction Scale (OGCAS, Revised Eysenck Personality Questionnaire Short Scale in Chinese (EPQ-RSC, Chinese College-student Stress Questionnaire (CCSQ, and Coping Style Questionnaire (CSQ. Structural equation modeling (SEM was used to explore the interactive effects of stressful life events, ACSs, and neuroticism on OGA. Of the 651 participants in the sample, 31 (4.8% were identified as addicts. The incidence of OGA was two times higher for males than females. The addicts had markedly higher scores on the neuroticism subscale of the EPQ-RSC than non-addicts. Compared to non-addicts, addicts were more apt to use ACSs. Having an avoidant coping strategy mediated the effect of stressful life events on OGA. Furthermore, neuroticism moderated the indirect effect of stressful life events on OGA via ACSs. Applications of these findings to etiological research and clinical treatment programs are discussed.

Role of Stressful Life Events, Avoidant Coping Styles, and Neuroticism in Online Game Addiction among College Students: A Moderated Mediation Model.

Science.gov (United States)

Li, Huanhuan; Zou, Yingmin; Wang, Jiaqi; Yang, Xuelin

2016-01-01

Online game addiction (OGA) is becoming a significant problem worldwide. The aim of this study was to explore the incidence of OGA and the roles of stressful life events, avoidant coping styles (ACSs), and neuroticism in OGA. A total of 651 Chinese college students were selected by random cluster sampling. Subjects completed the Chinese version of Young's eight-item Internet Addiction Scale (CIAS), Online Game Cognition Addiction Scale (OGCAS), Revised Eysenck Personality Questionnaire Short Scale in Chinese (EPQ-RSC), Chinese College-student Stress Questionnaire, and Coping Style Questionnaire. Structural equation modeling (SEM) was used to explore the interactive effects of stressful life events, ACSs, and neuroticism on OGA. Of the 651 participants in the sample, 31 (4.8%) were identified as addicts. The incidence of OGA was two times higher for males than females. The addicts had markedly higher scores on the neuroticism subscale of the EPQ-RSC than non-addicts. Compared to non-addicts, addicts were more apt to use ACSs. Having an avoidant coping strategy mediated the effect of stressful life events on OGA. Furthermore, neuroticism moderated the indirect effect of stressful life events on OGA via ACSs. Applications of these findings to etiological research and clinical treatment programs are discussed.

Role of Stressful Life Events, Avoidant Coping Styles, and Neuroticism in Online Game Addiction among College Students: A Moderated Mediation Model

Science.gov (United States)

Li, Huanhuan; Zou, Yingmin; Wang, Jiaqi; Yang, Xuelin

2016-01-01

Online game addiction (OGA) is becoming a significant problem worldwide. The aim of this study was to explore the incidence of OGA and the roles of stressful life events, avoidant coping styles (ACSs), and neuroticism in OGA. A total of 651 Chinese college students were selected by random cluster sampling. Subjects completed the Chinese version of Young’s eight-item Internet Addiction Scale (CIAS), Online Game Cognition Addiction Scale (OGCAS), Revised Eysenck Personality Questionnaire Short Scale in Chinese (EPQ-RSC), Chinese College-student Stress Questionnaire, and Coping Style Questionnaire. Structural equation modeling (SEM) was used to explore the interactive effects of stressful life events, ACSs, and neuroticism on OGA. Of the 651 participants in the sample, 31 (4.8%) were identified as addicts. The incidence of OGA was two times higher for males than females. The addicts had markedly higher scores on the neuroticism subscale of the EPQ-RSC than non-addicts. Compared to non-addicts, addicts were more apt to use ACSs. Having an avoidant coping strategy mediated the effect of stressful life events on OGA. Furthermore, neuroticism moderated the indirect effect of stressful life events on OGA via ACSs. Applications of these findings to etiological research and clinical treatment programs are discussed. PMID:27920734

Insomnia in a displaced population is related to war-associated remembered stress.

Science.gov (United States)

Basishvili, Tamar; Eliozishvili, Marine; Maisuradze, Lia; Lortkipanidze, Nani; Nachkebia, Nargiz; Oniani, Tengiz; Gvilia, Irma; Darchia, Nato

2012-08-01

Although traumatic events are presumed to cause sleep disturbances, particularly insomnia, sleep in populations subjected to forced displacement has received little attention. The present study examined the prevalence of insomnia and associated factors in internally displaced persons (IDPs) from Abkhazia 15 years after displacement to Tbilisi. Detailed subjective information about sleep-wake habits, sleep-related and stress-related parameters were obtained from 87 IDPs categorized into good sleepers and insomniacs. The Insomnia Severity Index, Perceived Stress Scale and Beck Depression Inventory were administered. The incidence of insomnia was 41.4%. The majority of insomniacs strongly believed that war-related stress accounted for the onset of their insomnia. Stepwise regression (95% confidence interval) revealed four variables significantly associated with insomnia status: self-estimated influence of war related stress (odds ratio (OR) = 2.51), frequency of nightmares (OR = 1.6), Perceived Stress Scale score (OR = 1.14) and Beck Depression Inventory score (OR = 1.12). Insomnia in IDPs was strongly related to war-associated remembered stress. ‛Over thinking' about major stress exposure enhanced IDPs' vulnerability to insomnia. These findings have implications for the management of insomnia and associated impairment of daytime functioning in IDPs. Copyright © 2011 John Wiley & Sons, Ltd.

Relevance of stress and female sex hormones for emotion and cognition.

Science.gov (United States)

ter Horst, J P; de Kloet, E R; Schächinger, H; Oitzl, M S

2012-07-01

There are clear sex differences in incidence and onset of stress-related and other psychiatric disorders in humans. Yet, rodent models for psychiatric disorders are predominantly based on male animals. The strongest argument for not using female rodents is their estrous cycle and the fluctuating sex hormones per phase which multiplies the number of animals to be tested. Here, we will discuss studies focused on sex differences in emotionality and cognitive abilities in experimental conditions with and without stress. First, female sex hormones such as estrogens and progesterone affect emotions and cognition, contributing to sex differences in behavior. Second, females respond differently to stress than males which might be related to the phase of the estrous cycle. For example, female rats and mice express less anxiety than males in a novel environment. Proestrus females are less anxious than females in the other estrous phases. Third, males perform in spatial tasks superior to females. However, while stress impairs spatial memory in males, females improve their spatial abilities, depending on the task and kind of stressor. We conclude that the differences in emotion, cognition and responses to stress between males and females over the different phases of the estrous cycle should be used in animal models for stress-related psychiatric disorders.

Dynamic stresses, coulomb failure, and remote triggering: corrected

Science.gov (United States)

Hill, David P.

2012-01-01

Dynamic stresses associated with crustal surface waves with 15–30 s periods and peak amplitudes Coulomb failure models based on a frictional strength threshold offer one explanation for instances of rapid‐onset triggered seismicity that develop during the surface‐wave peak dynamic stressing. Evaluation of the triggering potential of surface‐wave dynamic stresses acting on critically stressed faults using a Mohr’s circle representation together with the Coulomb failure criteria indicates that Love waves should have a higher triggering potential than Rayleigh waves for most fault orientations and wave incidence angles. That (1) the onset of triggered seismicity often appears to begin during the Rayleigh wave rather than the earlier arriving Love wave, and (2) Love‐wave amplitudes typically exceed those for Rayleigh waves suggests that the explanation for rapid‐onset dynamic triggering may not reside solely with a simple static‐threshold friction mode. The results also indicate that normal faults should be more susceptible to dynamic triggering by 20‐s Rayleigh‐wave stresses than thrust faults in the shallow seismogenic crust (<10  km) while the advantage tips in favor of reverse faults greater depths. This transition depth scales with wavelength and coincides roughly with the transition from retrograde‐to‐prograde particle motion. Locally elevated pore pressures may have a role in the observed prevalence of dynamic triggering in extensional regimes and geothermal/volcanic systems. The result is consistent with the apparent elevated susceptibility of extensional or transtensional tectonic regimes to remote triggering by Rayleigh‐wave dynamic stresses than compressional or transpressional regimes.

Incidence of Oral Lichen Planus in Perimenopausal Women: A Cross-sectional Study in Western Uttar Pradesh Population

Science.gov (United States)

Mohan, Ravi Prakash Sasankoti; Gupta, Akanksha; Kamarthi, Nagaraju; Malik, Sangeeta; Goel, Sumit; Gupta, Swati

2017-01-01

Background: Hormonal fluctuations during menopause lead to endocrine changes in women, especially in their sex steroid hormone production. Studies have documented the role of estrogen and progesterone (Pg) on autoimmune disorders such as multiple sclerosis, systemic lupus erythematosus, and rheumatoid arthritis. Lichen planus (LP), an autoimmune disorder, seen frequently in perimenopausal women, may also get affected by sex steroid hormones, but no direct relationship has been established yet. Aim: The aim of this study is to find the incidence of oral LP (OLP) in perimenopausal women and evaluate the factors associated with it. Materials and Methods: This cross-sectional study was conducted over a period of 1 year. All the perimenopausal women (44.69 ± 3.79 years) who came to the dental outpatient department were evaluated for the presence of LP and various factors associated with it. Depression Anxiety Stress Scale-21 questionnaire was used for psychometric evaluation of perimenopausal women. Results: According to our study, incidence of LP in postmenopausal women was 10.91%, which is higher than incidence of LP in general population, i.e., 0.5% to 2.0%. Incidence of LP increased with the severity of depression in perimenopausal women (P = 0.000). Conclusion: The incidence of OLP is higher in perimenopausal women than in general population and increases significantly with increase in the severity of depression. LP in perimenopausal women can be mediated by declined level of estrogen and Pg directly or indirectly through causing depression that can trigger LP. PMID:28706407

Experiences of Racism and the Incidence of Adult-Onset Asthma in the Black Women’s Health Study

Science.gov (United States)

Yu, Jeffrey; O’Connor, George T.; Brown, Timothy A.; Cozier, Yvette C.; Palmer, Julie R.; Rosenberg, Lynn

2014-01-01

Background: Chronic stress resulting from experiences of racism may increase the incidence of adult-onset asthma through effects on the immune system and the airways. We conducted prospective analyses of the relation of experiences of racism with asthma incidence in the Black Women’s Health Study, a prospective cohort of black women in the United States followed since 1995 with mailed biennial questionnaires. Methods: Among 38,142 participants followed from 1997 to 2011, 1,068 reported incident asthma. An everyday racism score was created based on five questions asked in 1997 and 2009 about the frequency in daily life of experiences of racism (eg, poor service in stores), and a lifetime racism score was based on questions about racism on the job, in housing, and by police. We used Cox regression models to derive multivariable incidence rate ratios (IRRs) and 95% CIs for categories of each racism score in relation to incident asthma. Results: The IRRs were 1.45 (95% CI, 1.19-1.78) for the highest compared with the lowest quartile of the 1997 everyday racism score (P for trend racism. Among women who reported the same levels of racism in 1997 and 2009, the IRRs for the highest categories of everyday and lifetime racism were 2.12 (95% CI, 1.55-2.91) and 1.66 (95% CI, 1.20-2.30), respectively. Conclusions: Given the high prevalence of experiences of racism and asthma in black women in the United States, a positive association between racism and asthma is of public health importance. PMID:23887828

Correlations Between Physical Activity, Smoking Habit And Attitude In Elderly With Incidence of Osteoporosis

Directory of Open Access Journals (Sweden)

Kiki Familia Dimyati

2017-04-01

Full Text Available Osteoporosis was one of degenerative disease that is common in the elderly. There was a several of risk factors of osteoporosis. Two of them were physical activity and smoking habits. Attitude was one part of a person’s behavior that may affect the prevention of disease. This study aimed to analyze the affect of physical activity, smoking habits, and attitude of the elderly to incidence of osteoporosis. This study is an observational study with case control design. The number of samples in this study was 66 elderly who visited Osteoporosis Clinic Husada Utama Hospital in Surabaya. Respondent selection taken with systematic random sampling. The independent variables of this study were physical activity, smoking habit, and attitude, while the dependent variable was incidence of osteoporosis. Based on correlation analysis with logistic regression test showed there was a significant correlation (p<0,05 between physical activity, smoking habits, and attitude. Odds Ratio (OR in this study for physical activity was 14,764 ,smoking habit was 9,646 and attitude was 5,623. The conclusion of this study, there was physical activity as a dominant affect after controlled smoking habits and attitude to incidence of osteoporosis. The suggestion is to do physical activity three times a week, consume healthy food and beverage, take an enough sleep,reduce stress factors and stop smoking also.   Keywords: Physical activity, smoking habits, elderly

Frozen moments: flashback memories of critical incidents in emergency personnel.

Science.gov (United States)

Kleim, Birgit; Bingisser, Martina-Barbara; Westphal, Maren; Bingisser, Roland

2015-07-01

Emergency Department personnel regularly face highly stressful situations or critical incidents (CIs) that may subsequently be recalled as unbidden intrusive memories. In their most extreme form, such memories are reexperienced as if they were happening again in the present, as flashbacks. This study examined (1) which CIs are associated with flashback memories; (2) candidate person and work-related features that predict flashback memories; and (3) the association between flashback memories and anxiety, depression, and emotional exhaustion. Emergency nurses (N = 91; 80.2% female) were recruited from two urban teaching hospitals and filled in self-report questionnaires. A majority (n = 59, 65%) experienced intrusive memories; almost half of the sample reported that their memories had flashback character. Those involved in resuscitations in the past week were at a fourfold risk for experiencing flashbacks. Having worked more consecutive days without taking time off was associated with a somewhat lower incidence of flashbacks. Moreover, older individuals who reported more work-related conflicts were at greater risk for experiencing flashback memories than their younger colleagues with heightened work conflict and flashback memory scores, respectively. Flashback memories were associated with heightened symptoms of anxiety, depression, and emotional exhaustion. The present findings have implications for evidence-based health promotion in emergency personnel and other individuals regularly exposed to CIs.

Real time freeway incident detection.

Science.gov (United States)

2014-04-01

The US Department of Transportation (US-DOT) estimates that over half of all congestion : events are caused by highway incidents rather than by rush-hour traffic in big cities. Real-time : incident detection on freeways is an important part of any mo...

True incidence of vestibular schwannoma?

DEFF Research Database (Denmark)

Stangerup, Sven-Eric; Tos, Mirko; Thomsen, Jens

2010-01-01

The incidence of diagnosed sporadic unilateral vestibular schwannomas (VS) has increased, due primarily to more widespread access to magnetic resonance imaging.......The incidence of diagnosed sporadic unilateral vestibular schwannomas (VS) has increased, due primarily to more widespread access to magnetic resonance imaging....

Effect of Free Radicals & Antioxidants on Oxidative Stress: A Review

Directory of Open Access Journals (Sweden)

Ashok Shinde

2012-01-01

Full Text Available Recently free radicals have attracted tremendous importance in the field of medicine including dentistry and molecular biology. Free radicals can be either harmful or helpful to the body. When there is an imbalance between formation and removal of free radicals then a condition called as oxidative stress is developed in body. To counteract these free radicals body has protective antioxidant mechanisms which have abilities to lower incidence of various human morbidities and mortalities. Many research groups in the past have tried to study and confirm oxidative stress. Many authors also have studied role of antioxidants in reducing oxidative stress. They have come across with controversial results and furthermore it is not yet fully confirmed whether oxidative stress increases the need for dietary antioxidants. Recently, an association between periodontitis and cardiovascular disease has received considerable attention. Various forms of antioxidants have been introduced as an approach to fight dental diseases and improve general gingival health. The implication of oxidative stress in the etiology of many chronic and degenerative diseases suggests that antioxidant therapy represents a promising avenue for treatment. This study was conducted with the objective of reviewing articles relating to this subject. A Pub Med search of all articles containing key words free radicals, oxidative stress, and antioxidants was done. A review of these articles was undertaken.

Incidence of epilepsy in Ferrara, Italy.

Science.gov (United States)

Cesnik, Edward; Pedelini, Francesco; Faggioli, Raffaella; Monetti, Vincenza Cinzia; Granieri, Enrico; Casetta, Ilaria

2013-12-01

Few studies have been carried out in the same area at different times, allowing an assessment of the incidence of epilepsy (E.), including all ages, over time. The available data on temporal trend show a decrease in E. incidence in childhood and an increase in the elderly. We sought to update the incidence of E. in the province of Ferrara, where a previous study estimated an incidence rate of 33.1 per 100,000, 35.8, if standardized to the European population. Newly diagnosed patients aged up to 14 years were drawn from a community-based prospective multi-source registry, and adult onset E. cases were collected through multiple overlapping sources of case collection. Cases were included and classified according to ILAE recommendations. During the study period (2007-2008), 141 newly diagnosed cases (66 men and 75 women) living in the study area were identified. The crude incidence rate was 46.1 per 100,000 person-years (95 % CI 39.0-54.5), 35.5 (95 % CI 28.0-43.0) if adjusted to the European population. The incidence of childhood and adolescence epilepsy was 57.0 per 100,000 person-years (95 % CI 33.8-90.0), lower than that reported in our previous study, and it was 44.8 (95 % CI 37.4-53.6) for adult onset E., which is significantly higher as compared to our previous study. The overall incidence of E. in northern Italy is stable over time. We detected a significant decrease in incidence of childhood and adolescence E. and an increase in adult-onset E. The burden of epilepsy will increase as the population continues to age.

Perceived stress and risk of colorectal cancer in men and women: a prospective cohort study

DEFF Research Database (Denmark)

Nielsen, N R; Kristensen, T S; Strandberg-Larsen, Katrine

2008-01-01

OBJECTIVE: We aim to assess the relationship between stress and risk of primary colorectal cancer in men and women. DESIGN: A prospective cohort study. SETTING: The Copenhagen City Heart Study, Denmark. SUBJECTS: A total of 6488 women and 5426 men were included in the study. The participants were...... there was no clear relationship between stress and colorectal cancer in men....... asked about intensity and frequency of stress at baseline in 1981-1983 and were followed until the end of 2000 in the Danish Cancer Registry. Less than 0.1% was lost to follow-up. MAIN OUTCOME MEASURES: First time incidence of primary colorectal cancer. RESULTS: During follow-up 162 women and 166 men...

The psychological impact of the Three Mile Island incident.

Science.gov (United States)

Cleary, P D; Houts, P S

1984-01-01

This study examines the psychological impact of the Three Mile Island incident. The results are based on data from a panel study of 403 persons living within five miles of Three Mile Island (TMI), and a telephone survey of 1,506 people living within 55 miles of that area. Active coping strategies were associated with continued high levels of distress. Having more friends was related to reduced distress, but introspection, taking protective actions, being active in organizations, and seeking out others were all related to higher levels of distress. High self-esteem was related to a decrease in symptoms and psychotropic drug use, and avoidance behaviors were related to higher than expected numbers of symptoms. Efforts to profile those who used different coping strategies were relatively unsuccessful. The results emphasize the need to consider the nature of the stressor when developing models of coping and response to stressful situations.

Oxidative Stress in the Pathogenesis of Colorectal Cancer: Cause or Consequence?

Directory of Open Access Journals (Sweden)

Martina Perše

2013-01-01

Full Text Available There is a growing support for the concept that reactive oxygen species, which are known to be implicated in a range of diseases, may be important progenitors in carcinogenesis, including colorectal cancer (CRC. CRC is one of the most common cancers worldwide, with the highest incidence rates in western countries. Sporadic human CRC may be attributable to various environmental and lifestyle factors, such as dietary habits, obesity, and physical inactivity. In the last decades, association between oxidative stress and CRC has been intensively studied. Recently, numerous genetic and lifestyle factors that can affect an individual's ability to respond to oxidative stress have been identified. The aim of this paper is to review evidence linking oxidative stress to CRC and to provide essential background information for accurate interpretation of future research on oxidative stress and CRC risk. Brief introduction of different endogenous and exogenous factors that may influence oxidative status and modulate the ability of gut epithelial cells to cope with damaging metabolic challenges is also provided.

Beyond Diabetes: Does Obesity-Induced Oxidative Stress Drive the Aging Process?

Directory of Open Access Journals (Sweden)

Adam B. Salmon

2016-07-01

Full Text Available Despite numerous correlative data, a causative role for oxidative stress in mammalian longevity has remained elusive. However, there is strong evidence that increased oxidative stress is associated with exacerbation of many diseases and pathologies that are also strongly related to advanced age. Obesity, or increased fat accumulation, is one of the most common chronic conditions worldwide and is associated with not only metabolic dysfunction but also increased levels of oxidative stress in vivo. Moreover, obesity is also associated with significantly increased risks of cardiovascular disease, neurological decline and cancer among many other diseases as well as a significantly increased risk of mortality. In this review, we investigate the possible interpretation that the increased incidence of these diseases in obesity may be due to chronic oxidative stress mediating segmental acceleration of the aging process. Understanding how obesity can alter cellular physiology beyond that directly related to metabolic function could open new therapeutic areas of approach to extend the period of healthy aging among people of all body composition.

Radiation incidents in dentistry

International Nuclear Information System (INIS)

Lovelock, D.J.

1996-01-01

Most dental practitioners act as their own radiographer and radiologist, unlike their medical colleagues. Virtually all dental surgeons have a dental X-ray machine for intraoral radiography available to them and 40% of dental practices have equipment for dental panoramic tomography. Because of the low energy of X-ray equipment used in dentistry, radiation incidents tend to be less serious than those associated with other aspects of patient care. Details of 47 known incidents are given. The advent of the 1985 and 1988 Ionising Radiation Regulations has made dental surgeons more aware of the hazards of radiation. These regulations, and general health and safety legislation, have led to a few dental surgeons facing legal action. Because of the publicity associated with these court cases, it is expected that there will be a decrease in radiation incidents arising from the practice of dentistry. (author)

Work-Related Stress in the Banking Sector: A Review of Incidence, Correlated Factors, and Major Consequences

Directory of Open Access Journals (Sweden)

Gabriele Giorgi

2017-12-01

Full Text Available For a number of years now, banks have been going through enormous changes in organization and structure. New technology and new ways of structuring the operation have left their mark on the working conditions and daily lives of employees. Deregulation of labor markets, emerging technologies and new types of jobs have significantly reshaping working lives by continuous changes on employment and working conditions. Such a scenario has a relevant impact not only on companies' organization but also on working population's health. The banking sector is particularly well-deserved of a specific and thorough analysis, in view of the recent increase in psycho-social disorders of employees. This may be related to the major organizational changes affecting this sector and, in particular, to the restructuring processes resulting from the global economic crisis. Our aim is to assess the scale of the phenomenon and how far it relates specifically to the processes of bank organization. With this in mind, through a review of the literature, we selected the main studies dealing with work-related stress in banking, so that we could reach a better understanding of the phenomenon as it relates specifically to this set of workers. The search took place on the MEDLINE® database; in total 20 articles were chosen. There was uniform agreement among the studies that stress in the banking workplace is now at critical levels, and that it can have deleterious psychological effects on workers, and on their physical health, and that organizations, too, are affected. Most studies showed that mental health problems had increased in the banking sector, and that they were stress-related. Examples began with anxiety and depression, carried on through maladaptive behaviors, and ended in job burnout. The reviewed studies' limitations were then discussed, and possible ways forward considered.

Work-Related Stress in the Banking Sector: A Review of Incidence, Correlated Factors, and Major Consequences

Science.gov (United States)

Giorgi, Gabriele; Arcangeli, Giulio; Perminiene, Milda; Lorini, Chiara; Ariza-Montes, Antonio; Fiz-Perez, Javier; Di Fabio, Annamaria; Mucci, Nicola

2017-01-01

For a number of years now, banks have been going through enormous changes in organization and structure. New technology and new ways of structuring the operation have left their mark on the working conditions and daily lives of employees. Deregulation of labor markets, emerging technologies and new types of jobs have significantly reshaping working lives by continuous changes on employment and working conditions. Such a scenario has a relevant impact not only on companies' organization but also on working population's health. The banking sector is particularly well-deserved of a specific and thorough analysis, in view of the recent increase in psycho-social disorders of employees. This may be related to the major organizational changes affecting this sector and, in particular, to the restructuring processes resulting from the global economic crisis. Our aim is to assess the scale of the phenomenon and how far it relates specifically to the processes of bank organization. With this in mind, through a review of the literature, we selected the main studies dealing with work-related stress in banking, so that we could reach a better understanding of the phenomenon as it relates specifically to this set of workers. The search took place on the MEDLINE® database; in total 20 articles were chosen. There was uniform agreement among the studies that stress in the banking workplace is now at critical levels, and that it can have deleterious psychological effects on workers, and on their physical health, and that organizations, too, are affected. Most studies showed that mental health problems had increased in the banking sector, and that they were stress-related. Examples began with anxiety and depression, carried on through maladaptive behaviors, and ended in job burnout. The reviewed studies' limitations were then discussed, and possible ways forward considered. PMID:29312044

Incidents with hazardous radiation sources; Zwischenfaelle mit gefaehrlichen Strahlenquellen

Energy Technology Data Exchange (ETDEWEB)

Schoenhacker, Stefan [Bundesministerium fuer Inneres, Traiskirchen (Austria). Abt. 1/9 - Zivilschutzschule

2016-07-01

Incidents with hazardous radiation sources can occur in any country, even those without nuclear facilities. Preparedness for such incidents is supposed to fulfill globally agreed minimum standards. Incidents are categorized in incidents with licensed handling of radiation sources as for material testing, transport accidents of hazardous radiation sources, incidents with radionuclide batteries, incidents with satellites containing radioactive inventory, incidents wit not licensed handling of illegally acquired hazardous radiation sources. The emergency planning in Austria includes a differentiation according to the consequences: incidents with release of radioactive materials resulting in restricted contamination, incidents with release of radioactive materials resulting in local contamination, and incidents with the hazard of e@nhanced exposure due to the radiation source.

Use of Concomitant Stress Incontinence Surgery at Time of Pelvic Organ Prolapse Surgery Since Release of the 2011 Notification on Serious Complications Associated with Transvaginal Mesh.

Science.gov (United States)

Drain, Alice; Khan, Aqsa; Ohmann, Erin L; Brucker, Benjamin M; Smilen, Scott; Rosenblum, Nirit; Nitti, Victor W

2017-04-01

There is controversy regarding the performance of concomitant anti-incontinence procedures at the time of pelvic organ prolapse repair. Data support improvement in stress urinary incontinence with a concomitant sling but increased adverse events. We assessed trends in preoperative stress urinary incontinence evaluation, concomitant anti-incontinence procedure at pelvic organ prolapse surgery and postoperative anti-incontinence procedures at our institution before and after the 2011 FDA (U.S. Food and Drug Administration) Public Health Notification pertaining to vaginal mesh. We retrospectively reviewed the records of patients who underwent pelvic organ prolapse surgery from 2009 to 2015. Preoperative workup included assessment of subjective stress urinary incontinence and/or evaluation for leakage with reduction of pelvic organ prolapse on physical examination, urodynamics or a pessary trial. The percentages of concomitant and postoperative anti-incontinence procedures were compared before and after the 2011 FDA notification. A total of 775 women underwent pelvic organ prolapse repair. The percentage of anti-incontinence procedures at pelvic organ prolapse repair decreased from 54.8% to 38.0% after the FDA notification (p = 0.002) while the incidence of preoperative objective stress urinary incontinence on examination, urodynamics and pessary trials remained constant. The incidence of postoperative anti-incontinence procedures within 1 year of the index surgery remained low. We found a decrease in the incidence of concomitant anti-incontinence procedures at the time of pelvic organ prolapse repair following the 2011 FDA notification despite no significant decline in subjective stress urinary incontinence or demonstrable stress urinary incontinence on preoperative evaluation. Further analysis is warranted to assess the impact of the FDA notification on treatment patterns in women with pelvic organ prolapse and stress urinary incontinence. Copyright © 2017 American

Pacific Islands Region Observer Program System

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This system integrates the longline debriefing steps and procedures for Hawaii and American Samoa into one tool to standardize and streamline the debriefing process....

Effect of Plastic Pre-straining on Residual Stress and Composition Profiles in Low-Temperature Surface-Hardened Austenitic Stainless Steel

DEFF Research Database (Denmark)

Bottoli, Federico; Christiansen, Thomas Lundin; Winther, Grethe

2016-01-01

The present work deals with the evaluation of the residual stress profiles in expanded austenite by applying grazing incidence X-ray diffraction (GI-XRD) combined with successive sublayer removal. Annealed and deformed (εeq=0.5) samples of stable stainless steel EN 1.4369 were nitrided...... or nitrocarburized. The residual stress profiles resulting from the thermochemical low-temperature surface treatment were measured. The results indicate high-residual compressive stresses of several GPa’s in the nitrided region, while lower-compressive stresses are produced in the carburized case. Plastic...... deformation in the steel prior to thermochemical treatment has a hardly measurable influence on the nitrogen-rich zone, while it has a measurable effect on the stresses and depth of the carbon-rich zone....

Attitudes and perceived barriers influencing incident reporting by nurses and their correlation with reported incidents: A systematic review.

Science.gov (United States)

Fung, Wing Mei; Koh, Serena Siew Lin; Chow, Yeow Leng

Clinical incident reporting is an integral feature of risk management system in the healthcare sector. By reporting clinical incidents, nurses allow for learning from errors, identification of error patterns and development of error preventive strategies. The need to understand attitudes to reporting, perceived barriers and incident reporting patterns by nurses are the core highlights of this review. INCLUSION CRITERIA: This review considered descriptive quantitative studies that examined nurses' attitudes or perceived barriers towards incident reporting.The participants in this review were nurses working in acute care settings or step-down care settings. Studies that included non-nursing healthcare personnel were excluded.This review considered studies which examined nurses' attitudes towards incident reporting, perceived barriers and incident reporting practices.The outcomes of interest were the attitudes that nurses have towards incident reporting, perceived barriers and the types of reported incidents in correlation with nurses' attitudes and barriers. A three-step search strategy was utilised in this review. An initial limited search of CINAHL and MEDLINE was undertaken. Search strategies were then developed using identified keywords and index terms. Lastly, the reference lists of all identified articles were examined. All searches were limited to studies published in English, between 1991 and 2010. The studies were independently assessed by two reviewers using the Joanna Briggs Institute Critical Appraisal Checklist for Descriptive/ Case Series studies. The reviewers extracted data independently from included studies using the Joanna Briggs Institute Data Extraction Form for Descriptive/ Case Series studies. Due to the descriptive nature of the study designs, statistical pooling was not possible. Therefore, the findings of this systematic review are presented in a narrative summary. Fifty-five papers were identified from the searches based on their titles and

Annual incidence and standardized incidence ratio of cerebrovascular accidents in patients with systemic lupus erythematosus.

Science.gov (United States)

Mok, C C; Ho, L Y; To, C H

2009-01-01

To study the annual incidence and standardized incidence ratio (SIR) of cerebrovascular accident (CVA) in patients with systemic lupus erythematosus (SLE). The annual incidence of CVA from 1999 to 2007 in a longitudinal cohort of SLE patients was calculated each year and compared with that of the regional population within the same study period. Age-specific SIRs and outcome of CVA in SLE patients were also studied. In 2007, there were 490 SLE patients in our cohort. The mean annual incidence of CVA between 1999 and 2007 was 6.45/1000 patients and no obvious trend over time was observed. Of the 20 CVAs in patients with SLE, 18 (90%) were ischaemic stroke whereas two (10%) were haemorrhagic stroke. The mean SIR of all types of CVA in SLE patients was 2.02 [95% confidence interval (CI) 1.30-3.81; p = 0.002]. The SIR of ischaemic stroke decreased with age and the stroke incidence was no longer significantly higher than that of the population in patients aged >or= 60 years. Haemorrhagic stroke occurred mainly in younger SLE patients. The duration of hospitalization and the mortality rate for CVA was non-significantly higher in SLE than in non-SLE patients. The incidence of CVA in SLE remained constant over the 8 years between 1999 and 2007. Younger SLE patients are at substantially increased risk of CVA compared to age-matched population. The duration of hospitalization and the mortality rate for CVA are similar in SLE and non-SLE patients.

Incidents Associated with Gas Operation

Directory of Open Access Journals (Sweden)

Szer J.

2017-06-01

Full Text Available This article shows incidents associated with the use of gas as an energy carrier. It presents selected incidents which have occurred in Poland and around the world in recent decades. Based on this, consequences of gas and air mixture explosions were analysed as well. The article presents the main causes of gas incidents which have taken place, as per instances which are similar worldwide. Incidents associated with the use of gas are not frequent, but at the same time very tragic as they often lead to illness or even death. In Poland, in the last twenty years, construction area disasters caused by gas explosions account for only 5% of all which have occurred, but the number of fatalities resulting from these cases is approximately 14%. The number of individuals injured reached 39% of all construction disaster victims. Considering all these facts, it is necessary to undertake wide preventive measures in order to increase safety in the use of gaseous fuels.

Optimized animal model to mimic the reality of stress-induced depression in the clinic.

Science.gov (United States)

Zhang, Yi; Wang, Yuting; Lei, Hui; Wang, Lei; Xue, Liang; Wang, Xin; Zhu, Xiongzhao

2017-05-06

Animal models are useful tools for verifying the relationship between stress and depression; however, an operational criterion for excluding the resilient animals from the analysis has not been established yet, which hinders the model's ability to more accurately mimic the scenario in humans. To induce depression-like symptoms, rats received maternal deprivation (MD) during PND1-14, and/or chronic unpredictable stress (CUS) exposure. The latent profile analysis (LPA) was used to determine latent subgroups in treatment naive adult rats. The percentile method was used to distinguish sensitive and non-sensitive behaviors in rats. The sucrose preference rate of treatment naive adult rats was fit using a Beta distribution, while immobility time was fit using a Gamma distribution. Indexes of behavioral tests revealed the 4-class model as the best fit for treatment naive adult rats. The incidence of stress-resilience in MD rats was significantly higher than that in CUS rats and MD + CUS rats. There was a significantly higher incidence of stress-resilience in CUS rats compared with MD + CUS rats. Recovery rate of anhedonia-like and sub anhedonia-like behaviors in CUS rats was significantly higher than that in MD and MD + CUS rats. There was a significantly higher recovery rate of anhedonia-like behaviors in MD rats compared to MD + CUS rats. The percentile method is suitable for setting up an operational cutoff to classify depression-like, sub depression-like, and resilient behaviors in rats exposed to MD and CUS.

Predicting incident size from limited information

International Nuclear Information System (INIS)

Englehardt, J.D.

1995-01-01

Predicting the size of low-probability, high-consequence natural disasters, industrial accidents, and pollutant releases is often difficult due to limitations in the availability of data on rare events and future circumstances. When incident data are available, they may be difficult to fit with a lognormal distribution. Two Bayesian probability distributions for inferring future incident-size probabilities from limited, indirect, and subjective information are proposed in this paper. The distributions are derived from Pareto distributions that are shown to fit data on different incident types and are justified theoretically. The derived distributions incorporate both inherent variability and uncertainty due to information limitations. Results were analyzed to determine the amount of data needed to predict incident-size probabilities in various situations. Information requirements for incident-size prediction using the methods were low, particularly when the population distribution had a thick tail. Use of the distributions to predict accumulated oil-spill consequences was demonstrated

Epidemiology of road traffic incidents in Peru 1973-2008: incidence, mortality, and fatality.

Science.gov (United States)

Miranda, J Jaime; López-Rivera, Luis A; Quistberg, D Alex; Rosales-Mayor, Edmundo; Gianella, Camila; Paca-Palao, Ada; Luna, Diego; Huicho, Luis; Paca, Ada

2014-01-01

The epidemiological profile and trends of road traffic injuries (RTIs) in Peru have not been well-defined, though this is a necessary step to address this significant public health problem in Peru. The objective of this study was to determine trends of incidence, mortality, and fatality of RTIs in Peru during 1973-2008, as well as their relationship to population trends such as economic growth. Secondary aggregated databases were used to estimate incidence, mortality and fatality rate ratios (IRRs) of RTIs. These estimates were standardized to age groups and sex of the 2008 Peruvian population. Negative binomial regression and cubic spline curves were used for multivariable analysis. During the 35-year period there were 952,668 road traffic victims, injured or killed. The adjusted yearly incidence of RTIs increased by 3.59 (95% CI 2.43-5.31) on average. We did not observe any significant trends in the yearly mortality rate. The total adjusted yearly fatality rate decreased by 0.26 (95% CI 0.15-0.43), while among adults the fatality rate increased by 1.25 (95% CI 1.09-1.43). Models fitted with splines suggest that the incidence follows a bimodal curve and closely followed trends in the gross domestic product (GDP) per capita. The significant increasing incidence of RTIs in Peru affirms their growing threat to public health. A substantial improvement of information systems for RTIs is needed to create a more accurate epidemiologic profile of RTIs in Peru. This approach can be of use in other similar low and middle-income settings to inform about the local challenges posed by RTIs.

Epidemiology of road traffic incidents in Peru 1973-2008: incidence, mortality, and fatality.

Directory of Open Access Journals (Sweden)

J Jaime Miranda

Full Text Available The epidemiological profile and trends of road traffic injuries (RTIs in Peru have not been well-defined, though this is a necessary step to address this significant public health problem in Peru. The objective of this study was to determine trends of incidence, mortality, and fatality of RTIs in Peru during 1973-2008, as well as their relationship to population trends such as economic growth.Secondary aggregated databases were used to estimate incidence, mortality and fatality rate ratios (IRRs of RTIs. These estimates were standardized to age groups and sex of the 2008 Peruvian population. Negative binomial regression and cubic spline curves were used for multivariable analysis. During the 35-year period there were 952,668 road traffic victims, injured or killed. The adjusted yearly incidence of RTIs increased by 3.59 (95% CI 2.43-5.31 on average. We did not observe any significant trends in the yearly mortality rate. The total adjusted yearly fatality rate decreased by 0.26 (95% CI 0.15-0.43, while among adults the fatality rate increased by 1.25 (95% CI 1.09-1.43. Models fitted with splines suggest that the incidence follows a bimodal curve and closely followed trends in the gross domestic product (GDP per capita.The significant increasing incidence of RTIs in Peru affirms their growing threat to public health. A substantial improvement of information systems for RTIs is needed to create a more accurate epidemiologic profile of RTIs in Peru. This approach can be of use in other similar low and middle-income settings to inform about the local challenges posed by RTIs.

Restraint stress enhances arterial thrombosis in vivo--role of the sympathetic nervous system.

Science.gov (United States)

Stämpfli, Simon F; Camici, Giovanni G; Keller, Stephan; Rozenberg, Izabela; Arras, Margarete; Schuler, Beat; Gassmann, Max; Garcia, Irene; Lüscher, Thomas F; Tanner, Felix C

2014-01-01

Stress is known to correlate with the incidence of acute myocardial infarction. However, the molecular mechanisms underlying this correlation are not known. This study was designed to assess the effect of experimental stress on arterial thrombus formation, the key event in acute myocardial infarction. Mice exposed to 20 h of restraint stress displayed an increased arterial prothrombotic potential as assessed by photochemical injury-induced time to thrombotic occlusion. This increase was prevented by chemical sympathectomy performed through 6-hydroxydopamine (6-OHDA). Blood-born tissue factor (TF) activity was enhanced by stress and this increase could be prevented by 6-OHDA treatment. Vessel wall TF, platelet count, platelet aggregation, coagulation times (PT, aPTT), fibrinolytic system (t-PA and PAI-1) and tail bleeding time remained unaltered. Telemetric analysis revealed only minor hemodynamic changes throughout the stress protocol. Plasma catecholamines remained unaffected after restraint stress. Tumor necrosis factor alpha (TNF-α) plasma levels were unchanged and inhibition of TNF-α had no effect on stress-enhanced thrombosis. These results indicate that restraint stress enhances arterial thrombosis via the sympathetic nervous system. Blood-borne TF contributes, at least in part, to the observed effect whereas vessel wall TF, platelets, circulating coagulation factors, fibrinolysis and inflammation do not appear to play a role. These findings shed new light on the understanding of stress-induced cardiovascular events.

Association between psychosocial stress and hypertension: a systematic review and meta-analysis.

Science.gov (United States)

Liu, Mei-Yan; Li, Na; Li, William A; Khan, Hajra

2017-06-01

The etiology of hypertension is various and complex, involving both genetic and behavioral factors. The relationship between psychosocial stress and hypertension has been hypothesized. More and more people experience increased anxiety, depression, and chronic psychosocial stress brought on by globalization, cultural changes, socioeconomic changes, and stress at the work place. Although a plethora of studies have investigated the interaction between psychosocial stress and hypertension, this relationship is still contentious. The objective of this study is twofold. First, a review of recent advancements in our understanding of the relationship between psychosocial stress and hypertension. Second, a meta-analysis aiming to assess the relationship between chronic psychosocial stress and blood pressure. We systematically searched and identified relevant studies from five databases, including PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), CQVIP, and the Wanfang Database until April 2016. Eleven studies encompassing 5696 participants were included in the final analysis. Data showed that psychosocial stress was associated with an increased risk of hypertension (OR = 2.40, 95% CI = 1.65-3.49), and hypertensive patients had a higher incidence of psychosocial stress compared to normotension patients (OR = 2.69, 95% CI = 2.32-3.11). Based on our meta-analysis, chronic psychosocial stress may be a risk factor for hypertension. The few cohort and case-control studies on the association between psychosocial stress and hypertension employed variable definition of stressors and the responses, making the meta-analysis difficult. Although we found an association between chronic psychosocial stress and hypertension, more studies are needed to confirm this relationship.

Comparison of welding induced residual stresses austenitic and ferritic steel weld joints

International Nuclear Information System (INIS)

Rajkumar, K.V.; Arun Kumar, S.; Mahadevan, S.; Manojkumar, R.; Rao, B. Purna Chandra; Albert, Shaju K.; Murugan, S.

2015-01-01

X-ray diffraction (XRD) is a well established technique for measurement of residual stresses in components and is being widely used. In XRD technique, the distance between the crystallographic planes (d spacing) is measured from peak position (2è) at various ø angles, where ø is the angle between the normal to the sample and the bisector of the incident and diffracted beam. From the slope of sin2ø vs. d spacing plot, the residual stresses are arrived by assuming a plane stress model. Welding induced residual stresses is of high importance as it is a major cause of failure in components. Surface compressive stresses improve the fatigue strength, whereas tensile residual stresses tend to decrease the fatigue strength. The present study compares the residual stresses that develop in 3 mm thick SS 316 and P91 TIG weld joints using the XRD technique. This study is aimed at understanding the influence of shrinkage during cooling and the effect of phase transformation induced volume changes on residual stress development in these two steels. While the first effect is predominant in the SS 316 weld, both the effects are present in the P91 welds. Stress measurements on SS 316 and P91 were carried out using Cr Kâ (λ-2.0840 Å) and Cr Ká (λ-2.2896 Å) radiations respectively. Typical 'M' type stress profile was observed across the weld centre line in both the welds. The variation and similarities between the longitudinal stress profiles observed in these two weld joints would be discussed. (author)

Risk Factors for Incident Diabetic Polyneuropathy in a Cohort With Screen-Detected Type 2 Diabetes Followed for 13 Years

DEFF Research Database (Denmark)

Andersen, Signe T; Witte, Daniel R; Dalsgaard, Else-Marie

2018-01-01

OBJECTIVE: To study incident diabetic polyneuropathy (DPN) prospectively during the first 13 years after a screening-based diagnosis of type 2 diabetes and determine the associated risk factors for the development of DPN. RESEARCH DESIGN AND METHODS: We assessed DPN longitudinally in the Danish arm...... of the Anglo-Danish-Dutch study of Intensive Treatment of Diabetes in Primary Care (ADDITION) using the Michigan Neuropathy Screening Instrument questionnaire (MNSIQ), defining DPN with scores ≥4. Risk factors present at the diabetes diagnosis associated with the risk of incident DPN were estimated using Cox...... DPN. CONCLUSIONS: This study provides further epidemiological evidence for obesity as a risk factor for DPN. Moreover, low HDL cholesterol levels and higher levels of methylglyoxal, a marker of dicarbonyl stress, are identified as risk factors for the development of DPN....

Posttraumatic stress disorder and dementia in Holocaust survivors.